Endoscope with an endoscope head and a reciprocating motion element with a tool guide surface

Abstract

Endoscope with an endoscope head (1) with a working channel (11) for guiding micro tools, and a moving element (2) which is movable back and forth in the axial direction of the endoscope head (1) and which has a tool guide surface (20) on which a tool which can be guided through the working channel (11) can come into contact in order to be deflected in the lateral direction of the endoscope head (1), wherein the moving element (2) has a rod (29) with an axis extending in the longitudinal direction of the endoscope head (1), and the moving element (2) is rotatable about the axis.

Description

[0001] The present invention relates to an endoscope with an endoscope head and a reciprocating motion element with a tool guide surface. More precisely, the invention relates to an endoscope with an endoscope head having a working channel for guiding microtools and a reciprocating motion element with a tool guide surface arranged on the endoscope head. The motion element has a similar function to an Albarran lever.

[0002] Such an Albarran lever can be used with an endoscope to examine, for example, the esophagus or the duodenum, the bile duct, the gallbladder, the pancreatic duct, the pancreas, etc.

[0003] Such an endoscope has optics (lighting device and camera). The endoscope also has an Albarran lever at the exit of the working channel, which, by pivoting, allows for the targeted redirection of the tools being pushed through the working channel.

[0004] After use, the endoscope undergoes reprocessing. This process must reliably prevent the transmission of all germs or microorganisms, such as bacteria, viruses, fungi, worms, and spores. Reprocessing begins with manual cleaning of the endoscope to completely remove any organic material or chemical residues. Following cleaning, it is disinfected or sterilized mechanically. This prevents the transmission of germs or microorganisms, etc., that the endoscope came into contact with during one use, to the patient during the next use.

[0005] For example, DE 196 27 016 C1 discloses an endoscope with an Albarran lever. More precisely, the endoscope has a detachable carrier in which the Albarran lever is pivotably mounted on an axis supported within the carrier. The pivoting of the Albarran lever is accomplished via a pull cable anchored to the lever and guided within the endoscope.

[0006] German patent DE 26 53 661 C2 discloses an endoscope with a recess on the distal side that is open on one side. A guide element is movably arranged in this recess. The guide element has a surface for deflecting a catheter that is guided in the working channel. The guide element is actuated by a wire so that it can move horizontally back and forth.

[0007] The JP S56 73802 U has an Albarran lever in a recess of an endoscope head, which can be moved back and forth in the longitudinal direction.

[0008] JP 2002 000558 A reveals an endoscope with an element that can be moved back and forth longitudinally by means of a wire.

[0009] US Patent 5,569,157 A discloses an endoscope with a pivoting Albarran lever. The Albarran lever is housed in a cap.

[0010] The present invention aims to create an endoscope that better prevents germs that have come into contact with the endoscope from being transferred to the patient during the next use.

[0011] This problem is solved by an endoscope having the features of claim 1. Advantageous further developments are the subject of the dependent claims.

[0012] The endoscope according to the invention has an endoscope head with a working channel for guiding micro tools, and a moving element movable back and forth in the axial direction of the endoscope head, with a tool guide surface against which a tool guided through the working channel can come into contact in order to be deflected in the lateral direction of the endoscope head. The moving element has a rod with an axis extending in the longitudinal direction of the endoscope head, and the moving element is rotatable about the axis.

[0013] Thus, in the present invention, the reciprocating moving element replaces a conventional Albarran lever. The movement of the moving element, which can be generated from the proximal side of the endoscope, is a movement in the longitudinal direction of the endoscope. The conventional pivoting movement of the Albarran lever is eliminated.

[0014] The moving element can be guided in a channel extending longitudinally along the endoscope head. At the distal end of the channel, a seal can be provided on the inner circumference of the channel, sealing the outer circumference of the moving element from its proximal to its distal position. Alternatively, the seal can be located on the outer circumference of the moving element and seal against the inner circumference of the channel from its proximal to its distal position. This allows movement from the proximal side of the endoscope to be transmitted to the moving element, while the transmission of this movement is designed to prevent germs or contaminants from entering the interior of the endoscope due to the seal.

[0015] The moving element can have a proximal base section with a uniform cross-sectional shape up to the transition to the tool guide surface, which is distal to the base section. The proximal base section can be mounted on a rod that is movably arranged within the channel. A seal can be provided on the rod. The rod facilitates a simple reciprocating motion of the moving element along the longitudinal direction of the endoscope head.

[0016] The tool guide surface can have a proximal-extending elevation on its lateral outer edge, which bends a tool guided by the tool guide surface in the proximal direction. This allows the angle at which the guided tool is advanced laterally from the endoscope head to be adjusted. In other words, the tool is advanced further proximally than without this elevation.

[0017] With the exception of the raised section, the moving element can be designed so that it has no sudden change in shape on its surface. Alternatively, the raised section can be omitted, so that there is no sudden change in shape on the surface of the moving element at all. This allows the moving element to be easily cleaned.

[0018] The moving element has an axis extending longitudinally along the endoscope head and is rotatable around this axis. This allows for better cleaning of the moving element from all sides, as the axial rotation of the moving element enables its entire circumference to be exposed to the flow of cleaning fluid at various angles.

[0019] A cable for actuating the moving element can be a rigid pull wire. This allows a pressure movement to be exerted on the moving element from the proximal side of the endoscope.

[0020] A pre-tensioning element can be provided on the moving element to pre-tension it in the distal direction, and the cable can be an elastic pull wire. Thus, a thin pull wire or cable can be used to actuate the moving element, which can be guided in a relatively small cable channel within the endoscope.

[0021] The pretensioning element can be designed as a spring element located on the proximal side of the moving element. This allows a tensile force to be applied to the moving element in the proximal direction from the elastic tension wire, and a compressive force to be applied to the moving element in the distal direction from the pretensioning element.

[0022] A cap can be placed on the outer circumference of the distal end of the endoscope head, with the proximal end of the cap being proximal to the moving element when in place. The cap can have a lateral tool opening on the side of the tool guide surface and be closed on the distal side.

[0023] The moving element can be detached from the endoscope head. This allows the moving element to be disposed of as a single-use component after use. Cleaning of the moving element is unnecessary. Recontamination by germs that may have accumulated on the surface of the moving element is thus avoided.

[0024] The aspects of the present invention explained above can be suitably combined. Brief description of the drawings Fig. Figure 1 shows a schematic perspective view of an endoscope head of an endoscope of an embodiment of the present invention with a reciprocating moving element. Fig. Figure 2 shows a schematic perspective view of the endoscope head of Fig. 1, where the moving element is rotated. Fig. Figure 3 shows a schematic perspective view of the endoscope head of Fig. 1, with a cap placed on the endoscope head. Fig. Figure 4 shows a schematic side view of the endoscope head of the embodiment, with the moving element in a first proximal position. Fig. Figure 5 shows a schematic side view of the endoscope head of the embodiment, with the moving element in a second distal position. Fig. Figure 6 shows a schematic perspective view of the endoscope head in the first proximal position of Fig. 4. Fig. Figure 7 shows a schematic perspective view of the endoscope head in the second distal position. Fig. 5.

[0025] The present invention is described in detail below with reference to the drawings and an exemplary embodiment. Example of implementation

[0026] The following is with reference to the Fig. 1, Fig. 2, Fig. 3, Fig. 4, Fig. 5, Fig. 6 to Fig. 7 describes an embodiment of the present invention.

[0027] The endoscope according to the invention has an endoscope head 1.

[0028] First, the endoscope head 1 is described with reference to the figures.

[0029] The endoscope head 1 according to the invention has a cylindrical housing 15 and includes, among other things, a working channel 11 and a cable pull channel (not shown), which extend along the longitudinal direction of the endoscope head 1 and parallel to each other.

[0030] The cable channel guides a cable (not shown). The cable serves to actuate a movement element 2 described below. For this purpose, the cable is mechanically connected to a rod 29 of the movement element 2. The rod 29 extends proximal to the movement element 2 and is integral with it. In the endoscope head 1, the rod 29 is guided in a rod channel 19, which forms a distal extension of the cable channel.

[0031] Working channel 11 guides micro-tools for the examination of, for example, the esophagus or duodenum, the bile duct, the gallbladder, the pancreatic duct, the pancreas, etc.

[0032] The endoscope head 1 has a circumferential groove 13 on its outer circumference, into which a ring-shaped projection of a cap 3 described below is placed when the cap 3 is positioned on the endoscope head 1.

[0033] On the distal side (distal to the circumferential groove 13) the endoscope head 1 has an optic extension 12 on which a lighting device 17 and a camera 18 are provided in a known manner, wherein this optic extension 12 is Fig. Figure 1 is shown on the right side. The optic extension 12 forms a flank section with a camera and lighting.

[0034] The working channel 11 terminates in a section of the endoscope head 1 that is spaced apart from the distal end, forming a distal exit opening 111 of the working channel 11.

[0035] Distal to the distal outlet 111 of the working channel 11 is the movement element 2, which can be moved back and forth relative to the endoscope head 1 in the longitudinal direction of the endoscope head 1. The working channel 11 thus extends distally towards the movement element 2.

[0036] The movement element 2 is described in more detail below.

[0037] In Fig. 1 is the movement element 2 shown in perspective. In the Fig. 4 and Fig. Figure 5 shows movement element 2 from the side. For better understanding, the Fig. 4 and Fig. 5 the endoscope head 1 as a transparent body.

[0038] The movement element 2 has a tool guide surface 20 on which a microtool, which can be guided through the working channel 11 of the endoscope head 1, can come into contact in order to move in the lateral direction of the endoscope head 1 (in Fig. 4 upwards) so that the microtool can be inserted, for example, into a bile duct. The tool guide surface 20 is opposite the distal end opening 111 of the working channel 11, see Fig. 1. Thus, the reciprocating moving element 2 has a function of a conventional Albarran lever.

[0039] On its proximal side, the movement element 2 has a base section 22. In the installed position of the movement element 2, the base section 22 extends in the proximal direction.

[0040] The rod 29 is inserted in the proximal region of the base section 22 and is guided in the rod channel 19. The rod 29 forms an axis of the moving element 2. The rod 29 can be rotated about its axis in the rod channel 19. Thus, the moving element 2 can be rotated about its axis, as shown in Fig. 2 is shown. Fig. Figure 2 shows the outwardly rotated position of the moving element 2. In this position, the moving element 2 is easy to clean.

[0041] Thus, the moving element 2 can be rotated in the axial direction of the moving element 2. The direction of rotation of the moving element 2 is in Fig. 2 shown by an arrow.

[0042] The rod 29 is designed as an elongated cylindrical element. A diameter expansion 28 is formed on the outer circumference of the rod 29 at a central section. The diameter expansion can be in the form of a disk 28 fixed to the outer circumference of the rod 29. The disk 28 moves with the rod 29.

[0043] The proximal surface of the disc 28 forms a contact surface for a spring 9 as a preload element, which is arranged on the outer circumference of the rod 29. The spring 9 rests against a spring seat 14 in the housing 15 of the endoscope head 1.

[0044] In this embodiment, spring 9 is designed as a coil spring. Spring 9 is inserted under preload between spring seat 14 and the proximal surface of disk 28. Spring 9 preloads the moving element 2 in the distal direction.

[0045] By pulling the rod 29 in the proximal direction by means of a pull rope, the preload of the spring 9, which preloads in the distal direction, can be overcome and the moving element 2 can be pulled in the proximal direction.

[0046] Fig. Figure 4 shows the first proximal position of the moving element 2, pulled in the proximal direction. In this state, the spring 9 is compressed. The rod 29 is pulled in the proximal direction by the pull cable.

[0047] Fig. Figure 5 shows the distally moved state of the movement element 2 as the second distal position of the movement element 2. In this state, the pull rope is not actuated.

[0048] The spring 9 has pressed the rod 29 into a distal end position. In the distal end position, the disc 28 of the rod 29 rests against a stop 191, which is formed in the housing 15 on the outer circumference of the rod channel 19. Thus, the rod channel 19 has a diameter widening in a section between the spring seat 14 and the stop 191.

[0049] Thus, the moving element 2 can be moved back and forth along the longitudinal direction of the endoscope head 1. The direction of the back-and-forth movement of the moving element 2 is defined in Fig. 1 shown by an arrow.

[0050] Distal to the stop 191, a seal 16 is provided on the rod channel 19. The seal 16 is designed as an annular sealing element and is seated in the housing 15, sealing against the outer circumference of the rod 29. The seal 16 is arranged between the stop 191 and the distal outlet of the rod channel 19. In other words, the seal 16 is arranged between the spring 9 and the distal outlet of the rod channel 19.

[0051] The movement element 2 can be pulled off the rod 29 in a distal direction. The movement element 2 can be pressed onto the distal end of the rod 29 in such a way that it can be pulled off the rod 29 again with a predetermined force. For this purpose, a blind hole with a suitable diameter is formed on the proximal side of the base section 22. The distal end of the rod 29 is pressed into this blind hole.

[0052] Thus, the movement element 2 can be detached from the endoscope head 1.

[0053] The movement element 2 can be made of plastic, e.g. by injection molding or by 3D printing.

[0054] A protective cap 3 is placed on the outer circumference of the endoscope head 1 on the distal section.

[0055] Protective cap 3 is described below.

[0056] The protective cap 3 is designed as a cylinder with a base. In other words, the protective cap 3 has a cup shape. The cup shape has a base located on the distal side of the protective cap 3 and a circumferential side wall. The size of the cup shape is chosen such that the protective cap 3 can be placed on the outer circumference of the endoscope head 1 in such a way that the distal outlet 111 of the working channel 11 and the area of ​​the movement element 2 are covered. Thus, the optic extension 12 is also covered by the cap 3.

[0057] The protective cap 3 has a window 31 that provides optical access to the lighting device 17 and the camera 18, see Fig. 3.

[0058] The protective cap 3 is made of plastic, e.g. by injection molding or by 3D printing.

[0059] Window 31 is provided as a side cutout in the side wall of the protective cap 3. When the protective cap 3 is mounted on the endoscope head 1, the side cutout in the side wall of the protective cap 3 is located above the movement element 2. Micro tools can be advanced through window 31. Furthermore, the cap 3 is positioned on the endoscope head 1 such that the illumination device 17 emits light through window 31 and the camera 18 captures images through window 31.

[0060] The protective cap 3 has a distal opening 32. A ring-shaped projection (not shown) is formed on the inner circumferential side of the distal opening 32 of the cap 3. This ring-shaped projection forms an engagement point for insertion into the circumferential groove 13 on the endoscope head 1. Function of the invention

[0061] The endoscope according to the invention is used as follows.

[0062] A new endoscope or a cleaned and sterilized endoscope is provided. A new cap 3 according to the invention is placed on the distal end section of the endoscope head 1. A ring-shaped projection of the distal opening 32 of the cap 3 engages in the circumferential groove 13 on the endoscope head 1 and snaps into place.

[0063] When attached to the endoscope head 1, the illumination device 17 and the camera 18 are exposed through the window 31. The proximal opening 32 of the cap rests tightly against the outer circumference of the endoscope head 1 via snap-in mechanisms.

[0064] The endoscope can be inserted into the patient for the purpose of examination or treatment.

[0065] When the endoscope has been inserted to a desired location, e.g. in the duodenum opposite the opening of the bile duct, the area of ​​the opening of the bile duct can be illuminated and recorded by the illumination device 17 and the camera 18.

[0066] Now a microtool can be inserted through working channel 11. The microtool could be, for example, a guide wire, biopsy forceps, a stent system, a catheter system, a papillotome, etc.

[0067] The microtool is advanced through the distal exit opening 111 of the working channel 11 and reaches the tool guide surface 20 of the movement element 2.

[0068] Now, to support the further forward movement of the microtool, the movement element 2 is moved back and forth.

[0069] For better understanding, the Fig. 6 and Fig. 7 the endoscope head 1 as a transparent body.

[0070] Fig. Figure 6 shows the proximal position of the moving element 2 as its first proximal position. In this position, the spring 9 is compressed. The rod 29 is pulled proximally by the cable.

[0071] Fig. Figure 7 shows the distally moved state of the movement element 2 as the second distal position of the movement element 2. In this state, the pull rope is not actuated.

[0072] By pulling and releasing the pull cord, the movement element 2 is moved back and forth between the distal and proximal positions. This alternating pulling and releasing motion of the pull cord allows the movement element 2, with its tool guide surface 20, to be moved alternately towards the proximal and distal sides. This facilitates the advancement of the microtool. Effects and advantages of the invention

[0073] The invention provides a simple and cost-effective solution for an endoscope in which a protective cap is spatially separated from a pull cord used to actuate a reciprocating movement of a tool guide surface. A conventional Albarran lever, due to its geometric design, has many undercuts where germs, etc., can accumulate during use and may remain on the lever even after intensive cleaning and sterilization.

[0074] In the present invention, the moving element 2 has the tool guide surface 20. Thus, the moving element 2 assumes the function of an Albarran lever. The moving element 2 can be pulled off the rod 29 in a distal direction. The distal end of the rod 29 is easily cleanable.

[0075] The moving element 2 can be disposed of after use.

[0076] The protective cap 3 can also be disposed of after use.

[0077] The surfaces of the optic extension 12 are flat and can be easily cleaned.

[0078] Thus, the endoscope according to the invention provides the possibility of preventing the transmission of germs etc., with which the endoscope came into contact during one use, to the next patient during the next use.

[0079] The movement element 2 can be designed as a single-use part and disposed of. Alternatively, the movement element 2 can be cleaned and sterilized.

[0080] The cable channel in the endoscope head is sealed, and the cable itself is completely sealed from the environment. The seal between the cable channel and the cable is watertight. This prevents germs from entering the cable channel or coming into contact with the cable. Alternatives

[0081] In this embodiment, spring 9 is designed as a coil spring. Any other suitable preloading device can be selected instead of spring 9. The preloading device simply needs to be capable of preloading the moving element 2 in the distal direction.

[0082] Instead of a pretensioning device that pretensions in the distal direction, a pretensioning device that pretensions in the proximal direction can also be used. In this case, the tension cable must be designed as a sufficiently rigid sliding element that can overcome the pretension of the pretensioning device that pretensions in the proximal direction and push the movement element 2 in the distal direction.

[0083] In the exemplary embodiment, the rod 29 of the movement element 2 can be pulled in the proximal direction by a pull cord actuated from the proximal side and moved in the distal direction by the spring. Alternatively, the rod channel in the endoscope can extend to the proximal operator side, and the rod can be elastic and extend to the proximal operator side. In this case, the pull cord and the pre-tensioning device can be omitted. The reciprocating movement of the movement element 2 is then generated directly at the proximal operator side of the endoscope by pushing and pulling the proximal end of the elastic rod forward and backward.

[0084] Another alternative is to go to the Fig. 4 and Fig.At the upper end of the tool guide surface 20, a proximal extension is provided, which can bend a microtool pushed along the tool guide surface 20 through the working channel 11 in the proximal direction. The extension causes a forward-advancing microtool to be bent more strongly in the proximal direction.

[0085] In the exemplary embodiment, the seal 16 is provided on the rod channel 19. This means that the seal 16 is located in the housing 15, sealing against the outer circumference of the rod 29, and the rod 29 moves relative to the seal 16. Alternatively, a design can be chosen in which the seal 16 is fixed to the outer circumference of the rod 29 and moves with the rod 29 relative to the housing, i.e., relative to the rod channel 19. In this case, the seal 16 should provide a seal from the proximal to the distal position of movement of the moving element 2.

[0086] The invention is applicable to a duodenoscope. The principle of the invention can also be applied to an ultrasound endoscope and any other type of endoscope. Reference symbol list 1 endoscope head 2 Movement element 3 caps 9 spring 11 Working channel 12 cable pull channel 13 circumferential groove 14 Spring seat 15 cases 16 Seal 17 Lighting equipment 18 Camera 19 rod channel 20 Tool guide surface 22 Basic section 28 disc 29 bars 31 windows 32 distal opening 111 distal exit of the working channel 191 attacks

Claims

Endoscope with an endoscope head (1) having a working channel (11) for guiding micro tools, and a moving element (2) movable back and forth in the axial direction of the endoscope head (1), which has a tool guide surface (20) on which a tool that can be guided through the working channel (11) can come into contact in order to be deflected in the lateral direction of the endoscope head (1), wherein the moving element (2) has a rod (29) with an axis extending in the longitudinal direction of the endoscope head (1), and the moving element (2) is rotatable about the axis. Endoscope according to claim 1, wherein the moving element (2) is guided in a channel (19) formed in the longitudinal direction of the endoscope head (1), and a seal (16) is provided at the distal end region of the channel (19) on the inner circumference of the channel (19), which seals around the outer circumference of the moving element (2) from the proximal to the distal position of movement of the moving element (2), or the seal (16) is provided on the outer circumference of the moving element (2) and seals against the inner circumference of the channel (19) from the proximal to the distal position of movement of the moving element (2). Endoscope according to claim 1 or 2, wherein the movement element (2) has a proximal base section (22) which has a uniform cross-sectional shape up to the transition to the tool guide surface (20), wherein the tool guide surface (20) is distal to the base section (22), and the proximal base section (21) is mounted on a rod (29) which is arranged to be movable back and forth in the channel (19). Endoscope according to one of claims 1 to 3, wherein the tool guide surface (20) has a proximal-extending elevation on the lateral outer edge area, through which a tool guided on the tool guide surface (20) is bent in the proximal direction. Endoscope according to claim 4, wherein, with the exception of the elevation, the movement element (2) has no sudden change in shape on its surface. Endoscope according to one of claims 1 to 5, wherein a cable pull (4) for actuating the movement element (2) is a rigid pull wire. Endoscope according to one of claims 1 to 5, wherein a pretensioning element (9) is provided on the movement element (2) to pretension the movement element (2) in the distal direction, and a cable pull (4) for actuating the movement element (2) is an elastic pull wire. Endoscope according to claim 7, wherein the preload element is designed as a spring element (9) arranged on the proximal side of the movement element (2). Endoscope according to one of claims 1 to 8, with a cap (3) which can be placed on the outer circumference of the distal end section of the endoscope head (1), wherein in the placed state the proximal end of the cap (3) is proximal to the movement element (2). Endoscope according to claim 9, wherein the cap (3) has a lateral tool opening on the side of the tool guide surface (20) and is closed on the distal side. Endoscope according to any one of claims 1 to 10, wherein the movement element (2) is detachable from the endoscope head (1).

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