Endoscope curved section

Abstract

An endoscope system is provided having a bending section that can be bent in four directions independently of a rotatable viewing configuration of the endoscope system. A method of using the endoscope system in a patient's body is further provided.

Description

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS

[0002] This application claims priority to U.S. Provisional Application Serial No. 63 / 044,506, filed on June 26, 2020, the entire contents of which are hereby incorporated by reference. Technical Field

[0003] The present disclosure relates to medical devices. More particularly, the present disclosure relates to curved segments for endoscope systems. Background Art

[0004] The statements in this section merely provide background information related to the present disclosure and may not constitute prior art.

[0005] A duodenoscope is a medical device used in various endoscopic procedures, including endoscopic retrograde cholangiopancreatography ("ERCP"). During ERCP, a physician inserts a duodenoscope into the patient's mouth, through the patient's gastrointestinal ("GI") tract, and into the duodenum until the distal end of the duodenoscope is positioned near the papilla of Vater, a small hillock-like structure that serves as the entrance to the duodenum from the common bile duct and pancreatic duct. The physician then uses various tools and accessories that are passed through the lumen in the duodenoscope to access the common bile duct or pancreatic duct through the papilla of Vater.

[0006] However, there are several design issues with duodenoscopes. For example, due to the location of the papilla of Vater and the shape of the duodenoscope, endoscopic tools or accessories must be bent sharply at (or sometimes exceeding) a 90-degree angle at the distal end of the duodenoscope, which results in significant friction between the tool and the duodenoscope and an accompanying loss of force transmission. Therefore, the accessories must be durable enough to withstand this sharp bend, and the physician must apply more force than required to continue advancing the tool. Further, the built-in camera system of the duodenoscope is lateral, making it difficult for novice and even experienced physicians to maneuver the duodenoscope through the GI tract. Moreover, conventional duodenoscopes have only one accessory channel, making the use of multiple accessories time-intensive and cumbersome. In addition, duodenoscopes are difficult to clean, which may lead to inadequate cleaning of the device after use and may lead to patient bacterial contamination during subsequent use of the duodenoscope.

[0007] It would be desirable to have an endoscopic system that eliminates or reduces the force transmission losses of a duodenoscope.It would be desirable to have an endoscopic system that provides improved and easier maneuverability through and within the GI tract.

[0008] All endoscopes should include a mechanism to bend the distal end so that the physician can steer the endoscope to scan the GI lumen and manipulate GI anatomy. The joint of the curved section is intact over the entire circumference of the distal-proximal longitudinal axis of the curved section. However, such a curved section does not allow the accessory channel to bend outward so that the curved section can advantageously switch between forward and side viewing angles. Further, such a curved section may be experimentally inefficient when deflected with appropriate degrees of freedom to cannulate the duodenum. Accordingly, for certain practical applications, a 4-way deflection of the joint with a "U" shaped profile may be preferred. Therefore, there remains a need for further contributions in this area of ​​technology. Summary of the Invention

[0009] In one form of the present disclosure, a scopist system is provided. The scopist system includes an elongated tube including a lumen extending therethrough and a distal portion. The scopist system further includes at least one accessory channel, the at least one accessory channel including a tubular structure including an accessory lumen extending therethrough, the at least one accessory channel being movably disposed at least partially within the lumen, the at least one accessory channel including a distal segment. The scopist system further includes a first control wire connected to the distal portion of the elongated tube and extending proximally along the elongated tube. The scopist system further includes a second control wire connected to the distal portion of the elongated tube and extending proximally along the elongated tube parallel to the first control wire. The scopist system further includes a third control wire connected to the distal portion of the elongated tube and extending proximally along the elongated tube parallel to the first control wire and the second control wire. The endoscope system further includes a fourth control wire connected to the distal portion of the elongated tube and extending proximally along the elongated tube parallel to the first control wire, the second control wire, and the third control wire. Proximal movement of the first control wire causes the distal portion to bend in a first direction. Proximal movement of the second control wire causes the distal portion to bend in a second direction, which is opposite to the first direction. Proximal movement of the third control wire causes the distal portion to bend in a third direction, which is perpendicular to the first direction and perpendicular to the second direction. Proximal movement of the fourth control wire causes the distal portion to bend in a fourth direction, which is opposite to the third direction.

[0010] According to another aspect of the present disclosure, a scopist system is provided. The scopist system includes an elongated tube including a lumen extending therethrough and a distal portion, the distal portion including circumferentially discontinuous ribs, each of the circumferentially discontinuous ribs including a rib opening, the rib openings of the circumferentially discontinuous ribs being coaxial. The scopist system further includes a tubular structure including an accessory lumen extending therethrough, each of the circumferentially discontinuous ribs surrounding at least one accessory channel, the at least one accessory channel being movably disposed at least partially within the lumen, the at least one accessory channel including a distal segment. The scopist system further includes a first control wire connected to the distal portion of the elongated tube and extending proximally along the elongated tube. The scopist system further includes a second control wire connected to the distal portion of the elongated tube and extending proximally along the elongated tube parallel to the first control wire. The endoscope system further includes a third control wire connected to the distal portion of the elongated tube and extending proximally along the elongated tube parallel to the first control wire and the second control wire. The endoscope system further includes a fourth control wire connected to the distal portion of the elongated tube and extending proximally along the elongated tube parallel to the first control wire, the second control wire, and the third control wire. Proximal movement of the first control wire causes the distal portion to bend in a first direction. Proximal movement of the second control wire causes the distal portion to bend in a second direction, which is opposite to the first direction. Proximal movement of the third control wire causes the distal portion to bend in a third direction, which is perpendicular to the first direction and perpendicular to the second direction. Proximal movement of the fourth control wire causes the distal portion to bend in a fourth direction, which is opposite to the third direction. The at least one accessory channel is reversibly removable from the internal cavity of each of the plurality of circumferentially discontinuous ribs through the rib opening.

[0011] According to another aspect of the present disclosure, a method for using an endoscope system is provided. The method includes the steps of inserting an endoscope system into a patient's body, the endoscope system including an elongated tube including a lumen extending therethrough, the elongated tube further including a distal portion; at least one accessory channel, the at least one accessory channel including a tubular structure including an accessory lumen extending therethrough, the at least one accessory channel being movably disposed at least partially within the lumen, the at least one accessory channel including a distal segment; and parallel control wires, each of the parallel control wires being connected to the distal portion of the elongated tube and extending proximally along the elongated tube, wherein individual proximal movement of one or more of the parallel control wires causes the distal portion to bend in one of a first direction, a second direction, a third direction, and a fourth direction, the second direction being opposite to the first direction, the third direction being perpendicular to the first direction and perpendicular to the second direction, and the fourth direction being opposite to the third direction. The method further includes the step of moving one or more of the parallel control wires so as to cause the distal portion to bend in one of the first direction, the second direction, the third direction, and the fourth direction. The method further includes the step of positioning the endoscopic system in a forward-viewing configuration, wherein the distal end section is substantially parallel to the distal portion in the forward-viewing configuration. The method further includes the step of moving the endoscopic system to a side-viewing configuration, wherein the distal end section is disposed at an angle of curvature greater than an angle of curvature of the distal portion in the side-viewing configuration.

[0012] Further areas of applicability will become apparent from the description provided herein.It should be understood that the description and specific examples are intended for purposes of illustration only and are not intended to limit the scope of the present disclosure. BRIEF DESCRIPTION OF THE DRAWINGS

[0013] In order that the present disclosure may be well understood, its various forms will now be described by way of example and with reference to the accompanying drawings. The components in the drawings are not necessarily drawn to scale. Additionally, in the drawings, like reference numerals represent corresponding parts throughout the different views.

[0014] Figure 1 shows a side view of an example of an endoscope system having a curved section according to the principles of the present disclosure;

[0015] Figure 2 shows a detailed view of a distal portion of an example of an endoscope system in a forward-facing configuration;

[0016] Figures 3 to 5 illustrates a view of an example circumferentially continuous annular rib for use with an example endoscopic system constructed according to the principles of the present disclosure;

[0017] Figures 6 to 8illustrates an example of a circumferentially continuous C-shaped or open rib for use in an example endoscope system constructed according to the principles of the present disclosure;

[0018] Figure 9A and Figure 9B illustrates symmetry views associated with examples of circumferentially continuous C-shaped or open ribs for use with an example endoscopic system constructed according to the principles of the present disclosure;

[0019] Figure 10 and Figure 11 shows a detailed view of an example of a distal portion of an endoscope system constructed according to the principles of the present disclosure;

[0020] Figure 12 Another example of a rib of an example of an endoscope system of the present disclosure disposed along a series of control wires is shown;

[0021] Figure 13 A detailed view of an example pivot arm of an example endoscope system is shown in a forward-facing configuration;

[0022] Figure 14 A detailed view of an example pivot arm of an example endoscope system is shown in a sideways configuration;

[0023] Figure 15 shows a detailed view of a distal portion of an example of an endoscope system in a sideways configuration;

[0024] Figure 16 A detailed view of a distal portion of an example of an endoscope system is shown in a bent configuration; and

[0025] Figure 17 A detailed view of an example of an axially rotatable bearing of an example endoscope system is shown.

[0026] The drawings described herein are for illustration purposes only and are not intended to limit the scope of the present disclosure in any way. DETAILED DESCRIPTION

[0027] The following description is merely exemplary in nature and is not intended to limit the present disclosure, application, or use. It should be understood that throughout the figures, corresponding reference numerals indicate identical or corresponding parts and features. It is also understood that the various cross-hatching patterns used in the figures are not intended to limit the specific materials that can be used with the present disclosure. The cross-hatching patterns are merely exemplary of preferred materials or are used for clarity purposes to distinguish adjacent or cooperating components shown in the figures.

[0028] When adding reference numerals to the elements of each figure, it should be noted that the same elements have the same reference numerals even though they are shown in different figures. In addition, when describing an aspect of the present disclosure, if it is determined that a detailed description of a related well-known configuration or function obscures the main purpose of an aspect of the present disclosure, it will be omitted.

[0029] In the following discussion, the terms "proximal" and "distal" will be used to describe opposite axial ends of a device and of various component features. The term "proximal" is used in its conventional sense to refer to the end of a device (or component) that is closest to a medical professional during use of the assembly. The term "distal" is used in its conventional sense to refer to the end of a device (or component) that is initially inserted into a patient, or that is closest to the patient, during use. The term "longitudinal" will be used to refer to an axis aligned with the proximal-distal axis 71 of the device (or component), for example, when the device is unbent. The terms "radially" and "radial" will be used to refer to elements, surfaces, or components relative to each other that can extend perpendicularly from the longitudinal axis. The terms "peripheral," "circumferentially," and "circumferential" will be used to refer to elements, surfaces, or components relative to each other that surround or substantially surround the longitudinal axis at a radius.

[0030] Unless otherwise indicated herein or clearly contradicted by context, the use of the terms "a" and "an" and "the" and similar references in the context of describing the present disclosure (especially in the context of the appended claims) are to be interpreted as covering both the singular and the plural. The use of the term "plurality" is defined by the applicant in the broadest sense and supersedes any other implied definition or limitation, preceding or following, to mean more than one, unless expressly stated to the contrary by the applicant. Unless otherwise indicated herein, the recitation of ranges of values ​​herein is merely intended to serve as a shorthand method of individually referring to each individual value falling within the range, and each individual value is incorporated into the specification as if it were individually enumerated herein. Unless otherwise indicated herein or clearly contradicted by context, all methods described herein can be performed in any suitable order.

[0031] As used herein, the terms "include," "comprising," "having," "having," "may," "containing," and variations thereof are intended to be open-ended transitional phrases, terms, or words that do not exclude the possibility of additional actions or structures. This specification also contemplates other examples of "comprising," "consisting of," and "consisting essentially of" the elements set forth herein, whether or not explicitly stated.

[0032] The term first (1) may be used herein when describing elements of the present disclosure. st )、Second (2 nd), first, second, A, B, (a), (b), etc. These terms are only used to distinguish one element from another element, but do not limit the corresponding elements regardless of the nature or order of the corresponding elements.

[0033] Unless otherwise defined, all terms used herein (including technical or scientific terms) have the same meaning as commonly understood by those skilled in the art to which this disclosure belongs. Such terms, such as those defined in general dictionaries, will be interpreted as having the same meaning as in the context of the relevant art.

[0034] In the context of this disclosure, a first piece is said to be integral with a second piece if the first piece and the second piece are formed as a single piece. For example, if the first piece and the second piece are cast as a single piece of plastic, the first piece is said to be integral with the second piece.

[0035] As used herein, the term "about," when used in the context of a stated value or range, refers to a variation of ±15% or less of that value. For example, values ​​that vary by ±15%, ±14%, ±10%, or ±5%, etc., would meet the definition of "about," unless more narrowly defined in a particular instance.

[0036] Reference Figure 1 , shows an example of an endoscope system 10. The endoscope system 10 can be roughly formed as an elongated tube that includes a distal portion 12, a central portion 14, and a proximal portion or handle portion 13. The central portion 14 can be a flexible elongated tube with at least one lumen 15 extending over the entire length of the central portion 14. The central portion 14 can connect the distal portion 12 and the proximal portion 13 together. The at least one lumen 15 of the central portion 14 can also extend through the distal portion 12 and the handle portion 13 of the endoscope system 10. The central portion 14 can be made of a braided material, such as a polyether block amide (including, for example, PEBAX) with a polytetrafluoroethylene ("PTFE") liner to provide sufficient twistability and pushability. Other possible materials for the central portion 14 include, but are not limited to, polyethylene, polypropylene, and nylon.

[0037] The endoscope system 10 may further include two accessory channels 16 and 18, each having a lumen extending therethrough. The accessory channels 16 and 18 may be designed as separate elongated tubes that are movable within at least one lumen 15 of the endoscope system 10, thereby allowing longitudinal movement of the accessory channels 16 and 18 relative to the central portion 14. While this example includes two accessory channels 16 and 18, one or even three or more accessory channels may be included. For example, a single, larger accessory channel may be used to accommodate larger endoscopic tools. Furthermore, instead of separate accessory channels 16 and 18, a single elongated tube may be used with two or more lumens extending therethrough. The diameters of the accessory channels 16 and 18 may range from 1 mm to 10 mm. In one example, the diameter of the accessory channel 16 may be 4.2 mm, while the diameter of the accessory channel 18 may be 3.7 mm. The accessory channels 16 and 18 may extend proximally from or through the handle portion 13, through the at least one lumen 15, and into the distal portion 12. Various tools, devices, and cameras may be at least partially inserted into the accessory passages 16 , 18 and removably disposed therein.

[0038] Now refer to Figure 2 , shows a detailed view of the distal portion 12 of an example of an endoscope system 10. The endoscope system 10 may include an axially rotatable bearing 80 disposed between the central portion 14 and the distal portion 12, which may allow or permit the distal portion 12 to rotate independently of the central portion 14. The distal portion 12 may have a ribbed flexible construction in which a plurality of individual ribs 22 are connected together to form an elongated tube having at least one lumen 15. The ribs 22 may be made of a variety of materials such as polycarbonate, nylon, polyethylene, polypropylene, and polyoxymethylene. The accessory channels 16, 18 may pass through the ribs 22 to a distal section 24 of the distal portion 12. The distal section 24 may include a pivot arm 26 (e.g., a pivot arm 26 having a first accessory lumen 28 and a second accessory lumen 30) . Figure 13 and Figure 14 ). The distal ends of the accessory channels 16, 18 can be fixedly or movably disposed within the respective first and second accessory lumens 28, 30. The distal end section 24 can also include a side port 32 that provides access from the at least one lumen 15 to a point external to the endoscope system 10.

[0039] exist Figure 13 and Figure 14 An example of the distal end section 24 of the distal portion 12 is shown in more detail in FIG. Figure 13 and Figure 14The accessory channels 16, 18 are omitted. The pivot arm 26 may be connected or coupled to the distal section 24 via a pin 34. The pin 34 may form a pivot point about which the pivot arm 26 may rotate or rotatably pivot relative to the distal section 24. Figure 14 The pivot arm 26 can be positioned as shown in FIG. Figure 13 The forward-looking position shown in Figure 14 . A light emitting diode ("LED") light 35 can be placed on the distal section 24 to aid in navigation through the patient's GI tract. Alternatively, the LED light 35 can be placed at other locations on the distal section 24, such as near the side port 32. Moreover, multiple LED lights 35 can be used at various locations on the endoscope system 10.

[0040] like Figure 2 and Figure 15 As shown in FIG, the distal ends of the accessory channels 16, 18 can be fixed to the pivot arm 26. Thus, the accessory channels 16, 18 can rotate with the pivot arm 26 when the pivot arm 26 is moved between the side view configuration and the front view configuration. Figure 2 The accessory channels 16, 18 are shown in a front view configuration, and Figure 15 The accessory channels 16, 18 are shown in a side view configuration. Figure 15 As can be seen in FIG, when in the side-view configuration and due to the rotation of the pivot arm 26, the distal portions of the accessory channels 16, 18 bend beyond the confines of the rib 22 and then bend back toward and into the pivot arm 26. Thus, in the front-view configuration, the angle of curvature or radius of curvature of the distal portion 12, or the distal portion angle of curvature, is the same as the angle of curvature of the accessory channels 16, 18, such that the accessory channels 16, 18 and the distal portion 12 of the endoscope system 10 are substantially parallel; but in the side-view configuration, the angle of curvature or radius of curvature of the accessory channels 16, 18 is greater than the angle of curvature of the distal portion 12, such that the distal portions of the accessory channels 16, 18 extend beyond the at least one lumen 15 of the distal portion 12.

[0041] To move pivot arm 26 from the forward-looking configuration to the side-looking configuration, accessory channels 16, 18 can be pushed in a distal direction relative to proximal portion 13 and central portion 14, thereby applying a force to pivot arm 26 through accessory channels 16, 18. The resulting force causes pivot arm 26 to rotate about the pivot point of pin 34, thereby moving accessory channels 16, 18 and pivot arm 26 to the side-looking configuration. To move back to the forward-looking configuration, a proximal force can be applied to accessory channels 16, 18 relative to proximal portion 13 and central portion 14, thereby transferring the proximal force to pivot arm 26. The proximal force then causes pivot arm 26 to rotate again in the opposite direction about the pivot point of pin 34, thereby moving accessory channels 16, 18 and pivot arm 26 back to the forward-looking configuration. To ensure that accessory channels 16, 18 move in unison during these movements, accessory channels 16, 18 can be secured together at any point along the length of endoscope system 10, or even along the entire length. In one example, the accessory channels 16, 18 can be secured together using plastic tubing along the entire length of the central portion. In another example, the accessory channels 16, 18 can be secured together at portions of the accessory channels 16, 18 that extend beyond the confines of the distal portion 12 when the endoscope system 10 is in the side-viewing configuration.

[0042] While a pivot arm 26 can be used to facilitate transitioning the accessory channels 16, 18 between the front-view and side-view configurations, various other methods and configurations can be used. Furthermore, rather than using a single pivot arm 26, multiple pivot arms can be used, or a single pivot arm can be used for each accessory channel 16, 18. Thus, each accessory channel 16, 18 can be moved independently of the other between the front-view and side-view configurations. Furthermore, the degree of rotation of the pivot arm 26 between the front-view and side-view configurations can vary, potentially ranging from 45 degrees to greater than 135 degrees.

[0043] Figures 3 to 5 A view illustrating an example of ribs 22, and in particular, an example of annular ribs 40, for an endoscope system 10 constructed according to the principles of the present disclosure is shown. Each annular rib 40 can be shaped to allow for minimal contact between the individual annular ribs 40. The endoscope system 10 can include one or more annular ribs 40 at the proximal end of the distal portion 12.

[0044] Figure 3A perspective view of an example of a circumferentially continuous or "annular" rib 40 is shown. The annular rib 40 can be symmetrical about a vertical plane 70 that includes both a longitudinal axis 71 and a vertical axis 72 of the endoscope system 10. The vertical axis 72 is perpendicular to the longitudinal axis 71. The annular rib 40 can include an internal cavity 46 in which the accessory passages 16, 18 can be disposed such that the annular rib 40 surrounds the accessory passages 16, 18. The annular rib 40 can include one or more protrusion mounts that are integral with the annular rib 40 and project toward the internal cavity 46 of the annular rib 40. The one or more protrusion mounts can extend across the proximal-distal width of the annular rib 40. The one or more protrusion mounts can include a top protrusion mount 47. The one or more protrusion mounts can include a proximal-distal top protrusion mount lumen 48 therethrough. The top protrusion mount 47 can include a top protrusion mount lumen 48 extending from a proximal end of the top protrusion mount 47 through to a distal end of the top protrusion mount 47. The one or more protrusion mounts can further include one or more side protrusion mounts 44 projecting from each side of the annular rib 40 toward the interior cavity 46 of the annular rib 40. In some examples of the annular rib 40, the one or more side protrusion mounts 44 are symmetrically positioned about the vertical plane 70. Each of the one or more side protrusion mounts 44 includes a proximal-distal side protrusion mount lumen 42 therethrough. In further examples of the annular rib 40, there can be one side protrusion mount 44 on each side of the annular rib 40. The annular rib 40 can include rib side surface points 49 that project longitudinally farther than the rib top surface and the rib bottom surface.

[0045] Figure 4 An example longitudinal proximal-distal cross-sectional view of the annular rib 40 is shown, highlighting the symmetry of the sides of the annular rib 40 about a vertical plane 70 including the longitudinal axis 71 , the top lug mount 47 , and the top lug mount lumen 48 .

[0046] Figure 5 A bottom view of an example of an annular rib 40 is shown, highlighting the side of the annular rib 40 about a portion including the longitudinal axis 71, the top protrusion mounting member 47, and the top protrusion mounting member inner cavity 48 ( Figure 5 Symmetry of the vertical plane 70 (not shown). Figure 5Illustrating the asymmetry of the longitudinal surfaces of the annular rib 40, one of these longitudinal surfaces will be the proximal surface, and one of these longitudinal surfaces will be the distal surface. Because the annular ribs 40 will alternate in longitudinal orientation along the distal portion 12 of the endoscope system 10, the distal surface of one annular rib 40 will correspond to the proximal surface of the next annular rib 40. This proximal surface of the next annular rib 40 will correspond to the distal surface of the subsequent annular rib 40, and so on. In a particular annular rib 40, the rib-side surface point 49 may be on one longitudinal surface, regardless of whether the longitudinal surface faces the proximal or distal end of the endoscope system 10, and the planar longitudinal surfaces 61, 62 may be on opposite longitudinal surfaces. The planar longitudinal surfaces 61, 62 may intersect at an intersection surface 63. The planar longitudinal surface 61 may be coplanar with a plane that forms an acute angle (i.e., less than 90 degrees) relative to a plane perpendicular to the vertical plane 70 and intersecting the proximal-distal longitudinal axis 71. The planar side longitudinal surface 62 can be coplanar with a second plane that forms an acute angle with respect to a plane perpendicular to the proximal-distal longitudinal axis 71. The annular rib 40 can generally have 90-degree rotational-reflective symmetry about an axis that is parallel to or identical to the longitudinal axis 71, alternatively referred to by those of ordinary skill in the art as an improper rotational axis and, more particularly, an S4 symmetry axis. In other words, each annular rib 40 can be substantially symmetrical when rotated 90 degrees about the longitudinal axis and reflected through the longitudinal axis 71, such that the rib side surface point 49 can also be the intersection of two planar longitudinal surfaces, each of which can be coplanar with a plane that forms an acute angle with respect to a plane perpendicular to the proximal-distal longitudinal axis 71. This rotational-reflective symmetry can be independent of the location of any male mounting element or male mounting element aperture, which may not be included in the rotational-reflective symmetry.

[0047] Figures 6 to 8 A view of another example of a rib 22 (particularly a circumferentially discontinuous rib 50, which in some examples can be generally "C-shaped") for an example endoscope system 10 constructed according to the principles of the present disclosure is shown. Each circumferentially discontinuous rib 50 can be shaped to allow for minimal contact between the individual circumferentially discontinuous ribs 50. The endoscope system 10 can include one or more circumferentially discontinuous ribs 50 in the distal portion 12 between the distal-most annular rib 40 and the distal end segment 24.

[0048] Figure 6A perspective view of an example of a circumferentially discontinuous rib 50 is shown. The circumferentially discontinuous rib 50 can be symmetrical about a vertical plane 70 including a longitudinal axis 71 of the endoscope system 10. The circumferentially discontinuous rib 50 can include an internal cavity 56 in which the accessory channels 16, 18 can be disposed, such that the circumferentially discontinuous rib 50 generally surrounds the accessory channels 16, 18 and the accessory channels 16, 18 can be reversibly removed from the internal cavity 56 by passing the accessory channels 16, 18 through a bottom rib opening 51. The bottom rib opening 51 interrupts the circumferential continuity of the circumferentially discontinuous rib 50. The circumferentially discontinuous rib 50 can include one or more protrusion mounts integral with the circumferentially discontinuous rib 50 that protrude toward the internal cavity 56 of the circumferentially discontinuous rib 50. The one or more protrusion mounts can extend across the proximal-distal width of the circumferentially discontinuous rib 50. The one or more protrusion mounts can include a top protrusion mount 57. The top protrusion mount 57 may include a proximal-distal top protrusion mount lumen 58 therethrough. The top protrusion mount lumen 58 extends from the proximal end of the top protrusion mount 57 to the distal end of the top protrusion mount 57. One or more protrusion mounts may further include a protrusion mount 53 adjacent to the rib opening, which may be flush with the surface of the circumferentially discontinuous rib 50 defining the bottom rib opening 51. In some examples of the circumferentially discontinuous rib 50, the protrusion mounts 53 adjacent to the rib opening are positioned symmetrically about the vertical plane 70. Each of these protrusion mounts adjacent to the rib opening includes a proximal-distal side protrusion mount lumen 52 therethrough. In some examples of the circumferentially discontinuous rib 50, the circumferentially discontinuous rib 50 may further include one or more side protrusion mounts 54 positioned between each protrusion mount 53 adjacent to the rib opening and the top protrusion mount 57. Each of the one or more side tab mounts 54 includes a proximal-distal side tab mount lumen 52 therethrough. The circumferentially discontinuous ribs 50 may include rib side surface points 59 that project longitudinally farther than the rib top surface.

[0049] Figure 7 A longitudinal proximal-distal cross-sectional view of an example of a circumferentially discontinuous rib 50 is shown, highlighting the symmetry of the sides of the circumferentially discontinuous rib 50 about a vertical plane 70 including the longitudinal axis 71 , the top boss mount 57 , and the top boss mount lumen 58 .

[0050] Figure 8 A bottom view of an example of a circumferentially discontinuous rib 50 is shown, highlighting the side of the circumferentially discontinuous rib 50 about a portion of the circumferentially discontinuous rib 50 including the longitudinal axis 71, the top protrusion mounting member 57, and the top protrusion mounting member inner cavity 58 (at Figure 8Symmetry of the vertical plane 70 (not shown). Figure 8 The asymmetry of the longitudinal surfaces of the circumferentially discontinuous ribs 50 is illustrated, with one of these longitudinal surfaces being the proximal surface and one of these longitudinal surfaces being the distal surface. Because the circumferentially discontinuous ribs 50 will alternate in longitudinal orientation along the distal portion 12 of the endoscope system 10, the distal surface of one circumferentially discontinuous rib 50 will correspond to the proximal surface of the next circumferentially discontinuous rib 50. This proximal surface of the next circumferentially discontinuous rib 50 will correspond to the distal surface of the subsequent circumferentially discontinuous rib 50, and so on. In a particular circumferentially discontinuous rib 50, the rib side surface point 59 may be on one longitudinal surface, regardless of whether the longitudinal surface faces the proximal or distal end of the endoscope system 10, and the planar side longitudinal surfaces 64, 65 may be on opposite longitudinal surfaces. The planar side longitudinal surfaces 64, 65 may intersect at an intersection surface 66. The planar side longitudinal surface 64 can be coplanar with a plane that forms an acute angle with respect to a cross-sectional plane perpendicular to the proximal-distal longitudinal axis 71. The planar side longitudinal surface 65 can be coplanar with a second plane that forms an acute angle with respect to a plane perpendicular to the proximal-distal longitudinal axis 71. The circumferentially discontinuous ribs 50 can generally have 90-degree rotational-reflective symmetry about an axis parallel to or identical to the longitudinal axis 71, alternatively referred to as an improper rotational axis and, more particularly, an S4 symmetry axis. In other words, each circumferentially discontinuous rib 50 can be substantially symmetrical when rotated 90 degrees about the longitudinal axis 71 and reflected through the longitudinal axis 71, such that the rib side surface point 59 can also be the intersection of two planar longitudinal surfaces, each of which can be coplanar with a plane that forms an acute angle with respect to a plane perpendicular to the proximal-distal longitudinal axis 71. This rotational-reflection symmetry may not take into account the location of any male mounts or male mount holes, or bottom rib openings 51, which may not be included in the rotational-reflection symmetry.

[0051] Figure 9A and Figure 9B Illustrations illustrating the rotational-reflection symmetry associated with an example of a circumferentially discontinuous rib 50 of an example endoscopic system 10 constructed according to the principles of the present disclosure. Figure 9A A side view of the circumferentially discontinuous rib 50 is shown. Figure 9A As shown, the rib side surface point 59 may be the intersection of two planar longitudinal surfaces. Figure 9B A top view of a circumferentially discontinuous rib 50 is shown, corresponding to the circumference of the Figure 9A 90 degree rotation-reflection of the longitudinal axis 71 of the circumferentially discontinuous rib 50 shown in FIG. Figure 9BAs shown, the planar side longitudinal surfaces 64, 65 may intersect at an intersection surface 66, similar to Figure 9A The two planar longitudinal surfaces intersect at the rib side surface point 59. The 90-degree rotational-reflective symmetry of the annular rib 40 and the circumferentially discontinuous rib 50 advantageously provides four-way deflection of the curved section of the distal portion 12 of the endoscope system 10. The curved section can advantageously move precisely laterally rather than at an angle. Further, this 90-degree rotational-reflective symmetry advantageously provides the curved section to bend equally to the left (i.e., a "first direction") and to the right (i.e., a "second direction," opposite to the first direction) in a horizontal plane including the longitudinal axis 71, and upward (i.e., a "third direction," perpendicular to the first direction and perpendicular to the second direction) and downward (i.e., a "fourth direction," opposite to the third direction) in the vertical plane 70.

[0052] Figure 10 and Figure 11 Shown is a detailed view of an example of the distal portion 12 of an endoscope system 10 constructed according to the principles of the present disclosure. Figure 10 A top view of an example of the distal portion 12 of an endoscope system 10 constructed according to the principles of the present disclosure is shown. The distal portion 12 of the endoscope system 10 can include one or more annular ribs 40 at the proximal end of the distal portion 12. The one or more annular ribs 40 are arranged sequentially in opposing orientations, with the proximal-most annular rib 40 arranged such that the intersection surface 63 can point distally. The annular rib 40 adjacent to the proximal-most annular rib 40 is arranged such that the intersection surface 63 can point proximally, facing the intersection surface 63 of the proximal-most annular rib 40. The next distal annular rib 40 is arranged in sequence such that the intersection surface 63 can point distally. The curved section can include additional distal annular ribs 40 in pairs, and such pairs can be arranged such that the intersection surface 63 of the distal-most annular rib 40 can point distally. The planar longitudinal surface 61 of the proximal-most annular rib 40 and the planar longitudinal surface 62 of the annular rib 40 adjacent to the proximal-most annular rib 40 can form an angle. Depending on the left-right movement of the curved section during operation, the angle between the proximally pointing planar side longitudinal surface 61 and the distally pointing planar side longitudinal surface 62 of the adjacent annular rib 40 can be an angle from about 5 degrees to about 90 degrees, preferably from about 40 degrees to about 60 degrees.

[0053] The curved section will include one or more circumferentially discontinuous ribs 50 distal to the distal-most annular rib 40. The proximal-most circumferentially discontinuous rib 50 may be arranged such that the intersection surface 66 may be directed proximally to face the intersection surface 63 of the distal-most annular rib 40. The planar side longitudinal surface 61 of the distal-most annular rib 40 and the planar side longitudinal surface 64 of the proximal-most circumferentially discontinuous rib 50 may form an angle that is substantially perpendicular to the distal-most annular rib 40. Figure 10denoted by α in FIG. Depending on the left-right movement of the curved section during operation, the angle α may be an angle of about 5 degrees to about 90 degrees, preferably about 40 degrees to about 60 degrees. The curved section may include pairs of additional circumferentially discontinuous ribs 50, and such pairs may be arranged such that the intersecting surface 66 of the distal-most circumferentially discontinuous rib 50 may be directed proximally. The planar side longitudinal surface 64 of the distally directed circumferentially discontinuous rib 50 and the planar side longitudinal surface 65 of the proximally directed adjacent circumferentially discontinuous rib 50 may form an angle. Depending on the left-right movement of the curved section during operation, the angle between the planar side longitudinal surface 64 and the adjacent planar side longitudinal surface 65 may be an angle of about 5 degrees to about 90 degrees, preferably about 40 degrees to about 60 degrees.

[0054] Figure 11 A side view of an example of the distal portion 12 of the endoscope system 10 constructed according to the principles of the present disclosure is shown. Although the proximal-most annular rib 40 is arranged so that the intersection surface 63 can point distally, due to the favorable 90-degree rotational-reflective symmetry of the annular rib 40, the rib side surface point 49 can point proximally, as shown in FIG. Figure 11 The two annular ribs 40 adjacent to the nearest annular rib 40 are arranged so that the rib side surface point 49 of one annular rib 40 faces the rib side surface point 49 of the adjacent annular rib 40, as shown. Figure 11 As shown. The planar side longitudinal surfaces of the annular ribs 40 intersect at rib side surface point 49, so that adjacent annular ribs 40 (these adjacent annular ribs face each other at their rib side surface points 49) can form an angle between the planar side longitudinal surfaces of the adjacent annular ribs 40. Depending on the up and down movement of the curved section during operation, the angle between the planar side longitudinal surfaces can be an angle from about 5 degrees to about 90 degrees, preferably from about 40 degrees to about 60 degrees. The planar side longitudinal surfaces of the circumferentially discontinuous ribs 50 intersect at rib side surface point 59, so that adjacent circumferentially discontinuous ribs 50 (these adjacent circumferentially discontinuous ribs face each other at their rib side surface points 59) can form an angle between the planar side longitudinal surfaces of the adjacent circumferentially discontinuous ribs 50. Depending on the up and down movement of the curved section during operation, the angle between the planar side longitudinal surfaces can be an angle from about 5 degrees to about 90 degrees, preferably from about 40 degrees to about 60 degrees.

[0055] Figure 12Another example of an example of a rib 22 assembled on a series of one or more control wires 60 is shown. The control wires 60 can be fixedly attached to the distal segment 24 and extend in parallel through at least one lumen 15 or extend outside of the at least one lumen to the handle portion 13. Alternatively, the control wires 60 can extend along the length of the endoscopic system 10 through a dedicated low-friction lumen or catheter to the handle portion 13. A first control wire 60 can be fixed to the wall of the distal segment 24 so that the control wire 60 passes through the top protrusion mounting lumen 58 of one or more circumferentially discontinuous ribs 50 and through the top protrusion mounting lumen 48 of one or more annular ribs 40. Additional control wires 60 can be fixed at advantageous locations on the wall of the distal segment 24 so that the control wire 60 passes through the side protrusion mounting lumen 52 of one or more circumferentially discontinuous ribs 50 and through the corresponding side protrusion mounting lumen 42 of one or more annular ribs 40, as Figure 12 The endoscope system 10 may include three, four, five, or more control wires 60. In addition to being able to switch between a forward-looking configuration and a side-looking configuration, the distal portion 12 of the endoscope system 10 may also advantageously bend and rotate as needed. Figure 15 The distal portion 12 is shown in a straight configuration so that the control wires 60 are straight and parallel, while Figure 16 The distal portion 12 is shown in a bent configuration such that the control wires 60 are parallel but not straight. Figure 15 The straight configuration shown in the figure moves to Figure 16 , the control wire 60 can be pulled in the proximal direction. The proximal movement of the control wire 60 can cause a force to be applied through the control wire 60 and to the distal segment 24. This force can cause the flexible ribs of the distal portion 12 to bend, as shown. Figure 15As shown. To move the distal portion 12 back to the straight configuration, the second and third control wires 60 opposite the initially pulled control wire 60 can be pulled in the proximal direction. Because the second and third control wires 60 are connected to opposite sides of the distal segment 24, force is applied through the second and third control wires 60 and applied to the distal segment 24, which can move the distal portion 12 back toward the straight configuration. The lateral projection mounting member lumens 42 and 52 of the annular rib 40 and the circumferentially discontinuous rib 50, respectively, can be advantageously arranged so that the control wires 60 can allow force to be applied through the control wires 60 and applied to the distal segment 24, and reversibly move the distal segment 24 upward, downward, left, or right. The side projection mounting member lumens 42 and 52 can be advantageously positioned on one or more annular ribs 40 and one or more circumferentially discontinuous ribs 50 so that the curved segments are not pulled out of plane, which allows the curved segments to advantageously move precisely laterally rather than at an angle, and without increasing force transmission by simultaneously pulling on either the annular rib 40 or the circumferentially discontinuous ribs 50. The circumferentially discontinuous ribs 50 can be arranged on the control wire 60 so that the bottom rib openings 51 can be longitudinally aligned so that the bottom rib openings 51 open in the same direction or coaxially.

[0056] Figure 17 A detailed view of an example of an axially rotatable bearing 80 and its function is shown for an example endoscope system 10. The axially rotatable bearing 80 may include a first ring 81 and a second ring 82. The axially rotatable bearing 80 may also include a first tube 83 and a second tube 84. The first tube 83 may be fixedly attached to the central portion 14 and the first ring 81. The second tube 84 may be fixedly attached to the distal portion 12 and the second ring 82. The first tube 83 and the first ring 81 may freely rotate relative to the second tube 84 and the second ring 82, thereby allowing the distal portion 12 to freely rotate relative to the central portion 14. Because the first ring 81 is indirectly fixed to the central portion 14 but is located distally of the second ring 82, which is indirectly fixed to the distal portion 12, the distal portion 12 and the central portion 14 can remain fixed to each other while still remaining freely rotatable relative to each other. When the endoscope system 10 is in any of the above-described configurations (including the forward-viewing configuration, the side-viewing configuration, the straight configuration, and the bent configuration), the distal portion 12 can freely rotate. The accessory channels 16, 18 and the control wire 60 can freely pass through the lumen 15 of the axially rotatable bearing 80 while causing no or minimal interference with the axially rotatable bearing 80. This is only one possible design for the axially rotatable bearing 80, and various other designs that allow the distal portion 12 to freely rotate relative to the central portion 14 can be used.

[0057] The control wire 60 can also advantageously secure the one or more annular ribs 40 and the one or more circumferentially discontinuous ribs 50 of the distal portion 12 together. Sufficient tension can be applied to the control wire 60 to advantageously secure the one or more annular ribs 40 and the one or more circumferentially discontinuous ribs 50 along the control wire 60. Due to this design, the one or more annular ribs 40 and the one or more circumferentially discontinuous ribs 50 can advantageously be shaped to allow minimal contact between the individual one or more annular ribs 40 and / or the one or more circumferentially discontinuous ribs 50. Optionally, the one or more control wires 60 can include built-in wires from a power source, which allow the one or more control wires 60 to also serve as a circuit for the LED light 35. Alternatively or in addition to the one or more control wires 60, the one or more annular ribs 40 and / or the one or more circumferentially discontinuous ribs 50 can be connected together using a variety of other methods, such as using mechanical hinges, adhesives, and other well-known devices. Further, similar to the one or more control wires 60 , additional elongated members may extend through the top boss mount lumens 48 and 58 and / or the side boss mount lumens 42 and 52 to provide additional support to the distal portion 12 .

[0058] In addition, one or more annular ribs 40 and one or more circumferentially discontinuous ribs 50 can be covered by a protective sheath, which can be made of various biocompatible materials (such as elastomeric materials). The protective sheath can protect the one or more annular ribs 40 and one or more circumferentially discontinuous ribs 50, while also preventing body tissue from being accidentally trapped between the one or more annular ribs 40 and one or more circumferentially discontinuous ribs 50 when the distal portion 12 moves between the curved configuration and the straight configuration. The protective sheath can also include a groove corresponding to the bottom rib opening 51 in the circumferentially discontinuous rib 50, which allows the accessory channels 16, 18 to move outside the protective sheath and move between the front-view configuration and the side-view configuration. The protective sheath can also advantageously assist in torque transmission when the distal portion 12 moves between the curved configuration and the straight configuration. When operating one or more control wires 60, some natural hysteresis may occur, which may cause a portion of the distal portion 12 to move initially, while the rest of the distal portion 12 lags behind, but eventually moves. The protective sheath may advantageously ensure that the entire distal portion 12 moves together and with minimal hysteresis.

[0059] The endoscope system 10 can be moved between a bent configuration and a straight configuration, and the endoscope system 10 can also be in a forward-looking configuration or a side-looking configuration. Figure 15 The endoscope system 10 is shown in a straight and side-viewing configuration. The endoscope system 10 can be manipulated and used in any combination of the above-described configurations and can be repeatedly moved between all of the configurations.

[0060] The accessory channels 16, 18 can be used to provide passage for various medical tools and accessories through the endoscope system 10 and into the patient's body. For example, a camera system can be inserted into one of the accessory channels 16, while various tools including, but not limited to, forceps, sphincterotomes, wires, dilation balloons, retrieval balloons, stents, needle knives, hemostatic clips, and any other catheter-based tools can be inserted into the other accessory channel 18. These tools can be advanced beyond the distal ends of the accessory channels 16, 18, where they can be used to perform operations on the patient.

[0061] The endoscope system 10 or any portion thereof may be designed to be disposable, thereby reducing the risk of bacterial infection due to incomplete cleaning between uses.

[0062] The present disclosure further contemplates a method of using the endoscope system 10, the method comprising the steps of inserting the endoscope system 10 into the body of a patient, the endoscope system 10 comprising an elongated tube including at least one lumen 15 and one or more accessory channels 16, 18 movably disposed at least partially within the at least one lumen 15 of the elongated tube, the one or more accessory channels 16, 18 comprising a tubular structure including a first accessory lumen 28 and a second accessory lumen 30 extending therethrough; and moving a control wire 60 so as to bend a distal portion 12 of the elongated tube in a first direction.

[0063] The method of using the endoscope system 10 may further include positioning the endoscope system 10 in a forward-looking configuration wherein the distal end segments 24 of the one or more accessory channels 16 , 18 are substantially parallel to the distal portion 12 of the elongated tube in the forward-looking configuration.

[0064] The method of using the endoscope system 10 may further include the step of moving the endoscope system 10 to a side-view configuration, wherein, in the side-view configuration, the distal end segments 24 of the one or more accessory channels 16, 18 are arc-shaped with a radius greater than the radius of the distal portion 12 of the elongated tube. Moving the endoscope system 10 to the side-view configuration may further include rotating the distal end segments 24 of the one or more accessory channels 16, 18 about a pivot point of the distal portion 12 of the elongated tube.

[0065] The method of using the endoscope system 10 may further include the step of moving the second control wire 60 to bend the distal portion 12 of the elongated tube in a second direction, the second direction being opposite to the first direction.

[0066] The method of using the endoscope system 10 may further include the step of moving the third control wire 60 to bend the distal portion 12 of the elongated tube in a third direction, the third direction being perpendicular to the first direction and perpendicular to the second direction.

[0067] The method of using the endoscope system 10 may further include the step of moving the fourth control wire 60 to bend the distal portion 12 of the elongated tube in a fourth direction, the fourth direction being opposite to the third direction.

[0068] The method of using the endoscope system 10 may further include the step of moving the endoscope system 10 from the side-viewing configuration back to the forward-viewing configuration.

[0069] The method of using the endoscope system 10 may further include the step of removing one or more accessory channels 16 , 18 from the interior cavity 56 of the one or more circumferentially discontinuous ribs 50 .

[0070] Although the present disclosure has been described with reference to the examples and the accompanying drawings, the present disclosure is not limited thereto, but various modifications and changes may be made by those skilled in the art to which the present disclosure pertains without departing from the spirit and scope of the present disclosure.

[0071] In addition, the subject matter of this disclosure may also involve the following aspects:

[0072] A first aspect relates to a endoscopic system, comprising: an elongated tube including a lumen extending therethrough, the elongated tube further including a distal portion; at least one accessory channel, the at least one accessory channel including a tubular structure including an accessory lumen extending therethrough, the at least one accessory channel being movably disposed at least partially within the lumen, the at least one accessory channel including a distal segment; a first control wire connected to the distal portion of the elongated tube and extending proximally along the elongated tube; a second control wire connected to the distal portion of the elongated tube and extending proximally along the elongated tube parallel to the first control wire; a third control wire connected to the distal portion of the elongated tube and extending parallel to the third control wire. A control wire and the second control wire extend proximally along the elongated tube; and a fourth control wire, the fourth control wire being connected to a distal portion of the elongated tube and extending proximally along the elongated tube parallel to the first control wire, the second control wire, and the third control wire; wherein proximal movement of the first control wire causes the distal portion to bend in a first direction; wherein proximal movement of the second control wire causes the distal portion to bend in a second direction, which is opposite to the first direction; wherein proximal movement of the third control wire causes the distal portion to bend in a third direction, which is perpendicular to the first direction and perpendicular to the second direction; and wherein proximal movement of the fourth control wire causes the distal portion to bend in a fourth direction, which is opposite to the third direction.

[0073] A second aspect relates to the endoscope system of aspect 1, wherein the distal portion includes a plurality of circumferentially discontinuous ribs, each of the plurality of circumferentially discontinuous ribs including a rib opening, the rib openings of the plurality of circumferentially discontinuous ribs being coaxial; wherein each of the plurality of circumferentially discontinuous ribs surrounds the at least one accessory channel; and wherein the at least one accessory channel is reversibly removable from the interior cavity of each of the plurality of circumferentially discontinuous ribs through the rib openings.

[0074] A third aspect relates to a scope system of any of the preceding aspects, wherein the distal portion further comprises: a plurality of annular ribs, each of the plurality of annular ribs being generally rotationally-reflectively symmetrical about a proximal-distal longitudinal axis, each of the plurality of annular ribs surrounding the at least one accessory channel, each of the plurality of annular ribs comprising an annular rib proximal surface and an annular rib distal surface, the annular rib proximal surface comprising a plurality of annular rib planar surfaces and the annular rib distal surface comprising a plurality of annular rib planar surfaces, each of the plurality of annular rib planar surfaces being at an angle of less than 90 degrees relative to a cross-sectional plane, the cross-sectional plane The first control wire, the second control wire, the third control wire and the fourth control wire connect the plurality of annular ribs and the plurality of circumferentially discontinuous ribs.

[0075] A fourth aspect relates to the endoscope system of any of the preceding aspects, wherein the at least one accessory channel is movable between a front-view configuration and a side-view configuration; wherein, in the front-view configuration, the distal segment is substantially parallel to the distal portion; and wherein, in the side-view configuration, the distal segment is disposed at an angle of curvature relative to the distal portion.

[0076] A fifth aspect relates to the scope system of any preceding aspect, wherein the distal section is rotatably coupled to the distal portion.

[0077] A sixth aspect relates to the endoscopic system of any of the preceding aspects, further comprising an axially rotatable bearing disposed between the distal portion and the proximal portion of the elongated tube, the axially rotatable bearing allowing the distal portion to rotate relative to the proximal portion about a proximal-distal longitudinal axis.

[0078] A seventh aspect relates to the endoscope system of any of the preceding aspects, further comprising a light connected to the distal portion, wherein one of the first control wire, the second control wire, the third control wire, and the fourth control wire further comprises an electrical wire between the light and a power source.

[0079] An eighth aspect relates to the scope system of any preceding aspect, wherein the camera system is at least partially and removably disposed within the at least one accessory lumen.

[0080] A ninth aspect relates to the scope system of any preceding aspect, wherein the at least one accessory lumen is configured to receive a tool.

[0081] A tenth aspect relates to the scope system of any of the preceding aspects, wherein the plurality of circumferentially discontinuous ribs are distal to the plurality of annular ribs.

[0082] An eleventh aspect relates to the scope system of any of the preceding aspects, wherein an angle between a planar surface of a circumferentially discontinuous rib and a second planar surface of an adjacent circumferentially discontinuous rib facing the planar surface is from about 5 degrees to about 90 degrees.

[0083] A twelfth aspect relates to the scope system of any one of aspects 2 to 11, wherein an angle between the planar surface of the circumferentially discontinuous rib and a third planar surface of an adjacent annular rib facing the planar surface is about 5 degrees to about 90 degrees.

[0084] A thirteenth aspect relates to the scope system of any one of aspects 2 to 11, wherein an angle between the fourth planar surface of the annular rib and a fifth planar surface of an adjacent annular rib facing the fourth planar surface is about 5 degrees to about 90 degrees.

[0085] A fourteenth aspect relates to the endoscope system of any one of aspects 2 to 13, which further includes a fifth control wire; wherein the proximal movement of the fourth control wire and the fifth control wire causes the distal portion to bend along the fourth direction; and wherein the fifth control wire connects the multiple annular ribs and the multiple circumferentially discontinuous ribs.

[0086] A fifteenth aspect relates to the scope system of any one of aspects 4 to 14, wherein, in the side-view configuration, the angle of curvature is greater than the angle of curvature of the distal portion.

[0087] A sixteenth aspect relates to the endoscope system of any one of aspects 4 to 14, wherein, in the forward-looking configuration, the distal section is substantially disposed within the lumen of the distal portion.

[0088] A seventeenth aspect relates to the scope system of any one of aspects 4 to 14, wherein movement of the proximal portion of the at least one accessory channel in a distal direction relative to the elongated tube moves the at least one accessory channel from the forward-viewing configuration to the side-viewing configuration.

[0089] An eighteenth aspect relates to the scope system of any one of aspects 4 to 14, wherein movement of the proximal portion of the at least one accessory channel in a proximal direction relative to the elongated tube moves the at least one accessory channel from the side-viewing configuration to the front-viewing configuration.

[0090] A nineteenth aspect relates to a method of using an endoscope system, the method comprising: inserting an endoscope system into a patient's body, the endoscope system comprising: an elongated tube including a lumen extending therethrough, the elongated tube further comprising a distal portion; at least one accessory channel, the at least one accessory channel comprising a tubular structure including an accessory lumen extending therethrough, the at least one accessory channel being movably disposed at least partially within the lumen, the at least one accessory channel comprising a distal segment; and a plurality of parallel control wires, each of the plurality of parallel control wires being connected to the distal portion of the elongated tube and extending proximally along the elongated tube, a separate portion of one or more of the plurality of parallel control wires being connected to the distal portion of the elongated tube. The proximal movement causes the distal portion to bend along one of a first direction, a second direction, a third direction, and a fourth direction, the second direction being opposite to the first direction, the third direction being perpendicular to the first direction and perpendicular to the second direction, and the fourth direction being opposite to the third direction; moving one or more of the plurality of parallel control wires so as to bend the distal portion along one of the first direction, the second direction, the third direction, and the fourth direction; positioning the endoscope system in a forward-looking configuration, wherein, in the forward-looking configuration, the distal segment is substantially parallel to the distal portion; and moving the endoscope system to a side-view configuration, wherein, in the side-view configuration, the distal segment is disposed at an angle of curvature that is greater than an angle of curvature of the distal portion.

[0091] In addition to the features mentioned in each of the above-listed independent aspects, some examples may show, alone or in combination, optional features mentioned in the dependent aspects and / or disclosed in the above description and shown in the drawings.

Claims

1. A scope system, comprising: an elongated tube including a lumen extending therethrough, the elongated tube further comprising a distal portion including a plurality of annular ribs and a plurality of circumferentially discontinuous ribs, each circumferentially discontinuous rib of the plurality of circumferentially discontinuous ribs including a rib opening; at least one fitting passageway, the at least one fitting passageway comprising a tubular structure including a fitting lumen extending therethrough, the at least one fitting passageway being movably disposed at least partially within the lumen, the at least one fitting passageway including a distal section, each of the plurality of annular ribs circumscribing the at least one fitting passageway, each of the plurality of circumferentially discontinuous ribs partially circumscribing the at least one fitting passageway; a first control wire connected to the distal portion of the elongated tube and extending proximally along the elongated tube; a second control wire connected to the distal portion of the elongated tube and extending proximally along the elongated tube in parallel with the first control wire; a third control wire connected to the distal portion of the elongated tube and extending proximally along the elongated tube parallel to the first control wire and the second control wire; as well as a fourth control wire connected to the distal portion of the elongated tube and extending proximally along the elongated tube parallel to the first control wire, the second control wire, and the third control wire; wherein the proximal movement of the first control wire causes the distal portion to bend along a first direction; wherein the proximal movement of the second control wire causes the distal portion to bend along a second direction, the second direction being opposite to the first direction; wherein the proximal movement of the third control wire causes the distal portion to bend along a third direction, the third direction being perpendicular to the first direction and perpendicular to the second direction; and wherein the proximal movement of the fourth control wire causes the distal portion to bend along a fourth direction, the fourth direction being opposite to the third direction; The first control wire, the second control wire, the third control wire, and the fourth control wire connect the plurality of annular ribs and the plurality of circumferentially discontinuous ribs; wherein the rib openings of the plurality of circumferentially discontinuous ribs are coaxial, and wherein the at least one fitting passage is reversibly laterally movable from the interior cavity of each of the plurality of circumferentially discontinuous ribs through the rib openings.

2. The endoscope system of claim 1 , wherein each of the plurality of annular ribs comprises an annular rib proximal surface and an annular rib distal surface, the annular rib proximal surface comprising a plurality of annular rib planar surfaces and the annular rib distal surface comprising a plurality of annular rib planar surfaces, each of the plurality of annular rib planar surfaces being angled less than 90 degrees relative to a cross-sectional plane that intersects the proximal-distal longitudinal axis; and Each of the plurality of circumferentially discontinuous ribs includes a proximal surface including a plurality of planar surfaces and a distal surface including a plurality of planar surfaces, each of the plurality of planar surfaces being angled less than 90 degrees relative to the cross-sectional plane.

3. The scope system of claim 2, wherein: The plurality of circumferentially discontinuous ribs are distal to the plurality of annular ribs.

4. The scope system of claim 2, wherein: An angle between a planar surface of a circumferentially discontinuous rib and a second planar surface of an adjacent circumferentially discontinuous rib facing the planar surface is in a range of 5 degrees to 90 degrees.

5. The scope system of claim 2, wherein: An angle between the planar surface of the circumferentially discontinuous rib and a third planar surface of an adjacent annular rib facing the planar surface is 5 degrees to 90 degrees.

6. The scope system of claim 2, wherein: An angle between a fourth planar surface of the annular rib and a fifth planar surface of an adjacent annular rib facing the fourth planar surface is in a range of 5 to 90 degrees.

7. The scope system of claim 2, further comprising a fifth control wire; in, Proximal movement of the fourth control wire and the fifth control wire causes the distal portion to bend along the fourth direction; and The fifth control wire connects the plurality of annular ribs and the plurality of circumferentially discontinuous ribs.

8. The scope system of claim 1, wherein: the at least one accessory channel being movable between a front-view configuration and a side-view configuration; wherein, in the forward-looking configuration, the distal section is substantially parallel to the distal portion; and wherein, in the side-view configuration, the distal segment is disposed at an angle of curvature relative to the distal portion.

9. The scope system of claim 8, wherein: In the side-view configuration, the angle of curvature is greater than the angle of curvature of the distal portion.

10. The scope system of claim 8, wherein: In the forward-looking configuration, the distal segment is substantially disposed within the lumen of the distal portion.

11. The scope system of claim 8, wherein: Movement of the proximal portion of the at least one fitting channel in a distal direction relative to the elongated tube moves the at least one fitting channel from the forward-viewing configuration to the side-viewing configuration.

12. The scope system of claim 8, wherein: Movement of the proximal portion of the at least one fitting channel in a proximal direction relative to the elongated tube moves the at least one fitting channel from the side-view configuration to the front-view configuration.

13. The scope system of claim 1, wherein: The distal end section is rotatably coupled to the distal portion.

14. The endoscope system of claim 1 , further comprising an axially rotatable bearing disposed between the distal portion and the proximal portion of the elongated tube, the axially rotatable bearing allowing the distal portion to rotate relative to the proximal portion about a proximal-distal longitudinal axis.

15. The speculum system of claim 1 , further comprising a light coupled to the distal portion, wherein One of the first control wire, the second control wire, the third control wire, and the fourth control wire further comprises an electrical wire between the lamp and a power source.

16. The scope system of claim 1, wherein: A camera system is at least partially and removably disposed within the at least one accessory cavity.

17. The scope system of claim 1, wherein: The at least one fitting lumen is configured to receive a tool.

18. A scope system, comprising: an elongated tube including a lumen extending therethrough, the elongated tube further comprising a distal portion, the distal portion comprising a plurality of annular ribs and a plurality of circumferentially discontinuous ribs, each circumferentially discontinuous rib of the plurality of circumferentially discontinuous ribs comprising a rib opening, the rib openings of the plurality of circumferentially discontinuous ribs being coaxial; at least one fitting passageway, the at least one fitting passageway comprising a tubular structure including a fitting lumen extending therethrough, each of the plurality of annular ribs circumscribing the at least one fitting passageway and each of the plurality of circumferentially discontinuous ribs partially circumscribing the at least one fitting passageway, the at least one fitting passageway being movably disposed at least partially within the lumen, the at least one fitting passageway including a distal end segment; a first control wire connected to the distal portion of the elongated tube and extending proximally along the elongated tube; a second control wire connected to the distal portion of the elongated tube and extending proximally along the elongated tube in parallel with the first control wire; a third control wire connected to the distal portion of the elongated tube and extending proximally along the elongated tube parallel to the first control wire and the second control wire; as well as a fourth control wire connected to the distal portion of the elongated tube and extending proximally along the elongated tube parallel to the first control wire, the second control wire, and the third control wire; wherein the proximal movement of the first control wire causes the distal portion to bend along a first direction; wherein the proximal movement of the second control wire causes the distal portion to bend along a second direction, the second direction being opposite to the first direction; wherein the proximal movement of the third control wire causes the distal portion to bend along a third direction, the third direction being perpendicular to the first direction and perpendicular to the second direction; wherein the proximal movement of the fourth control wire causes the distal portion to bend along a fourth direction, the fourth direction being opposite to the third direction; and wherein the at least one fitting passage is reversibly laterally movable from the interior cavity of each of the plurality of circumferentially discontinuous ribs through the rib openings.

19. The scope system of claim 18, wherein: the at least one accessory channel being movable between a front-view configuration and a side-view configuration; wherein, in the forward-looking configuration, the distal section is substantially parallel to the distal portion; and Wherein, in the side-view configuration, the distal segment is disposed at an angle of curvature that is greater than an angle of curvature of the distal portion.

20. A method of using an endoscope system, the endoscope system comprising: an elongated tube including a lumen extending therethrough, the elongated tube further comprising a distal portion including a plurality of annular ribs and a plurality of circumferentially discontinuous ribs, each circumferentially discontinuous rib of the plurality of circumferentially discontinuous ribs including a rib opening; at least one fitting passageway, the at least one fitting passageway comprising a tubular structure including a fitting lumen extending therethrough, the at least one fitting passageway being movably disposed at least partially within the lumen, the at least one fitting passageway including a distal section, each of the plurality of annular ribs circumscribing the at least one fitting passageway, each of the plurality of circumferentially discontinuous ribs partially circumscribing the at least one fitting passageway; as well as a plurality of parallel control wires, each of the plurality of parallel control wires being connected to a distal portion of the elongated tube and extending proximally along the elongated tube, wherein individual proximal movement of one or more of the plurality of parallel control wires causes the distal portion to bend in one of a first direction, a second direction, a third direction, and a fourth direction, the second direction being opposite the first direction, the third direction being perpendicular to the first direction and perpendicular to the second direction, and the fourth direction being opposite the third direction; wherein the plurality of parallel control wires connect the plurality of annular ribs and the plurality of circumferentially discontinuous ribs; the rib openings of the plurality of circumferentially discontinuous ribs are coaxial, and the at least one accessory passage is reversibly movable laterally from the interior cavity of each of the plurality of circumferentially discontinuous ribs through the rib openings; moving one or more control wires of the plurality of parallel control wires to bend the distal portion in one of the first direction, the second direction, the third direction, and the fourth direction; positioning the endoscopic system in a forward-looking configuration, wherein, in the forward-looking configuration, the distal end section is substantially parallel to the distal portion; and The endoscopic system is moved to a side-view configuration, wherein, in the side-view configuration, the distal section is disposed at an angle of curvature that is greater than an angle of curvature of the distal portion.

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