Medical articulating devices and methods of using the same

Abstract

A medical device includes a handle, a shaft extending distally from the handle, an end effector extending distally from the shaft, a first actuator movably coupled to the handle, and a second actuator movably coupled to the handle. The first actuator is configured to (1) articulate the shaft as the first actuator is translated in a first direction relative to the handle and the second actuator, and (2) actuate the end effector as the first actuator is translated in a second direction relative to the handle and the second actuator. The second actuator is configured to (1) articulate the shaft as the second actuator is translated in the first direction relative to the handle and the first actuator, and (2) actuate the end effector as the second actuator is translated in the second direction relative to the handle and the first actuator.

Description

[0001] Cross-reference to related applications

[0002] This application claims priority to U.S. Provisional Patent Application No. 63 / 081,807, filed September 22, 2020, the entire contents of which are incorporated herein by reference. Technical Field

[0003] Various aspects of this disclosure generally relate to medical articulation systems, devices, and related methods. In other aspects, examples of this disclosure relate to systems, devices, and related methods for articulating medical instruments relative to a subject. Background Technology

[0004] Endoscopic and surgical procedures of the gastrointestinal (GI) tract include, for example, submucosal dissection, colectomy, bariatric surgery, esophagectomy, gastric bypass, and sleeve gastrectomy, among others. These procedures involve lifting and / or removing tissue from the patient's body. Assistive devices used to perform such procedures may include complex interfaces for operating the devices. Furthermore, these interfaces may provide limited articulation capabilities for manipulating the device inside the patient, thus requiring the use of additional devices or multiple hands to operate the device. Summary of the Invention

[0005] In other respects, aspects of this disclosure relate to systems, apparatus, and methods for treating target treatment sites using articulated devices that provide enhanced maneuverability. Each aspect disclosed herein may include one or more features described in conjunction with any other disclosed aspect.

[0006] According to one example, the medical device includes a handle, a shaft extending distally from the handle, an end effector extending distally from the shaft, a first actuator movably coupled to the handle, and a second actuator movably coupled to the handle. The first actuator is configured to (1) hinge the shaft by translating the first actuator relative to the handle and the second actuator in a first direction, and (2) actuate the end effector by translating the first actuator relative to the handle and the second actuator in a second direction. The second actuator is configured to (1) hinge the shaft by translating the second actuator relative to the handle and the first actuator in the first direction, and (2) actuate the end effector by translating the second actuator relative to the handle and the first actuator in a second direction.

[0007] Any medical device described herein may include any of the following features. A handle includes a first track extending along the body of the handle. A first actuator is received within the first track and configured to translate along the first track. The first track has a longitudinal length corresponding to a first degree of hinge of (1) the shaft and a first range of actuation of (2) the end effector. The handle includes a second track extending along the body of the handle. A second actuator is received within the second track and configured to translate along the second track. The second track has a longitudinal length corresponding to a second degree of hinge of (1) the shaft and a second range of actuation of (2) the end effector. A first line and a second line are also included disposed within the handle and the shaft. The first line is coupled to a first portion of the first actuator and the end effector. The second line is coupled to a second portion of the second actuator and the end effector. The first actuator is configured to move the first line in a first direction to hinge the shaft and move the first and second portions in the first direction. The second actuator is configured to move the second line in a second direction to move the second portion relative to the first portion. The second actuator is configured to move the second line in the first direction to hinge the shaft and move the first and second parts in the first direction. The first actuator is configured to move the first line in the second direction to move the second part relative to the first part. The first actuator is configured to move the first part relative to the second part, and the second actuator is configured to move the second part relative to the first part. The first actuator is configured to move towards the first actuator and hinge the shaft in the first direction as the first actuator translates relative to the handle and the second actuator in the first direction. The second actuator is configured to move towards the second actuator and hinge the shaft in the first direction as the second actuator translates relative to the handle and the first actuator in the first direction. The first and second actuators are arranged about the circumference of the handle. The first and second actuators are at least partially arranged inside the handle. The first actuator includes a first ring, the second actuator includes a second ring, and the handle includes a third ring. The third ring is fixed relative to the first and second rings, and the first and second rings are movable relative to each other and relative to the third ring. The first actuator has a nearest side position corresponding to the hinged position of the shaft, a farthest side position corresponding to the actuated state of the end effector, and an intermediate position between the nearest side position and the farthest side position, corresponding to the unhinged position of the shaft and the unacted state of the end effector.

[0008] According to another example, the medical device includes: a handle having a first movable actuator and a second movable actuator; a shaft extending distally from the handle and having an end effector at a distal end of the shaft; a first wire disposed within the shaft and connected to the first movable actuator and the end effector; and a second wire disposed within the shaft and connected to the second movable actuator and the end effector. The first movable actuator is configured to (1) hinge the shaft by translating the first wire proximally relative to the shaft and the second movable actuator wire, and (2) actuate the end effector by translating the first wire distally relative to the shaft and the second movable actuator. The second movable actuator is configured to (1) hinge the shaft by translating the second wire proximally relative to the shaft and the first movable actuator, and (2) actuate the end effector by translating the second wire distally relative to the shaft and the first movable actuator.

[0009] Any medical device described herein may include any of the following features. A handle includes a first track and a second track extending along opposite sides of the handle. A first movable actuator is received within the first track and configured to translate along the first track, and a second movable actuator is received within the second track and configured to translate along the second track. The first track has a first longitudinal length corresponding to a first degree of hinge on (1) the shaft and a first range of actuation of (2) the end effector. The second track has a second longitudinal length corresponding to a second degree of hinge on (1) the shaft and a second range of actuation of (2) the end effector. The first movable actuator is configured to hinge toward the first movable actuator and in the first direction the shaft is hinged in the first direction as the first actuator translates relative to the handle and the second actuator in the first direction. The second movable actuator is configured to hinge toward the second movable actuator and in the first direction the shaft is hinged in the first direction as the second actuator translates relative to the handle and the first actuator in the first direction.

[0010] According to another example, the medical device includes a handle having a first longitudinal rail and a second longitudinal rail; a shaft extending distally from the handle; an end effector at the distal end of the shaft; and a first actuator coupled to a first line disposed within the shaft. The first actuator translates along the first longitudinal rail. The medical device includes a second actuator coupled to the second line disposed within the shaft. The second actuator translates along the second longitudinal rail. The first actuator is configured to retract the first line proximally relative to the axial direction to hinge the shaft in a first direction when the first actuator moves proximally in the first longitudinal rail and the second actuator is fixed relative to the second longitudinal rail. The second actuator is configured to retract the second line proximally relative to the axial direction to hinge the shaft in a second direction when the second actuator moves proximally in the second longitudinal rail and the first actuator is fixed relative to the first longitudinal rail. The second direction is opposite to the first direction.

[0011] It is understood that both the foregoing overview and the following detailed description are exemplary and illustrative only, and not intended to limit the invention as claimed. Attached Figure Description

[0012] The accompanying drawings, which are incorporated in and form part of this specification, illustrate exemplary aspects of this disclosure and, together with the description, are intended to explain the principles of this disclosure.

[0013] Figure 1A This is a side view of an exemplary medical device according to various aspects of this disclosure, the medical device including a pair of actuators, a handle, and an actuator in an actuated (closed) state and an unhinged position;

[0014] Figure 1B Based on all aspects of this disclosure Figure 1A A side view of a medical device, in which the end effector is in an unactuated (open) state and in a hinged position;

[0015] Figure 2 Based on all aspects of this disclosure Figure 1A A side view of a medical device including a pair of line end effectors;

[0016] Figure 3 It is based on various aspects of this disclosure that are in a passive (closed) state. Figure 1A A perspective view of the end effector of a medical device;

[0017] Figure 4 It is in a non-activated (open) state according to all aspects of this disclosure. Figure 1A A perspective view of the end effector of a medical device, wherein the lines of this pair of lines are arranged inside the axis of the medical device;

[0018] Figure 5 Based on all aspects of this disclosure Figure 1A A sectional perspective view of the proximal axis of a medical device;

[0019] Figure 6 Based on all aspects of this disclosure Figure 1A A cross-sectional perspective view of the distal articulated joint of a medical device; and

[0020] Figure 7 This is a perspective view of the handle of another exemplary medical device according to various aspects of this disclosure. Detailed Implementation

[0021] In endoscopic submucosal dissection (ESD), objects in the gastrointestinal tract are targeted for removal, such as tumors. A medical device capable of removing the target object is incorporated within a medical instrument (e.g., an endoscope) that is placed at the target treatment site via an endoscope through the gastrointestinal tract. An auxiliary device can be placed at the target treatment site using the endoscope to manipulate tissue near the target object. Suitable auxiliary devices and systems for endoscopic submucosal dissection are limited. However, this disclosure is not limited to endoscopic submucosal dissection procedures, but can be used for any suitable medical procedure.

[0022] Examples of this disclosure include systems, apparatus, and methods for controlling materials and / or objects (e.g., tissue) at a target treatment site within a subject (e.g., a patient) with enhanced maneuverability. In various examples, endoscopic submucosal dissection includes the placement of an end effector (such as a chuck assembly or other similar tool) within the lumen of the target treatment site. Placement of the end effector can be via a catheter, observation instrument (endoscope, bronchoscope, colonoscope, etc.), tube, or cannula inserted into the gastrointestinal tract through a natural orifice. This orifice can be, for example, the nose, mouth, or anus, and placement can be in any part of the gastrointestinal tract, including the esophagus, stomach, duodenum, large intestine, or small intestine. Placement can also be in other organs or other body spaces accessible via the gastrointestinal tract, other body cavities, or openings in the body.

[0023] Reference will now be made in detail to aspects of this disclosure, examples of which are illustrated in the accompanying drawings. Wherever possible, the same or similar reference numerals will be used in the drawings to refer to the same or similar parts. The term "distal" refers to the portion furthest from the user when the device is inserted into the patient. Conversely, the term "proximal" refers to the portion closest to the user when the device is placed in the subject. The terms "comprising," "having," or any other variations thereof as used herein are intended to cover non-exclusive inclusion, and a process, method, article, or apparatus that comprises a list of elements does not necessarily include only those elements, but may include other elements not expressly listed or therefore inherent to such a process, method, article, or apparatus. The term "exemplary" is used in the meaning of "illustrated" rather than "ideal." The terms "about," "approximately," and "about" as used herein refer to a range of values ​​within + / - 10% of the stated values.

[0024] Examples of this disclosure may relate to apparatus and methods for performing various medical procedures and / or treating portions of the large intestine (colon), small intestine, cecum, esophagus, any other part of the gastrointestinal tract, and / or any other suitable patient anatomy (collectively referred to herein as "target treatment sites"). As noted above, this disclosure is not limited to any particular medical device or method, and aspects of this disclosure may be used in conjunction with any suitable medical tool and / or medical method at any suitable site within the body. The various examples described herein include single-use or disposable medical devices.

[0025] Figures 1A-1B An exemplary medical device 100 according to one embodiment of the present disclosure is shown. The medical device 100 may include a handle 102 having a longitudinal length defined by a proximal end 104 and a distal end 106. The proximal end 104 may include a gripping feature configured to facilitate manual control of the handle 102. For example, the gripping feature may include a ring sized and shaped to receive the fingers of a user of the medical device 100. The handle 102 may also include a pair of rails 108, 109 positioned along opposite sides of the handle 102 and extending between the proximal end 104 and the distal end 106. As further described herein, the rails 108, 109 may define a path of movement for one or more actuators 110, 112, and the longitudinal length of the rails 108, 109 may define the range (degree) of articulation and actuation of the medical device 100.

[0026] The medical device 100 may also include a pair of actuators 110, 112, which are movably coupled to the handle 102 at tracks 108, 109. For example, the medical device 100 may include a first actuator 110 slidably coupled to a first track 108 and a second actuator 112 slidably coupled to a second track 109. The first actuator 110 may be configured to translate along the first track 108 in one or more directions A, B, and the second actuator 112 may be configured to translate along the second track 109. That is, the first actuator 110 and the second actuator 112 may each be movable in a first direction A or a second direction B. The first actuator 110 and the second actuator 112 may be configured to move independently of each other and relative to each other. The actuators 110, 112 may be actuated in various suitable ways and sequences, such as simultaneously and / or independently of each other. In some embodiments, the first actuator 110 and the second actuator 112 may be arranged around the circumference of the handle 102 and together enclose at least a portion of the handle 102 between them.

[0027] Although not illustrated, it should be understood that the first actuator 110 may be coupled to a first wire 170 received within the handle 102, and the second actuator 112 may be coupled to a second wire 172 received within the handle 102 (see Figure 112). Figures 2-4 Various suitable mechanisms (including, for example, crimping, adhesives, UV curing, etc.) can be used to connect wires 170, 172 to actuators 110, 112. Thus, each actuator 110, 112 can be configured to move the corresponding wire 170, 172 relative to handle 102 as it translates along its respective track 108, 109.

[0028] Still refer to Figures 1A-1B The first actuator 110 may include a body having a gripping feature 114 extending laterally outward from the body of the first actuator 110. The second actuator 112 may include a body having a gripping feature 116 extending laterally outward from the body of the second actuator 112. Each gripping feature 114, 116 may be configured to facilitate movement of the respective actuator 110, 112 relative to corresponding tracks 108, 109. In this example, each gripping feature 114, 116 may include a ring sized and shaped to receive a corresponding finger of the user of the medical device 100. It should be understood that the gripping features 114, 116 may have various other suitable sizes, shapes, and / or configurations without departing from the scope of this disclosure.

[0029] The medical device 100 may include a shaft 120 fixed to and extending distally from a handle 102 (specifically from the distal end 106). The shaft 120 may include a proximal shaft 122 and a distal articulated joint 130. The proximal end of the proximal shaft 122 may be coupled to the distal end 106, and the proximal end of the distal articulated joint 130 may be coupled to the distal end of the proximal shaft 122. The medical device 100 may also include an end effector 140 coupled to the distal end of the distal articulated joint 130. The end effector 140 may include one or more components, such as a U-clamp 142, a first jaw 148A, and a second jaw 148B. The U-clamp 142 may be fixed to the distal end of the distal articulated joint 130, and the jaws 148A and 148B may be pivotally coupled to the U-clamp 142. As further described herein, each of the grippers 148A, 148B is movable with the translation of actuators 110, 112. In this embodiment, the end effector 140 may exclude one or more links coupled to the pair of grippers 148A, 148B. As further described herein, the medical device 100 may be configured to enhance the gripping force between the grippers 148A, 148B due to the exclusion of the links in the end effector 140.

[0030] Now refer to Figures 2-3Each of the jaws 148A and 148B can be connected to at least one of the actuators 110 and 112 via corresponding lines 170 and 172. For example, the first jaw 148A can be connected to the second actuator 112 via the second line 172, and the second jaw 148B can be connected to the first actuator 110 via the first line 170. In this example, the first jaw 148A may include a proximal arm 144A that receives the second line 172, and the second jaw 148B may include a proximal arm 144B that receives the first line 170. Therefore, it should be understood that the end effector 140 excludes a link (or any other structure) between the jaws 148A and 148B and the lines 170 and 172, such that the lines 170 and 172 are directly connected to the jaws 148A and 148B at the corresponding proximal arms 144A and 144B. By eliminating one or more links (or any other structure) between lines 170, 172 and claws 148A, 148B, the medical device 100 can operatively minimize the mechanical loss of force transmission between actuators 110, 112 and claws 148A, 148B.

[0031] It should be understood that, Figure 2 An end effector 140 is depicted, wherein the U-shaped clamp 142 is omitted for illustrative purposes only. The end effector 140 may include a pin 146 defining a pivot point for jaws 148A, 148B, i.e., jaws 148A, 148B may be movably coupled to each other near the pin 146. Furthermore, at the pin 146, the first jaw 148A and the second jaw 148B may be movably coupled to the U-shaped clamp 142. Each jaw 148A, 148B may include a plurality of teeth along its inner surface for gripping an object (e.g., tissue) arranged between the jaws 148A, 148B. It should be understood that the end effector 140 may include a variety of suitable configurations, including but not limited to one or more clamps, large scissors, pliers, scissors, suturing devices, lighting devices, imaging systems, gripper assemblies, and a variety of other suitable tools and / or devices. Therefore, the end effector 140 illustrated and described herein is merely exemplary, and the medical device 100 may include various other end effectors without departing from the scope of this disclosure.

[0032] Now refer to Figure 4The first wire 170 and the second wire 172 may be arranged inside the shaft 120 and extend distally from the distal hinge joint 130 to engage with the proximal arms 144B and 144A, respectively. In this example, the shaft 120 may include a first cavity 128A configured to receive the first wire 170 and a second cavity 128B configured to receive the second wire 172. It should be understood that movement of the first actuator 110 along the handle 102 provides movement of the first wire 170 within the first cavity 128A and a corresponding movement of the second pawl 148B. Furthermore, movement of the second actuator 112 along the handle 102 provides movement of the second wire 172 within the second cavity 128B and a corresponding movement of the first pawl 148A. As described in detail herein, each actuator of the first actuator 110 and the second actuator 112 may be configured to actuate the end effector 140 and hinge the distal hinge joint 130. Furthermore, as described in more detail below, shaft 120 (e.g., proximal shaft 122, distal articulated joint 130) may include one or more inner layers, including a first inner layer 134 in a braided configuration and a second inner layer 136 (e.g., a multi-cavity shaft) defining a first inner cavity 128A and a second inner cavity 128B.

[0033] Now refer to Figure 5 The proximal axis 122 is depicted as having multiple layers. In this example, the proximal axis 122 may include an outer layer 123, a first inner layer 124, a second inner layer 126, and a third inner layer 128. The outer layer 123 may be disposed around the first inner layer 124 and may be configured to insulate the first inner layer 124, for example, from a tool (e.g., a cautery knife) positioned adjacent to the medical device 100. In some examples, the outer layer 123 may be made of an insulating material (e.g., containing...) The outer layer 123 is formed by reflow soldering of the resin. It may also be made of a material having a predetermined hardness in the range of about 10D (hardness) to about 100D, more specifically 30D to 75D. In other embodiments, the outer layer 123 may be omitted entirely.

[0034] A first inner layer 124 may be disposed around a second inner layer 126 and may comprise a braid consisting of multiple threads woven together (e.g., straight, circular, etc.). In some instances, the first inner layer 124 may comprise multiple threads ranging from about 10 to about 100, more specifically from 16 to 32. In some embodiments, the braiding of the first inner layer 124 may be angled, for example at an angle of about 10 to about 100 degrees, more specifically from 30 to 50 degrees. The braiding of the first inner layer 124 may employ various suitable patterns, including, for example, diamond braids, threaded braids, etc. The first inner layer 124 may be configured to increase the torque and / or stiffness of the proximal shaft 122. In other embodiments, the first inner layer 124 may be omitted entirely.

[0035] Still refer to Figure 5 The second inner layer 126 may be disposed around the third inner layer 128 and may include a coil wound (e.g., clockwise, counterclockwise, etc.) around the third inner layer 128. In some embodiments, the helix pitch of the second inner layer 126 may be approximately similar to the wire diameter of the coil. The second inner layer 126 may be configured to provide rigidity to the proximal shaft 122.

[0036] The third inner layer 128 may be made of polytetrafluoroethylene (PTFE) and includes a first inner cavity 128A and a second inner cavity 128B for receiving each of the first wire 170 and the second wire 172, respectively. In this example, the cavities of the third inner layer 128 may have diameters that are similar to and / or different from each other. The third inner layer 128 may include a diameter ranging from about 0.5 mm to about 1.0 mm, specifically 0.8 mm. The first inner cavity 128A may include a diameter ranging from about 0.2 mm to about 0.8 mm, specifically 0.4 mm, and the second inner cavity 128B may include a diameter ranging from about 0.1 mm to about 0.7 mm, specifically 0.3 mm. In other embodiments, the third inner layer 128 may be completely omitted or replaced by a pair of sleeves (each defining a cavity for receiving at least one of wires 170, 172).

[0037] Still refer to Figure 5 The first wire 170 and the second wire 172 can be made of various materials, including, for example, stainless steel, nickel-titanium alloy, plastic, aluminum, etc. In some instances, the first wire 170 and / or the second wire 172 can be coated with polytetrafluoroethylene (PTFE) and / or other suitable materials. Furthermore, the first wire 170 and / or the second wire 172 can comprise a single wire or a group of multiple strands. As described in more detail herein, each wire of the first wire 170 and the second wire 172 can be configured to provide articulation of the shaft 120 and actuation of the end effector 140.

[0038] Now refer to Figure 6 The distal articulated joint 130 is depicted as having multiple layers. In this example, the distal articulated joint 130 may include an outer layer 132, a first inner layer 134, and a second inner layer 136. The outer layer 132 may be disposed around the first inner layer 134 and may be configured to insulate the first inner layer 134. For example, the outer layer 132 may be made of an insulating material (e.g., containing...) The outer layer 132 is formed by reflow soldering of resin. The outer layer 132 may be made of a material having a predetermined hardness relatively less than that of the outer layer 123 of the proximal axis 122. For example, the outer layer 132 may have a predetermined hardness in the range of about 5D to about 100D, more specifically 30D to about 50D. As described in detail herein, the distal hinge joint 130 may be configured to bend relative to the proximal axis 122 upon actuation of at least one of the lines 170, 172.

[0039] The first inner layer 134 may be disposed around the second inner layer 136 and may include a braid consisting of multiple interwoven threads (e.g., straight, circular, etc.). The first inner layer 134 may be substantially similar to the first inner layer 124. For example, the first inner layer 134 may include multiple threads ranging from about 10 to about 100 threads, more specifically 16 to 32 threads. In other instances, the first inner layer 134 may include fewer threads than the first inner layer 124. The first inner layer 134 may be configured to increase the torque and / or stiffness of the distal articulated joint 130. In some embodiments, the braid of the first inner layer 134 may be angled, for example at an angle ranging from about 10 degrees to about 100 degrees, more specifically 30 to 50 degrees. The braid of the first inner layer 134 may employ various suitable patterns, including, for example, diamond braids, threaded braids, etc.

[0040] Still refer to Figure 6 The second inner layer 136 may be made of polytetrafluoroethylene (PTFE) and may include a first inner cavity 128A and a second inner cavity 128B for receiving each of the first wire 170 and the second wire 172, respectively. In this example, the first inner cavity 128A and the second inner cavity 128B of the second inner layer 136 may have similar and / or different diameters relative to each other. In other embodiments, the second inner layer 136 may be completely omitted or replaced by a pair of sleeves (each defining an inner cavity for receiving at least one of the wires 170, 172). The second inner layer 136 may be made of a material having a predetermined hardness in the range of about 15D to about 95D, more specifically 33D to 50D. The first wire 170 may extend distally from the second inner layer 136 through a U-shaped clip 142 for engagement with the proximal arm 144B (see...). Figures 2-3 The first wire 170 can be fixed to the proximal arm 144B using adhesives, welding, crimping, ultraviolet (UV) curing, etc. The second wire 172 can extend distally from the second inner layer 136 through the U-shaped clip 142 to engage with the proximal arm 144A (see...). Figures 2-3 The second line 172 can be fixed to the proximal arm 144A using adhesives, welding, crimping, ultraviolet (UV) curing, etc.

[0041] According to an exemplary method of using medical device 100, a medical device (e.g., an endoscope) may be initially guided through the body of a subject to position the distal end of the medical device at a target treatment site. Medical device 100 may be received within the medical device, and an end effector 140 may extend outward from the distal end of the medical device. In this case, the end effector 140 may be positioned inside the subject and at the target treatment site, while the handle 102 is positioned proximally to the subject outside the medical device. It should be understood that the end effector 140 will be held in an actuated (closed) state during delivery through the medical device.

[0042] Now refer to Figure 1A The first actuator 110 and the second actuator 112 can each be positioned in a first position relative to the handle 102, thus holding the distal articulated joint 130 in an unhinged state (e.g., aligning the longitudinal axis of the distal articulated joint 130 with the longitudinal axis of the shaft 120) and holding the end effector 140 in an actuated state. In other words, actuators 110 and 112 can be positioned along the middle of tracks 108 and 109, thus holding lines 170 and 172 in an intermediate position relative to the shaft 120 and the end effector 140. In this case, the first line 170 does not apply tension to the second jaw 144B, and the second line 172 does not apply tension to the first jaw 144A, thereby holding the end effector 140 in an actuated state and holding the distal articulated joint 130 in an unhinged state (e.g., parallel to the shaft 120 and / or the handle 102).

[0043] Now refer to Figure 1B The first actuator 110 can be translated (e.g., proximally) along the first track 108 in a first direction A to pull the first line 170 proximally relative to the axis 120 and the handle 102. In this case, the first actuator 110 can be moved to the proximal position and configured to hinge the distal hinge joint 130 toward the side of the handle 102 including the first actuator 110, thereby causing the end effector 140 to move radially outward and in the first direction A. For example, the user of the medical device 100 can move the first actuator 110 relative to the handle 102 by pulling the first actuator 110 proximally toward the proximal end 104. As a proximal force is applied to the gripping feature 114, the first actuator 110 can slide relative to the handle 102. In this case, the first line 170 (which is fixed to the body of the first actuator 110 along a portion inside the handle 102) can move in the first direction A relative to the handle 102 together with the gripping feature 114. Since the first line 170 is fixed to the proximal arm 144B, the first actuator 110 can be configured to move the first line 170 relative to the handle 102 and the shaft 120.

[0044] The first actuator 110 can pull the first line 170 proximally to apply a proximal force (tension) to the proximal arm 148B, thereby causing the distal articulation joint 130 to bend. In this case, the end effector 140 can be deflected in the first direction A, i.e., in the same direction as the movement of the first actuator 110 relative to the handle 102, because the connection point between the line 170 and the arm 148B is eccentric and radially outward from the longitudinal axis of the distal articulation joint 130 toward the same side of the medical device 100 as the first actuator 110. The user of the medical device 100 can selectively adjust the degree of hinge of the distal articulation joint 130 and the corresponding degree of deflection of the end effector 140 based on the degree of movement of the first actuator 110 relative to the handle 102. Furthermore, the handle 102 can be rotated to rotate the shaft 120 and move the end effector 140 relative to the target treatment site, thereby facilitating further movement of the medical device 100 toward the target object within the target treatment site. In some embodiments, the second actuator 112 may remain stationary during the translation of the first actuator 110 relative to the handle 102.

[0045] Still refer to Figure 1B This allows the second actuator 112 to translate along the second track 109 in a second direction B opposite to the first direction A, pushing the second line 172 distally relative to the shaft 120 and the handle 102. In this case, since the distal hinge joint 130 has been hinged by the first actuator 110, the second actuator 112 can be moved to the distal position, thereby causing the end effector 140 to move from the actuated state ( Figure 1A The device can be switched to an inactive state. For example, the user of the medical device 100 can move the second actuator 112 relative to the handle 120 by sliding it distally toward the distal end 106 to its furthest position. As a distal force is applied to the gripping feature 116, the second actuator 112 can slide relative to the handle 120. In this case, the second line 172 (which is fixed to the body of the second actuator 112 along a portion inside the handle 102) can move relative to the handle 102 together with the gripping feature 116. Since the second line 170 is fixed to the proximal arm 144A, the second actuator 112 can be configured to move the second line 172 relative to the handle 102 and the axis 120.

[0046] The second actuator 112 can push the second line 172 distally to apply a distal force (thrust) to the proximal arm 144A, thereby causing the first pawl 148A to move around the pin 146 away from the second pawl 148B. In this case, the end effector 140 can be switched to an unactuated state by using the pawls 148A and 148B that are separated from each other. The user of the medical device 100 can selectively adjust the degree of separation between the pawls 148A and 148B according to the range of translation of the second actuator 112 relative to the second track 109. In other words, the gap formed between the pawls 148A and 148B can correspond to the longitudinal translation of the second actuator 112 along the handle 102. In some embodiments, the first actuator 110 may remain stationary during the translation of the second actuator 112 relative to the handle 102.

[0047] By utilizing the gripping features at the distal end 104 to control the position, orientation, and / or configuration of the handle 102, the end effector 140 can be manipulated near the target treatment site to position the end effector 140 close to the target object. Since the target object is positioned within the opening formed between the jaws 148A and 148B, the second actuator 112 can be translated proximally in the first direction A (e.g., to a mid-position and / or a proximal position) to move the first jaw 148A toward the second jaw 148B and clamp the target object (e.g., tissue) between them.

[0048] It should be understood that actuators 110 and 112 can provide multifunctional capabilities based on the actuation sequence of each actuator 110 and 112 relative to each other. For example, in other embodiments, instead of the first actuator 110, the second actuator 112 can be moved in a first direction A (e.g., to a proximal position) such that the distal articulated joint 130 can be directed toward the second actuator 112 and bend in the first direction A. In this case, subsequent actuation of the first actuator 110 in a second direction B (e.g., to a distal position) can provide movement of the second pawl 148B relative to the first pawl 148A to change the end effector from a closed configuration to an open configuration. Since both actuators 110 and 112 can articulate the shaft 120 and actuate the end effector 140, the medical device 100 can provide an ergonomic interface for manipulating a target object (e.g., tissue) during single-handed surgery by the user. In addition, the medical device 100 can provide a variety of degrees of articulation and / or multiple directions of movement via actuators 110, 112.

[0049] Now refer to Figure 7 This illustration depicts another exemplary medical device 200 according to one example of this disclosure. Unless otherwise described herein, medical device 200 may be constructed and operated in a manner similar to medical device 100. Therefore, similar reference numerals are used to identify similar components.

[0050] The medical device 200 may include a handle 202 292 having a longitudinal length defined between a proximal end 204 and a distal end 206. The size, shape, and construction of the handle 202 may be designed to be gripped by a user of the medical device 200. That is, the handle 202 provides an ergonomic interface for gripping the medical device 200 and manipulating the handle 202 with one hand. The handle 202 may also include a pair of tracks located on opposite sides of the handle 202 and extending between the proximal end 204 and the distal end 206. For example, the handle 202 may include a first track 208 along the upper wall of the handle 202 and a second track (not shown) positioned along the lower wall of the handle 202. Each track may define a travel path for one or more actuators 210, 212, and the longitudinal length of these tracks may define the articulation and actuation range (span) of the medical device 200.

[0051] The medical device 200 may also include a pair of actuators 210, 212 movably coupled to the handle 202 at these tracks. For example, the medical device 200 may include a first actuator 210 slidably coupled to a first track 208 and a second actuator 212 slidably coupled to a second track. In this example, the first track 208 and the second track 210 may include openings formed along the exterior of the handle 202, such that the actuators 210, 212 may be at least partially arranged within the openings and secured within the handle 202. The first actuator 210 may be configured to move along the first track 208, and the second actuator 212 may be configured to translate along the second track in one or more directions (e.g., proximal, distal, etc.). Although not illustrated, it should be understood that the first actuator 210 may be coupled to a first wire 170 within the handle 202, and the second actuator 212 may be coupled to a second wire 172 within the handle 202. Therefore, each actuator 210, 212 can be configured to move the corresponding line 170, 172 relative to the handle 202 as it translates along its respective track.

[0052] Still refer to Figure 7 The first actuator 210 may include a body with a gripping feature 214, and the second actuator 212 may include a body with a gripping feature 216. Each gripping feature 214, 216 may be configured to facilitate movement of its respective actuator 210, 212 relative to a corresponding track. In this example, the gripping features 214, 216 may include sliding buttons and / or knobs, sized and shaped to receive a user's fingers. It should be understood that the gripping features 214, 216 may have various other suitable sizes, shapes, and / or configurations without departing from the scope of the disclosure.

[0053] The medical device 200 may also include a shaft 120 extending distally (specifically from the distal end 206) from the handle 202. Although not illustrated, it should be understood that the medical device 200 may include a proximal shaft 122 and a distal articulated joint 130, wherein the end effector 140 is coupled to the distal end of the articulated joint 130. The medical device 200 may be constructed and operated in a manner similar to that of the medical device 100 described above, such that movement of actuators 210, 212 relative to the handle 202 may provide similar articulation and actuation of the shaft 120 and the end effector 140, respectively, as described in detail above with respect to the medical device 100.

[0054] Each of the aforementioned systems, devices, components, and methods can be used to manipulate target tissue with enhanced maneuverability. By providing the medical device with an intuitive handle that allows for single-handed control of the actuation and articulation of the end effector, the user can use their other hand to control other devices and / or tools during surgery for treatment of the target site. In this case, the user can reduce the total surgical time, increase the efficiency of the surgery, and / or avoid unnecessary harm to the subject's body due to limited control over other tools / devices.

[0055] It will be apparent to those skilled in the art that various modifications and variations may be made to the disclosed apparatus and methods without departing from the scope of this disclosure. Other aspects of this disclosure will be apparent to those skilled in the art based on consideration of this specification and the implementation of the features disclosed herein. It is intended that this specification and examples be considered exemplary only.

Claims

1. A medical device comprising: handle; A shaft extending distally from the handle; An end effector extending distally from the said axis; A first actuator movably connected to the handle; A second actuator movably connected to the handle; as well as A first wire and a second wire are arranged within the handle and the shaft, wherein the first wire is connected to the first actuator and a first part of the end effector, and wherein the second wire is connected to the second actuator and a second part of the end effector. The first actuator is configured to (1) cause the shaft to articulate by translating the first actuator relative to the handle and the second actuator in a first direction, and (2) actuate the end effector by translating the first actuator relative to the handle and the second actuator in a second direction; and The second actuator is configured to (1) cause the shaft to articulate by translating the second actuator relative to the handle and the first actuator in the first direction, and (2) actuate the end effector by translating the second actuator relative to the handle and the first actuator in the second direction.

2. The medical device of claim 1, wherein the handle includes a first track extending along the body of the handle; and The first actuator is received within the first track and configured to translate along the first track.

3. The medical device of claim 2, wherein the first track has a longitudinal length corresponding to (1) the degree of movement of the first joint of the shaft and (2) the first actuation range of the end effector.

4. The medical device of claim 3, wherein the handle includes a second track extending along the body of the handle; and The second actuator is received within the second track and configured to translate along the second track.

5. The medical device of claim 4, wherein the second track has a longitudinal length corresponding to (1) the degree of movement of the second joint of the shaft and (2) the second actuation range of the end effector.

6. The medical device of claim 1, wherein the first actuator is configured to move the first line in the first direction to cause articulation of the axis and to move the first portion and the second portion in the first direction; and The second actuator is configured to move the second line in the second direction so that the second part moves relative to the first part.

7. The medical device of claim 6, wherein the second actuator is configured to move the second line in the first direction to cause articulation of the axis and to move the first portion and the second portion in the first direction; and The first actuator is configured to move the first line in the second direction, so that the second part moves relative to the first part.

8. The medical device of any one of claims 1 to 7, wherein the first actuator is configured to move the first portion relative to the second portion, and the second actuator is configured to move the second portion relative to the first portion.

9. The medical device of any one of claims 1 to 7, wherein the first actuator is configured to move the axis toward the first actuator and articulate in the first direction as the first actuator is translated relative to the handle and the second actuator in the first direction.

10. The medical device of claim 9, wherein the second actuator is configured to cause the axis to move toward the second actuator and articulate in the first direction as the second actuator is translated relative to the handle and the first actuator in the first direction.

11. The medical device according to any one of claims 1 to 7, wherein the first actuator and the second actuator are arranged circumferentially along the handle.

12. The medical device according to any one of claims 1 to 7, wherein the first actuator and the second actuator are at least partially disposed inside the handle.

13. The medical device of any one of claims 1 to 7, wherein the first actuator comprises a first ring, the second actuator comprises a second ring, and the handle comprises a third ring; and The third ring is fixed relative to the first and second rings, and the first and second rings move relative to each other and relative to the third ring.

14. The medical device of any one of claims 1 to 7, wherein the first actuator has a proximal position corresponding to the articulated position of the shaft, a distal position corresponding to the actuated state of the end effector, and an intermediate position between the proximal and distal positions and corresponding to the unarticulated position of the shaft and the unactuated state of the end effector.

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