Distal end piece of access assembly of endoscope, access assembly and method of using the same

Abstract

A distal end piece of an access assembly of an endoscope is provided, comprising: a tubular housing configured to be connected to the distal end of the access assembly at its proximal end; and a plurality of sealing flaps arranged at the distal end of the tubular housing. The plurality of sealing flaps can be opened and closed to respectively open and seal the distal end of the access assembly, and at least one of the plurality of sealing flaps comprises a fluid nozzle configured to spray fluid toward the proximal direction of the distal end piece, a fluid inlet configured to receive fluid, and a fluid channel that fluidly connects the fluid inlet and the fluid nozzle. Also provided is an access assembly comprising the above-mentioned distal end piece, and a method for cleaning an endoscope using the same.

Description

Technical Field

[0001] The present application relates to a distal end piece of an access assembly of an endoscope, an access assembly including the distal end piece, and a method for using the access assembly. Background Art

[0002] Minimally invasive surgical procedures such as endoscopic surgery reduce the invasiveness of the surgical procedure. Endoscopic surgery involves surgical procedures through the body wall, for example, to observe and / or operate on the ovaries, uterus, gallbladder, intestines, kidneys, appendix, etc. There are many common endoscopic surgical methods, including arthroscopy, laparoscopy, gastroenteroscopy, and laryngobronchoscopy, for example. In these methods, a trocar is used to create an incision through which endoscopic surgery is performed. The trocar tube or access assembly extends into the body cavity and remains in the body cavity to provide an access port for endoscopic surgical tools. A camera or endoscope is inserted through the access assembly to allow visual inspection and magnification of the body cavity. The surgeon can then diagnose and / or treat at the surgical site with the aid of specialized instruments (such as forceps, graspers, cutters, applicators, etc.) designed to be matched with additional sleeves.

[0003] During use, the lens of the endoscope may become covered by condensation, tissue, blood, other body fluids, etc. in the body cavity. Therefore, it is difficult to keep the lens of the endoscope clean during surgery. Conventionally, the surgeon (such as, the endoscope operator) withdraws the endoscope from the incision on the patient's body via the access component, cleans the lens with pre-prepared physiological saline at body temperature, then wipes the endoscope body with disinfectants such as iodine tincture, and reinserts it into the incision on the patient's body via the access component. During the surgical procedure, the time required to clean the lens may increase the total time of the operation and the amount of time the patient needs to maintain anesthesia, and because the endoscope needs to be repeatedly withdrawn and inserted into the incision on the patient's body, this may lead to an increased risk of infection and increased recovery time. Although there are currently some access components that can flush the lens of the endoscope with liquid in the body cavity, these access components are not accepted by most surgeons and have not been promoted and applied because they directly discharge the flushing liquid and condensation, tissue, blood and other body fluids into the patient's body cavity. It can be seen that there is a need in the art for an improved access assembly that can easily and quickly clean the lens of an endoscope during surgery without introducing additional flushing fluid or dirt into the patient's body cavity. Summary of the invention

[0004] According to one aspect of the present application, a distal end piece of an access assembly of an endoscope is disclosed. The distal end piece includes: a tubular housing and a plurality of sealing flaps. The tubular housing is configured to be connected to the distal end of the access assembly at its proximal end, and the plurality of sealing flaps are arranged at the distal end of the tubular housing. The plurality of sealing flaps are configured to be openable and closable to respectively open and seal the distal end of the access assembly, and at least one of the plurality of sealing flaps includes a fluid nozzle configured to spray fluid toward the proximal direction of the distal end piece, a fluid inlet configured to receive fluid, and a fluid channel that fluidly connects the fluid inlet and the fluid nozzle.

[0005] According to some embodiments, in the open state of the sealing flap, the sealing flap blocks the fluid passage.

[0006] According to some embodiments, the fluid nozzle is proximate to the longitudinal axis of the tubular housing.

[0007] According to some embodiments, each of the plurality of sealing petals is a mountain-like shape protruding toward the proximal direction of the distal end member. The mountain-like shape has the same fan-shaped shape that equally divides the cross section of the tubular housing, and there is a gap between each pair of adjacent two sealing petals.

[0008] According to some embodiments, each of the plurality of sealing petals comprises a ridge extending in the radial direction of the tubular housing and a first curved surface portion and a second curved surface portion symmetrically arranged on both sides of the ridge. The first curved surface portion and the second curved surface portion form an angle less than 180° at the ridge to form a mountain-like shape.

[0009] According to some embodiments, the fluid jet, the fluid inlet and the fluid channel are arranged in the ridge, and the fluid inlet is coplanar with the outer wall of the tubular housing.

[0010] According to some embodiments, the ridge includes an indentation disposed on the distal surface, such that when the sealing flap is in an open state, the sealing flap bends at the indentation to block the fluid passage.

[0011] According to some embodiments, at least one of the plurality of sealing petals includes a boss disposed at least at at least one radial edge thereof, the boss protruding toward the proximal side of the distal end piece and extending along the at least one radial edge.

[0012] According to some embodiments, the boss includes a scraper disposed proximal to the longitudinal axis of the tubular housing, the scraper protruding toward the proximal side of the distal end piece and extending along a portion of the boss.

[0013] According to some embodiments, the plurality of sealing petals includes four sealing petals.

[0014] According to some embodiments, the distal piece is formed of silicone.

[0015] According to another aspect of the present application, an access assembly for receiving an endoscope is disclosed. The access assembly for receiving an endoscope comprises a tubular body for receiving the endoscope and a distal end piece according to any embodiment of the above aspects connected to the distal end of the tubular body. The outer wall of the tubular housing of the distal end piece forms a seal with the inner wall of the tubular body.

[0016] According to some embodiments, the access assembly further comprises a fluid supply passage. The fluid supply passage comprises a fluid receiving port, a fluid outlet, and a fluid conduit connecting the fluid receiving port to the fluid outlet. The fluid outlet is on the inner wall of the tubular body and is in fluid communication with the fluid inlet of the distal piece.

[0017] According to some embodiments, the access assembly further comprises a vacuum passage. The vacuum passage comprises a vacuum port, a vacuum suction port, and a vacuum line fluidically connecting the vacuum port with the vacuum suction port. The vacuum suction port is on the inner wall of the tubular body.

[0018] According to another aspect of the present application, a method for using an access assembly of an endoscope is disclosed. The method includes: providing an access assembly according to any embodiment of the above aspects; connecting a fluid supply passage of the access assembly to a fluid source; connecting a vacuum passage of the access assembly to a vacuum source; retracting the distal end of the endoscope from the distal end piece to the interior of the tubular body of the access assembly so that a plurality of sealing flaps of the distal end piece are closed to seal the distal end of the access assembly; and ejecting a fluid from a fluid nozzle onto a lens at the distal end of the endoscope through the fluid supply passage, and then removing the fluid through the vacuum line.

[0019] In some embodiments, the method further includes: extending the distal end of the endoscope from the distal piece so that the multiple sealing petals of the distal piece gradually open and abut against the outer wall of the endoscope to form a seal, and block the fluid channel of the sealing petals to stop the injection of fluid from the fluid nozzle. BRIEF DESCRIPTION OF THE DRAWINGS

[0020] Various aspects of the disclosed systems and methods are described herein below with reference to the accompanying drawings, in which:

[0021] Figure 1 is a side cross-sectional view of a distal end member according to an embodiment of the present application;

[0022] Figure 2 yes Figure 1 A top side perspective view of the distal end member;

[0023] Figure 3 yes Figure 1 A bottom-up side perspective view of the distal end member;

[0024] Figure 4 yes Figure 1 A top view of the distal end member in FIG.

[0025] Figure 5 is a side cross-sectional view of an access assembly according to an embodiment of the present application;

[0026] Figure 6 yes Figure 5 A partially enlarged side cross-sectional view of the dotted line portion of the access component in the observation state; and

[0027] Figure 7 yes Figure 5 A partially enlarged side cross-sectional view of the dashed portion of the access assembly in the cleaning state. DETAILED DESCRIPTION

[0028] The distal end piece, access assembly and method of use thereof for cleaning the lens of an endoscope during surgery are described in detail with reference to the accompanying drawings, wherein the same reference numerals refer to the same or corresponding elements in each of the several views. As used herein, the term "distal" refers to a direction in which an endoscope, a portion of an access assembly or a component thereof is farther from an operator (e.g., a physician) (e.g., a doctor). Figure 1 , Figure 5-7 For example, "distal" refers to the direction in which the endoscope is inserted, and "distal end" refers to one end of the endoscope in the direction of insertion; and the term "proximal" refers to the direction in which the endoscope, the portion of the access assembly, or its components are closer to the operator (such as, Figure 1 , Figure 5-7 In some embodiments, the term "endoscope" refers to any device used to observe a patient's body cavity through a small diameter incision or cannula, such as a laparoscope, an arthroscope, a gastroenteroscope, a laryngeal bronchoscope, etc., for observing the patient's body cavity through a small diameter incision or cannula. As used herein, the term "approximately" means that the value is approximate and small changes will not significantly affect the practice of the aspects disclosed in the present disclosure. Where numerical limitations are used, unless the context indicates otherwise, "approximately" means that the value can vary by ±10% and still be within the scope of the present disclosure.

[0029] According to the present disclosure, during a surgical operation, the lens of an endoscope can be cleaned in real time and efficiently without removing the endoscope from the access assembly as a whole.

[0030] One aspect of the present application relates to a distal piece 100 for receiving an access assembly 200 of an endoscope 300, which is mounted at the distal end of the access assembly 200, which enables cleaning of the endoscope 300, such as a lens at the distal end of the endoscope 300, during use of the endoscope. Figure 1 is a side cross-sectional view of the distal end member 100 according to an embodiment of the present application, Figure 2 The interception is taken in the direction shown by the dotted line BB. Figure 2yes Figure 1 A top side stereoscopic view of the distal end piece 100 in FIG. Figure 3 yes Figure 1 A bottom-side stereoscopic view of the distal end piece 100 in FIG. Figure 4 yes Figure 1 A top view of the distal end piece 100 in FIG.

[0031] like Figures 1 to 4 As shown, the distal member 100 includes a tubular housing 110 and a plurality of sealing petals 120. The tubular housing 110 includes an outer wall 112 and an inner wall 114, and the outer diameter of the outer wall 112 corresponds to the inner diameter of the inner wall surface 232 of the tubular body 230 of the access assembly 200 as will be described in more detail later. As an example, the outer diameter of the outer wall 112 of the tubular housing 110 of the distal member 100 is substantially equal to or slightly larger than the inner diameter of the inner wall surface 232 of the tubular body 230 of the access assembly 200, so that when the distal member 100 is installed on the inner wall surface 232, the outer wall 112 is sealed with the inner wall surface 232.

[0032] A plurality of sealing flaps 120 are disposed at the distal end of the tubular housing 110. The plurality of sealing flaps 120 are configured to be closable to seal the distal side of the tubular housing 110 and the distal end of the access assembly 200, and to be openable to allow the distal end 320 of the endoscope 300 to pass therethrough, as will be described in more detail below. In some embodiments, when the plurality of sealing flaps 120 are closed, each of the plurality of sealing flaps 120 is located near the longitudinal axis ( Figure 1 The tip of the dashed line Z-Z' in FIG. 1 is closed at, for example, Figure 1 In some embodiments, when the sealing flaps are closed and / or when the sealing flaps are open and sealed against the outer wall of the endoscope 300, the plurality of sealing flaps 120 prevent fluid (e.g., gas, liquid, or a gas-liquid two-phase mixture) from passing through in any direction. In other embodiments, when the sealing flaps are closed and / or when the sealing flaps are open and sealed against the outer wall of the endoscope 300, the plurality of sealing flaps 120 prevent fluid from passing through in only one direction. These two configurations of the plurality of sealing flaps 120 and their advantages will be described in detail below. Figure 6 to Figure 7 The method of using the access component 200 is further described in detail.

[0033] At least one of the plurality of sealing petals 120 includes a fluid inlet 132, a fluid orifice 136, and a fluid passage 134 that fluidly connects the fluid inlet 132 to the fluid orifice 136. The fluid orifice 136 is configured to eject fluid along the proximal direction of the distal member 100, such as Figure 1 As shown by arrow A in FIG. 1 , the fluid nozzle 136 is in fluid communication with the fluid inlet 132 via the fluid passage 134 in the sealing flap 120 where the fluid nozzle 136 is located. The fluid inlet 132 is used to receive the fluid into the sealing flap 120 so as to be ejected from the fluid nozzle 136 .

[0034] In some embodiments, when the plurality of sealing flaps 120 are opened to a certain angle (e.g., sufficient to allow the endoscope 300 to pass) at the apex 140 of the distal member 100, the fluid channel 134 is blocked, thereby disconnecting the fluid connection between the fluid nozzle 136 and the fluid inlet 132. In this case, the fluid received from the fluid inlet 132 cannot reach the fluid nozzle 136, so that the injection of the fluid from the fluid nozzle 136 is automatically stopped without additionally operating a switch and / or valve of the fluid source. As an example, the blocking of the fluid channel 134 can be achieved by bending the tip portion of the sealing flap 120 close to the longitudinal axis of the distal member 100 radially outward to clamp the fluid channel 134 when the sealing flap 120 is opened.

[0035] In some embodiments, the fluid jet 136 is located radially close to the longitudinal axis of the distal member 100 and parallel to the longitudinal axis of the distal member 100. In this case, the fluid ejected from the fluid jet 136 is closer to the longitudinal axis of the inner wall surface 232 of the tubular body 230 of the access assembly 200. Conventionally, during the surgical procedure, the endoscope 300 is centrally disposed in the tubular body 230 of the access assembly 200. Therefore, the fluid ejected close to the longitudinal axis can improve the cleaning effect by directly flushing the lens of the endoscope 300.

[0036] It should be understood that although Figures 1 to 4 The plurality of sealing flaps 120 are shown as 4 sealing flaps, but the distal end member 100 according to the present application is not limited thereto. In some embodiments, the plurality of sealing flaps 120 include 3 to 12 sealing flaps, for example, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 sealing flaps. The number of the plurality of sealing flaps 120 can be selected based on factors such as the outer diameter of the outer wall of the endoscope 300, the inner diameter of the tubular body 230 of the access assembly 200, and the elasticity of the material of the sealing flaps 120, so as to obtain the best sealing effect for the endoscope 300. In addition, it should be understood that although Figures 1 to 4 It is shown that only one of the plurality of sealing flaps 120 includes a set of fluid inlet 132, fluid channel 134 and fluid nozzle 136, but the distal end member 100 according to the present application is not limited thereto and may include a plurality of sets of fluid inlet 132, fluid channel 134 and fluid nozzle 136, the number of which may be as many as the number of the plurality of sealing flaps 120. In this case, the plurality of fluid nozzles 136 may be arranged at different radial positions to improve the overall cleaning effect from the center to the edge of the distal end of the endoscope.

[0037] like Figures 2 to 3 As shown, each of the plurality of sealing petals 120 is generally mountain-shaped, with the middle portion of the circumference extending toward the proximal direction of the distal end member 100 ( Figure 1The upper part of the mountain is bulging (in the upward direction shown in the figure), forming a "mountain-like" shape with high in the middle and low on both sides, high on the outside and low on the inside. Figure 4 yes Figure 1 The projection of the distal end piece 100 on a plane perpendicular to the longitudinal axis ZZ' is the circular cross section of the tubular housing 110 of the distal end piece 100. Figure 4 As shown, the plurality of sealing petals 120 collectively present a circular shape corresponding to the inner wall 114 of the tubular housing 110 of the distal end piece 100 in this projection and cross section. As an example, Figure 4 In the figure, the plurality of sealing flaps 120 are shown as 4 sealing flaps 120, which divide the circular shape in the projection and cross section into four equal parts, and each sealing flap 120 is a fan-shaped shape with a vertex angle of 90° in the projection and cross section. It can be understood that when the distal end member 100 has n sealing flaps 120, each sealing flap 120 is a fan-shaped shape with a vertex angle of 360° / n in the projection and cross section. There is a gap 160 between each pair of adjacent two sealing flaps 120. In the projection and cross section, the gap 160 partially extends from the vertex 140 of the distal end member 100 to the inner wall 114 of the tubular housing 110 in the radial direction. In some embodiments, as will be described in more detail later, since the outer diameter of the endoscope 300 is smaller than the inner diameter of the access assembly 200 and the inner diameter of the distal end member 100, the length of the gap 160 matches the outer diameter of the endoscope 300, and does not extend completely to the inner wall 114 of the tubular housing 110, thereby achieving a good sealing effect.

[0038] In some embodiments, such as top-down stereoscopic Figure 2 As shown, the sealing flap 120 includes a first curved surface portion 124 and a second curved surface portion 126 arranged symmetrically, which intersect at a ridge 122. The ridge 122 extends radially outward ( Figure 1 in the direction perpendicular to the paper plane, and Figure 4 The upward direction shown in the figure) and the near direction ( Figure 1 The first curved surface portion 124 and the second curved surface portion 126 extend from the vertex 140 of the distal end member 100 to the inner wall 114 of the tubular housing 110 in the upward direction shown in the figure, thereby forming the above-mentioned "mountain-like" shape. In some embodiments, the first curved surface portion 124 and the second curved surface portion 126 are planes, curved surfaces or a combination thereof. In some embodiments, the first curved surface portion 124 and the second curved surface portion 126 form an angle less than 180°, such as 30° to 170°, such as 60° to 150°, such as 90° to 120°, etc., so that when the external part of the distal end member 100 is observed along the radial inward direction, the first curved surface portion 124 and the second curved surface portion 126 of each sealing flap 120 generally present an "A-shaped" (or "inverted V-shaped") shape, such as the stereoscopic side view of the distal end member 100. Figure 3 As shown in the top view Figure 4As shown, in the projection and cross section perpendicular to the longitudinal axis of the distal end member 100, the ridge 122 divides the fan-shaped shape of the sealing flap 120 into two equal fan-shaped shapes at the angle of the vertex. Figure 4 In the illustrated embodiment, the distal end piece 100 has four sealing flaps 120, each of which has a fan-shaped shape with a 90° vertex angle in the projection and cross section. In this case, the ridge 122 divides each sealing flap 120 into two fan-shaped shapes with a 45° vertex angle in the projection and cross section. When the sealing flap 120 is opened, the ridge 122 can at least partially alleviate or avoid the deflection of the sealing flap 120 in the circumferential direction, so that the sealing flap 120 is limitedly opened in the radially outward direction to improve the sealing effect on the outer wall of the endoscope 300. In addition, when the plurality of sealing flaps 120 are opened, the first curved surface portion 124 and the second curved surface portion 126 angled at the ridge 122 can be gradually flattened against the outer wall of the endoscope 300 to provide sufficient contact surface area between the plurality of sealing flaps 120 and the outer wall of the endoscope 300, thereby ensuring a good seal with the outer wall of the endoscope 300.

[0039] In some embodiments, Figures 2 to 4 As shown, in the sealing flap 120 including the fluid nozzle 136, the fluid inlet 132 and the fluid channel 134, the fluid nozzle 136, the fluid inlet 132 and the fluid channel 134 are arranged in the ridge 122' of the sealing flap 120. In some embodiments, the fluid nozzle 136 is arranged at a position of the ridge 122' close to the apex 140 of the distal member 100, such as Figure 2 and Figure 4 In some embodiments, the fluid inlet 132 is arranged at the radial distal end of the ridge 122' to be exposed on the outer surface of the distal member 100 and coplanar with the outer wall 112 of the tubular housing 110 of the distal member 100, as shown in FIG. Figure 1 and Figure 3 As shown. The fluid channel 134 connects the fluid nozzle 136 to the fluid inlet 132. In some embodiments, as will be described in more detail below, when the distal member 100 is mounted on the distal end of the access assembly 200, the fluid inlet 132 is connected to the fluid outlet 216 on the inner wall surface 232 of the tubular body 230 of the access assembly 200 by sealing the outer wall 112 of the tubular housing 110 of the distal member 100 to the inner wall surface 232 of the tubular body 230 of the access assembly 200, so as to receive the fluid from the access assembly 200.

[0040] In some embodiments, Figure 3As shown, the ridge 122' in the sealing flap 120 including the fluid nozzle 136, the fluid inlet 132 and the fluid channel 134 has a notch 128 on the distal surface. The wall thickness of the ridge 122' at the position of the notch 128 is thinner than that at other positions, so when the sealing flap 120 is opened, the ridge 122' is bent more at the position of the notch 128 than at other positions, so that the fluid channel 134 can be clamped to block the fluid communication between the fluid nozzle 136 and the fluid inlet 132 to stop the fluid from being ejected from the fluid nozzle 136, as will be described in more detail later. In this case, after the endoscope 300 is cleaned, when the endoscope 300 is extended from the distal end 100, the fluid ejection can be automatically stopped due to the clamping of the fluid channel 134, without the need to manually operate a switch or valve of a fluid source (e.g., a fluid pump, a saline bottle, etc.).

[0041] In some embodiments, Figure 2 As shown, at least one of the sealing flaps 120 further includes a boss 150, which is arranged at at least one of the two edges of each sealing flap 120 and extends from the apex 140 of the distal member 100 to the inner wall 114 of the tubular housing 110. Figure 4 As shown, in the projection and cross section perpendicular to the longitudinal axis of the distal piece 100, the boss 150 is arranged at two radii of the fan-shaped shape of the sealing flap 120 in the projection and cross section, and extends from the center (apex 140) to the inner wall 114 of the tubular housing 110 in the radial direction along the entirety of the two radii. As will be described in more detail later, when the endoscope 300 is extended or retracted, the boss 150 gradually opens or closes against the outer wall of the endoscope 300 as the sealing flap 120 opens or closes, respectively, to improve the sealing effect of the multiple sealing flaps 120 at the apex 140 of the distal piece 100. In some embodiments, the boss 150 has a scraper 152 at a position close to the longitudinal axis of the distal piece 100, and the scraper 152 protrudes on the boss 150 toward the proximal side of the distal piece 100, as shown in FIG. Figure 2 In the projection and cross section perpendicular to the longitudinal axis of the distal end member 100, the scraper 152 partially extends from the apex 140 of the distal end member to the inner wall 114 of the tubular housing 110 in the radial direction, as shown in FIG. Figure 4 As described above, when the endoscope 300 is extended or retracted, the boss 150 gradually opens or closes against the outer wall of the endoscope 300 as the sealing flap 120 opens or closes, and the scraper 152 also gradually opens or closes against the outer wall of the endoscope 300, thereby scraping off most of the liquid attached to the outer wall of the endoscope 300. In some cases, the scraping process can form a liquid film on the lens surface of the endoscope 300, thereby extending the anti-fogging time of the lens.

[0042] In some embodiments, the distal end piece 100 including the plurality of sealing flaps 120 and the tubular housing 110 may be formed by integral molding of a silicone material to provide good sealing performance, biocompatibility, and soft and flexible properties. In other embodiments, the plurality of sealing flaps 120 and the tubular housing 110 of the distal end piece 100 may also be formed of other materials having similar properties and characteristics, such as elastic plastic or silicone rubber elastic material.

[0043] Another aspect of the present application relates to an access assembly 200 having the above-mentioned distal end piece 100 installed as a part thereof. The access assembly 200 according to the present application enables intraoperative cleaning of the distal end of the endoscope 300, such as the lens, without removing the endoscope 300 from the access assembly 200. Figure 5 is a side cross-sectional view of an access assembly 200 for receiving an endoscope 300 installed with a distal end piece 100 according to an embodiment of the present application. Figure 6 yes Figure 5 A side cross-sectional view of the access assembly 200 in the observation state. Figure 7 yes Figure 5 A side cross-sectional view of the access assembly 200 in a cleaned state.

[0044] like Figure 5 As shown, the access assembly 200 has a generally cylindrical tubular body 230, a proximal portion 250 at the proximal end of the tubular body 230, a distal piece 100 installed at a distal position of the tubular body 230, and a terminal 240 at the distal end of the tubular body 230. The inner diameter of the inner wall surface 232 of the tubular body 230 is slightly larger than the outer diameter of the outer wall of the endoscope 300, thereby receiving the endoscope 300. The distal piece 100 is installed at a distal position of the inner wall surface 232 of the tubular body 230. The inner diameter of the inner wall surface 232 of the tubular body 230 corresponds to (e.g., substantially equal to or slightly smaller than) the outer diameter of the outer wall 112 of the tubular housing 110 of the distal piece 100, thereby forming a good seal between the distal piece 100 and the tubular body 230. The proximal portion 250 at the proximal end of the tubular body 230 is used to receive the endoscope 300 and may have a seal (not shown) to form an additional seal with the outer wall of the endoscope 300. The tip 240 at the distal end of the tubular body 230 may have a truncated cylindrical shape so as to be inserted into a body cavity from an incision on the patient's body.

[0045] Further references Figure 5, the access component 200 has a fluid supply passage, including a fluid receiving port 212 for connecting to a fluid source (not shown) to receive fluid, a fluid outlet 216 for providing fluid to the fluid inlet 132 of the distal member 100, and a fluid conduit 214 that fluidly connects the fluid receiving port 212 with the fluid outlet 216. In some embodiments, the fluid conduit 214 is formed between the inner wall surface 232 and the outer wall (not marked) of the tubular body 230 of the access component 200, thereby improving the integrity of the access component 200 and eliminating the need to provide additional conduits. In some embodiments, the fluid outlet 216 is an orifice, which is provided on the inner wall surface 232 of the tubular body 230 and is located at an axial position corresponding to the fluid inlet 132 of the distal member 100. In this case, when the distal member 100 is mounted on the inner wall surface 232 of the tubular body 230 of the access component 200, it is necessary to align the fluid inlet 132 of the distal member 100 with the fluid outlet 216 as the orifice in the circumferential direction. In other embodiments, the fluid outlet 216 is an annular groove formed on the inner wall surface 232 of the tubular body 230, which is also provided on the inner wall surface 232 of the tubular body 230 and is located at an axial position corresponding to the fluid inlet 132 of the distal piece 100. In this case, when the distal piece 100 is installed on the inner surface of the tubular body 230 of the access assembly 200, it is not necessary to adjust the orientation of the fluid inlet 132 of the distal piece 100 in the circumferential direction, thereby making the installation more convenient.

[0046] In some embodiments, the fluid provided by the fluid source is a continuous liquid, which can be achieved by a simple physiological saline bottle, for example. In other embodiments, the fluid provided by the fluid source is a pulse of liquid, such as an intermittent liquid stream, thereby improving the efficiency of cleaning. In other embodiments, the fluid provided by the fluid source is a gas-liquid two-phase flow, to further improve the effect of cleaning.

[0047] Continue to refer Figure 5 , the access assembly 200 has a vacuum passage, including a vacuum port 222 for connecting to a vacuum suction source (not shown, such as a vacuum pump, a vacuum source as a hospital infrastructure), a vacuum suction port 226 for providing vacuum suction to the interior of the tubular body 230 of the access assembly 200, and a vacuum line 224 for fluidly connecting the vacuum port 222 with the vacuum suction port 226. Although Figure 5 The vacuum suction port 226 is shown as being arranged at the proximal end of the tubular body 230 close to the access assembly 200, but the access assembly 200 according to the present application is not limited thereto and may also be arranged in the middle or near the distal end of the tubular body 230 of the access assembly 200. It should be understood that during the process of performing surgery using the endoscope 300 and the access assembly 200 according to the present application, in order to facilitate observation of the required field of view, the endoscope 300 may be oriented to be partially upright (i.e., as shown in FIG. 1 ). Figure 5 In the illustrated orientation, the proximal end is above the distal end), substantially horizontal, or even partially inverted (i.e., the proximal end is below the distal end). In the case of different orientations of the endoscope 300, fluid or liquid may accumulate at different positions inside the tubular body 230 of the access assembly 200 due to gravity. Accordingly, the vacuum suction port 226 is disposed at a position where the fluid or liquid is likely to accumulate, so as to more easily suck the fluid or liquid out of the interior of the tubular body 230. At the same time, since the distal end piece 100 has a fluid nozzle 136 located at a position radially close to the longitudinal axis, and the direction of fluid ejection from the fluid nozzle 136 is parallel to the longitudinal axis, the fluid can be ejected onto the distal end of the endoscope 300 to clean its lens regardless of the orientation of the endoscope 300.

[0048] In some embodiments, the distal end piece 100 installed at the distal end position of the inner wall of the tubular body 230 of the access assembly 200 can disconnect the fluid connection of the fluid channel 134 when the plurality of sealing flaps 120 are opened to a certain angle (e.g., sufficient to allow the endoscope 300 to pass) at the apex 140 of the distal end piece 100. In this case, since the disconnection of the fluid connection of the fluid channel 134 can be achieved by the distal end piece 100 itself, the fluid source connected to the fluid receiving port 212 does not need to provide a switch / valve, thereby simplifying the facilities and accessories required for the operation. In some embodiments, the access assembly 200 may also have a passage (not shown) similar to the endoscope access assembly of the prior art to provide fluid (e.g., gas and / or liquid) or vacuum suction, thereby improving the compatibility with the use method of the access assembly of the prior art.

[0049] Yet another aspect of the present application relates to a method for cleaning an endoscope 300 during surgery using the access assembly 200 described above. Figure 6 yes Figure 5 A partially enlarged side cross-sectional view of the dotted portion of the access component 200 in the observation state. Figure 7 yes Figure 5 200 in a partially enlarged side cross-sectional view of the dashed line portion of the access assembly 200 in the cleaning state. During the use process (e.g., using the endoscope for surgery), the endoscope 300 is connected to the proximal end 250 ( Figure 6 and Figure 7 (not shown) is received in the tubular body 230 of the access assembly 200. Figure 6As shown, in the observation state, the distal end 320 of the endoscope 300 is extended out of the access assembly 200 through the distal end piece 100 (as shown by arrow C), for example, into the patient's body cavity (such as, the abdominal cavity) to observe the field of view. During the process of extending the endoscope 300, the plurality of sealing flaps 120 of the distal end piece 100 are opened against the outer wall of the endoscope 300, and are sealed to the outer wall of the endoscope 300 at the gaps 160 between the plurality of sealing flaps 120. Optionally, the optional bosses 150 of the sealing flaps 120 assist in improving the sealing effect on the outer wall of the endoscope 300 when the endoscope 300 passes through the plurality of sealing flaps 120, and the sealing effect at the apex 140 of the distal end piece 100 when the plurality of sealing flaps 120 are closed. During the extension of the endoscope 300 through the plurality of sealing flaps 120, the optional scraper 152 on the optional boss 150 of the sealing flap 120 at least partially scrapes the liquid at the distal end 320 of the endoscope 300 and forms a liquid film, thereby improving the anti-fogging performance and duration. In addition, during the extension of the endoscope 300 through the plurality of sealing flaps 120, the ridge 122 of the sealing flap 120 prevents the sealing flap 120 from deflecting in the circumferential direction when opening, thereby avoiding the reduction of the sealing effect on the outer wall of the endoscope 300 due to the circumferential deflection. In addition, when the plurality of sealing flaps 120 are opened, the first curved surface portion 124 and the second curved surface portion 126 angled at the ridge 122 can be gradually flattened against the outer wall of the endoscope 300 to provide sufficient contact surface area between the plurality of sealing flaps 120 and the outer wall of the endoscope 300, thereby ensuring a good seal with the outer wall of the endoscope 300.

[0050] In some embodiments, in the observation state, the fluid channel 134 blocks the fluid communication between the fluid nozzle 136 and the fluid inlet 132, so that the fluid injection stops automatically without manually closing the fluid source or the valve or switch associated therewith. In some embodiments, this is achieved by the indentation 128 on the distal surface of the ridge 122' of the sealing flap 120 of the distal member 100. When the distal end 320 of the endoscope 300 extends out of the access assembly 200 through the distal member 100, the plurality of sealing flaps 120 open to a certain angle to allow the distal end 320 of the endoscope 300 to pass through. At this time, the ridge 122' is bent at the position of the indentation 128 so that the fluid channel 134 is clamped, thereby blocking the fluid communication between the fluid nozzle 136 and the fluid inlet 132.

[0051] When the lens of the distal end 320 of the endoscope 300 is fogged or contaminated by condensation, tissue, blood, other body fluids, etc., causing blurred vision, the distal end 320 of the endoscope 300 can be cleaned during surgery. Figure 7As shown in FIG. 1 , in the cleaning state, the distal end 320 of the endoscope 300 is retracted from the outside of the access assembly 200 (e.g., the patient's body cavity, such as the abdominal cavity) into the tubular body 230 of the access assembly 200 (as shown by arrow D). During the retraction of the distal end 320 of the endoscope 300, the plurality of sealing flaps 120 of the distal end piece 100 gradually close against the outer wall of the endoscope 300 to seal the distal end of the access assembly 200. At this time, the sealing flaps 120 of the distal end piece 100 are restored from the open bent state to the closed initial state (as shown in FIG. 1 ). Figure 1-4 128 ), so that the previously clamped fluid channel 134 is restored to a conductive state. In this case, the fluid channel 134 connects the fluid nozzle 136 with the fluid inlet 132, so that the fluid from the fluid source is sequentially ejected toward the proximal direction of the distal member 100 through the fluid receiving port 212, the fluid line 214 and the fluid outlet 216 of the access component 200 and the fluid inlet 132, the fluid channel 134 and the fluid nozzle 136 of the distal member 100 (as shown by arrow E) to the distal end 320 of the endoscope 300, thereby washing away the dirt (e.g., condensate, tissue, blood, other body fluids, etc.) on the distal end 320. Then, the fluid mixed with dirt in the tubular body 230 of the access component 200 sequentially leaves the access component 200 through the vacuum suction port 226, the vacuum line 224 and the vacuum port 222 under the action of the suction source. In some embodiments, as described above, in the observation state, the fluid ejection is stopped by clamping the fluid channel 134 at the indent 128. In this case, the fluid source can remain operational and connected to the fluid receiving port 212 of the fluid supply passage of the access assembly 200. Accordingly, after the endoscope 300 is retracted, the sealing flap 120 is restored from the open bent state to the closed initial state (eg, Figure 1-4 As shown in the figure, the fluid passage 134 is reopened, so that fluid injection can be started automatically without manually starting the fluid source or operating the valve or switch associated therewith.

[0052] After cleaning is completed, the distal end 320 of the endoscope 300 is extended out of the access assembly 200 through the distal end member 100 (eg, Figure 6 During the extension process, the plurality of sealing flaps 120 of the distal end piece 100 and their ridges 122, 122', the optional indentations 128, the optional bosses 150 and the optional scrapers 152 on the bosses 150 interact with the endoscope 300 as described above with reference to Figure 6The same as described above. In some embodiments, the completion of the cleaning can be determined based on the duration of the cleaning, the clarity of the image captured by the lens of the endoscope 300, and the cleanliness of the fluid leaving the vacuum port 222 of the access assembly 200. After the endoscope 300 is extended, the observation state is re-entered. In some embodiments, in the observation state, the fluid injection is automatically stopped, as described above.

[0053] In some embodiments, in the observation state (i.e., the state in which the plurality of sealing flaps 120 are opened and sealed to the outer wall of the endoscope 300) and / or in the cleaning state, the plurality of sealing flaps 120 of the distal member 100 prevent fluid (i.e., gas and / or liquid) from passing through in any direction. In other words, the fluid in the tubular body 230 of the access assembly 200 cannot pass through the seals between the plurality of sealing flaps 120 or between the plurality of sealing flaps 120 and the outer wall of the endoscope 300 to the outside of the distal end of the access assembly 200 (e.g., to the body cavity of the patient), and the fluid outside the distal end of the access assembly 200 (e.g., the body cavity of the patient) cannot pass through the seals between the plurality of sealing flaps 120 or between the plurality of sealing flaps 120 and the outer wall of the endoscope 300 to the inside of the tubular body 230 of the access assembly 200. In this case, the interior of the tubular body 230 of the access assembly 200 can be completely isolated from the outside of the distal end of the access assembly 200 (e.g., the body cavity of the patient). In other embodiments, in the observation state and / or the cleaning state, the plurality of sealing flaps 120 of the distal member 100 only unidirectionally prevent the passage of fluid (i.e., gas and / or liquid). In other words, the fluid in the tubular body 230 of the access component 200 cannot pass through the seals between the plurality of sealing flaps 120 or between the plurality of sealing flaps 120 and the outer wall of the endoscope 300 to the outside of the distal end of the access component 200 (e.g., to the body cavity of the patient), but when there is a vacuum in the tubular body 230 relative to the outside of the distal end of the access component 200, the fluid outside the distal end of the access component 200 (e.g., gas used for artificial pneumoperitoneum, such as CO2) can pass through the seals between the plurality of sealing flaps 120 or between the plurality of sealing flaps 120 and the outer wall of the endoscope 300 to the inside of the tubular body 230 of the access component 200. In this case, the access assembly 200 can be allowed to serve as a path for the gas (such as CO2) used for artificial pneumoperitoneum to leave the patient's body cavity, thereby maintaining the circulation of the gas in the body cavity and its positive pressure relative to the operating room environment, and using the gas flow to at least partially blow away the liquid on the distal end 320 of the endoscope 300. In any case, the seal between the multiple sealing flaps 120 and the outer wall of the endoscope 300 can ensure that the cleaning fluid and the dirt (e.g., condensate, tissue, blood, other body fluids, etc.) removed from the distal end 320 of the endoscope 300 will not move outside the distal end of the access assembly 200, such as into the patient's body cavity.

[0054] It should be understood that various modifications may be made to the disclosed methods and systems. Therefore, the above description should not be construed as limiting, but merely as an example of aspects of the present disclosure. Other modifications within the scope and spirit of the present disclosure will be contemplated by those skilled in the art. For example, any and all features of an aspect described may be appropriately integrated into another aspect.

Claims

1. A distal end member of an access assembly of an endoscope, characterized in that: include: a tubular housing configured to be connected at its proximal end to the distal end of the access assembly; as well as A plurality of sealing flaps are disposed at the distal end of the tubular housing, the plurality of sealing flaps being configured to be openable and closable to respectively open and seal the distal end of the access assembly, at least one of the plurality of sealing flaps comprising: a fluid nozzle configured to eject fluid proximally of the distal member; a fluid inlet configured to receive the fluid; and a fluid passage fluidly connecting the fluid inlet and the fluid nozzle, When the sealing flap is opened, the sealing flap blocks the fluid passage. The fluid channel is configured so that when the distal end of the endoscope extends from the distal piece, the plurality of sealing petals of the distal piece gradually open and abut against the outer wall of the endoscope to form a seal, and the fluid channel is clamped to block the fluid channel.

2. The distal piece of claim 1, wherein the fluid jet is proximate to a longitudinal axis of the tubular housing.

3. The distal end piece according to any one of claims 1 to 2, wherein each of the plurality of sealing petals is in a mountain-like shape that bulges proximally toward the distal end piece, the mountain-like shape has the same fan-shaped shape in the cross-section of the tubular shell that equally divides the cross-section of the tubular shell, and there is a gap between each pair of adjacent two sealing petals.

4. The distal end piece according to claim 3, wherein each of the plurality of sealing petals comprises a ridge extending radially along the tubular shell and a first curved surface portion and a second curved surface portion symmetrically arranged on both sides of the ridge, wherein the first curved surface portion and the second curved surface portion form an angle less than 180° at the ridge to form the mountain-like shape.

5. The distal piece of claim 4, wherein the fluid jet, the fluid inlet, and the fluid passage are arranged in the ridge, and the fluid inlet is coplanar with an outer wall of the tubular housing.

6. The distal piece according to claim 5, wherein the ridge comprises a dimple provided on the distal surface, so that when the sealing flap is in an open state, the sealing flap bends at the dimple to block the fluid passage.

7. The distal end piece according to claim 3, wherein at least one of the plurality of sealing petals comprises a boss disposed at least at at least one radial edge thereof, the boss protruding toward the proximal side of the distal end piece and extending along the at least one radial edge.

8. The distal end piece according to claim 7, wherein the boss includes a scraper blade disposed near the longitudinal axis of the tubular housing, the scraper blade protruding toward the proximal side of the distal end piece and extending along a portion of the boss.

9. The distal piece according to any one of claims 1 to 2, wherein the plurality of sealing petals comprises four sealing petals.

10. The distal piece according to any one of claims 1 to 2, wherein the distal piece is formed of silicone.

11. An access assembly for receiving an endoscope, comprising: a tubular body for receiving an endoscope; and a distal end piece according to any one of claims 1 to 10 connected to the distal end of the tubular body, The outer wall of the tubular housing of the distal piece forms a seal with the inner wall of the tubular body.

12. An access component according to claim 11, wherein the access component further comprises a fluid supply passage, the fluid supply passage comprising a fluid receiving port, a fluid outlet and a fluid conduit connecting the fluid receiving port with the fluid outlet fluid, the fluid outlet being on the inner wall of the tubular body and connected with the fluid inlet fluid of the distal piece.

13. The access component according to claim 12, wherein the access component further comprises a vacuum passage, the vacuum passage comprising a vacuum port, a vacuum suction port and a vacuum line fluidically connecting the vacuum port with the vacuum suction port, the vacuum suction port being on the inner wall of the tubular body.

14. A method of using an access assembly of an endoscope, comprising: Providing an access assembly according to claim 13; connecting the fluid supply passage of the access assembly to a fluid source; connecting the vacuum passage of the access assembly to a vacuum source; retracting the distal end of the endoscope from the distal end piece into the interior of the tubular body of the access assembly so that the plurality of sealing petals of the distal end piece close to seal the distal end of the access assembly; and The fluid is ejected from the fluid nozzle onto the lens at the distal end of the endoscope through the fluid supply passage, and then the fluid is removed through the vacuum line.

15. The method according to claim 14, further comprising: The distal end of the endoscope is extended from the distal piece, so that the multiple sealing petals of the distal piece gradually open and abut against the outer wall of the endoscope to form a seal and block the fluid channel of the sealing petals, so that the injection of the fluid from the fluid nozzle stops.

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