Actuation handle for auxiliary device

Abstract

The present invention provides an actuating device, comprising: (a) a device body, which includes a first fixing mechanism configured to attach the proximal end of a first slender member of an auxiliary device to the device body, (b) an actuator, which includes an operable mechanism and a second fixing mechanism configured to attach the proximal end of a second slender member of the auxiliary device to the actuator, wherein the operable mechanism is configured to move the second slender member relative to the first slender member, and (c) a fastener configured to attach the device body to an endoscope. The present invention also provides an endoscope system, which includes this type of actuating device in an assembly having an endoscope and an auxiliary device, and also provides a kit including this type of actuating device and one or more auxiliary devices.

Description

[0001] This application is a divisional application of application No. 201680062292.9, application date 2016.11.21, and application title “Actuating handle for auxiliary device”.

[0002] CROSS-REFERENCE TO RELATED APPLICATIONS

[0003] This application claims priority to U.S. Provisional Patent Application Serial No. 62 / 258,107, filed on November 20, 2015, which is incorporated herein by reference in its entirety. Technical Field

[0004] The present invention generally relates to an actuation device suitable for use in operating an auxiliary device during endoscopic surgery. Background Art

[0005] At present, the operator generally usually actuates the auxiliary device to perform endoscopic surgery with the help of an assistant. Ideally, the operator can operate the endoscope while actuating the auxiliary device. Summary of the invention

[0006] In various aspects, the present invention relates to an actuation device suitable for operating an auxiliary device during endoscopic surgery. The actuation device includes: (a) a device body including a first fixing mechanism configured to attach a proximal end of a first slender member of the auxiliary device to the device body, (b) an actuator including an operable mechanism and a second fixing mechanism configured to attach a proximal end of a second slender member of the auxiliary device to the actuator, wherein the operable mechanism is configured to move the second slender member relative to the first slender member, and (c) a fastener configured to attach the device body to an endoscope.

[0007] In some embodiments, the device body includes an opening that allows access to a working channel of the endoscope.

[0008] In some embodiments that may be used in combination with any of the above aspects and embodiments, the device body may include a protrusion configured to be inserted into a working channel of an endoscope when the device body is attached to the endoscope. In some of these embodiments, the protrusion may include a lumen through which the first and second elongated members of the auxiliary device can pass into the working channel of the endoscope.

[0009] In some embodiments that may be used in combination with any of the above aspects and embodiments, the first mechanism may include a fixing screw or clamp and a through hole, the second mechanism may include a fixing screw or clamp and a through hole or a blind hole, or a combination of the two.

[0010] In some embodiments which may be used in combination with any of the above aspects and embodiments, the second securing mechanism may include an electrical connector configured to electrically connect the second elongated member to the generator.

[0011] In some embodiments, which may be used in combination with any of the above aspects and embodiments, the fastener may include an attachment assembly that extends and snaps onto the endoscope.

[0012] In some embodiments, which may be used in combination with any of the above aspects and embodiments, the device body may be connected to the fastener in a hinged configuration.

[0013] In some embodiments that may be used in combination with any of the above aspects and embodiments, the actuator may be pivotally mounted relative to the device body, and the actuator may include a lever capable of moving the actuator about a pivot axis, such that movement of the lever in a first direction causes the second elongated member to retract relative to the first elongated member, and such that movement of the lever in a second direction opposite to the first direction causes the second elongated member to advance relative to the first elongated member. In some of these embodiments, (a) the actuator may include a protrusion and the device body may include a curved slot in which the protrusion travels when the actuator is rotated about the pivot axis, or (b) the actuator may include a first arm having a lever, and a second arm having a second securing mechanism, or (c) the actuator may further include a spring configured to cause the actuator to reach a default position when the lever is released, or (d) a combination of any two or all three of (a), (b), and (c) above.

[0014] In some embodiments that may be used in combination with any of the above aspects and embodiments, the actuator can be set at multiple fixed positions within the device body. For example, the actuator and the device body can include interlocking stepped ridges, or one of the actuator and the device body can include multiple recesses and the other of the actuator and the device body can include a spring-driven ball that engages the recesses, among other possibilities.

[0015] In some embodiments, which may be used in combination with any of the above aspects and embodiments, the device body may include a port configured to allow entry of a guidewire.

[0016] Other aspects of the invention relate to an endoscope system comprising (a) an endoscope having an endoscope control and a working channel, (b) an actuation device according to any of the above aspects and embodiments attached to the endoscope by a fastener, and (c) an auxiliary device comprising first and second elongated members, the first elongated member attached to the device body by a first fixing mechanism, and the second elongated member attached to the actuator by a second fixing mechanism. The actuation device can be configured so that when it is attached to the endoscope, a user can operate both the endoscope control and the operable mechanism of the actuation device with a single hand.

[0017] In some embodiments that may be used in combination with any of the above aspects and embodiments, the first slender member can be an external slender member having an inner lumen (e.g., in the form of a tube), and the second slender member can be an internal slender member (e.g., in the form of a wire or tube) at least partially disposed within the inner lumen of the external slender member.

[0018] In some embodiments, which may be used in combination with any of the above aspects and embodiments, an auxiliary device may be fed through a working channel of an endoscope.

[0019] In some embodiments, which may be used in combination with any of the above aspects and embodiments, an auxiliary device may be fed alongside the endoscope.

[0020] In some embodiments that may be used in combination with any of the above aspects and embodiments, the auxiliary device may be selected from a knife, a sphincterotomy, a snare, an injection device, and forceps.

[0021] In some embodiments that may be used in combination with any of the above aspects and embodiments, the cutting member may be attached to the distal end of the second slender member so that the cutting member can be exposed when the second slender member is advanced relative to the first slender member, or so that the cutting member can be exposed when the second slender member is retracted relative to the first slender member.

[0022] Further aspects of the present invention may relate to a kit comprising (a) an actuation device according to any one of the above aspects and embodiments and (b) an auxiliary device according to any one of the above aspects and embodiments. BRIEF DESCRIPTION OF THE DRAWINGS

[0023] Figure 1A and 1B is a schematic perspective view of an endoscope handle, a proximal part of an auxiliary device and a braking device according to the present invention, wherein a lever of the actuating device is placed in two positions for actuating the auxiliary device.

[0024] Figure 2A and 2B 2 are front and rear views of an actuating device according to the present invention.

[0025] Figure 3 is a perspective view of an endoscope handle, a proximal portion of an auxiliary device and an actuation device according to the present invention.

[0026] Figure 4 is a view of an endoscope handle, a proximal portion of an auxiliary device and a portion of an actuation device according to the present invention.

[0027] Figure 5A and 5B2 is a view of a distal portion of a sphincterotomy device operable using an actuation device according to the present invention, wherein the sphincterotomy device is shown in non-deployed and deployed configurations, respectively.

[0028] Fig. 6A and 6B are views of a distal portion of an endoscope and an attached cutting blade operable using an actuation device in accordance with the present invention, wherein the cutting blade is shown in non-deployed and deployed configurations, respectively. DETAILED DESCRIPTION

[0029] Various specific aspects and embodiments of the invention are now described. As used herein, the term "distal" refers to the end of the device that is farthest from the medical professional when introduced into the patient, while the term "proximal" refers to the end of the device that is closest to the medical professional when introduced into the patient.

[0030] Now refer to Figure 1A , the actuating device 100 is shown in a state of being coupled to the endoscope 200 and the auxiliary device 132. The actuating device 100 shown includes a device body 110, which in the specific embodiment shown includes a housing portion 110h, a bracket portion 110b, and a link portion 110l that links the housing portion 110h to the bracket portion 110b. The device body 110 also includes a first connection point 110p, where the proximal end of the first elongated member of the auxiliary device 132, specifically, the hollow outer elongated member 132o (e.g., a catheter) in the specific embodiment shown is fixed to the body 110. The connection is made via a first attachment mechanism. For example, a through hole can be formed in the housing portion 110h, and a fixing member (e.g., a fixing screw, a clamp, etc.) can be used to fix the proximal end of the hollow outer elongated member 132o in the through hole.

[0031] In the illustrated embodiment, the actuating device 100 further comprises an operable mechanism, specifically, an actuator 122 pivotally mounted relative to the housing portion 110h. The illustrated actuator 122 comprises a lever 122a capable of rotating the actuator 122 about a pivot 126 (e.g., via a pivot pin). The actuator 122 further comprises a second connection point 122p, wherein a second elongated member of the auxiliary device 132, specifically, a proximal end of an inner elongated member 132i in the particular illustrated embodiment, is attached to the actuator 122. The inner elongated member 132i is slidably disposed within an outer elongated member 132o of the auxiliary device 132. The inner elongated member 132i may be solid (e.g., in the form of a wire) or hollow (e.g., in the form of a tube). The connection is made via a second attachment mechanism. For example, a hole (e.g., a blind hole or a through hole) may be formed in the actuator 122, and a fixing member (e.g., a fixing screw, a clamp, etc.) may be used to fix the proximal end of the inner elongated member 132i in the hole. In this way, an operable mechanism may be provided that is configured to move one elongated member (i.e., the inner elongated member 132i in the illustrated embodiment) relative to another elongated member (i.e., the outer elongated member 132o in the illustrated embodiment).

[0032] In applications where electrosurgery is desired, the actuation device 100 may have an electrically active port so that it can be connected to an electrosurgical generator. In certain of these embodiments, the second attachment mechanism may be provided with a port for electrical connection to the inner elongate member 132i.

[0033] In some embodiments, the actuator 122 may include a first arm corresponding to the joystick 122a and a second arm provided with a second connection point 122p , wherein the proximal end of the inner elongated member 132i of the auxiliary device 132 is attached to the actuator 122 .

[0034] In addition to the foregoing components, the actuation device 100 may also include a fastener 112 configured to attach the device body 110 to the endoscope 200 at a point adjacent to the endoscope handle. Examples of fasteners for this purpose include, for example, bands (e.g., elastic bands, VELCRO hook and loop fastening bands, etc.), snap clamps, and form-fitting grooves, among other possibilities.

[0035] Use as Figure 1A and 1B , rotation of the actuator 122 about the pivot 126 and relative to the device body 110 causes the inner elongated member 132i (which is fixed to the actuator 122) to move relative to the outer elongated member 132o (which is fixed to the device body 110). In the particular embodiment shown, as Figure 1BAs shown, pulling the joystick 122a toward the endoscope 200 causes the inner elongated member 132i to advance distally relative to the outer elongated member 132o, and as shown in FIG. Figure 1A Pushing the joystick 122a away from the endoscope 200 is shown causing the inner elongate member 132i to retract proximally relative to the outer elongate member 132o.

[0036] As will be appreciated by one of ordinary skill in the art, the distance that the inner elongated member 132i moves relative to the outer elongated member 132o is determined by the degree (angle) of rotation of the actuator 122 about the pivot 126 and the distance between the second connection point 122p and the pivot 126 .

[0037] Thus, by attaching the outer elongated member 132o to the housing 110h of the device body 110 and by attaching the inner elongated member 132i that travels within the outer elongated member 132o to the pivoting actuator 122, rotation of the actuator 122 can actuate the desired effect.

[0038] Although in the illustrated embodiment pulling the lever 122a advances the inner elongated member 132i relative to the outer elongated member 132o and pushing the lever 122a retracts the inner elongated member 132i relative to the outer elongated member 132o, those skilled in the art will appreciate that in other arrangements, such as Figure 4 As shown, pulling the joystick 122a will retract the inner elongated member 132i relative to the outer elongated member 132o, and pushing the joystick 122a will advance the inner elongated member 132i relative to the outer elongated member 132o. As discussed in more detail below, this advancement and retraction can be used to actuate various auxiliary devices 132 during endoscopic surgery.

[0039] In some embodiments, the actuation device 100 will further include a spring or another mechanism configured to cause the actuator 122 to a default position when the lever 122a is released. For example, the default position may correspond to the position of the actuator 122 when the inner elongated member 132i is retracted relative to the outer elongated member 132o. Alternatively, the default position may correspond to the position of the actuator 122 when the inner elongated member 132i is advanced relative to the outer elongated member 132o, or a position therebetween. In a specific example, the default position may correspond to the position of the actuator 122 when an implement (knife, needle, etc.) disposed at the distal end of the inner elongated member 132i is retracted within the outer elongated member 132o.

[0040] In some embodiments, the actuation device 100 will further include a port configured to allow for the entry of a guidewire. In applications where a guidewire is used in conjunction with the auxiliary device 132, a separate guidewire port may be provided in the actuation device 100 to allow for the entry of a guidewire.

[0041] In some embodiments, the actuator 122 (and thereby the position of the inner elongated member 132i relative to the outer elongated member 132o) can be set in any of a number of different positions. For example, the actuator 122 can be maintained at a desired position relative to the housing portion 110h via a releasable locking mechanism, for example, by providing the actuator 122 and the housing portion 110h with interlocking stepped ridges (e.g., similar to the complementary ridges of a hemostat). Once released, the actuator 122 can, in some embodiments, return to a default position via a spring mechanism as discussed above. As another example, the joystick actuator 122 can include a plurality of recesses and the housing portion 110h can include a spring-actuated ball (e.g., in the form of a ball-tipped spring plunger, etc.) that engages the recesses, or conversely, the housing portion 110h can include a plurality of recesses and the actuator 122 can include a spring-actuated ball that engages the recesses.

[0042] Now combine Figure 2A and 2B The actuator 100 is described as follows Figure 1A and 1B More details are shown. Shown are the components of the device body 110, specifically the housing portion 110h, the bracket portion 110b and the link portion 110l, which are fixed to each other and can be easily formed as a single piece if desired. Figure 2A As can be seen, the fastener 112 configured to attach the device body 110 to the endoscope is in the form of a piece that stretches and snaps onto the endoscope body. The fastener 112 is linked to the bracket 110b via a hinge in the illustrated embodiment, which allows the fastener 112 to hinge about the endoscope body 220. In addition, a protrusion 128 configured to be inserted into the working channel of the endoscope 200 is also seen, and the actuating device 100 is attached thereto. In certain embodiments, an opening is provided in the actuating device 100 that allows an auxiliary device 132 to enter the working channel of the endoscope. In the illustrated embodiment, a lumen extends from a proximal point 127p to a distal point 127d at the distal end of the protrusion 128, and the auxiliary device 132 can penetrate the lumen. Figure 3 The layout can be further understood with the help of Figure 3 The actuator 100 is shown attached to the endoscope body 220 via the fastener 112. The protrusion 128 is not visible because it is inserted into the port of the working channel 210 of the endoscope, and the auxiliary device 132 is introduced into the working channel 210 by looping the auxiliary device 132 into the lumen entrance at point 128p. In this way, the auxiliary device 132 can be looped around from the bottom of the actuator 100 to the top of the actuator 100 to enter the working channel 210, among other possibilities.

[0043] If you can Figure 3As can be seen, the actuator 100 allows the endoscopist to control both the endoscope 200 and the auxiliary device 132 using one hand. In this way, the endoscopist can manipulate and deploy the auxiliary device 132 without the help of an assistant. In this regard, the present invention solves the inconvenience of the endoscopist having to rely on an assistant to operate the auxiliary device, thereby allowing the endoscopist to fully control the endoscope and the auxiliary device. In this way, the endoscopist can easily and comfortably switch between using the features of the endoscope (e.g., water diversion, suction, aspiration, left / right movement, up / down movement, endoscope locking, etc.) and operating the auxiliary device with one hand. This also allows the endoscopist's other hand to be free to continue to manipulate the sheath of the endoscope.

[0044] Although the auxiliary device 132 Figure 3 In the embodiment of the present invention, the auxiliary device 132 is determined to be routed through the working channel 210 of the endoscope 200, but in other embodiments, the auxiliary device 132 can be routed beside the endoscope (e.g., along the length of the endoscope body 220) rather than in the working channel 210 of the endoscope. In these embodiments, the actuation device can be provided with a through hole or clip for auxiliary device management. In various embodiments, the auxiliary device 132 can be longer than the endoscope body 220 to allow the physician to push the auxiliary device 132 over the distal end of the endoscope body and pull it back as needed.

[0045] Now refer to Figure 2B , the housing portion 110h, the bracket portion 110b and the link portion 1101 of the device body 110 can be seen. A first connection point 110p is further shown, where the proximal end of the hollow outer elongated member 132o is fixed to the body 110. Also shown is the portion of the actuator 122 that is pivotally mounted relative to the housing portion 110h, specifically the lever 122a used to rotate the actuator 122 about the pivot 126 (in this particular case, it is in the form of a pivot pin). Also shown is a second connection point 122p, where the proximal end of the inner elongated member 132i (in the form of an actuation wire) is attached. In this particular embodiment, the actuation wire is attached via a two-in-one active cord connector 123, which is screwed into the D-block 127 until the actuation wire is fixed in place. Therefore, in this embodiment, the connector plays the role of both a mechanical connector and an electrical connector (e.g., a monopolar electrical connector). In addition, the connector also forms a protrusion that travels within a slot 119 formed in the housing 110h. The slot 119 limits the travel of the protrusion, thereby limiting the rotation of the actuator within the housing 110h.

[0046] Auxiliary devices that can be actuated by the actuation device of the present invention include those used in conjunction with various surgeries, including, for example, endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD), polypectomy, colonoscopy, transurethral surgery, respiratory surgery, and laparoscopic surgery, among others.

[0047] One specific example of an auxiliary device 132 is a sphincterotomy. Figure 5A-5B 132a, the sphincterotomy device 132 is shown with its distal end shown in FIG. 132. The sphincterotomy device 132 includes an outer elongated member 132o (i.e., a catheter) and an inner elongated member 132i (i.e., a pull wire) emerging from the outer elongated member 132o at a point 132p near its distal end. As previously described, the outer elongated member 132o and the inner elongated member 132i are connected to the actuation device 100. When the joystick 122a of the actuation device 100 is positioned so that the inner elongated member 132i is advanced distally relative to the outer elongated member 132o, the sphincterotomy device 132 appears as shown in FIG. Figure 5A On the other hand, when the joystick 122a of the actuator 100 is positioned so that the inner elongated member 132i is retracted proximally relative to the outer elongated member 132o, the distal tip of the sphincterotomy device 132 is as shown. Figure 5B The bend is shown exposing the distal end of the inner elongate member 132i which serves as a cutting wire. Electrical current may be passed through the exposed wire during the cutting procedure, for example, by establishing a monopolar connection to an electrosurgical generator using an electrical connector as previously described.

[0048] If desired, the auxiliary device 132 may be configured such that the default position of the joystick is a position in which the inner elongate member 132i is advanced relative to the outer elongate member 132o, resulting in a default position of the sphincterotomy device 132 such as: Figure 5A Such an auxiliary device 132 may be routed alongside the endoscope or routed through the working channel of the endoscope.

[0049] In the previous examples of sphincterotomes, the auxiliary device 132 is deployed by retracting the inner elongated member 132i relative to the outer elongated member 132o. In other cases, the auxiliary device 132 is deployed by advancing the inner elongated member 132i relative to the outer elongated member 132o. In this regard, turning Figure 6A-6B, another example of an auxiliary device 132 is shown in the form of a cutting knife. As previously described, the auxiliary device 132 includes an inner elongated member 132i (i.e., wire) and an outer elongated member 132o (i.e., catheter) connected to the actuation device 100 at a proximal end (not shown). As shown, the distal end of the auxiliary device 132 can be reversibly attached to the distal end 200d of the endoscope via a ring 135, wherein the auxiliary device 132 travels outside the endoscope 200 rather than being routed through the working channel of the endoscope, although a similar auxiliary device 132 can be routed through the working channel if desired.

[0050] When the lever 122a of the actuation device 100 is positioned so that the inner elongated member 132i is retracted proximally relative to the outer elongated member 132o, the auxiliary device 132 appears as shown in FIG. Fig. 6A On the other hand, when the operating rod 122a of the actuating device 100 is positioned so that the inner elongated member 132i is advanced distally relative to the outer elongated member 132o, the cutting knife 136 disposed at the distal end of the inner elongated member 132i extends from the distal end 132od of the outer elongated member 132o, as shown in FIG. Figure 6B Electrical current may be passed through the exposed cutting blade 136 during the cutting process, for example, by establishing a monopolar connection to an electrosurgical generator as previously described.

[0051] If desired, the actuation device may be configured such that the default position of the joystick 122a is a position in which the inner elongated member 132i is retracted relative to the outer elongated member 132o, resulting in the default position of the auxiliary device 132 being such as Fig. 6A The action of engaging the lever 122a (e.g., squeezing the lever 122a or pushing the lever 122a, depending on the configuration) deploys the cutting knife 136 beyond the distal end 132od of the outer elongated member 132o, thereby exposing the cutting knife 136 for use. For safety reasons, releasing the lever 122a places the cutting knife 136 in its default retracted position.

[0052] In other embodiments, the actuator 100 may be coupled to an auxiliary device 132, which includes an articulated hook or grasper at the distal end. Similar to the above-mentioned sphincterotomy device, the joystick 122a can be used to engage the distal tool to one side, wherein the internal elongated member 132i is disposed at an eccentric position (e.g., in an eccentric lumen). In other embodiments, the actuator 100 can be used to deploy a clip, can be used to deploy a band during EMR, or can be used to deploy a stent. In other embodiments, the actuator 100 can be used to inject a solution, for example, for contrast or for elevating a lesion and many other possible applications. In other embodiments, the actuator 100 can be used to actuate a snare (including a hot snare) or actuate a hot or cold biopsy forceps. In other embodiments, the actuator 100 can be used to actuate a catheter (e.g., AlairTM bronchial thermoforming system, Boston Scientific Corporation, Marlborough MA), a medical laser probe (e.g., a thulium laser system), or a mechanical scissors.

[0053] In some embodiments, the actuation device can be made universal so that different auxiliary devices can be easily attached thereto. In this way, when the doctor switches tools, the handle can remain in place when exchanging auxiliary tools.

[0054] Although the apparatus, components and methods of the present invention have been described in terms of preferred embodiments, it will be apparent to those skilled in the art that changes may be made without departing from the concept, spirit and scope of the present invention. It will be apparent to those skilled in the art that all such similar substitutions and modifications are considered to be within the spirit, scope and concept of the present invention as defined by the appended claims.

Claims

1. An actuating device, include: a device body including a curved slot on a surface thereof and a first securing mechanism configured to attach a proximal end of a first elongated member of an auxiliary device to the device body; and an actuator comprising an operable mechanism and a second securing mechanism configured to attach a proximal end of a second elongated member of the auxiliary device to the actuator, wherein movement of the operable mechanism from a first position to a second position is configured to move the second elongated member distally relative to the first elongated member, and movement of the operable mechanism from the second position to the first position is configured to move the second elongated member proximally relative to the first elongated member, wherein the operable mechanism pivots about a point offset from the longitudinal axes of the first and second elongate members, wherein the protrusion of the second fixing mechanism is configured to move from a first end of the curved slot to a second end of the curved slot, and The distance from the first end to the second end defines a maximum distance that the second elongated member can move relative to the first elongated member.

2. An actuation device as described in claim 1, wherein the device body includes an opening that allows access to a working channel of an endoscope, and wherein the device body includes a port configured to allow entry of a guide wire.

3. An actuation device as described in claim 2, wherein the device body includes a protrusion configured to be inserted into the working channel of the endoscope when the device body is attached to the endoscope.

4. The actuation device of claim 3, wherein the protrusion includes an inner lumen, and wherein the first and second elongated members of the auxiliary device are capable of passing through the inner lumen into the working channel of the endoscope.

5. The actuation device of any one of claims 1-4, further comprising a fastener having an attachment assembly that extends and snaps onto the endoscope.

6. An actuating device as described in claim 5, wherein the attachment assembly includes a hinge having a hinge rotation axis parallel to the extension direction of the endoscope attached to the actuating device, and wherein the hinge is configured to rotate the device body around the hinge rotation axis.

7. An actuating device as described in any one of claims 1 to 4, wherein the actuator is pivotally mounted relative to the device body, and wherein the actuator includes a rod that enables the actuator to move about a pivot axis.

8. An actuating device as described in any one of claims 1 to 4, wherein the actuator can be set at multiple fixed positions within the device body.

9. The actuating device according to any one of claims 1 to 4, wherein the first fixing mechanism comprises a fixing screw or a clamp and a through hole, wherein the second fixing mechanism comprises a fixing screw or a clamp and a through hole or a blind hole, or both.

10. The actuation device of any one of claims 1-4, wherein the second securing mechanism comprises an electrical connector configured to electrically connect the second elongated member to a generator.

11. The actuation device of claim 1 further comprising a biasing member configured to bias the actuator in the first position, wherein the operable mechanism is configured to move from the first position to the second position in response to the operable mechanism receiving a force sufficient to overcome the force of the biasing member.

12. An actuating device as described in claim 11, wherein the proximal end of the actuator is pivotally mounted to the device body, and wherein the distance between the distal end of the actuator and an endoscope fastened to the actuating device decreases as the actuator moves from the first position to the second position.

13. An endoscope system, include: an endoscope having endoscope controls and a working channel; An actuation device as claimed in any one of claims 1 to 12, attached to the endoscope; an auxiliary device comprising a first elongated member attached to the device body by the first securing mechanism and a second elongated member attached to the actuator by the second securing mechanism; The actuation device is configured to enable a user to operate both the endoscope controls and the operable mechanism of the actuation device with a single hand.

14. The endoscopic system of claim 13, wherein the first elongated member is an outer member having a lumen, and the second elongated member is an inner member at least partially disposed within the lumen of the outer member.

15. The endoscopic system of claim 13 or 14, wherein the auxiliary device is fed through a working channel of the endoscope, and wherein the auxiliary device is selected from the group consisting of a knife, a sphincterotomy, a snare, an injection device, and forceps.

16. An endoscopic system as described in claim 13 or 14, wherein a cutting member is attached to the distal end of the second slender member, and wherein the cutting member is exposed when the second slender member is advanced relative to the first slender member, or wherein the cutting member is exposed when the second slender member is retracted relative to the first slender member.

17. A kit comprising an actuation device as claimed in any one of claims 1 to 12 and an auxiliary device having the first elongated member and the second elongated member.

18. An actuating device, include: a device body including a first securing mechanism configured to attach a proximal end of a tube of an auxiliary device to the device body; and a rod configured to be attached to a proximal end of a wire of the assistive device at a connection point, wherein movement of the rod from a first position to a second position is configured to move the wire distally relative to the tube, and movement of the rod from the second position to the first position is configured to move the wire proximally relative to the tube, wherein the rod pivots about a point offset from the line and the longitudinal axis of the tube, and Wherein the protrusion of the connection point is configured to move from a first end of a curved slot located on a surface of the device body to a second end of the curved slot, and wherein the distance from the first end to the second end defines a maximum distance that the wire moves relative to the tube.

19. The actuation device of claim 18, further comprising a spring configured to bias the lever in the first position, wherein the lever is configured to move from the first position to the second position in response to the lever receiving a force sufficient to overcome the force of the spring.

20. An actuation device as claimed in claim 18 or 19, wherein the device body includes an opening defining the curved slot.

21. An endoscope system, include: an endoscope having endoscope controls and a working channel; An actuation device as claimed in any one of claims 18 to 20, attached to the endoscope; and an auxiliary device comprising said tube and said wire, The actuation device is configured to enable a user to operate both the endoscope controls and the lever of the actuation device with a single hand.

22. A kit comprising an actuation device as claimed in any one of claims 18 to 20 and an auxiliary device having said tube and said line.

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