Endoscope with multiple viewing directions

Abstract

An endoscope can include a shaft having a longitudinal axis, a first image sensor facing in a distal direction, and a second image sensor facing in a lateral direction. The endoscope can also include a tubular element having a lumen with a distal end opening and defining a longitudinal axis through a center of the lumen. The tubular element can be movable between a first configuration and a second configuration. In the first configuration of the tubular element, the longitudinal axis of the lumen can be parallel to the longitudinal axis of the shaft. In the second configuration of the tubular element, the longitudinal axis of the lumen can extend through a lateral opening in a wall of the shaft.

Description

[0001] This application is a divisional application of application number 201880008979.3, filed on January 29, 2018, entitled "Endoscope with Multiple Viewing Directions".

[0002] Cross-references to related applications

[0003] Pursuant to 35 U.S.SC §119, this patent application claims priority to U.S. Provisional Patent Application No. 62 / 453,186, filed February 1, 2017, the entire contents of which are incorporated herein by reference. Technical Field

[0004] This disclosure generally relates to an endoscope having multiple viewing directions and an adjustable lift to provide multiple working directions. Background Technology

[0005] Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure used to diagnose and treat patients with pancreatic and biliary diseases. ERCP is typically performed using a side-viewing endoscope with a lifting mechanism. The layout of the side-viewing endoscope and the lifting mechanism allow the physician to cannulate the duodenal papilla and access the target site with the instruments used for diagnosis and treatment during the ERCP procedure.

[0006] Anterior-viewing endoscopes are occasionally used for patients with altered anatomy, but because they lack a lift or lateral imaging sensor, the physician's diagnostic and therapeutic capabilities may be limited compared to lateral-viewing endoscopes with these features. Additionally, currently available anterior-viewing endoscopes may be longer than lateral-viewing endoscopes, potentially requiring different intubation methods and tools. While commercially available anterior-viewing endoscopes can be successful in some patients with altered anatomy, their use may require changes to the physician's procedure and necessitates additional effort compared to performing ERCP using lateral-viewing endoscopes. Summary of the Invention

[0007] Among other things, examples of this disclosure relate to endoscopes having multiple viewing directions and adjustable lifts (e.g., tubular elements) to provide multiple working directions. Each of the examples disclosed herein may include one or more of the features described in conjunction with any other disclosed examples.

[0008] In one example, the endoscope may include a shaft having a longitudinal axis, a first image sensor oriented distally, and a second image sensor oriented laterally. The endoscope may also include a tubular element having a lumen with a distal opening defining a longitudinal axis extending through the center of the lumen. The tubular element is movable between a first configuration and a second configuration. In the first configuration of the tubular element, the longitudinal axis of the lumen may be parallel to the longitudinal axis of the shaft. In the second configuration of the tubular element, the longitudinal axis of the lumen may extend through a lateral opening in the wall of the shaft.

[0009] Any example of an endoscope described herein may also include one or more of the following features: a first image sensor may be positioned on a distal wall of the axis, and a second image sensor may be positioned on a lateral wall of the axis; in a first configuration, a distal opening may be parallel to the distal wall of the axis; the distal wall may be located at the distal end of the axis; the first image sensor may be adjustable relative to the distal wall, and the second image sensor may be adjustable relative to the lateral wall; the lateral wall of the axis may be flat, and the distal wall and the lateral wall may be perpendicular to each other; the distal direction and the lateral direction may be about 90° to each other; the endoscope may also include a medical device positioned within a tubular element, wherein in a first configuration, the medical device may extend from the distal opening of the tubular element, and the first image sensor... The sensor can be configured to image a medical device; in a second configuration, the medical device can extend from a distal opening of the tubular element, and a second image sensor can be configured to image the medical device; the tubular element can be further moved to a third configuration, in which the medical device can be locked relative to the wall of the shaft; the endoscope can also include a first light source associated with a first image sensor and a second light source associated with a second image sensor; the endoscope can also include multiple light sources; the wall of the shaft can include a distally facing notch configured to receive and fix the medical device relative to the wall of the shaft; in the first configuration of the tubular element, the longitudinal axis of the lumen can extend through a distal opening in the wall of the shaft; the range of motion of the tubular element can be at least 80°; or the tubular element can be axially translated relative to the shaft.

[0010] In another example, the endoscope may include a first image sensor positioned on a distal wall of the axis; a second image sensor positioned on a laterally facing wall of the axis; and a tubular element having a lumen with a distal opening defining a longitudinal axis through the center of the lumen. The tubular element is movable between a first configuration and a second configuration. In the first configuration of the tubular element, the distal opening may be parallel to the distal wall of the axis. In the second configuration of the tubular element, the longitudinal axis of the lumen may extend through the lateral opening of the axis.

[0011] Any example of an endoscope described herein may also include one or more of the following features: a first image sensor may be oriented in a first direction, a second image sensor may be oriented in a second direction, and the first and second directions may be approximately 90° to each other; the endoscope may also include a first light source associated with the first image sensor and a second light source associated with the second image sensor; the lateral wall of the axis may be flat, and the distal wall and the lateral wall may be perpendicular to each other; the tubular element may be further moved to a third configuration, in which a medical device positioned within the lumen may be locked relative to the axis; the tubular element may be translated relative to the distal wall and the lateral wall; or in the first configuration of the tubular element, the longitudinal axis of the lumen may be parallel to the longitudinal axis of the axis.

[0012] In yet another example, a method of imaging a patient using an endoscope may include imaging a first portion of the patient using a first image sensor oriented distally; moving a tubular element having a lumen having a distal opening and defining a longitudinal axis through the center of the lumen from a first configuration to a second configuration; and imaging a second portion of the patient using a second image sensor oriented laterally. In the first configuration of the tubular element, the longitudinal axis of the lumen may be parallel to the longitudinal axis of the endoscope's axis; and in the second configuration of the tubular element, the longitudinal axis of the lumen may extend through the lateral opening of the axis.

[0013] Any method described herein may also include one or more of the following features or steps: the method may further include positioning a medical device within the lumen of a tubular element; the method may further include moving the tubular element from a second configuration to a third configuration, wherein moving the tubular element from the second configuration to the third configuration locks the medical device relative to the axis; in the first configuration, the distal opening of the lumen may be parallel to the distal wall of the axis; or, when the tubular element is in the second configuration, performing the step of imaging a second portion of the patient using a second image sensor.

[0014] It is understood that the foregoing general description and the following detailed description are merely exemplary and illustrative, and are not intended to limit the claimed invention. As used herein, the terms “comprising,” “including,” or any other variation thereof are intended to cover non-exclusive inclusion, such that a process, method, article, or apparatus that includes a list of elements includes not only those elements, but may include other elements not expressly listed or inherent to such process, method, article, or apparatus. The term “exemplary” is used in the sense of “example,” not “ideal.” Attached Figure Description

[0015] The accompanying drawings, which are included in and form part of this specification, illustrate examples of this disclosure and, together with the specification, serve to explain the principles of this disclosure.

[0016] Figure 1 A perspective view of the distal end of an endoscope with a tubular element, according to an example, is shown, wherein the tubular element is in a straight configuration to form a front exit working channel.

[0017] Figure 2 Showing an example, Figure 1 A stereoscopic view of the distal end of a central endoscope, in which the tubular element is in a curved configuration to form a side outlet working channel.

[0018] Figure 3 Showing an example, Figure 1 A stereoscopic view of the distal end of a central endoscope, with the medical device in the tubular element in the locked position.

[0019] Figure 4 Showing an example, Figure 1 The distal view of the endoscope.

[0020] Figure 5 Showing an example, Figure 2 Top view of the end of the endoscope. Detailed Implementation

[0021] This disclosure describes an endoscope having multiple viewing directions. To image in multiple directions, the endoscope may have more than one image sensor. Additionally, the endoscope may have a lift (e.g., a tubular element) with an adjustable distal portion, thereby allowing the endoscope to have both a front exit working channel and a side exit working channel.

[0022] Reference Figure 1 Endoscope 2 may include an elongated, flexible tubular shaft having a distal end 4. The distal end 4 may bend left, right, upward, and downward relative to the proximal portion of the tubular shaft. Endoscope 2 may also include a lift or tubular element 6 defining a lumen 8, a forward viewing system 12, and a side viewing system 14. The tubular shaft (or distal end 4) of endoscope 2 may define a longitudinal axis A extending in a proximal-distal direction through the center of the distal end 4. In other examples, the longitudinal axis A may extend in a proximal-distal direction through the distal end 4, but may be off-center. The forward viewing system 12 may include an image sensor 16, a light source 18, and a lens cleaner 20. Similarly, the side viewing system 14 may include an image sensor 22, a light source 24, and a lens cleaner 26. Endoscope 2 may be any device for visually examining a patient's anatomy and may be used for any suitable surgical procedure. For example, endoscope 2 may be used to examine a patient's gastrointestinal, vascular, respiratory, or urinary systems.

[0023] The tubular element 6 may include an elongated tube extending from the proximal end of the endoscope 2 to the distal end of the endoscope 2. The tubular element 6 may include any suitable biocompatible material, such as a polymer, urethane, a fluoropolymer blend, or a metal (e.g., stainless steel). The tubular element 6 may include a distal portion 28, as shown, which is bendable relative to the proximal portion (not shown) of the tubular element 6. To facilitate bending in a desired region between the proximal and distal portions 28 of the tubular element 6, the tubular element 6 may include a helical portion, a laser-cut pattern forming a weakened and bendable region, a hinge, or any other suitable feature that allows the two portions to bend relative to each other.

[0024] The tubular element 6 may have or define an inner lumen 8. In one example, the inner lumen 8 may have a circular cross-section. In other examples, the cross-section of the inner lumen 8 may be elliptical, polygonal, irregular, or any other suitable shape. The inner lumen 8 may include a distal opening 30 at the distal end of the distal portion 28. The inner lumen 8 (or the distal portion 28 of the tubular element 6) may define a longitudinal axis B extending through the center of the distal portion 28 from the proximal end (e.g., adjacent to a flexible region of the tubular element 6) to the distal opening 30. In other examples, the longitudinal axis B may extend through the distal portion 28 in a proximal-distal direction, but may be off-center. The opening 30 provides an outlet for a medical device 32 (e.g., a guidewire or other therapeutic or diagnostic device). To position the medical device 32 within the inner lumen 8, as... Figure 1 As shown, the distal end of the medical device 32 can be inserted into the proximal end of the tubular element 6, pass through the lumen 8, and exit from the distal opening 30.

[0025] The distal portion 28 of the tubular element 6 can be, for example... Figure 1 The first configuration shown and as Figure 2 Move between the second configurations shown. Figure 3 The tubular element in the third configuration is shown. It should be understood that the distal portion 28 is also movable between the first and third configurations, and between the second and third configurations. Figure 1 In the first configuration, the distal opening 30 may be parallel to the distal wall 34 of the distal end 4. Furthermore, the longitudinal axis B of the lumen 8 may be parallel to the longitudinal axis A of the tubular axis (or the distal end 4) of the endoscope 2. Therefore, in the first configuration, the tubular element 6 may define a working channel (lumen 8) for the endoscope 2 with a forward exit. The forward exit may be adjacent to or coplanar with the distal wall 34. When the tubular element 6 is in the first configuration, the forward viewing system 12 can be used to visualize tools extending from the tubular element 6, such as a medical device 32.

[0026] When the tubular element 6 is in the second configuration, such as Figure 2As shown, the distal opening 30 can form an angle with the distal wall 34 of the distal end 4. Similarly, the longitudinal axis B of the distal portion 28 of the tubular element 6 can form an angle θ with the longitudinal axis A of the tubular axis (or the distal end 4) of the endoscope 2. Thus, in the second configuration, the tubular element 6 can define a working channel (lumen 8) for the endoscope 2 with a lateral or transverse exit. When the tubular element 6 is in the second configuration, the lateral viewing system 14 can be used to visualize tools extending from the tubular element 6, such as a medical device 32.

[0027] Figure 3 The tubular element 6 is shown in a third configuration, which may be referred to as a locking configuration. In the third configuration, movement of the medical device 32 relative to the tubular element 6 can be suppressed or prevented. In one example, the third configuration may be the position of the tubular element 6 when the distal portion 28 of the tubular element 6 (together with the medical device 32 extending from the distal opening 30) is in its maximum bending position relative to the longitudinal axis of the distal end 4 of the endoscope 2. In other words, in the third configuration, the angle θ may be greater than the angle θ of the tubular element 6 in the first or second configuration. The distal end 4 may include a notch or notch 36, which is sized to receive the medical device 32 and secure the medical device 32 relative to the distal end 4 of the tubular axis. The notch 36 may be distally oriented. When the tubular element 6 moves to the third configuration, the medical device 32 may be pressed between the wall of the distal portion 28 and the notch 36, and may form a press-fit attachment with the distal end 4 through the notch 36. In the third configuration of the tubular element 6, as will be further described below, the medical device 32 can be securely held while a catheter or other medical device is advanced along the medical device 32 within the lumen 8. However, advancement of the medical device along the device 32 can occur in any of the first, second, or third configurations.

[0028] Reference Figure 3 , 4 5. The wall of the distal end 4 of the tubular shaft of endoscope 2 may include a lateral opening 38 and a distal opening 40 (in the distal wall 34) to allow tools exiting the distal opening 30 of the tubular element 6 to access the exterior of endoscope 2. Openings 38 and 40 combine to form a single opening at the distal end 4 that is distally and laterally oriented. Lateral opening 38 may extend proximally from the distal wall 34. Starting from the distal wall 34, a first side 37 and a second side 39 of lateral opening 38 may extend parallel to each other for a portion of the length of lateral opening 38 (in a proximal-distal direction). The two sides 37, 39 may then move proximally toward a notch 36 and toward each other. Notch 36 may be part of lateral opening 38 and may be proximally defined by a curved portion of the wall of the distal end 4 extending between the first and second sides 37, 39.

[0029] The distal opening 40 may be the distal end of the lumen 44, which extends longitudinally through the distal end 4 of the tubular axis of the endoscope 2. (See reference...) Figure 4 The distal opening 40 may extend from the top edge of the distal end 4, where it connects with and is continuous with the lateral opening 38. Starting from the lateral opening 38, the distal opening 40 may extend toward the opposing wall of the distal end 4 (see...). Figure 4 (When facing the bottom of the page). At its bottom edge (in) Figure 4 In the view, the distal opening 40 is flexible such that the wall of the distal wall 34 forms a U-shape around the distal opening 40. The U-shape of the distal opening 40 allows the distal portion 28 of the tubular element 6 to extend to... Figure 1 and 4 The first configuration is completely straight, as shown. In one example, the curvature of the distal opening 40 at the bottom can match the curvature of the outer surface of the tubular element 6.

[0030] When the tubular element 6 is moved from the first configuration to the second or third configuration, the medical device 32 can continuously access the exterior of the endoscope 2 via the distal opening 40 and the lateral opening 38. For example, in Figure 1 In the first configuration shown, the medical device 32 can access the exterior of the endoscope 2 through the distal opening 40. As the tubular element 6 approaches... Figure 2 In the second configuration shown, the medical device 32 can extend from the lumen 8 to the outside of the endoscope 2 through the lateral opening 38. Thus, the distal opening 40 and the lateral opening 38 provide passageway so that a tool extending from the distal opening 30 of the lumen 8 can access the outside of the endoscope 2. In other words, when the tubular element 6 is in the first configuration, the longitudinal axis B of the tubular element 6 can extend through the distal opening 40. However, in the second configuration of the tubular element 6, the longitudinal axis B can extend through the lateral opening 38. In the third configuration of the tubular element 6, if the longitudinal axis B passes through the center of the lumen 8 (e.g., as...), Figure 3 As shown), the longitudinal axis B can extend through the wall of the distal end 4. However, if the longitudinal axis B is off-center, when the tubular element 6 is in the third configuration, the longitudinal axis B can also extend through the lateral opening 38.

[0031] The tubular element 6 can be moved through its range of motion (e.g., between the first, second, and third configurations) by any mechanism known in the art. In one example, a wire (not shown) may be secured to the outside of the distal portion 28 (e.g., by a loop around the tubular element 6, by adhesive, by solder, etc.) and may travel proximally toward the proximal end of the tubular element 6. The user may pull the wire proximally to move the distal portion 28 from the first configuration to the second or third configuration. In other words, proximal movement of the wire may cause the distal portion 28 to bend further relative to the distal end 4 of the endoscope 2 (e.g., may cause an increase in angle θ). For convenience, the bending movement of the distal portion 28 at an increased angle θ is referred to herein as “proximal” movement of the distal portion 28. Conversely, the user may push the wire or other mechanism distally to move the distal portion 28 from the second or third configuration toward the first configuration. In other words, moving the line distally causes the distal portion 28 to bend less relative to the distal end 4 of the endoscope 2 (e.g., causing a decrease in angle θ) and move toward a position where the longitudinal axis B is parallel to the longitudinal axis A. For convenience, the straightening movement of the distal portion 28 that reduces angle θ is referred to herein as the “distal” movement of the distal portion 28.

[0032] In one example, the distal portion 28 of the tubular element 6 may have a range of motion of approximately 85°. As used herein, “approximately” means positive or negative 5%, including the endpoints. Depending on the example, the range of motion may be defined as the angle θ between the first and second configurations (e.g., ...). Figure 1 and 2 The angle θ between (between) or between the first and third configurations (e.g., Figure 1 and 3 (between). When the range of motion is an angle θ between the first and third configurations, the range of motion may include any position of the distal portion 28 that allows the medical device 32 to move freely while extending from the distal opening 30 of the distal portion 28. When the range of motion is an angle θ between the first and third configurations, the range of motion may include any position of the distal portion 28 that allows the medical device 32 to extend from the distal opening of the distal portion 28, whether the medical device 32 is freely movable or locked.

[0033] In other examples, the distal portion 28 may have a range of motion of about 70°, about 75°, about 80°, or about 90°. In other examples, the range of motion of the distal portion 28 may be at least 80°, at least 85°, at least 90°, at least 95°, less than 95°, less than 90°, less than 85°, or less than 80°. To increase the range of motion shown in the figure, the lateral opening 38 of the distal end 4 may extend proximally to allow the distal portion 28 and any medical device 32 within its lumen to bend further proximally. Alternatively, the tubular element 6 may be sufficiently translated or slid distally within the lumen 44 of the tubular shaft to allow the distal portion 28 to have the desired range of motion. To reduce the range of motion, the lateral opening 38 of the distal end 4 may be shortened (e.g., the notch 36 may be movable distally) to prevent the distal portion 28 and any medical device 32 within its lumen from bending proximally. Alternatively, the tubular element 6 can be sufficiently translated or slid proximally within the inner cavity 44 of the tubular shaft to reduce the range of motion of the distal portion 28.

[0034] Figure 4 The endoscope 2 shows a distal view of the forward viewing system 12. Figure 5 The distal end 4 is shown as a top view of the side-viewing system 14. Image sensors 16, 22 can be any sensor that detects light and transmits information to allow remote viewing of images, such as CMOS or CCD sensors. Light sources 18, 24 can emit any type of light to illuminate areas near their respective image sensors 16, 22. Lens cleaners 20, 26 can provide outlets for water, brine, or other fluids for cleaning the respective image sensors 16, 22 and / or light sources 18, 24. Lens cleaner 20 may include an outlet nozzle 20a for discharging fluid from lens cleaner 20. Similarly, lens cleaner 26 may include an outlet nozzle 26a for discharging fluid from lens cleaner 26.

[0035] Reference Figure 4 For the distal view, the components of the forward viewing system 12 can be positioned on the distal wall 34 of the distal end 4 / tubular axis / endoscope 2. The distal wall 34 can be perpendicular to the longitudinal axis A. The image sensor 16 can be positioned toward the left side of the distal opening 40. The light source 18 can be positioned below the image sensor 16 (in... Figure 4 (in the view), and can be associated with the image sensor 16 by positioning it to illuminate the area near the image sensor 16. The lens cleaner 20 can be positioned above the image sensor 16 (in the view), and can be associated with the image sensor 16 by positioning it to illuminate the area near the image sensor 16. Figure 4 (in the view) and can be configured to release fluid to clean image sensor 16 and / or light source 18. However, image sensor 16, light source 18, and lens cleaner 20 can be positioned relative to each other in any other order or configuration. For example, two or more components can be positioned adjacent to each other (in the view) Figure 4(in the view, side by side). Alternatively, one or more of the image sensor 16, light source 18, and lens cleaner 20 may be positioned on opposite sides of the distal opening 40 (e.g., Figure 4 In the view, the distal wall 34 is located to the right of the distal opening 40, closer to the observation system 14. In an alternative example, one or more of the image sensor 16, the light source 18, and the lens cleaner 20 may be positioned on the distal wall of the tubular axis of the endoscope 2, not at the distal end of the endoscope 2 (e.g., on the distal wall 46 (see...)). Figure 1 (or on another wall facing the far side).

[0036] Reference Figure 5 In a top view, image sensor 22 may be positioned near (and proximal to) the distal wall 34, and light source 24 may be positioned proximal to image sensor 22. Image sensor 22 and light source 24 may be positioned on the sidewall 42 of the distal end 4 / tubular axis / endoscope 2. Light source 24 may be associated with image sensor 22 by being positioned to illuminate the area near image sensor 22. Sidewall 42 may be any lateral wall and may be curved or flat. (See reference...) Figure 1-3 In one example, sidewall 42 may be a flat wall extending proximally from distal wall 34. In another example, sidewall 42 may be a curved outer surface of the distal end 4. See again... Figure 5 Lens cleaner 26 may be positioned on the distal sidewall 46 proximal to the light source 24 and may include an outlet through which brine or another fluid may be released along the sidewall 42 to clean image sensor 22 and / or light source 24. Image sensor 22, light source 24, and lens cleaner 26 may be positioned relative to each other in any other order or configuration. Alternatively, one or more of these components may be positioned on opposite sides of the lateral opening 38 (e.g., Figure 5 (In the view, to the left of the side opening 38).

[0037] The image sensor 16 on the distal wall 34 can be oriented distally. Thus, when the tubular element 28 is in the first configuration and moves proximally toward the second configuration, the image sensor 16 can be used to view the medical device 32 and any other tools extending from the distal opening 30. In contrast, the image sensor 22 in the side wall 42 can be oriented laterally. Thus, when the tubular element 28 approaches the second configuration or when it is in the second or third configuration, the image sensor 22 can be used to view the medical device 32 and any other tools extending from the distal opening 30.

[0038] In one example, the distal wall 34 (or any other wall including image sensor 16 facing distally) and the side wall 42 (or any other wall including image sensor 22 facing laterally) may be perpendicular to each other. The angle between the two walls described herein may correspond to the angle between the viewing directions of image sensors 16, 22. In another example, the distal wall 34 and the side wall 42 (and the respective viewing directions of image sensors 16, 22) may be offset by 90° and may be positioned relative to each other at approximately 90°. In other examples, the two walls may be positioned relative to each other at approximately 85°, approximately 80°, or approximately 75°. In yet another example, the two walls may be positioned relative to each other at at least 90° or less than 90°.

[0039] In one example, the viewing orientation of image sensors 16 and 22 can be adjusted relative to their respective walls. For example, the viewing orientation of image sensor 16 can be adjusted to pivot relative to its default position within the distal wall 34 along one or more axes, where the default position is oriented in the same direction as the distal wall 34. Similarly, the viewing orientation of image sensor 22 can be adjusted to pivot relative to its default position within the side wall 42 along one or more axes, where the default position is oriented in the same direction as the side wall 42.

[0040] In an exemplary procedure using endoscope 2, the distal end 4 can be inserted into the patient's mouth, esophagus, stomach, and duodenum during the first part of the procedure. During the first part of the procedure, the forward-viewing system 12 can be used to assist the user in navigating through the patient's anatomy. While navigating into the duodenum, the tubular element 6 can be in a first configuration to allow a medical device 32 (e.g., a guidewire) or other tool to move distally across the distal wall 34 of the distal end 4. For example, a guidewire can be inserted from the stomach and through the pylorus to aid in navigating the distal end 4 from the stomach into the duodenum.

[0041] Near the duodenal papilla, the user can use the lateral viewing system 14 to help locate the duodenal papilla. Using guidance from the lateral viewing system 14, the medical device 32 (e.g., a guidewire) can be inserted through the duodenal papilla and into the patient's pancreatic duct. To aid in insertion of the medical device 32 into the duodenal papilla, the tubular element 6 can be moved to a second configuration to allow the medical device 32 to exit from the side of the endoscope 2. The endoscope 2 and its distal end 4 can be maintained in a generally straight configuration within the duodenum, while the medical device 32 extends from the side of the distal end 4 into a distal opening 30. Once the medical device 32 is inserted into the pancreatic duct, the tubular element 6 can be moved to a third configuration to lock the medical device 32 relative to the distal end 4 of the tubular axis. In one example, both viewing systems 12 and 14 can be used simultaneously during any part of the procedure.

[0042] A cannula (not shown) can then be inserted through the lumen 8 of the tubular element 6 along the medical device 32. Once the cannula reaches the distal end 4, the tubular element 6 can be moved proximally to a second configuration (or through the second configuration toward the first configuration) to unlock the medical device 32. The cannula can then exit from the distal opening 30 and enter the pancreatic duct along the medical device 32 for pancreatic duct cannulation. Contrast agent can be injected into the pancreatic duct, and fluorescence images can be taken to study the bile duct, gallbladder, and pancreatic duct. If necessary, other instruments can be inserted through the tubular element 6 and / or cannulas into the pancreatic duct to treat pancreatic or biliary diseases.

[0043] While the principles of this disclosure have been described herein with reference to illustrative examples of specific applications, it should be understood that this disclosure is not limited thereto. Those skilled in the art and those who will recognize the teachings provided herein will understand that further modifications, applications, and substitutions of equivalents all fall within the scope of the examples described herein. Therefore, this invention should not be considered as limited to the foregoing description.

Claims

1. An endoscope (2), comprising: The axis has a longitudinal axis (A), a first image sensor (16) facing the distal direction, and a second image sensor (22) facing the lateral direction. and A tubular element (6) having an inner cavity (8) having a distal opening (30) and defining a longitudinal axis (B) passing through the center of the inner cavity (8), the tubular element (6) being movable between a first configuration, a second configuration and a third configuration; In the first configuration of the tubular element (6), the longitudinal axis of the inner cavity is parallel to the longitudinal axis of the shaft; and In the second configuration of the tubular element (6), the distal portion (28) of the tubular element (6) is bent such that the longitudinal axis (B) of the inner cavity (8) extends laterally in the distal portion (28) through a lateral opening (38) in the wall of the axis. In the third configuration of the tubular element (6), the medical device positioned within the tubular element (6) is locked relative to the wall of the shaft.

2. The endoscope of claim 1, wherein the tubular element (6) is configured to translate sufficiently distally within the cavity (44) of the shaft to allow the distal portion (28) to have a desired range of motion.

3. The endoscope of claim 1, wherein the tubular element (6) is configured to translate sufficiently proximally within the cavity (44) of the shaft to reduce the range of motion of the distal portion (28).

4. The endoscope of claim 1, wherein the wall of the axis includes a distally facing notch (36) configured to receive a medical device (32) and fix the medical device (32) relative to the wall of the axis.

5. The endoscope of claim 4, wherein when the tubular element (6) is moved to the third configuration, the medical device (32) presses between the wall of the distal portion (28) and the notch or groove (36) and forms a press-fit attachment with the distal end (4) via the notch or groove (36).

6. The endoscope as claimed in any of the preceding claims, wherein the lateral opening (38) and the distal opening (40) in the distal wall (34) allow tools to exit the distal opening (30) of the tubular element (6) to access the exterior of the endoscope (2).

7. The endoscope of claim 6, wherein the lateral opening (38) and the distal opening (40) are combined to form a single opening at the distal end (4) of the shaft that is both distal and lateral.

8. The endoscope of claim 6, wherein the lateral opening (38) extends proximally from the distal wall (34).

9. An endoscope, comprising: The first image sensor facing the far side; A second image sensor facing laterally; A tubular element having a distal opening and an inner lumen defining a longitudinal axis passing through the center of the lumen for receiving a medical device, wherein the tubular element is configured to move between a first configuration, a second configuration, and a third configuration; and In the first configuration of the tubular element, the longitudinal axis of the lumen is parallel to the longitudinal axis of the endoscope. In the second configuration of the tubular element, the longitudinal axis of the inner cavity extends laterally through a lateral opening of the axis; and In the third configuration of the tubular element, the shaft at least partially blocks the distal opening and engages the medical device to connect the shaft to the medical device.

10. The endoscope of claim 9, wherein the tubular element is configured to extend the medical device distally from the lumen when in the first configuration.

11. The endoscope of claim 10, wherein the tubular element is configured to move from the second configuration to the third configuration to lock the medical device into the notch of the shaft.

12. The endoscope of any one of claims 9-11, wherein, in the first configuration, the distal opening of the lumen is parallel to the distal wall of the axis such that the lumen is accessible from the distal direction of the axis.

Images