Medical system

Abstract

The medical system may include an insertion device having a handle (102), a shaft (104) coupled to the handle (102) of the insertion device, and a port (150) positioned on the handle (102) of the insertion device. The port (150) may be in fluid communication with the working channel (110) of the shaft (104). The port (150) may be a concave Luer port. The medical system may further include a medical device having a control member (206) terminating at an end effector (208), a handle (202) having a plurality of circumferential slots (210) along the length of the handle (202), and a plunger (230) movable between a first position and a second position along the longitudinal axis (216) of the handle (202) of the medical device. In the first position, the end effector (208) may be positioned within the shaft (104), and in the second position, the end effector (204, 208) may be positioned distal to the shaft (104).

Description

[0001] This application is a divisional application of the Chinese patent application with the application date of April 27, 2017, the national application number of 201780026446.3 (PCT application number of PCT / US2017 / 029824), and the name of “Medical Systems, Devices and Related Methods”.

[0002] CROSS-REFERENCE TO RELATED APPLICATIONS

[0003] This patent application claims the benefit of priority under 35 U.S.C. §119 to U.S. Provisional Patent Application No. 62 / 332,682, filed on May 6, 2016, the contents of which are incorporated herein by reference in their entirety. Technical Field

[0004] Various aspects of the present disclosure generally relate to medical systems, devices, and related methods. More specifically, the present disclosure relates to devices, systems, and methods for removing objects and / or performing treatments within a subject. Background Art

[0005] Medical devices, such as baskets, are often used to remove organic materials (e.g., blood clots, tissues, and bioliths, such as urinary stones, gallstones, and pancreatic stones) and inorganic materials (e.g., parts of a medical device or other foreign matter) that may obstruct or otherwise reside within a subject's body cavity or passage. For example, stones may develop in certain parts of the body, such as in the kidneys, pancreas, ureters, and gallbladder. Minimally invasive medical procedures are used to remove these stones through natural orifices or through incisions, such as during percutaneous nephrolithotomy (PNCL) procedures. Medical devices are also used in lithotripsy and ureteroscopy procedures to treat urinary stones (e.g., kidney stones) in a subject's ureters.

[0006] Such a medical device can pass through the working channel of a suitable insertion device (such as an endoscope, ureter, laparoscope, etc.) positioned in the body cavity to reach the surgical site at the distal end of the insertion device. Typically, such an operation requires two or more operators: one operator holds the insertion device, and the other operator moves the medical device. If multiple medical devices are deployed, even more operators may be required. Using more than one operator increases the cost and complexity of the medical operation, because each additional operator may increase the marginal cost, and each operator must carefully coordinate their movement in order to complete the operation.

[0007] The systems, devices, and methods of the present disclosure may remedy some of the deficiencies discussed above or address other aspects of the prior art. Summary of the invention

[0008] Examples of the present disclosure relate particularly to medical retrieval devices.Each of the examples disclosed herein may include one or more of the features described in conjunction with any of the other disclosed examples.

[0009] In one example, a medical system may include an insertion device having a handle, a shaft coupled to the handle of the insertion device, and a port positioned on the handle of the insertion device. The port may be in fluid communication with a working channel of the shaft. The port may be a concave Luer port. The medical system may further include a medical device having a control member terminating in an end effector, a handle having a plurality of circumferential slots along the length of the handle, and a plunger movable between a first position and a second position along the longitudinal axis of the handle of the medical device. In the first position, the end effector may be positioned within the shaft, and in the second position, the end effector may be positioned distally of the shaft.

[0010] Examples of medical systems may additionally and / or alternatively include one or more of the following features. The port may be a T-shaped or Y-shaped port having a first branch and a second branch. An adapter may be connected to the port and may include a supplemental line terminating at a stopcock. A tapered introducer, the distal end of which is positioned within the adapter. The adapter may include a male Luer connector. The handle of the insertion device may include a clamp located at its proximal end, which may include a plurality of arms defining a receiving space therebetween. The plunger may rotate about the longitudinal axis of the handle of the medical device. The handle of the medical device may include a channel extending along the longitudinal axis. The distal end of the plunger may be slidably positioned within a portion of the channel. A spring may be positioned within the channel. The plunger may include a knob at its proximal end. The plunger may include a plurality of markings. A circumferential slot may extend along the entire length of the handle of the medical device between the proximal end and the distal end of the handle of the medical device. The distal end of the medical device may include a male Luer port. The medical device may further include a sheath coupled to the male Luer port of the handle of the medical device.

[0011] In another example, a medical system may include an insertion device having a handle, an axis coupled to the handle of the insertion device, and a fixture positioned along the proximal end of the handle of the insertion device. The fixture may include a plurality of arms extending from the handle of the insertion device. The insertion device may also include a port positioned on the handle of the insertion device, which is in fluid communication with the working channel of the shaft. The port may include a concave Luer port. The medical system may also include a medical device having a control member terminating in an end effector, a handle positioned in a receiving space between a plurality of arms of the fixture, and a plunger movable between a first position and a second position along the longitudinal axis of the handle of the medical device. In the first position, the end effector may be positioned within the shaft, and in the second position, the end effector may be positioned distally of the shaft.

[0012] Examples of medical systems may additionally and / or alternatively include one or more of the following features. The handle of the medical device may include a channel extending along a longitudinal axis, and the distal end of the plunger may be slidably positioned within a portion of the channel. The distal end of the plunger may rotate about the longitudinal axis of the handle of the medical device relative to a portion of the channel. The plunger may include a plurality of markings. A spring is positioned within the channel. The handle of the medical device may include a plurality of circumferential slots.

[0013] In another example, a method for treating a patient may include positioning an insertion device relative to a position in the patient's body and delivering the medical device through a concave Luer port and a working channel of the insertion device. The method may also include clamping the handle of the medical device to the handle of the insertion device via a clamp on the handle of the insertion device, and simultaneously holding the handle of the insertion device and the handle of the medical device with a single hand. In addition, the method may include axially advancing a plunger of the medical device with a finger of a hand, and extending an end effector of the medical device distal to the working channel of the insertion device.

[0014] Examples of the method may additionally and / or alternatively include one or more of the following features: Rotating a plunger of a medical device and rotating an end effector of the medical device. Axially advancing the plunger and simultaneously rotating the plunger via fingers of a hand. Bending a handle of a medical device.

[0015] Both the foregoing general description and the following detailed description are exemplary and illustrative only and do not limit the claimed features. As used herein, the terms "comprises," "comprising," or other variations thereof are intended to encompass a non-exclusive inclusion, such that a process, method, article, or apparatus that includes a list of elements includes not only those elements, but may also include other elements not expressly listed or inherent to such process, method, article, or apparatus. Additionally, the term "exemplary" as used herein is used herein in the sense of "example," rather than in the sense of an ideal. BRIEF DESCRIPTION OF THE DRAWINGS

[0016] The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate exemplary features of the disclosure and, together with the description, serve to explain the principles of the disclosure.

[0017] Figure 1 An exemplary medical system having an exemplary insertion device and an exemplary medical device arranged to be operated by a single operator is shown;

[0018] Figure 1A Shows Figure 1 A magnified view of a portion A of the medical system;

[0019] Figure 2 Shows Figure 1 A perspective view of an exemplary medical device of ; and

[0020] Figure 3 Arranged for one-handed operation Figure 1 medical system. DETAILED DESCRIPTION

[0021] Examples of the present disclosure relate to medical systems and devices for diagnosing and / or treating an internal region of a subject's body. A medical system may include an insertion device and one or more medical devices operably coupled to the insertion device for introduction of an end effector through the insertion device.

[0022] Reference will now be made in detail to examples of the present invention described above and illustrated in the accompanying drawings. Wherever possible, the same reference numerals will be used throughout the drawings to refer to the same or like parts.

[0023] The terms "proximal" and "distal" are used herein to represent the relative positions of the components of an exemplary medical device or insertion device. When used herein, "proximal" refers to a position relatively closer to the outside of the body or closer to an operator using the medical device or insertion device. In contrast, "distal" refers to a position relatively farther away from an operator using the medical device or insertion device or closer to the inside of the body.

[0024] Figure 1 An exemplary medical system 100 is shown, which includes a handle 102 connected to a shaft 104. Insertion device 100 may include any device configured to allow an operator to perform medical diagnosis and / or treatment on an object. For example, insertion device 100 may include any device configured to allow a user to approach and observe the internal area of ​​the object's body. Additionally or alternatively, insertion device 100 itself may be a medical device and / or include any device configured to deliver one or more medical devices 200 (such as, for example, biopsy forceps, graspers, baskets, snares, probes, scissors, extraction devices, lasers and / or other tools) to the object's body. Insertion device 100 may be inserted into one of various body openings, inner chambers and / or cavities. For example, insertion device 100 may be inserted into any part of the urethra (such as a ureter), a gastrointestinal cavity (such as an esophagus), a vascular cavity and / or an airway.

[0025] According to aspects of the present disclosure, the insertion device 100 can be a ureteroscope. In some contemplated examples, the insertion device 100 can be a sterile, single-use, and disposable ureteroscope. Alternatively, the insertion device 100 can be a multiple-use, non-disposable ureteroscope. However, other types of devices can replace the ureteroscope, including, for example, endoscopes, hysteroscopes, hysteroscopes, bronchoscopes, cystoscopes, and similar devices. Such devices can be single-use and disposable, or multiple-use and non-disposable.

[0026] The handle 102 of the insertion device 100 can have any shape suitable for grasping and controlling the insertion device 100. For example, the handle 102 can have an ergonomic shape designed to be comfortably held in a hand (e.g., the palm of the left hand 304). The shaft 104 can extend from the proximal end 106 to the distal end 108, so that the proximal end 106 of the shaft 104 can be connected to (e.g., removably or permanently connected to) the distal end 112 of the handle 102. The insertion device 100 may include a steering mechanism for deflecting the shaft 104 along one or more planes. For example, the handle 102 may include an actuator 120 that is connected to one or more parts of the shaft 104 at or near the distal end 108 via one or more control members (such as a steering line (not shown)). Any suitable steering mechanism and / or actuator can be used.

[0027] The shaft 104 may include at least one working channel 110 extending between the proximal end 106 and the distal end 108 of the shaft 104. Although only a single working channel 110 is shown, such a description is merely exemplary. For example, the working channel 110 may be a main working channel 110 for delivering one or more medical devices 200, which will be described in further detail below. However, the shaft 104 may include additional channels (not shown) extending between the distal end 108 and the proximal end 106 of the shaft 104. These additional channels may have different shapes and / or sizes. In some examples, the shaft 104 may include one or more electronic devices, such as cameras or other imaging devices, light sources, and / or other sensors (not shown). Additionally or alternatively, one of the additional channels may provide a lumen for steering a control member (not shown) associated with an actuator 120 for steering the shaft 104.

[0028] The handle 102 may also include an umbilical hub or connector 130 for facilitating electrical connections and functions, such as transmitting data and / or powering a light source. Figure 1 and Figure 1AAs shown, the handle 102 may include at least one port connector 150 (e.g., a concave Luer port connector of a T-shape or Y-shape). The port connector 150 may include a first branch 154. The first branch 154 may be fluidically connected to one or more flushing and / or suction fluid sources. Therefore, a flushing fluid (not shown) may be delivered (e.g., pumped) through the working channel 110 via the first branch 154 to provide lubrication and / or assist visualization. The port connector 150 may also include a second branch 152 in communication with the working channel 110, for example, to allow one or more medical devices 200 to be inserted into the distal end 108 of the shaft 104 through the working channel 110. For example, the second branch 152 may include a concave medical (e.g., threaded) or sliding Luer port. The second branch 152 may be connected to an adapter 156, and the end effector 208, control member 206, and / or sheath 204 of the medical device 200 may be delivered to the second branch 152 and the working channel 110 through the adapter 156. The adapter 156 may be, for example, the Urolok Adaptor sold by Boston Scientific Corporation. TM . The adapter 156 may define a channel (not shown) that extends axially through the adapter 156 and has a blade seal (not shown) disposed therein. The blade seal may be made of silicone or a low-durometer rubber material to prevent fluid from flowing back from the subject's body. The blade seal may include a small opening. In order to allow one or more of the end effector 208, the control member 206, and / or the sheath 204 of the medical device 200 to pass through the blade seal of the adapter 156, the introducer 158 may be inserted into the small opening of the blade seal to expand the size (e.g., diameter) of the opening. Once the introducer 158 is located at an appropriate position within the channel of the adapter 156 and the small opening of the blade seal, the blade seal contacts the outer surface of the introducer 158 and seals around it to maintain a fluid seal therebetween. The adapter 156 may also include a supplementary line or conduit 148 extending from the T-connector 146 of the adapter 156. The conduit 148 may be fluidly coupled to one or more flushing and / or suction fluid sources. Thus, in addition to or in lieu of first branch 154 of port coupling 150, an irrigation fluid (not shown) may be delivered (e.g., pumped) through working channel 110 via tubing 148. The end of tubing 148 opposite T-connection 146 may include a stopcock 144. When tubing 148 is not in use, tubing 148 may be sealed via stopcock 144 to prevent fluid leakage.

[0029] The introducer 158 may have a proximal end 160 and a distal end 162 and include an introducer channel 164 extending therebetween. In use, as described above, the distal end 162 of the introducer 158 may be inserted into the adapter 156 to open the blade seal. The introducer 158 may be tapered so that the cross-sectional dimension (e.g., diameter) of the introducer 158 adjacent the proximal end 160 is different from (e.g., larger than) the cross-sectional dimension of the distal end 162 of the introducer 158. That is, the introducer 158 may include a tapered or angled transition portion 166 between the distal end 162 and the proximal end 160 of the introducer 158. In this way, the introducer channel 164 may narrow or taper distally along the length of the introducer 158. Thus, the end effector 208, the control member 206, and / or the sheath 204 may be guided or directed into the working channel 110 through the introducer 158. In the case of a basket or snare, the tapered introducer channel 164 of the introducer 158 may facilitate retraction of the basket or snare end effector 208 into the working channel 110 .

[0030] The handle 102 may also include a mounting bracket, clamp or fixture 170 for selectively coupling and decoupling the medical device 200 to the handle 102. The fixture 170 may include a pair of arms 172 and 174. Each of the arms 172 and 174 may have a first end coupled to the handle 102 in any suitable manner, such as gluing, fastening, tying or any other such mechanical fastening (e.g., screws, pins, etc.). Alternatively, the first end of each of the arms 172 and 174 may be integrally formed as a one-piece construction with the handle 102 via any suitable process (e.g., molding). Additionally, each of the arms 172 and 174 may have a second end opposite the first end that is free or otherwise uncoupled from the handle 102. One or both of the arms 172 and 174 can be semi-rigid, conformable, flexible, or resilient such that one or both of the arms 172 and 174 can pivot, bend, or deflect away from the other of the arms 172 or 174 to increase the intermediate holding space 176 between the arms 172 and 174 when a force is applied. The arms 172 and 174 can define opposing mating surfaces between which the handle 202 of the medical device 200 can be securely held. In some arrangements, the arms 172 and 174 can have a curved or arcuate profile or shape. The placement of the handle 202 of the medical device 200 in the intermediate holding area 176 between the arms 172 and 174 can enable one-handed operation of the medical system 100, as will be described in further detail below.

[0031] In addition to the handle 202, the medical device 200 may include a sheath 204 and an end effector 208 (e.g., a basket, snare, clamp, scissors, laser fiber, and / or needle) located at the distal end of a shaft or control member 206 (e.g., a wire, rod, hypotube, braid, shaft, and / or any other suitable drive member configured to transmit translational and / or rotational forces from its proximal end to its distal end). The end effector 208 may be integrally formed as a one-piece construction with the control member 206, or a separate component coupled to the control member 206 in any suitable manner (e.g., gluing, heat staking, insert molding, etc.). At least a portion of the end effector 208 may be rotatable relative to the sheath 204 and / or the working channel 110 of the shaft 104, such as Figure 1 The end effector 208 can be configured to move between an extended state (not shown) and a retracted state (not shown), which will be described in further detail below. In addition, in some arrangements, the end effector 208 can be radially expandable and retractable. For example, the end effector 208 can include a basket, grasper, or snare formed of a shape memory material such as nitinol. Thus, movement from the retracted state to the extended state can simultaneously cause the end effector 208 to move from a radially contracted configuration (not shown) within the sheath 204 to a radially contracted configuration (not shown) such as Figure 1 104 is a radially expanded configuration outside of the sheath 204 shown. The working length of the sheath 204 can be selected based on the operator's desired manipulation or holding method. For example, in an arrangement in which the medical device 200 is held in one hand while the handle 102 is held in the other hand, the working length of the sheath 204 can be selected to enable the sheath 204 to extend from the handle 202, through the introducer 158, through the adapter 156, through the port coupling 150, and through the working channel 110 to a position flush with the distal-most end of the shaft 104, or slightly recessed or extended relative to the distal-most end of the shaft 104, while achieving sufficient slack for manipulation by the operator. In an arrangement in which the handle 202 of the medical device 200 is coupled to the handle 102 via the clamp 170 ( Figure 3 ), as will be described in further detail below, the working length of the sheath 204 can be reduced because less slack is required for operator manipulation. In an alternative arrangement as described below, the medical device 200 can be directly coupled to the port coupling 150 without the use of the introducer 158 and the adapter 156. Thus, the working length of the sheath 204 can be reduced even further. In any such arrangement, the length of the control member 206 is selected based on the length of the sheath 204.

[0032] Reference Figure 1 and Figure 2, the handle 202 of the medical device 200 can be formed or composed of any suitable material, such as a molded polymer. In some arrangements, the handle 202 can be a molded polymer element having one or more circumferential, circular or spiral (e.g., spiral) shaped cuts, cuts and / or slots 210 extending into the thickness of the handle 202. Such slots 210 can be continuous or discontinuous along the entire axial length of the handle 202 between the proximal end 212 and the distal end 214 of the handle 202 or along any portion of the handle 202. The slots 210 can extend along a plane that is substantially perpendicular to the longitudinal axis 216 of the handle 202. Alternatively, the slots 210 can extend along a plane that is angled relative to the longitudinal axis 216 of the handle 202. As used herein, the terms "approximately," "substantially," and "approximately" can represent a range of values ​​within + / - 5% of the stated value. The slot 210 may be formed via any suitable mechanism, such as a knife, and need not extend through the entire thickness of the handle 210 at any given axial position. The slot 210 imparts flexibility to the handle 202. In use, an operator may grasp the handle 202 in the palm of their hand, and due to the slot 210, the handle 202 may be appropriately bent, conformed, or otherwise deflected to best fit the operator's hand. For example, bending the handle 202 may include moving the proximal end 212 toward or away from the distal end 214 about an axis perpendicular to the longitudinal axis 216. That is, bending the handle may move the proximal end 212 toward the distal end 214 by bending the handle 202. In this way, the handle 202 ergonomically conforms to each operator's hand to achieve comfortable control of the medical device 200. In an alternative arrangement, there is no slot 210 along the handle 202. In such an arrangement, the handle 202 may include a clamshell arrangement in which two halves of the handle 202 are coupled to one another to form the handle 202 .

[0033] The handle 202 may include a lumen 218 extending between the distal end 214 and the proximal end 212 of the handle 202. The lumen may extend along the central longitudinal axis 216 or may be positioned parallel to the central longitudinal axis 216. The lumen 218 may include a first portion 220 and a second portion 222. Figure 2 As shown, the second portion 222 may have a cross-sectional dimension (e.g., diameter) that is greater than the cross-sectional dimension (e.g., diameter) of the first portion 220. The spring 224 may be received within the second portion 222. Thus, the second portion 222 may include a spring chamber. The flange 226 located between the first portion 220 and the second portion 222 may abut the distal end of the spring 224. Thus, the flange 226 may serve as a distal stop for the spring 224. In some arrangements, the distal end of the spring 224 may be fixed to the flange 226.

[0034] The plunger 230 may be movably received within the second portion 222. For example, Figure 2 As shown, the distal end 232 of the plunger 230 can be received and can slide or otherwise move along the central longitudinal axis 216 of the handle 202 to selectively compress the spring 224. The distal end 232 can define a seat 234, and the proximal end of the spring 224 can abut the seat 234 while achieving relative (e.g., rotational) movement between the seat 234 and the spring 224. In this way, the seat 234 can serve as a proximal stopper for the spring 224. The control member 206 of the medical device 200 can extend through the first portion 220 and the second portion 222 and be coupled to the plunger 230. For example, as shown, the control member 206 can extend through the central channel or opening of the spring 224. The proximal end of the control member 206 can be fixedly (e.g., hot melt, glue, suturing, insert molding, etc.) coupled to a portion of the plunger 230 to move therewith. That is, axial advancement, retraction, and rotation of the plunger 230 relative to the central longitudinal axis 216 also results in advancement, retraction, and rotation of the control member 206 and, therefore, the end effector 204, as will be described in greater detail below.

[0035] The plunger 230 may further include markings 240 of the size of the material (e.g., stone) to be removed from the subject's body and the extent of the plunger 230 stroke. The markings 240 may include a first marking band 242 and a second marking band 244. The marking band 242 may have different characteristics (e.g., size, color, pattern, shape and / or texture) than the marking band 244. Thus, an operator can distinguish between the marking band 242 and the marking band 244 to determine the size of the material (e.g., stone) to be removed from the subject and measure the extension of the stroke of the plunger 230, which will be described in further detail below. The proximal end of the plunger 230 may be coupled to (or integrally formed with) a grip, flange, wheel or knob 250 in any suitable manner (e.g., glued, threaded, welded, hot melted, etc.). The knob 250 may include an enlarged surface relative to the rest of the plunger 230 and facilitates the operator to place a finger thereon in order to manipulate the medical device 200, which will be described in further detail below. For example, the knob 250 may include a disk, a ring, or a wheel extending, for example, along an axis perpendicular to the longitudinal axis 216. The knob 250 may include a plurality of grips 252 thereon. As shown, the grips 252 may be equally spaced around the circumferential surface of the knob 250 (e.g., spaced in regular and consistent radial increments), and therefore, may indicate a consistent rotation angle of the plunger 230 and thus the control member 206 and the end effector 208. In other arrangements, the grips 252 may not be equally spaced around the circumferential surface of the knob 250. The grips 252 may have any suitable shape. As shown, for example, the grips 252 may define a raised surface 254 relative to the proximal end of the knob 250.

[0036] The handle 202 may include a proximal male medical (e.g., threaded) or sliding Luer connector 260. The Luer connector 260 may be coupled to a corresponding female medical or sliding Luer connector 262, which in turn is fixedly coupled (e.g., via an adhesive, etc.) to the sheath 204. Thus, the sheath 204 may be securely secured to the handle 202 via the interaction between the male Luer connector 260 and the female Luer connector 262. The male Luer connector 260 may optionally include a wiper seal (not shown) to prevent leakage of fluid when flushing and / or aspirating through the working channel 110. It should be understood that in arrangements using the adapter 156, such an additional wiper seal may not be necessary.

[0037] In use, an operator may deliver an access sheath (not shown) through an opening in a subject and position the distal end of the access sheath at a location within the subject's body. Once in position, the operator may deliver shaft 104 through the lumen of the access sheath and insert medical device 200 through working channel 110. Figure 1 and Figure 2As shown, the operator can hold the handle 102 in the palm of his or her left hand 304, and can hold the handle 202 in the palm of his or her right hand 302, while placing one of his or her right hand fingers (e.g., thumb 310) on the knob 250. Although the following description details the use of the medical system 100 with the handle 202 of the medical device 200 located in the operator's right hand 302 and the handle 102 located in the operator's left hand 304, such description is merely illustrative, and the manner of grasping the handles 102 and 202 may be reversed according to the operator's preference.

[0038] With the handle 202 of the medical device 200 located in the operator's right hand 302, he or she can control all operations of the end effector 208 via a single hand. That is, he or she can apply a force to overcome the bias of the spring 224 to push, push, advance, or otherwise depress the plunger 230 in the direction E so as to move the end effector 208 distal to the shaft 104 and sheath 204 toward the extended state, and in the case of an expandable end effector 208 toward the radially expanded state, as shown. Figure 1 . The second marking band 244 can indicate the full travel or full extension of the end effector 208. That is, the operator can press the plunger 230 in direction E until the second marking band 244 enters the second portion 222 and is no longer visible to the operator, thereby indicating the maximum extension of the end effector 208 relative to the sheath 204 and / or the working channel 110. Due to the spring 224, removing the force on the plunger 230 can cause the plunger 230 to move in the direction E as shown. Figure 1 The spring 224 is retracted in the direction R shown. This retraction can cause the end effector 208 to transition from an extended (and optionally, expanded) state to a retracted (and optionally, radially contracted) state (not shown). It should be understood that the restoring force of the spring 224 can be selected to adjust the stress and strain applied to the distal end of the sheath 204 during material removal or other such operations, and to adjust the force required by the operator to transition the end effector 208 between the retracted state and the extended state. The restoring force can be calculated or estimated by Hooke's law. In some alternative arrangements, the spring 224 can be omitted. In contrast, the plunger 230 and therefore the end effector 208 do not automatically return to the retracted state. Instead, the operator must manually retract or pull the plunger 230 in the direction R in order to move the end effector 208 from the extended state to the retracted state.

[0039] In addition to moving the end effector 208 between the extended and retracted states, the operator may rotate the knob 250 in a clockwise or counterclockwise direction, as indicated by arrow T, to rotate or turn the end effector 208. It should be understood that the end effector 208 may be extended and rotated simultaneously, or retracted and rotated simultaneously.

[0040] The ability to simultaneously extend and rotate or retract and rotate enables the operator to employ a "spin scoop" or "spin drop" action, wherein the end effector 208 (e.g., basket) is positioned such that the end effector 208 (e.g., basket) is moved in a "spin scoop" or "spin drop" motion. Figure 1 , and when the end effector 208 (e.g., basket) is positioned against or contacts tissue or material (e.g., stone), rotation of the end effector 208 will cause one or more portions of the end effector (e.g., basket wire legs) to expand to capture the material in the end effector 208. That is, the operator can extend the end effector 208 distally in the direction E, and push, guide, or otherwise direct a portion of the end effector 208 to contact tissue (e.g., tissue wall, organ wall, body cavity, etc.) within the subject's body. When the end effector 208 (which may include a basket with legs) contacts such tissue, the operator can rotate the end effector 208 by turning the knob 250. Due to the contact between at least a portion of the end effector 208 and such tissue, the rotation of the end effector can cause a portion of the end effector 208 (e.g., the first leg) to expand from another portion (e.g., the second leg) to form a widened opening or space between the first leg and the second leg. The widened space between the first leg and the second leg may allow stones or other such materials to enter the end effector 208 for removal. In a similar manner, any captured material may be released from the end effector 208 by depressing the plunger 230 so that the end effector 208 is positioned against the tissue and rotating the plunger 230 to expand one or more portions (e.g., basket legs) of the end effector 208 to release or drop the captured material (e.g., stones). That is, when the end effector 208 (which may include a basket with legs) is in contact with tissue, the operator may rotate the end effector 208 by turning the knob 250. Due to the contact between at least a portion of the end effector 208 and such tissue, the rotation of the end effector 208 may cause a portion of the end effector 208 (e.g., the first leg) to expand from another portion (e.g., the second leg) to form a widened opening or space between the first leg and the second leg. The widened space between the first leg and the second leg may allow stones or other such materials previously contained within the end effector 208 to be released.

[0041] When a stone or other such material having a size greater than the size of the working channel 110 (e.g., diameter, size) and / or greater than the size of the sheath 204 is captured, the restoring force of the spring 224 retracts the end effector 208 toward the retracted state and holds the stone or other material against the distal-most end of the shaft 104 or sheath 204. The first marker band 242 can indicate the size of the captured stone or material relative to the working channel 110 of the shaft 104 or the sheath 204. For example, if the first marker band 242 remains visible and outside of the second portion 222 when the operator's thumb 310 is released from the knob 250, the captured stone or material is small enough to pass through the access sheath for removal. However, if the first marker band 242 is not visible after the operator's thumb 310 is released from the knob 250, but is instead located in the second portion 222 of the handle 202, the captured stone or other material is too large to pass through the access sheath without fragmentation (e.g., lithotripsy).

[0042] Thus, the operator can extend, retract, and rotate the end effector 208 by manipulating the plunger 230 via his thumb 310 while holding the handle 102 in his other hand. In this way, a single operator can perform an entire medical procedure without an assistant if necessary. In another arrangement, such as Figure 3 As shown, medical device 200 can be coupled to handle 102 of medical system 100 so that both handle 102 and handle 202 can be operated by a single hand of an operator. Figure 3 As shown in , the handle 202 of the medical device 200 can be coupled to the handle 102 of the medical system 100 via the clamp 170. The handle 202 can be received in the intermediate holding space 176 between the arms 172 and 174 to firmly hold the handle 202 therein. In this way, the operator can hold both the handle 102 and the handle 202 with a single hand (such as the right hand 302). The medical device 200 can be actuated in the same manner as described above by the thumb 310 on the knob 250. As described above, the working length of the sheath 204 and the control member 206 can be selected to remove any unnecessary slack, or the slack can be physically adjusted to selectively position the end effector 208. By coupling handle 202 to handle 102, the operator's other hand (e.g., their left hand 304) is free to perform other functions, such as, for example, inserting additional tools through working channel 110, manipulating handle 102 or shaft 104 relative to an entry sheath, holding one or more parts of a subject's body, and / or actuating or discontinuing irrigation or aspiration of fluid.

[0043] As described above, in an alternative arrangement, the medical device 200 may be coupled directly to the port coupling 150 without the use of the introducer 158 and the adapter 156. In this arrangement, relative to Figure 1 and Figure 3 150, the working length of the sheath 204 can be even further reduced. In this arrangement, the male Luer connector 260 of the medical device 200 (with a wiper seal therein) can be directly coupled to the female Luer port coupling 150. Optionally, the extension and retraction of the end effector 208 of the medical device 200 can be controlled via the degree of seating (e.g., threads) between the female Luer connector and the male Luer connector 260 of the port coupling 150. That is, when the male Luer connector 260 is not fully seated or threaded onto the female Luer connector of the port coupling 150, the distal end of the sheath 204 and / or the end effector 208 may not extend distally of the shaft 104, and when the male Luer connector 260 is fully seated or threaded onto the female Luer connector of the port coupling 150, the distal end of the sheath 204 and / or the end effector 208 may extend distally of the shaft 104.

[0044] Furthermore, in any of the arrangements discussed above, the medical device 200 can be a "sheathless" or "sheath-free" medical device 200. A sheathless medical device does not include a sheath 204, a cannula, or other such limiting member positioned around the control member 206 and the end effector 208. As such, when the medical device 200 is positioned in the retracted state, the expandable or otherwise actuatable portion of the medical device 200 (e.g., the end effector 208), if any, can freely expand within the shaft 104 toward the inner circumferential wall of the working channel 110. Thus, rather than movement of the end effector 208 relative to the sheath 204 causing the end effector 208 to move between the extended (and optionally radially expanded) state and the retracted (and optionally radially contracted) state, the end effector 208 of the medical device 200 moves between the extended (and optionally radially expanded) state and the retracted (and optionally radially contracted) state due to interaction between the end effector 208 and the working channel 110.

[0045] Although the principles of the present disclosure are described herein with reference to illustrative examples of specific applications, it should be understood that the present disclosure is not limited thereto. Personnel with ordinary skills in the art and who can obtain the teachings provided herein will recognize that additional modifications, applications, embodiments, and equivalent substitutions all fall within the scope of the features described herein. Therefore, the features claimed should not be considered to be limited by the foregoing description.

Claims

1. A medical system comprising: An insertion device having: handle; as well as a port positioned on the handle of the insertion device and in fluid communication with the working channel of the shaft; and A medical device having: a control member terminating in the end effector; and a handle of the medical device having an inner lumen extending between a distal end and a proximal end of the handle of the medical device and at least one slot positioned along the length of the handle of the medical device, the at least one slot extending to at least one of the proximal end or the distal end and extending into the thickness of the handle of the medical device, the inner lumen comprising a spring, wherein the handle of the medical device is deflectable by means of the at least one slot so that the proximal end of the handle of the medical device is movable toward or away from the distal end of the handle of the medical device about an axis perpendicular to the longitudinal axis of the handle of the medical device; as well as A plunger is movable along a longitudinal axis of the handle of the medical device and is configured to abut a spring within the lumen of the handle of the medical device.

2. The medical system according to claim 1, wherein: The plunger is rotatable about a longitudinal axis of a handle of the medical device.

3. The medical system according to any one of claims 1 to 2, wherein: The plunger includes a plurality of markings.

4. The medical system according to any one of claims 1 to 2, wherein: The at least one slot is angled relative to a longitudinal axis of the handle of the medical device.

5. The medical system according to any one of claims 1-2, wherein: The at least one slot comprises at least one helical slot.

6. The medical system according to any one of claims 1-2, wherein: The at least one slot extends along a plane perpendicular to a longitudinal axis of the handle of the medical device.

7. The medical system according to any one of claims 1-2, wherein: The at least one slot comprises a circumferential slot or a circular slot.

8. The medical system according to any one of claims 1-2, wherein: The at least one slot comprises a cut extending into the thickness of the handle of the medical device.

9. The medical system according to any one of claims 1-2, wherein: The at least one slot includes a plurality of slots.

10. The medical system according to any one of claims 1-2, wherein: The handle of the insertion device includes a clamp on a proximal end thereof, the clamp including a plurality of deflectable arms defining a receiving space therebetween.

11. The medical system according to claim 10, wherein: In the coupled configuration, the handle of the medical device is positioned within the receiving space of the clamp and the medical system is configured for single-handed operation.

12. The medical system according to any one of claims 1-2, wherein: The handle of the medical device includes a flange positioned within the lumen and configured to abut a distal end of the spring.

13. The medical system according to claim 12, wherein: The lumen of the handle of the medical device includes a first portion having a first diameter and a second portion having a second diameter greater than the first diameter, and wherein the flange is positioned between the first and second portions of the lumen.

14. The medical system according to claim 12, wherein: The plunger includes a distal end defining a seat configured to abut a proximal end of a spring within a lumen of a handle of the medical device.

15. The medical system according to any one of claims 1-2, wherein: The at least one slot is continuous and extends along the entire length of the handle of the medical device.

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