Medical scope accessory, medical scopes comprising the accessory, and use thereof

Abstract

Abstract A cover (1) for a shaft of a medical scoping device comprises tubular member (2) arranged for application on the distal tip of the medical scoping device. The cover (1) 5 comprises a plurality of projecting elements (3) spaced apart circumferentially around the tubular member (2), each projecting element having a base portion (13) and an arm portion. The projecting elements are pivotably mounted on the tubular member about a pivot axis. The base portion (13) comprises a detent (20), and the tubular member comprises a contact region, for example a protuberance (23), said contact 10 region being located such that pivoting movement of the projecting element for moving the arm portion in a distal direction can effect impacting of the detent (20) on the contact region (23). Abstract A cover (1) for a shaft of a medical scoping device comprises tubular member (2) 5 arranged for application on the distal tip of the medical scoping device. The cover (1) comprises a plurality of projecting elements (3) spaced apart circumferentially around the tubular member (2), each projecting element having a base portion (13) and an arm portion. The projecting elements are pivotably mounted on the tubular member about a pivot axis. The base portion (13) comprises a detent (20), and the tubular 10 member comprises a contact region, for example a protuberance (23), said contact region being located such that pivoting movement of the projecting element for moving the arm portion in a distal direction can effect impacting of the detent (20) on the contact region (23). 20 24 26 46 54 14 N ov 2 02 4 2 0 2 4 2 6 4 6 5 4 1 4 N o v 2 0 2 4

Description

This application is a divisional application of Australian patent application 2022205212 which is a divisional application of 2017264835, which is the national phase application of PCT / GB2017 / 051341 filed 12 May 2017, which claims the benefit of GB 1608380.0 filed 12 5 May 2016, the disclosures of which are incorporated herein by reference in their entirety. Technical Field The present disclosure relates to a device for use with a medical scoping device shaft and to a medical scoping device including a said device. Background 10 In endoscopic examinations / procedures, flexible instruments designed to view the gastrointestinal tract are inserted along a body cavity to an internal part such as the stomach, duodenum, small intestine or large intestine. The instruments are provided with imaging devices, for example fibre-optic or charge-couple device (CCD) cameras, which enable images to be transmitted around bends and images to be produced to a 15 display screen. Accordingly, it is possible to view the inside surfaces of the oesophagus, stomach and duodenum using a gastroscope, the small intestine with an enteroscope, part of the colon using a flexible sigmoidoscope and the whole of the large intestine (the bowel) with a colonoscope. Enteroscopy is the endoscopic examination of the small intestine whereas colonoscopy 20 is the endoscopic examination of the colon and the distal part of the small bowel and flexible sigmoidoscopy is the examination of the rectum and lower part of the bowel. Each scoping procedure may provide a visual diagnosis (e.g. ulceration, polyps) and grants the opportunity for biopsy or removal of suspected lesions. Whilst colonoscopic and enteroscopic examinations are the most effective techniques to assess the state of 25 health of the bowel, they are inconvenient, uncomfortable, expensive procedures that are associated with significant risks of potentially serious complications. The most common complications are: failure to achieve a complete examination (5-10%); failure to detect a polyp (up to 20%); reaction to intravenous drugs; over-sedation leading to hypoxia and cardio-vascular collapse; splenic injury (rare); bowel perforation, (1 in 30   500-1500); full thickness burn (uncommon) and; bleeding following polypectomy. 2024264654   20 Aug 2026 The anatomy of the intestine is such that the lining is formed into folds. In the small intestine the folds are essentially permanent and are not smoothed out when the intestine is extended. In contrast, extending of the colon results in the colonic folds collapsing. In all endoscopic examinations, folds present may hamper the endoscopist's 5 ability to visualise the entire surface of the mucosa and in particular, detect pre-malignant and malignant lesions tucked away on the proximal face of these folds during extubation. WO2011 / 148172 discloses a covering for a shaft of a medical scoping device in the form of a cuff which is mountable near the tip of the shaft and which comprises a 10 multiplicity of projecting elements positioned in one or more circumferentially extending rings around the cover. The projecting elements are movable from a rest position to a position in which they point towards the proximal end of the shaft and a position in which they extend distally. The projecting elements, in use, become fanned out to provide support for and dilate a lumen wall of a body passage into which the 15 scoping device has been inserted. As the tip of the endoscope passes along the lumen during withdrawal, the folds may be flattened further enhancing visualisation. The device of WO2011 / 148172 has been found to have considerable advantages in terms of facilitating entry and exit of the medical scoping device shaft to which it is attached, and improving visualisation. Nonetheless, further improvement in 20 visualisation would be advantageous. In addition, or instead, in some circumstances, a different range of movement of the projecting elements could offer advantages. WO2014 / 123563 discloses an endoscopic sleeve having projections in the form of full rings or partial rings about a central sleeve, the rings being flexible. The rings or partial rings may be connected to the sleeve through a root portion which facilitates 25 bending. However, in practice, the rings or partial rings can collapse only to a relatively limited extent. The remaining relatively large overall diameter of the sleeve including the collapsed rings is undesirable. A smaller diameter is desirable in order to minimise patient discomfort when the scope and mounted device pass through constricted areas such as the sphincter or sharp bends within the cavity to be examined. 30 Any discussion of documents, acts, materials, devices, articles or the like which has been included in the present specification is not to be taken as an admission that any or 2024264654   20 Aug 2026 all of these matters form part of the prior art base or were common general knowledge in the field relevant to the present disclosure as it existed before the priority date of each of the appended claims. Summary 5 The present disclosure provides a cover for a shaft of a medical scoping device, the cover comprising a tubular member arranged for application over a distal tip of the medical scoping device shaft with the tubular member, in use, extending along a portion of the length of the distal end of the shaft, the tubular member comprising a proximal circumferential edge, a distal circumferential edge, an inner surface at least a 10 part of which grips the shaft, and an outer surface, the cover comprising a plurality of projecting elements spaced apart circumferentially around the tubular member, each projecting element having a base portion and an arm portion, the base portion comprising first and second mountings by which the projecting element is pivotably mounted on the tubular member about a pivot axis, wherein the base portion comprises 15 a detent, and wherein the tubular member comprises a contact region, said contact region being so located that pivoting movement of the projecting element for moving the arm portion in a distal direction can effect impacting of said detent on said contact region. In use of the cover disclosed herein the locus of movement of each of the projecting 20 elements is limited by the interaction of the detent with the contact region on the tubular member. On pivoting movement of a projecting element towards the distal direction, the detent will impact on the contact region, thereby hindering further pivoting movement of the base of the projecting element. Movement of the rest of the projecting element may, however, be unaffected by the detent. Thus, for example, in 25 the preferred arrangement in which the projecting elements are flexible, the projecting elements may still be capable of being everted such that their distal tips are directed distally with regard to the scope shaft. Accordingly, the base portion of the projecting element can be movable through an angular range having a first, proximal range in which the base portion is relatively freely pivotable and a second, distal range in which, 30 following initial impact of the detent on the contact region, the continued distal movement of the base portion by pivoting is resisted or even stopped. The greater resistance to movement towards the distal direction may be advantageous in terms of 2024264654   20 Aug 2026 controlling the position and movement of the projecting elements in use, for example enabling increased opening force to be applied to folds of the cavity wall for opening folds and / or giving increased resistance to withdrawal of the scope which can enable more effective examination. In the second, distal angular range, even if further 5 pivoting at the mountings is reduced or prevented, in the case of flexible projecting elements, further distal bending of the remainder of the projecting element may still be achievable through bending of the projecting element at an intermediate position displaced from the base, rather than primarily by bending at the base of the projecting element. That can advantageously reduce any tendency of the projecting elements, 10 during retraction of the scope, to come into contact with the distal edge of the cover. It may also reduce the tendency for the projecting elements to contact, or to bend across immediately in front of, the distal surface. The positioning of the projecting elements is thus better controllable to obtain a desired interaction with the surrounding cavity wall and / or to achieve visualisation of the distal ends of the projecting elements within 15 a desired range of positions relative to the tip of the scope. The cover disclosed herein may thus offer the possibility of improved visualisation by the clinician. The present disclosure further includes a method of examination of a cavity, for example a body cavity of a human or a non-human animal, which method comprises insertion of an endoscopy device comprising a cover as disclosed herein into said 20 cavity, and causing everting of the projecting elements of said cover, wherein the angle of inclination of the base portions of the projecting elements when everted is limited to not more than 140°. The present disclosure further includes a cover for a medical scoping device, the medical scoping device comprising a visualization system having a field of view, the 25 cover comprising a body member arranged for application over a distal tip of the medical scoping device shaft, a plurality of projecting elements extending from the body member, each projecting element having a base portion and being mounted on the body member via said base portion, wherein the body member comprises a hindering structure so located that on pivoting movement of the projecting element towards the 30 distal direction, the base portion of the projecting element is configured to be impacted by the hindering structure, thereby hindering further pivoting movement of the base 2024264654   20 Aug 2026 portion of the projecting element, and wherein at least one of the projecting elements can move independently to at least one of the other projecting elements. Throughout this specification the word "comprise", or variations such as "comprises" or "comprising", will be understood to imply the inclusion of a stated element, integer or 5 step, or group of elements, integers or steps, but not the exclusion of any other element, integer or step, or group of elements, integers or steps. Detailed Description In this specification the words “distal” and “proximal” are defined with reference to a clinician who, in use, is operating the scoping device. The term “proximal” refers to a 10 position or element that is closer to the operating clinician, and the term “distal” refers to a position or element that is further away from the operating clinician. The expression “pivot axis” is used herein as referring to an axis about which turning may occur, and is not to be understood as requiring relative movement of separate parts. Indeed, in general pivot axes referred to herein are axes which are nominal axes 15 about which turning can take place within a monolithically formed article. The terms “pivotable”, “pivotably”, “pivoting”, and “pivot” are to be correspondingly understood. The cover disclosed herein preferably has a multiplicity of projecting elements arranged in a ring around the cover. In practice, the cover will usually comprise from three to ten, preferably at least four, more preferably at least six projecting elements. It 20 is preferred that each of the projecting elements is identical, although other embodiments may not be limited to covers in which all the projecting elements are identical. The description of a projecting element and its mounting below is to be understood as preferably being applicable to all projecting elements of the cover, but for the avoidance of doubt, covers in which one or more projecting elements that are 25 present are differently constructed are not excluded. The projecting elements are mounted by means of first and second mountings to permit pivoting movement of the projecting element about a pivot axis. Advantageously the first and second mountings are positioned on opposed surfaces of the base portion, the pivot axis being defined between the mountings and extending through the intervening 30 base portion. Advantageously, the detent is located on an opposite side of the pivot axis from said arm portion. In consequence, pivoting movement of the projecting 2024264654   20 Aug 2026 element forward towards the distal direction will generally result in pivoting of the detent in a different direction. Advantageously, at least one of said detent and said contact region is resiliently deformable. Preferably both are resiliently deformable, at least in the region of contact. 5 Advantageously, said contact region comprises a protuberance. The protuberance provides a region that is elevated relative to at least a part of the surrounding surface to provide a clearly defined contact region. Advantageously, the protuberance comprises a portion that extends distally beyond the base portion of the projecting element. Preferably the contact region is integrally formed with the tubular member. More 10 especially, the contact region, the protuberance if present, and the projecting elements are preferably integrally formed with the tubular member. Advantageously, a respective contact region is so located relative to the respective projecting element that it delimits the locus of movement of at least the base portion of the said projecting element. 15 The projecting elements are spaced circumferentially about the tubular member. In one embodiment, the projecting elements are spaced apart in a ring around the tubular member. For example, in an illustrative arrangement in which there are eight projecting elements, the central axes of each adjacent pair of projecting elements subtend an angle of 45° at the centre of the tubular member. In other embodiments, the 20 projecting elements may be circumferentially spaced about the tubular member in a pattern that includes one or more projecting elements that is / are spaced from the distal edge by a greater distance than one or more other projecting elements. For example, the projecting elements may be spaced from one another in a helical arrangement. Advantageously, the said ring or at least some of the said helically arranged projecting 25 elements are spaced from the distal edge of the tubular member by a distance that is less than the length of the projecting elements. It is desirable for the cover to be positioned close to the tip of the scope on which it is mounted. That may serve to reduce the discomfort of insertion of the tip of the scope through the musculature on entry to the gastrointestinal tract. The tip is typically provided with a front surface 30 through which imaging can be achieved, for example a lens through which visualisation can take place. Positioning of the projecting elements relatively close to the scope tip enables optimal benefit to be obtained from the action of the projecting elements in the 2024264654   20 Aug 2026 opening up of tissue structures to improve visualisation and / or the maintenance of the desired position of the scope tip within the cavity being examined. Preferably, the projecting elements of a said ring or of a said helical arrangement are located no more than 10mm from the distal edge of the tubular member. 5 In practice, the cover will typically extend along a relatively short portion (for example up to 2 or up to 3cm in length) of the distal tip of the scope shaft on which it is mounted, for example a short length of the shaft immediately behind the distal tip of the shaft. Whilst it is preferable to apply the cover at a position on the scope that is close to the distal tip of the scoping device, it will be appreciated that the cover of the 10 device may if desired be positioned differently on the scope. For example the cover may be so positioned on the scope that the distal edge of the tubular member is set back from the distal tip of the scope. The distal edge may, for example, be set back from the tip at least so as to ensure that the distal edge of the cover does not cover or interfere with visualisation at the front surface. In some circumstances the cover may even be 15 set back from the distal end of the scope by a greater distance, for example 10mm or more. In certain advantageous embodiments the distal edge is bevelled. That further reduces the tendency for undesirable interaction between the projecting elements and the distal edge when the projecting elements are deflected into a distal position or into the field of view. 20 Advantageously, the cover comprises on its outer surface a multiplicity of channels extending axially relative to the tubular member, each channel being defined between a pair of axially extending channel walls, and each projecting element being mounted in a said channel. Advantageously, each projecting element is mounted between a said pair of channel walls by means of said first and second mountings. The first and 25 second mountings may, for example, comprise opposed connector portions on the base portion that extend between the base portion and the channel walls. Where present, the connector portions are advantageously formed integrally with the rest of the device and are resiliently deformable by twisting so as to permit pivoting of the projecting element about a pivot axis extending through the base portion, between the opposed connector 30 portions. The cover preferably comprises a multiplicity of spaced longitudinally extending ridges, the said channel walls each being formed by lateral surfaces of a respective said 2024264654   20 Aug 2026 longitudinally extending ridge. Advantageously, each contact region is provided in a respective channel. Advantageously, the or each projecting element comprises a tip portion and an intermediate portion between said base portion and said tip portion, the base portion, 5 intermediate portion and tip portion being resiliently deformable. In practice, the tip portion will include a free end of the projecting element. The degree of freedom of movement of the projecting element in practice will be greater in the intermediate and tip portions as a result of the impeding of the movement of the base portion consequential to the impacting of the detent on the contact region of the cover. The 10 projecting elements are preferably elongate in configuration. For example, they may advantageously have an aspect ratio (ratio of length to maximum width) of no less than three, preferably no less than four. Advantageously, each projecting element is movable from a resting position to a proximal position in which its tip portion is directed in a proximal direction towards a 15 proximal end of the scoping device shaft and is movable in a distal direction to a forward position in which the detent of the base portion of the respective projecting element abuts the corresponding contact region. Advantageously, on movement of the projecting element to said forward position, the detent impacts on the corresponding contact region when the projecting element, or at least the base portion thereof, is at an 20 angle of from 80° to 140° relative to the proximal direction, whereby the contact region impedes further forward movement of the base portion beyond said angle. In an advantageous embodiment, the detent is so arranged and so movable relative to the contact region that on moving towards the forward position the detent first impacts on the contact region when the base portion of the projecting element is at an angle of 25 from 90° to 160°, for example up to 150° or up to 140°, relative to the proximal direction. In certain advantageous embodiments the detent and / or contact region are resiliently deformable. For example, one or both of the detent and / or contact region may be resiliently deformable so as to permit further forward movement of said base portion through an angle of at least 10°, for example at least 20°, at least 30° or at least 30   40°. In certain embodiments, the detent of the projecting element may, on the projecting element being moved distally, first impact on the corresponding contact region when the projecting element, or at least the base portion thereof, is at an angle of 2024264654   20 Aug 2026 from 80° to 120°, for example 90° to 110° relative to the proximal direction. In an illustrative embodiment the detent may impact on the contact region when the base portion is at an angle in the range of 90° to 120° to the proximal direction, and further pivoting towards the distal direction is permitted, for example, by resilient deformation 5 of the detent or contact region, to a position in which the base portion is at an angle in the range of about 140° with reference to the proximal direction. Advantageously, the detent and contact region are so arranged that distal movement of said base portion beyond about 160° is prevented. That reduces any tendency of the projecting elements, during retraction of the scope, to come into contact with the distal edge of the cover. It 10 also reduces any tendency for the projecting elements to fold over the tip and across the tip surface itself since the restriction on the mobility of the base portion limits the locus of movement of the intermediate and tip portions of the projecting elements which, when they are in view through the tip, will consequently tend to be spaced from the tip surface. That facilitates operations that involve a need to visualise the tip of the 15 projecting element, for example manipulation of the scope tip to open colonic folds to view a hidden polyp, or use of a projecting element with a measuring scale to measure polyp size as described further below. On insertion through the anus of a scoping device carrying a cover as disclosed herein the projecting elements are easily deflected towards the proximal direction without any 20 obstruction by a combination of pivoting at the mountings and deformation or bending of the projecting elements themselves. On withdrawal of the scoping device and cover, the projecting elements are initially deflected towards the distal direction as a result of frictional force between the projecting element and the cavity wall through a combination of pivoting at the mountings and deformation or bending of the projecting 25 elements. However, as a result of impacting of the detent on the corresponding contact region, pivoting is, after the point of impact, initially limited to that permitted by the detent and contact region, as for example by resilient deformation of one or both of the detent and contact region, with pivoting beyond a certain point being prevented; after the point of impact, further deflection of the elements typically requires deformation or 30 bending of the projecting elements themselves and the force required to do that may be greater than the force required for pivoting. In this way, the device has a substantially 2024264654   20 Aug 2026 greater resistance to deflection of the projecting elements in the distal direction than in the proximal direction. The dimensions of the cover may to some extent depend on the type of scope with which it is to be used. The cover may, by way of example, have a total axial length of 5 at least 10mm, for example, in the range of from 10 to 20mm. The internal diameter should advantageously be such that, when in position on the scope to be used, the cover is slightly elastically radially expanded, as that provides a close fit on the scope and more reliable and reproducible movement of the projecting elements. Whilst the internal diameter will be selected according to the scoping device with which the cover 10 is to be used, for use with certain scoping devices the tubular member may have an internal diameter of at least 7mm, for example at least 8mm, with the internal diameter typically not exceeding 15mm, for example not exceeding 14mm. A cover may have an overall diameter of, for example, 35 to 45mm, preferably 37 to 43mm, and may especially have an overall diameter of 39 to 40mm when at rest and including the 15 projecting elements. The projecting elements may have a length of up to 20mm, for example from 10 to 18mm, or 12 to 16mm. The width of the projecting elements may advantageously be in the region of 1.5 to 3mm, for example 1.8 to 2.5mm. The inner longitudinal ridges may be, for example, about 0.1 to 0.3mm wide. The outer ridges are thicker, for example 0.3 to 0.6mm in width, and are separated by a web of 0.3 to 20   0.5mm in width. The projecting elements may be of any suitable shape, for example, they may be tapered and / or may be of uniform or non-uniform thickness. The cover may if desired comprise projecting elements of differing diameters, lengths, numbers in rings and where present rows of rings may be differentially spaced apart in a nonuniform manner. 25 The preferred dimensions may vary according to the type of endoscopy for which the cover is to be used. For example, for use in enteroscopy, the dimensions may be essentially the same as those for a sigmoidoscopy cover, although it may be advantageous for the projecting elements to be shorter, for example from 8 to 14mm or from 8 to 12mm in length. 30 The dimensions of the cover can be adapted for other procedures, for example, a larger diameter may be required for a cover for some colonoscopes. 2024264654   20 Aug 2026 Advantageously, the cover comprises from three to ten projecting elements, each of said projecting elements having a respective detent and being associated with a respective contact region. Advantageously, the cover is monolithic. The cover may be made by any suitable method for forming of polymer materials, 5 including especially methods suitable for forming of thermoplastic elastomers. Advantageously the cover is formed by injection moulding. In one preferred embodiment, the cover is injection moulded in one piece. The illustrative covers shown in the drawings and described below are suitable for production using injection moulding in a single shot moulding process, with a line of 10 draw permitting the cover to be formed and removed in a single piece. Whilst manufacture using a single polymer material in a one-shot process offers particular advantages in terms of simplicity and speed of manufacture, other methods are possible. For example, in some embodiments it may be desirable to use a first shot of a first polymer and a second shot of a second polymer, with optional further shots of 15 further polymers, in order to generate desired different characteristics in different regions of the cover. In one illustrative example, a distal part of the cover including the projecting elements may be made of a first polymer, and the proximal part of the cover of a different polymer, for example of a polymer of slightly greater hardness. In yet another example, the configuration of the detent may be such that there is no line of 20 draw and the device may be made using two or more shots of the same polymer. Whilst certain embodiments of the cover are described below with reference to illustrative examples having one ring of projecting elements, it is also within the scope of the present disclosure for the cover to further include one or more rings of projecting fingers arranged proximally of said projecting elements. Such additional projecting 25 fingers may be, but are not necessarily, of like structure to the projecting elements described herein. Where a plurality of rings is present, it may be desirable for the projecting elements or fingers of one ring to be shorter or longer than those of another said ring of projecting elements or fingers. Some embodiments may have rings or helical patterns of projecting elements or fingers that alternate in length, or having a 30 length that increases with increased distance from the tip. 2024264654   20 Aug 2026 The cover disclosed herein may incorporate further functional features. For example, it may include a radio-opaque dye for easier identification. For example, different colour dyes can be used to indicate different sizes of cover. The cover may in some embodiments comprise at least one structure that enables 5 deformation of the tubular member to take place preferentially at a location remote from the base portions of the projecting elements. That may in particular enable the cover to be usable on scope tips with different diameters. It may be advantageous, for example, to provide two or more circumferentially spaced regions of the tubular member that are more easily deformable than circumferentially adjacent regions. In that 10 manner it may be possible for stretching of the cover, when mounted on a large scope tip, to be concentrated in regions that are circumferentially spaced from those regions at which the projecting elements are mounted. That can reduce the tendency for stretching of the tubular member to affect the freedom of movement of the projecting elements at the mountings. 15 In an embodiment, at least one of said projecting elements comprises a measurement scale. In a variant of that embodiment two or more projecting elements with measurement scales may be present, or each projecting element may have a measurement scale. In such embodiments the cover disclosed herein facilitates the assessment of the size of a structure visualised in a body cavity. Structures that may 20 advantageously be measured using the scale include polyps. Because the scale is provided on a movable projecting element it provides a versatile approach to measurement, since the projecting element is readily movable relative to the distal tip of the scoping device. That enables the distal tip and a projecting element carrying a said scale to be manoeuvred into suitable positions relative to one another and to a 25 structure to be assessed to enable a relatively accurate measurement to be made using the measuring scale on the projecting element. Importantly, in addition to their advantageous manoeuvrability to permit visualisation of a said measurement scale, the projecting elements of the device disclosed herein can serve to open up areas of tissue when the projecting elements become everted during withdrawal of the scope, allowing 30 improved visualisation of structures that may otherwise be hidden within the folds of tissue. Thus, the combination of effective opening up the folds of tissue together with relative movability of the measurement scale and the lens of the distal tip provide a 2024264654   20 Aug 2026 simple approach to polyp assessment that may be used on a standard scoping apparatus, providing versatility in the direction of measurement as well as reliable measurement. Furthermore, there is no need for advancing of an additional part from the scoping device for effecting measurement - the operator only needs to advance a snare or other 5 cutting device from the scoping device if it is concluded that a polyp is to be removed. Polymer materials suitable for use in the cover disclosed herein include those which are suitable for use within a cavity of the human or animal body. The polymer or polymers will also in practice be selected having regard to desired characteristics of the cover, for example, flexibility and elastic deformability. Polymer materials with suitable physical 10 characteristics may include elastomeric polymers including elastomeric polyesters, copolyesters, polyamides, polyolefins, silicones, polyetherketones, natural rubbers, synthetic rubbers, and styrene polymers, and further including copolymers or mixtures of any of the aforementioned. Advantageously the polymer comprises a thermoplastic elastomer which may, for example, be selected from polyamide elastomers, copolyester 15 elastomers, olefinic elastomers, styrenic elastomers, urethane elastomers and copolymers or mixtures of any of the aforementioned. Illustrative suitable polymers include styrene-olefin block copolymers, for example, styrene-ethylene / butylene-styrene block copolymers or styrene isobutylene styrene block copolymers, and silicone rubbers. 20 Polymers suitable for use in the cover disclosed herein, or at least in the parts thereof including the projecting elements, preferably have a shore A hardness not exceeding 60. Advantageously, the cover comprises a polymer material of Shore A hardness from 40 to 60, for example 45 to 55, such materials being suitable for providing an appropriate degree of flexibility of the projecting elements and appropriate stretching 25 properties for facilitating mounting of the cover on a scope. Shore A hardness values referred to herein are as determined according to ASTM D2240. Whereas it is often expedient in practice that the cover is formed from a single polymer material, the cover may instead comprise a first polymer material of first Shore A hardness, and a second polymer material of second Shore A hardness, wherein at least the projecting elements 30 are formed of the first polymer material and the first Shore A hardness is lower than the Shore A hardness of the second polymer material. 2024264654   20 Aug 2026 Covers disclosed herein may be suitable for use on enteroscopes, colonoscopes, sigmoidoscopes, gastroscopes, and paediatric models of any of the aforementioned. In use, the cover disclosed herein is applied to a distal tip portion of the scoping device. Brief description of the drawings 5 Fig. 1 is a perspective view of cover according to a first embodiment of the present disclosure for use in sigmoidoscopy. Fig. 2 is a side view of the cover of Fig. 1; Fig. 3 is a bottom view of the cover of Fig. 1 and includes a detail view showing a portion of the base of a projecting element and the adjacent portion of the tube; 10 Fig. 4 is a view of the cover of Fig. 1 from above, showing a detail of a portion of the cover at the base portion of a projection element; Fig. 5 is a vertical section through the cover of Figs.1 to 4 along the line V-V shown in Fig. 4; Fig. 6 is a vertical section through the cover of Figs. 1 to 4 along the line VI-VI shown 15 in Fig. 4, further showing in section a detail of a portion of the cover showing the base portion of the projecting element and the adjacent portion of the tube in section; Fig. 7 is a horizontal section along the line VII-VII of Fig. 2; Fig. 8 is a perspective view of cover according to a second embodiment of the present disclosure for use in enteroscopy; 20 Fig. 9 is a bottom view of the cover of Fig. 8 and includes a detail view showing a portion of the base of a projecting element and the adjacent portion of the tube; Fig. 10 is a view of the cover of Fig. 1 from above, showing a detail of a portion of the cover at the base portion of a projection element; Fig. 11 is a section through a cover according to Figs. 1 to 7 in the rest position; 25 Fig. 12 is a section through the cover of Fig. 11 showing the projecting elements in a forward position; 2024264654   20 Aug 2026 Fig. 13 is a schematic view of a cover as disclosed herein, as used in a first stage of colonoscopic examination; Fig. 14 is a schematic view of the cover of Fig. 13 during a main visualisation stage of a colonoscopic examination; 5 Fig. 15 is a perspective view of a projecting element for use in a cover according to a third embodiment of the present disclosure; Fig. 16 is a partial side view of the cover of the third embodiment of the present disclosure in which the projecting elements are in an extreme distal position; and Fig. 17 is a section through the cover shown in Fig. 16 along the line A-A shown in 10 Fig. 16 The cover, devices and methods disclosed herein will be described hereafter, by way of non-limiting example, with reference to first and second illustrative embodiments of the present disclosure comprising a tip cover device for sigmoidoscopy (Figs. 1 to 7) and a tip cover device for enteroscopy (Figs. 8 to 10). The embodiments disclosed 15 herein may be applied in cover devices suitable for other types of internal examination, for example endoscopy, colonoscopy, and any other technique in which a visualisation device is advanced into a bodily orifice for examination. Figs. 1 to 7 show, as a first illustrative embodiment of the present disclosure, a scope cover of dimensions suitable for mounting on the end of a sigmoidoscope. The cover 1 20 is formed in one piece from a resiliently deformable polymer material. Dimensions referred to herein are, except where otherwise stated, when the cover or parts thereof are in their rest positions, that is, are not subject to any applied deformation. With reference to Figs. 1 to 7, the cover 1 has a tubular member 2 generally indicated by reference numeral 2 and eight projecting elements 3. The projecting elements 3 are 25 joined to the tubular member 2 by a mounting structure described further below. The projecting elements are evenly spaced around the circumference of the tubular member 2 at 45° intervals. The tubular member 2 comprises a circumferential outer surface 4, a circumferential inner surface 5, a distal edge 6 and a proximal edge 7. The axial length of the tubular 30 member 2 may vary in size relative to the diameter of the tubular member 2. 2024264654   20 Aug 2026 Irrespective of whether the axial length is longer or shorter than the diameter of the cover, the direction extending parallel to the axis of the tubular member 2 is referred to herein as the longitudinal direction. The circumferential inner surface 5 has a multiplicity of parallel interior ridges 8 5 extending longitudinally, which are separated into eight groups of three, which groups are spaced apart about the circumference of the inner surface. The interior ridges serve to improve the grip of the cover when mounted on a scoping device tip, which may especially be useful where the tip is exposed to bodily fluids or other fluids which can have a lubricating effect that has the potential to lead to dislodging of a cover that is not 10 firmly attached. The circumferential outer surface 4 comprises outer surface ridges 9 extending longitudinally from a location in the vicinity of the distal edge 6 towards the proximal edge 7. The outer surface ridges 9 are arranged in eight pairs, the pairs being spaced apart evenly around the circumference of the tubular member 2. Embraced between 15 each said pair 9’, 9” of ridges and the adjacent pairs on each side are channels 10. With reference to the detail in Fig. 3, each channel 10 is defined by a lateral wall surface 11 of a ridge 9’ of one pair, and an opposed lateral wall surface 12 of a ridge 9” of the adjacent pair, the channel 10 having a channel base. The channel serves to receive an associated projecting element in some orientations as hereafter described. The 20 longitudinal outer surface ridges 9 are wider and deeper than the inner surface ridges 8, and in addition to serving to mount the projecting elements 3 the pairs of outer ridges 9 impart additional structural stability with stretching capability of the tube portion in the radial direction as will be described further below, thereby facilitating application to, and removal from, a scoping device. 25 The structure of one projecting element 3, and associated channel 10 will now be described in more detail. The cover of Figs. 1 to 7 comprises seven further projecting elements and associated channels which are of like structure and configuration. The projecting element 3 has a base portion 13 via which the projecting element is mounted on the cover and an arm 14 which extends from the base portion. The arm 14 30 comprises an intermediate portion 15 and a tip portion 16 terminating in free end 17. The projecting element is of monolithic structure, and the intermediate portion 15 and 2024264654   20 Aug 2026 tip portion 16 are therefore designated for reasons of convenience and do not constitute visibly distinct portions. As previously mentioned, the projecting element 3 is also integrally formed with the rest of the cover in the embodiment described. The projecting element 3 is connected to the tubular member 2 via a pair of mountings 5 provided on opposite sides of the base portion 13 of the projecting element. A first mounting of said pair comprises a first connector portion 18 extending laterally from a first side of the base portion 13 joining the base portion at one side to the lateral wall surface 11 of ridge 9’. A second mounting of said pair comprises a second connector portion 19 extending laterally from the opposite side of the base portion 13 to the 10 adjacent lateral wall surface 12 of ridge 9”. The connector portions 18 and 19 permit pivoting of the projecting element 3 relative to the rest of the cover 1 by means of twisting deformation of the first and second connector portions. The connector portions 18, 19 define a pivot axis which extends through the intervening part of the base portion 13 of the projecting element from one connector 15 portion 18 to the other connector portion 19. Pivoting of the projecting element about the pivot axis can occur in two directions. Pivoting movement of the free end 17 towards the proximal direction enables the projecting element to adopt a proximal position in which the projecting element is received at least partly within the channel 10. That position may be adopted on application of force in the proximal direction 20 during insertion of the scope (as shown in Fig. 12) or when folds of the intestinal wall are encountered during advancing of the scope within narrow parts of the body cavity being examined. Pivoting of the free end 17 in the distal direction, as may occur on withdrawal of the scope through the area of the intestine to be visualised, can cause partial eversion of the projecting element from the position shown in Fig. 1 to a 25 forward position in which the free ends of the projecting elements are at an angle of greater than perpendicular relative to the proximal direction. The base portion 13 comprises a detent 20 which is on the opposite side of the pivot axis from the arm 14 of the projecting element. As a result, when the arm 14 comprising the intermediate portion 15 and tip portion 16 is pivoted towards the distal direction, the detent 20 is 30 pivoted downwardly towards the surface of the tubular member 2. The detent 20 includes a contoured contact region 21 which, after a certain degree of pivoting, impacts upon the outer surface of the tubular member 2, within the base of the channel 2024264654   20 Aug 2026 10. The base of the channel 10 is configured in the embodiment shown to have a contoured region in the vicinity of the base portion 13 of the projecting element 3. The contoured region includes a recessed region 22 and a raised region forming a protuberance 23. The protuberance 23 provides a contact region which obstructs the 5 locus of movement of the detent 20 when the projecting element 3 is pivoted towards the distal direction. In the embodiment shown, the protuberance 23 is essentially level with the part of the floor of the channel 10 that is proximal of the projecting element, and the recessed region 22 around it is recessed relative to the floor of the channel 10. It is also possible, however, for the contact region to be provided on a protuberance 23 10 at a level that is higher than the proximally located floor of the channel 10. The presence of recessed regions 22 defining between them a protuberance 23, can be advantageous in simplifying mouldability, especially for injection moulding processes where removal from a mould in the line of draw may be facilitated. In the covers shown in Figs. 1 to 7 and Figs. 8 to 10, the rest position of the projecting 15 elements 3 is such that the arm portions are directed slightly proximally, for example at an angle of about 70 to 80° relative to the proximal direction. The detent 20 on the base portion 13 of the projecting element 3, and the protuberance 23 on the tubular member 2 are so arranged relative to one another that contact occurs when the projecting element has been pivoted to be approximately perpendicular or slightly 20 greater than perpendicular relative to the proximal direction. In practice, that may correspond to pivoting the projecting element 3 by about 30° forward from the rest position shown in Fig. 1. Since the cover is of a resiliently deformable material, further advancing of the base portion 13 of the projecting element 3 is permitted by deformation of the detent 20 and / or of the region of contact on protuberance 23. The 25 degree of resistance may increase with the degree of deformation of the contact regions, and further movement may eventually be stopped. In at least some embodiments it is preferred that the advancing of the arm in the distal direction is limited to 120° or less, relative to the proximal direction. For the avoidance of doubt, since the intermediate portion 15 and tip portion 16 of the arm are flexible, bending in 30 the distal direction will be able to occur in those parts, and will occur preferentially in comparison to further bending at the base portion 13 which is subject to the resistance imposed by the contact between the base portion 13 and the cover 2 at protuberance 23. 2024264654   20 Aug 2026 Thus, reference to an angular position relative to the proximal direction is to be taken to refer to the angle of the part of the arm 14 closest to the base portion 13, whilst the remainder of the arm 14 may be subject to additional forward bending. As shown in Fig. 7, in the rest position the cover comprises longitudinally regions 5 made up of alternating grip regions 24 and expansion regions 25. The grip regions 24 include the inner grip ridges 8 which serve to enhance security of gripping of the cover. Alternating with, and slightly displaced radially outwards relative to, the grip regions 24 are the expansion regions 25 that are located under the pairs of external longitudinal ridges 9. The expansion regions and adjacent grip regions are so joined to one another 10 by inclined web portions 26 that they permit a certain degree of radial expansion of the tubular member 2. Webs 27 of material between each ridge of the outer pairs 9’, 9” of ribs also permit a degree of stretching in the distal region of the cover. By comparison, in the channels 10 between adjacent pairs of outer ribs 9, the degree of stretching in the distal region of the cover is limited by the mounting of the projecting elements 3 in the 15 channels between adjacent pairs of outer ribs 9 in that region. In practice, the cover of Figs. 1 to 7 for use on a sigmoidoscope may have an internal diameter of from 8 to 10mm (not including the gripping ridges) when at rest. When mounted on the tip of a scope, the cover will adopt an internal diameter approximating to the external diameter of the scope. The cover may, by way of example, have a total 20 axial length of 15 to 16mm, an overall diameter of 39 to 40mm. The projecting elements may have a length of 12 to 16mm. The width of the projecting elements may advantageously be in the region of 1.5 to 3mm, for example 1.8 to 2.5mm. The inner longitudinal ridges may be, for example, about 0.2mm wide. The outer ridges are thicker, for example about 0.4mm in width, and are separated by a web of about 0.3mm 25 in width. In use, the cover will, when mounted on a scope tip, generally be in a slightly radially expanded configuration, which enhances grip of the cover on the device. In that configuration, the spacing between the base portion 13 and the nearest part of tubular member 2 will be reduced as compared with that shown in the drawings. It may even 30 be possible for the base portion 13 to be in contact with the tubular member 2, provided that the contact does not impede forward pivoting of the projecting element or interaction of the detent 20 with the protuberance 23. The application and removal of 2024264654   20 Aug 2026 the cover 1 to a scoping device is facilitated by stretching of the proximal region of the tubular member 2, where the structure of outer ridges 9, webs 27 and the inclined web portions 26 enhances resilient radial deformation of the tubular member 2. In practice, that is advantageous in that, if the cover is placed on a relatively large-diameter scoping 5 device, the rib pairs 9’ 9” are able to pull apart and open up preferentially deforming to maintain the integrity and function of the mountings of the projecting elements and the interaction of the base portion of the projecting elements with the adjacent portions of the tubular member 2. However, the cover is equally usable on a scoping device of relatively small diameter - the rib pairs 9’, 9” and intervening web 27 do not need to 10 deform to maintain the integrity and function of the mountings of the projecting elements and the interaction of the base portion of the projecting elements with the adjacent portions of the tubular member 2. Whilst the embodiment described has two parallel ribs 9’, 9” defining intervening web 27 it will be appreciated that other structures that focus stretching at regions circumferentially spaced from the mountings 15 of the projecting elements are also possible. With reference to Figs. 8 to 10, there is shown an enteroscope cover 101 suitable for mounting over the tip of an enteroscope. The enteroscope cover 101 is of generally similar structure to the sigmoidoscope cover 1. In the cover 101, however, the structure of the projecting elements differs, being somewhat shorter than those of the cover of 20 Fig. 1. Otherwise, the features of the cover 101 are essentially the same as corresponding features of cover 1 as described above and are indicated by the same reference numerals. Although not visible in the drawings, the projecting elements 103 may be slightly wider than those of the cover 1 as well as being slightly shorter. With the exception of the projecting elements, suitable dimensions for the cover 101 may be 25 the same as, or similar to, those for cover 1. The dimensions of the cover can readily be adapted for use with colonsocopes, gastroscopes, and any other type of endoscope. As previously mentioned, the sigmoidoscope cover of Figs. 1 to 7 or the enteroscope cover of 8 to 10 is formed of a resiliently deformable material. In the embodiments described in Figs. 1 to 10, the covers were made of a thermoplastic elastomer, for 30 example Cawiton PR10942E (trade mark), a styrene-ethylene butylene styrene block copolymer of Shore A hardness 46 available from Wittenburg B.V. and suitable for medical use. The covers can be made by any suitable process, with injection moulding 2024264654   20 Aug 2026 being one suitable process for many of the suitable materials. Methods of injection moulding suitable polymers are well-known and widely practised in the art. In use of the cover devices disclosed herein, advantageous control of the forward movement of the arms is achieved, as illustrated in Figs. 11 and 12 and with reference 5 to Figs. 13 and 14. Fig. 11 shows the cover of Figs. 1 to 7 in the rest position. In practice, it is usual for a scoping device for visualisation of a part of the gastrointestinal system to be advanced relatively quickly through the cavity to be examined until the furthest point requiring examination is reached. The device is then withdrawn more slowly with most of the visual examination being carried out during withdrawal. Since 10 the cover preferably surrounds the tip of the scope very close to the lens system, the clinician’s field of view primarily includes the region in front of the distal end 6 of the cover. As the device is withdrawn, the projecting elements encounter structures on the wall of the cavity being examined, such as colonic folds 201 in the case of colonoscopy, and / or encounter bends 202 in the cavity walls (see Figs. 13 and 14). The 15 relative movement of the scope with reference to those features of the cavity during withdrawal results in the application of a force on the projecting elements tending to push them towards the distal direction with reference to the rest of the cover 1. The projecting elements 3 are able to pivot relatively freely until the contact region 21 of the detent 20 impacts on the tubular member 2 at protuberance 23. As the cover is 20 formed of a resiliently deformable material, the protuberance provides some resistance to further forward movement of the base portion 13 whilst not completely preventing some further forward movement. The movement of the arm 14 is, however, unimpeded, so that further deformation occurs preferentially at intermediate portion 15 and tip portion 16. As a result the projecting elements are able to open up structures for 25 examination whilst minimising any tendency for the free ends 17 to contact the distal edge of the tubular member 2 or to fold over closely against the distal tip of the scope thereby disproportionately and undesirably obstructing the field of view of the scope. The distal edge 6 is bevelled and that further reduces the tendency for undesired contact between the distal edge and the projecting elements. 30 More specifically, on withdrawal, the projecting elements, acted on by the cavity wall, are urged towards the distal direction. That results initially in relatively free movement towards the distal direction as the base portion is pivoted through a first proximal 2024264654   20 Aug 2026 angular range. However, once the detent 20 reaches a position where it is in contact with the contact region 21 at protuberance 23, the deformation or bending of the intermediate and distal portions of the projecting elements assumes greater importance as further pivoting of the base portion at the mountings is resisted as a result of the 5 contact between the detent 20 and protuberance 23 and relies on deformation or compression of one or both of detent 20 and protuberance 23. However, further distal deflection is still able to occur through bending or deformation of the projecting elements 3 themselves. Use of a cover disclosed herein is illustrated with reference to Figs. 13 and 14 in which 10 colonoscopy is referred to by way of illustration. The distal end tip 200 of the medical scoping device comprises a channel through which a light source, image relaying mean and air suction are supplied. The medical scoping device distal tip 200 with the cover 1 is inserted via the anus into the colon of an individual under investigation. On inserting the medical scoping device with cover into the patient the projecting elements 3 are 15 moved from an at rest position to a second position (referred to herein as a proximal position) where they are flattened towards the medical scoping device shaft. During intubation, the projecting elements 3 are designed to collapse into the channels 10 during insertion through the anus. This exposes a smooth low friction surface of the cover to the mucosa to aid intubation. 20 The flexible shaft of the medical scoping device 200 is advanced in a distal direction through the colon towards the bend or loop region of the colon (Figure 14) whilst insufflating the colon immediately forwards of the distal tip of the scoping device 200. The projecting elements once passed the anus revert to their resting first position. As the scope passes further up the colon and encounters the loop region the projecting 25 elements engage with the colon wall in a soft grip (where the projecting elements can fan out and the endoscopist can perform a controlled proximal withdrawal flattening the colonic folds for good visualisation). The projecting elements 3, 103 of the cover of the present disclosure act to gently open and flatten the colonic folds for inspection during withdrawal. 30 In that manner, the projecting elements can be used to straighten out loops in the colon for more thorough examination and / or reduce the need for acute tip deflection and / or open out structures such as folds for examination. In accordance with the present 2024264654   20 Aug 2026 disclosure these objectives may be achievable with improved visualisation through reducing encroachment of the projecting elements into the field of vision. Improved visualisation is important for identifying small pre-malignant and malignant lesions that can be hidden or difficult to view when performing conventional endoscopy. 5 The projecting elements of the cover also serve to gently stabilise the tip of the scoping device within the lumen of the colon or small intestine immediately prior to and during therapeutic procedures. This has the advantage of permitting the endoscopist the reassurance that the tip will remain in position from the stage of visualising a lesion or polyp until completion of the therapeutic procedure. 10 In use, the projecting elements are designed to pivot forwards so that they become flared outwards on withdrawal. They keep the instrument tip in the central part of the bowel lumen as the instrument moves backwards, gently holding the mucosa to prevent the tip from flipping backwards, they maintain position during therapy and improve allround visualisation, whilst the possibility of obstruction of the main field of vision in 15 front of the scope tip by one or more projecting elements is reduced. On withdrawing the scope especially through the anus the projecting elements are able, notwithstanding the limitation on movement of the base portion of the projecting elements, to be moved into a forward position. This is achievable as a result of the flexibility of the arm comprising the intermediate portion 15 and tip portion 16, which 20 permit bending at the intermediate portion and distal portion such that the arm is positioned parallel or nearly parallel to the distal direction. With the arms in that position, the scope can be comfortably withdrawn. Fig. 15 shows a projecting element 3’ that may be used in a further embodiment of the cover disclosed herein. Projecting element 3’ is essentially the same as the projecting 25 element 3 as described with reference to Figs. 1 to 12 above. However, the upper distal surface is provided with a measurement scale 28 comprising four spaced elongate ridges. The measurement scale as shown extends along at least a part of said projecting element in a direction from the base portion towards the distal tip portion of the projecting element. Whilst the measurement scale 28 is shown in Fig. 15 as comprising 30 four spaced elongate ridges it will be appreciated that the measurement scale may be of any suitable form (for example printed) and may extend in a different direction. Fig. 16 2024264654   20 Aug 2026 shows a distal portion of the cover when in use. The projecting elements 3’ are in a measuring, position, in which the free ends are deflected into the field of view. Since the distal pivoting of the base portion of the projecting elements is limited to, for example about 140° relative to the proximal direction, the deflection of the projecting 5 elements into the field of view is achieve at least in part through bending of the intermediate and distal portions of the projecting element. The projecting elements 3’ are shown schematically in Figs. 16 and 17 as being deflected distally with their tips including measurement scales 28 deflected radially inwardly beyond the distal edge of the tubular member. With reference to Fig. 17, which is a section along line A-A in 10 Fig. 16, when the projecting elements are in that position, the measurement scales 28 are comfortably within the field of vision of a scoping device visualisation system in which visualisation takes place from the distal end of the scoping tip portion positioned in the axial channel 18. However, any tendency of the tips of the projecting elements 3’ with measurement scales 28 to collapse towards the distal tip surface of the scope is 15 reduced as a result of the limitation on distal pivoting provided by the interaction of the detent 20 and contact region 21 (not visible in Fig. 16). Whilst the measurement scale can be visualised when the projecting elements 3’ are inclined at no more than 180°, for example no more than 160° or 140° relative to the proximal direction, visualisation and accuracy of measurement may be further enhanced when the projecting element is 20 deflected further, as shown in Fig. 16 and 17. In Figs. 16 and 17 and also in each of Figs. 11 and 12 respectivaly, for ease of illustration, the cover device is shown with all projecting elements deflected distally to the same extent. In practice, it is possible for the degree of distal deflection to be different in different projecting elements 3, 3’, for example according to the proximity 25 to, and local configuration of, the cavity wall. If desired, the distal tip carrying the cover may be so manoeuvred relative to the colon wall such that one or more of the projecting elements 3, 3’ is intentionally caused to be deflected by a greater amount than other projecting elements 3, 3’. Distal deflection of the projecting elements 3, 3’ is a consequence of interaction 30 between the free ends and the surrounding wall regions of the cavity being examined during the withdrawal of the distal tip of the scope through the body cavity. Radial inward deflection may be induced for one or more of the projecting elements 3, 3' by 2024264654   20 Aug 2026 means of manoeuvring the endoscope relative to adjacent structures within the cavity being examined, for example, by controlling the position and motion of the distal tip portion 200 remotely such that one or more said projecting elements contacts a wall region of the cavity, the relative movement of the distal tip of the scope 200 and the 5 cavity wall serving to deflect the projecting element(s) 3, 3’. In the embodiment of Figs. 16 and 17, each of the projecting elements 3’ is provided with its own measuring scale 28. Whilst in principle the present disclosure includes devices in which a single measuring scale is provided on one of a plurality of projecting elements, providing measuring scales on all projecting elements enables measurement to be carried out with 10 any projecting element 3’ so that the device can readily be used to measure a polyp at any angular location of the inner wall of the body cavity without the need for significant pivoting of the endoscope tip to bring a single measurement scale into a suitable angular location. Embodiments having a measurement scale advantageously enable assessment of the size of an anatomical abnormality in an elongate body cavity, 15 which abnormality may at least in part be visually obscured by a movable obstruction. In practice this may be achieved by advancing towards said abnormality a scoping device 200 having a distal tip portion comprising the cover, if necessary manoeuvring the distal tip portion such that one or more of the projecting elements 3’ contacts said movable obstruction so as to move said obstruction relative to said abnormality to be 20 assessed; further manoeuvring said distal tip portion such that a said projecting element is positioned adjacent to said abnormality; assessing a dimension of said abnormality by comparison of said object with a said measurement scale 28 on the adjacent projecting element; and optionally surgically removing said abnormality. Where in the foregoing description, integers or elements are mentioned which have 25 known, obvious or foreseeable equivalents, then such equivalents are herein incorporated as if individually set forth. Reference should be made to the claims for determining the true scope of the present invention, which should be construed so as to encompass any such equivalents. It will also be appreciated by the reader that integers or features of the present disclosure that are described as preferable, advantageous, 30 convenient or the like are optional and do not limit the scope of the independent claims. Moreover, it is to be understood that such optional integers or features, whilst of 2024264654   20 Aug 2026 possible benefit in some embodiments of the present disclosure, may not be desirable, and may therefore be absent, in other embodiments.

Claims

1. A cover for a medical scoping device, the medical scoping device comprising a visualization system having a field of view, the cover comprising a body member arranged for application over a distal tip of the medical scoping device shaft, a5 plurality of projecting elements extending from the body member, each projecting element having a base portion and being mounted on the body member via said base portion,wherein the body member comprises a hindering structure so located that on pivoting movement of the projecting element towards the distal direction, the base 10 portion of the projecting element is configured to be impacted by the hindering structure, thereby hindering further pivoting movement of the base portion of the projecting element, andwherein at least one of the projecting elements can move independently to at least one of the other projecting elements.15   2. A cover according to claim 1, wherein the hindering structure comprises adefined contact region on the body member, the contact region being raised relative to the surrounding surface of the body member.

3. A cover according to claim 1 or claim 2, wherein the hindering structure is resiliently deformable.20   4. A cover according to any one of claims 1 to 3, wherein the hindering structureis integrally formed with the body member.

5. A cover according to any one of the preceding claims, wherein the respective hindering structure is so located relative to the respective projecting element that it delimits the locus of movement of at least the base portion of the said projecting25 element.

6. A cover according to any one of the preceding claims, wherein the hindering structure is configured to hinder further pivoting movement of the base portion of the projecting element during the withdrawal of the medical scoping device through the colon.30   7. A cover according to any one of the preceding claims, wherein a length of theat least one of the projecting elements is dimensioned so that the distal tip portion of2024264654   20 Aug 2026the projecting element extends beyond the distal end of the medical scoping device when the hindering structure is hindering the pivoting movement of the base of the projecting element.

8. A cover according to claim 7, wherein said at least one projecting element is5 configured to move to a position in which the distal tip portion of the projecting element is within the field of view of the visualization system of the medical scoping device when the hindering structure is hindering the pivoting movement of the base of the projecting element.

9. A cover according to any one of the preceding claims, wherein the hindering 10 structure comprises an elastomeric polymer selected from elastomeric polyesters, copolyesters, polyamides, polyolefins, silicones, polyetherketones, natural rubbers, synthetic rubbers, and styrene polymers, and copolymers or mixtures of any of the aforementioned elastomeric polymers.

10. A cover according to claim 9, wherein the elastomeric polymer is selected15 from styrene-olefin block copolymers and silicone rubbers.

11. A cover according any one of the preceding claims, wherein at least one of the plurality of projecting elements comprises at least one bump.

12. A cover according to any one of the preceding claims, wherein the cover comprises a radio-opaque dye for identification during an examination of a human20 body.

13. A cover according to any one of the preceding claims, wherein the body member comprises a tubular member.

14. A cover according to any one of the preceding claims, wherein the projecting elements are spaced apart circumferentially around the body member.25   15. A set of covers comprising a plurality of covers according to any one of thepreceding claims, the covers of the set comprising a colored dye having a color, the color of the dye indicating a type of the cover.

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