Medical device including a medical device management system

Abstract

An actuation mechanism for an endoscope is disclosed. The actuation mechanism includes a housing configured to attach to a handle of the endoscope and a thumbwheel coupled to the housing. Rotation of the thumbwheel causes an elongated medical device to longitudinally translate through a working channel of the endoscope. In some cases, the actuation mechanism includes a drive wheel and / or a roller wheel, where the elongated medical device is compressively positioned between the roller wheel and / or the drive wheel. Rotation of the thumbwheel can cause the drive wheel and / or the roller wheel to rotate in opposite rotational directions.

Description

[0001] Cross-reference to related applications

[0002] This application claims the benefit and priority of U.S. Provisional Patent Application No. 63 / 155,955, filed March 3, 2021, the disclosure of which is incorporated herein by reference. Technical Field

[0003] This disclosure relates to medical devices and methods for manufacturing medical devices. More specifically, this disclosure relates to medical devices including an ergonomic medical device management system for use in conjunction with an elongated device. Background Technology

[0004] Flexible ureteroscopes are used for the examination and treatment of the kidneys and often include features that improve accessibility to treatment sites and patient comfort. A flexible ureteroscope may have a flexible distal end that is controlled by a physician through manipulation of various components attached to the endpiece handle. This manipulation allows the physician to maneuver the end of the endpiece to different locations within the body (e.g., different locations within the kidney). Furthermore, ureteroscopes are often used in conjunction with other medical devices during medical procedures. For example, a urologist may combine a flexible ureteroscope with laser fibers and a retrieval device (e.g., a retrieval basket) to break up kidney stones and remove the fragmented material from the body. Therefore, these procedures may require not only manipulating the various features of the ureteroscope to control its distal end but also the introduction and manipulation of auxiliary devices used in conjunction with the ureteroscope.

[0005] Manipulating a ureteroscope and its auxiliary devices may require an assistant to change one or more elongated devices while the physician manipulates the ureteroscope handle. This replacement can be time-consuming and may result in accidental dislodgement or damage to the elongated devices, adding extra time and cost to the procedure. Therefore, it may be desirable to design a handle for a ureteroscope or other endoscope device that allows the physician to manipulate the end of the endoscope's elongated shaft with one hand while simultaneously manipulating the auxiliary devices with the same hand. This document discloses a medical device including a handle with a device management system that allows the user to manipulate the handle in addition to the auxiliary devices. Summary of the Invention

[0006] This disclosure provides designs, materials, manufacturing methods, and alternatives for use in medical devices.

[0007] One example is an actuation mechanism for an endoscope. This actuation mechanism includes a housing configured to attach to a handle of the endoscope and a first thumbwheel coupled to the housing. Rotation of the first thumbwheel causes longitudinal translation of a first elongated medical device through the working channel of the endoscope.

[0008] As an alternative or supplement to any of the above embodiments, the actuation mechanism further includes a first drive wheel coupled to the housing. A first thumb wheel engages the first drive wheel such that rotation of the first thumb wheel causes rotation of the first drive wheel.

[0009] As an alternative or supplement to any of the above embodiments, the actuation mechanism further includes a first roller coupled to the housing. The outer circumferential surface of the first roller is positioned adjacent to the outer circumferential surface of the first drive wheel, such that the first elongated medical device can be positioned between the outer circumferential surface of the first roller and the outer circumferential surface of the first drive wheel. Rotation of the first roller causes rotation of the first drive wheel, thereby moving the first elongated medical device through the working channel of the endoscope.

[0010] As an alternative or supplement to any of the above embodiments, the first roller and the first drive wheel are configured to collaboratively apply a compressive force on the first elongated medical device to frictionally engage the first elongated medical device between the first roller and the first drive wheel.

[0011] As an alternative or supplement to any of the above embodiments, the first thumb wheel includes a circumferential surface, and wherein a strip of material extends around each of the first thumb wheel, the first drive wheel, and the first roller wheel.

[0012] As an alternative or supplement to any of the above embodiments, the housing includes an inner housing and an outer housing, wherein the first thumb wheel, the first drive wheel and the first roller wheel are positioned between the inner housing and the outer housing.

[0013] As an alternative or supplement to any of the above embodiments, the actuation mechanism further includes a second thumb wheel coupled to the housing, a second drive wheel coupled to the housing, and a second roller coupled to the housing. The second thumb wheel engages the second drive wheel, such that rotation of the second thumb wheel causes the second elongated medical device to longitudinally translate through the working channel of the endoscope.

[0014] As an alternative or supplement to any of the above embodiments, the first thumb wheel includes a first diameter, and the first drive wheel includes a second diameter, wherein the second diameter is smaller than the first diameter.

[0015] As an alternative or supplement to any of the above embodiments, the actuation mechanism further includes a first roller coupled to the housing, wherein the outer circumferential surface of the first roller is positioned adjacent to the outer circumferential surface of the first thumb wheel, such that the first elongated medical device can be positioned between the outer circumferential surface of the first roller and the outer circumferential surface of the first thumb wheel, and wherein rotation of the first thumb wheel causes rotation of the first roller to move the first elongated medical device through the working channel of the endoscope.

[0016] As an alternative or supplement to any of the above embodiments, the housing includes a channel extending from the outer surface of the housing into a portion of the housing wall, wherein the channel is configured to receive the proximal end of the tubular member of the first elongated medical device, and wherein the proximal end of the tubular member of the first elongated medical device is fixedly attached to the channel.

[0017] As an alternative or supplement to any of the above embodiments, the channel is configured to be housed within the lumen of the tubular member of the first elongated medical device, extending from the elongated member of the first elongated medical device.

[0018] As an alternative or supplement to any of the above embodiments, the actuation mechanism further includes a rotating cap coupled to the housing. The proximal end of the elongated member is attached to the rotating cap, such that rotation of the rotating cap causes the elongated member to move within the lumen of the tubular member of the first elongated medical device.

[0019] Another example is an endoscopic medical device. The endoscopic medical device includes a handle having a proximal end region and a distal end region, an elongated shaft coupled to and extending distally from the distal end region of the handle, and an actuation assembly coupled to the proximal end region of the handle. The actuation assembly includes a housing, a first thumbwheel coupled to the housing, and a second thumbwheel coupled to the housing. Rotation of the first thumbwheel causes a first elongated medical device to translate through the elongated shaft. Rotation of the second thumbwheel causes a second elongated medical device to translate through the elongated shaft.

[0020] As an alternative or supplement to any of the above embodiments, the rotation of the first thumb wheel that causes the first medical device to translate occurs independently of the rotation of the second thumb wheel that causes the second medical device to translate.

[0021] As an alternative or supplement to any of the above embodiments, the actuation assembly further includes a first drive wheel and a first roller coupled to the housing. The first drive wheel is configured to rotate via a first thumbwheel. The actuation assembly further includes a second drive wheel and a second roller coupled to the housing. The second drive wheel is configured to rotate via a second thumbwheel. The first drive wheel and the first roller are configured to cooperatively apply force to a first medical device positioned between the first drive wheel and the first roller. The second drive wheel and the second roller are configured to cooperatively apply force to a second medical device positioned between the second drive wheel and the second roller.

[0022] As an alternative or supplement to any of the above embodiments, rotation of the first thumb wheel causes the first drive wheel and the first roller wheel to rotate in opposite directions of rotation to cause the first elongated medical device to translate through the elongated shaft, and wherein rotation of the second thumb wheel causes the second drive wheel and the second roller wheel to rotate in opposite directions of rotation to cause the second elongated medical device to translate through the elongated shaft.

[0023] As an alternative or supplement to any of the above embodiments, the first thumb wheel includes a first diameter, and the first drive wheel includes a second diameter, wherein the second diameter is smaller than the first diameter.

[0024] Another example is an actuation assembly for an endoscope. This actuation assembly includes a housing configured to attach to a handle of the endoscope, a thumbwheel coupled to the housing, and a rotating cap coupled to the housing. Rotation of the thumbwheel causes translation of a first elongated shaft within the working channel of the endoscope. The rotating cap is coupled to a second elongated shaft extending within the lumen of the first elongated shaft. Rotation of the rotating cap causes movement of the second elongated shaft within the lumen of the first elongated shaft.

[0025] As an alternative or supplement to any of the above embodiments, rotation of the thumb wheel causes the first and second slender shafts to move together within the working channel of the endoscope.

[0026] As an alternative or supplement to any of the above embodiments, the rotating cap can be actuated between a retracted position and an extended position, wherein the rotating cap is biased toward the retracted position.

[0027] As an alternative or supplement to any of the above embodiments, the actuation assembly further includes a drive wheel. The drive wheel has a circumferential surface that contacts both the thumb wheel and the first elongated shaft.

[0028] The above overview of some embodiments is not intended to describe every disclosed embodiment or every implementation of this disclosure. The accompanying drawings and the following detailed description illustrate these embodiments in more specific terms. Attached Figure Description

[0029] This disclosure will be more fully understood in light of the following detailed description taken in conjunction with the accompanying drawings, in which:

[0030] Figure 1 This is a perspective view of an example medical device;

[0031] Figure 2 yes Figure 1 Another perspective view of the example medical device shown;

[0032] Figure 3 yes Figure 1 Another perspective view of the example medical device shown;

[0033] Figure 4 yes Figure 3 An exploded view of the components of the shaft propulsion mechanism of the medical device shown;

[0034] Figure 5A yes Figure 1 A detailed view of the shaft propulsion mechanism of the medical device shown;

[0035] Figure 5B yes Figure 1 Another detailed view of the shaft propulsion mechanism of the medical device shown;

[0036] Figure 6 This is a perspective view of another example medical device;

[0037] Figure 7 yes Figure 6 Another perspective view of the example medical device shown;

[0038] Figure 8 yes Figure 7 A detailed view of the shaft propulsion mechanism of the medical device shown;

[0039] Figure 9-10 It shows in Figure 6-8 Example steps of advancing wires within a portion of the medical device shown;

[0040] Figure 11 This is a perspective view of another example medical device;

[0041] Figure 12 yes Figure 11 A detailed view of the shaft propulsion mechanism of the medical device shown;

[0042] Figure 13-15 It shows in Figure 11-12 Example steps of advancing multiple medical devices within a portion of the medical device shown;

[0043] Figure 16 This is a side view of another example medical device;

[0044] Figure 17 yes Figure 16 A perspective view of the example medical device shown;

[0045] Figure 18A A perspective view of another construction of the shaft propulsion mechanism; and

[0046] Figure 18B yes Figure 18A Side view of the shaft propulsion mechanism.

[0047] While this disclosure is applicable to various modifications and alternatives, details of which have been shown by way of example in the accompanying drawings and will be described in detail, it should be understood that it is not intended to limit this disclosure to the specific embodiments described. Rather, the invention is intended to cover all modifications, equivalents, and alternatives falling within the spirit and scope of this disclosure. Detailed Implementation

[0048] The following description should be read with reference to the accompanying drawings, which are not necessarily drawn to scale, wherein the same reference numerals denote the same elements in several views. The detailed description and accompanying drawings are intended to illustrate the present disclosure and not to limit it. Those skilled in the art will recognize that the various elements described and / or shown can be arranged in various combinations and configurations without departing from the scope of this disclosure. The detailed description and accompanying drawings illustrate exemplary embodiments of the present disclosure. However, for clarity and ease of understanding, although not every feature and / or element may be shown in every drawing, such feature and / or element can be understood to be present in any way unless otherwise stated.

[0049] The terms defined below shall be used unless otherwise defined in the claims or elsewhere in this specification.

[0050] Whether explicitly stated or not, all numerical values ​​assumed herein are modified by the term "approximately". In the context of numerical values, the term "approximately" generally refers to a range of numbers that a person skilled in the art would consider equivalent to (e.g., having the same function or result) the stated value. In many cases, the term "approximately" may include numbers rounded to the nearest significant number. Unless otherwise stated, other uses of the term "approximately" (e.g., in contexts other than numerical values) may be assumed to have their common and conventional definition, as understood from and consistent with the context of the specification.

[0051] The representation of an endpoint to a range of numbers includes all numbers in that range, including the endpoints (e.g., 1 to 5 includes 1, 1.5, 2, 2.75, 3, 3.80, 4, and 5).

[0052] While some suitable dimensions, ranges and / or values ​​for various components, features and / or specifications are disclosed, those skilled in the art will understand, inspired by this disclosure, that desired dimensions, ranges and / or values ​​may deviate from those explicitly disclosed.

[0053] As used in this specification and the appended claims, the singular forms “a,” “an,” and “the” include plural referents unless expressly stated otherwise. As used in this specification and the appended claims, the term “or” is generally used to mean “and / or” unless expressly stated otherwise. It should be noted that, for ease of understanding, certain features of this disclosure may be described in the singular, even if such features may be plural or repeated in the disclosed examples. Each instance of a feature may include and / or be covered by a single disclosure unless expressly stated otherwise. For simplicity and clarity, not all elements of the present disclosure need to be shown in every figure or discussed in detail below. However, it should be understood that the following discussion can be equally applied to any and / or all components having more than one component, unless expressly stated otherwise. Additionally, for clarity, not all instances of some elements or features may be shown in every figure.

[0054] Relative terms such as “proximal,” “distal,” “advance,” “retract,” and variations thereof are generally considered relative to the positioning, orientation, and / or operation of various elements relative to the user / operator / manipulator of the device. “Proximal” and “retract” indicate or refer to being closer to or towards the user, while “distal” and “advance” indicate or refer to being farther from or away from the user. In some cases, the terms “proximal” and “distal” may be arbitrarily assigned to aid in understanding this disclosure, and these cases will be readily understood by those skilled in the art. Other relative terms, such as “upstream,” “downstream,” “inflow,” and “outflow,” refer to the direction of fluid flow within a lumen (e.g., body cavity, blood vessel) or device. Other relative terms, such as “axial,” “circumferential,” “longitudinal,” “lateral,” “radial,” and / or variations thereof, generally refer to the direction and / or orientation relative to the central longitudinal axis of the disclosed structure or device.

[0055] The term "range" can be understood as referring to the maximum measured value of the stated or identified dimension, unless the range or dimension in question is preceded by "minimum" or is identified as "minimum," in which case it can be understood as referring to the minimum measured value of the stated or identified dimension. For example, "outer range" can be understood as referring to an outer dimension, "radial range" can be understood as referring to a radial dimension, "longitudinal range" can be understood as referring to a longitudinal dimension, and so on. Each instance of "range" can be different (e.g., axial, longitudinal, lateral, radial, circumferential, etc.), and will be clear to those skilled in the art from the context in which it is used. Generally, "range" can be considered as the maximum possible dimension measured according to its intended use, while "minimum range" can be considered as the minimum possible dimension measured according to its intended use. In some cases, "range" can typically be measured orthogonally within a plane and / or cross-section, but it will be clear from the specific context that it can be measured in different ways, such as, but not limited to, angular measurement, radial measurement, circumferential measurement (e.g., along an arc), etc.

[0056] The terms "integral" and "monolithic" should generally refer to one or more elements made or constituted by a single structural or basic unit / element. Integral and / or monolithic elements should exclude structures and / or features formed by assembling or otherwise connecting multiple discrete structures or elements together.

[0057] Note that references to "embodiments," "some embodiments," "other embodiments," etc., in the specification indicate that the described embodiments may include specific features, structures, or characteristics, but each embodiment may not necessarily include those specific features, structures, or characteristics. Furthermore, such phrases do not necessarily refer to the same embodiment. Additionally, when a specific feature, structure, or characteristic is described in connection with an embodiment, unless expressly stated to the contrary, implementing that specific feature, structure, or characteristic in conjunction with other embodiments will be within the knowledge of those skilled in the art, whether explicitly described or not. That is, the various individual elements described below, even if not explicitly shown in a specific combination, are contemplated as being able to be combined with or arranged with each other to form other additional embodiments or to supplement and / or enrich the described embodiments, as understood by those skilled in the art.

[0058] For clarity, certain designated numerical names (e.g., first, second, third, fourth, etc.) may be used throughout the description and / or claims to name and / or distinguish the various described and / or claimed features. It should be understood that the numerical names are not intended to be limiting and are merely exemplary. In some embodiments, for brevity and clarity, the previously used numerical names may be modified and deviated from. That is, a feature designated as a “first” element may subsequently be referred to as a “second” element, a “third” element, etc., or may be omitted entirely, and / or different features may be referred to as a “first” element. The meaning and / or name in each case are clear to a person skilled in the art.

[0059] As described above, this disclosure relates to medical devices with a handle that can be designed to manipulate the distal end of a endoscopic shaft and other medical devices used in conjunction with an endoscope. For example, the medical device may include a ureteroscope with a handle, wherein the handle includes a manual medical device propulsion system. In these examples, the medical device propulsion system may include one or more drive wheels that can be manipulated by a surgeon's single thumb.

[0060] Figure 1 This is a perspective view of an exemplary medical device 10. The medical device 10, shown as an endoscope, can be any of many different types of medical devices used in various medical interventions. For example, a particular type of medical device 10 can be identified by the specific anatomical structure to be reached. For example, the medical device 10 can be a ureteroscope (e.g., a LithoVue). TM This includes endoscopes such as bronchoscopes, hysteroscopes, cystoscopes, colonoscopes, duodenoscopes, esophagoscopes, or any other type of related endoscope. The medical device 10 may include a handle 12 having a distal end 14, a proximal end 16, and an intermediate region 18 positioned between the distal end 14 and the proximal end 16. Note that, as used herein, the terms "proximal" and "distal" are intended to refer to directions toward (proximal) and away from (distal) the device for the user (e.g., a surgeon). Furthermore, the medical device 10 may include an elongated shaft 20 extending distally from the handle 12. Generally, the elongated shaft 20 may be in the form of a polymer tube or a metal tube. In some embodiments, the elongated shaft 20 may be constructed from reinforcing braids, linings, mesh, fabrics, etc.

[0061] The elongated shaft 20 may include a lumen defining a working channel extending from a distal end region of the shaft 20 through the shaft to an access port 30 (e.g., a Y-connector) that can engage with a handle 12 or another portion of the medical device 10. Although the elongated shaft 20... Figure 1While described as having a single working channel, it is understood that in other embodiments, the medical device 10 may include multiple working channels as needed.

[0062] Additionally, the handle 12 may include a deflection knob 40 or other actuator that can be used to control the movement (e.g., deflection) of the distal end of the shaft 20 during operation. For example, the deflection knob 40 can control the up-and-down movement or deflection of the distal end of the shaft 20. In some cases, the deflection knob may be a self-locking knob or a friction-locking knob that holds the knob (and the elongated shaft 20) in its deflected position after being released. The handle 12 may also include one or more buttons 24 that can be used to initiate aspiration or delivery of fluids (such as air, saline, and / or water) through the lumen of the medical device 10 or to perform other functions as needed. These are just examples. Other variations and / or features for the medical device 10 are contemplated.

[0063] In some embodiments, cable 22 extends from handle 12 and is configured to be attached to an electronic device (not shown), such as a computer system, console, microcontroller, etc., for providing power, analyzing endoscopic data, controlling endoscopic interventions, or performing other functions. In some embodiments, the electronic device to which cable 22 is connected may have the function of recognizing data and exchanging data with other endoscopic accessories.

[0064] As mentioned above, Figure 1 The endoscope handle 12 is shown to be used in conjunction with additional medical devices during medical procedures. For example, the medical device 10 may be a ureteroscope (e.g., a flexible ureteroscope) for crushing and removing kidney stones (e.g., kidney stones). Thus, in some examples, the handle 12 may be used in conjunction with a laser fiber 36 for crushing kidney stones and a retrieval device (e.g., a retrieval basket) for removing kidney stone fragments. Furthermore, the handle 12 (and its various components) can be used not only to manipulate the elongated shaft 20, but also to manipulate the laser fiber 36 and / or retrieval device 38 that may extend through portions of the handle 12 and shaft 20. While the following disclosure may generally describe the medical device 10 as being used with the laser fiber 36 and / or retrieval device 38, it is understood that the medical device 10 (and its components) can be used with any elongated medical device, including sheaths, tubular members, guidewires, lasers, etc.

[0065] Figure 1 Further illustrating that the laser fiber 36 can pass through the first hub 32a of the access port 30, continue through the distal end 14 of the handle 12, and enter the working channel of the elongated shaft 20. After passing through the length of the working channel of the elongated shaft 20, the laser fiber 36 can exit the distal end of the elongated shaft 20 ( Figure 1 (Not shown in the image).

[0066] Figure 1 A retrieval device 38 is shown entering the shaft propulsion device 34, which is coupled to the proximal end region 16 of the handle 12. The retrieval device 38 may include a tubular shaft 37 having a lumen extending from its distal end to its proximal end. After passing through the shaft propulsion device 34, the retrieval device 38 can enter the lumen of a first connecting tube 26 (note that the proximal end of the first connecting tube 26 may be securely attached to the shaft propulsion device 34). The retrieval device 38 can continue through the lumen of the first connecting tube 26 into the first hub 32a of the access port 30. Although... Figure 1 An access port 30 including three hubs is shown, but it will be understood that access port 30 may include more or fewer than three hubs. For example, access port 30 may include one, two, three, four, five, six or more hubs.

[0067] Furthermore, access port 30 can include various geometries and may include one or more hubs configured to connect to one or more connecting tubes. Additionally, in some examples, access port 30 can be removed from the handle 12. In these examples, the handle housing itself may include one or more hubs extending directly from the outer surface of the handle housing. These hubs can be used to directly attach to one or more connecting tubes.

[0068] Figure 1 Further illustrating that the retrieval device 38 can pass through the first hub 32a of the access port 30, continue through the distal end 14 of the handle 12, and enter the working channel of the elongated shaft 20 or an additional working channel of the elongated shaft 20. After passing through the length of the working channel of the elongated shaft 20, the retrieval device 38 can exit from the distal end of the elongated shaft 20 (e.g., Figure 1 (as shown in the image).

[0069] Figure 1 Further illustrated, in some examples, the retrieval device 38 may include an end effector (e.g., retrieval basket 50) for manipulating and / or grasping particles, such as fragments of kidney stones. The retrieval device 38 may include a retrieval line 39 extending within the lumen of the tubular shaft 37 of the retrieval device 38 for manipulating the end effector, such as the retrieval basket 50. For example, Figure 1 As shown, in some examples, the retrieval line 39 may enter the lumen of the tubular shaft 37 of the retrieval device 38 at the proximal end of the tubular shaft 37 of the retrieval device 38, pass through the lumen of the tubular shaft 37 of the retrieval device 38 before leaving the distal end of the tubular shaft 37 of the retrieval device 38 (and thus pass through the first connecting tube 26, the first hub 32a, the distal end 14 of the handle 12 and through the working channel of the elongated shaft 20).

[0070] Although Figure 1 Retrieval line 39 is shown as including retrieval basket 50, but it will be understood that retrieval line 39 may include various different end effectors used in conjunction with retrieval device 38. For example, retrieval line 39 may include retrieval net, forceps, fixation device, stone removal device or other similar medical device.

[0071] Understandably, in some examples, the retrieval basket 50 can be converted from a first unexpanded configuration to a second expanded configuration by longitudinally actuating the retrieval line 39 relative to the tubular member of the retrieval device 38. During use, the retrieval basket 50, in its expanded configuration, can be used to capture kidney stones or fragments thereof. After the kidney stones and / or fragments have been captured in the retrieval basket 50, the clinician can remove the kidney stones and / or fragments from the body by retracting the retrieval basket 50 proximally toward the distal end of the tubular axis 37 of the retrieval device 38 to close the retrieval basket 50 around the kidney stones and / or fragments. Understandably, the kidney stones and / or fragments can remain trapped in the retrieval basket 50 while remaining outside the lumen of the tubular member of the retrieval device 38. To remove the kidney stones and / or fragments from the body, the clinician can withdraw the retrieval device 38 proximally from the patient through the working channel of the elongated axis 20 of the medical device 10.

[0072] Similar to the description of retrieval device 38, Figure 1 A laser fiber 36 is shown entering the shaft propulsion device 34, which is coupled to the proximal end region 16 of the handle 12. After passing through the shaft propulsion device 34, the laser fiber 36 can enter the cavity of the second connecting tube 28 (note that the proximal end of the second connecting tube 28 can be fixedly attached to the shaft propulsion device 34). The laser fiber 36 can continue through the cavity of the second connecting tube 28 into the second hub 32b of the access port 30. It is understood that... Figure 1A retrieval device 38 extending from the distal end of the elongated shaft 20 is shown, while the distal end of the laser fiber 36 is shown in dashed lines for illustrative purposes only. Therefore, it can be understood that during a medical procedure, only one or the other of the laser fiber 36 or the retrieval device 38 (including the retrieval line 39 positioned within the lumen of the tubular shaft 37 of the retrieval device 38) may occupy the working channel of the elongated shaft 20, while the other of the laser fiber 36 and the retrieval device 38 may be positioned proximal to the access port 30 within the first connecting tube 26 or the second connecting tube 28. In other cases, the laser fiber 36 may occupy the first working lumen of the elongated shaft 20, while the retrieval device 38, including the tubular shaft 37 and the retrieval line 39 extending through the tubular shaft, occupies the second working lumen of the elongated shaft 20. Understandably, in some examples, each of the first connecting tube 26 and the second connecting tube 28 may be transparent or translucent, thereby allowing clinicians to see the distal end of the laser fiber 36 or the distal end of the retrieval device 38 located therein when withdrawn from the working channel of the elongated shaft 20, thus allowing another device to occupy the working channel of the elongated shaft 20. When the other of the retrieval device 38 and the laser fiber 36 is advanced distally into the working channel of the elongated shaft 20, clinicians may wish to be able to visually confirm that the distal end of the retrieval device 38 or the distal end of the laser fiber 36 is located in the first connecting tube 26 or the second connecting tube 28, respectively.

[0073] For example, a medical procedure to remove kidney stones may include manipulating a shaft propulsion device 34 (described in more detail below) to advance a laser fiber 36 into a second connecting tube 28, such that the laser fiber 36 is positioned proximal to the second hub 32b of the access port 30. As described above, when positioned proximal to the second hub 32b, the distal end of the laser fiber 36 is visible within the transparent or translucent connecting tube 28. Next, the shaft propulsion device 34 may be used to advance a retrieval device 38 (including a tubular shaft 37 of the retrieval device 38 and a retrieval line 39 disposed therein) into a first connecting tube 26, such that the retrieval device 38 is positioned proximal to the first hub 32a of the access port 30. As described above, when positioned proximal to the first hub 32a, the distal end of the retrieval device 38 is visible within the transparent or translucent connecting tube 26. In this configuration, each of the retrieval device 38 and the laser fiber 36 can be referred to as "parked" in its corresponding connecting tube 26 / 28 so as to allow the other to be pushed into the working channel of the elongated shaft 20.

[0074] The next example step in the procedure may involve a clinician manipulating the shaft propulsion device 34 to advance the laser fiber 36 through the working channel of the elongated shaft 20 to the target site, whereby the laser fiber 36 can be used to break up kidney stones. Next, the clinician may use the propulsion device 34 to retract the laser fiber 36 proximally until the distal end of the laser fiber 36 is positioned proximally to the second hub 32b and returns to the second connecting tube 28. It is understood that the laser fiber 36 exits the working channel of the elongated shaft 20 when the distal end of the laser fiber 36 is visible through the transparent or translucent connecting tube 28. It is understood that retracting the laser fiber 36 into the second connecting tube 28 leaves the working channel of the elongated shaft 20 empty, thereby allowing the retrieval device 38 to be advanced distally through that working channel. Therefore, the next step in the procedure may include a clinician manipulating the shaft propulsion device 34 to advance the retrieval device 38 distally through the working channel of the elongated shaft 20 to the target site, whereby the retrieval basket 50 can be deployed distally at the distal end of the elongated shaft 20 of the medical device 10 to capture kidney stones and / or fragments.

[0075] As described above, when the clinician withdraws the retrieval device 38 and the elongated shaft 20 of the medical device 10 from the patient's body, kidney stones and / or fragments can remain trapped in the retrieval basket 50. If necessary, the medical device 10 can then be reinserted to capture additional kidney stones and / or fragments.

[0076] Figure 2-5B The components and functions of the shaft propulsion device 34 will be described in the following discussion.

[0077] Figure 2 The diagram shows that the shaft propulsion device 34 can be removably coupled to the proximal end region 16 of the handle 12. In other cases, the shaft propulsion device 34 can be coupled to the proximal end region 16 of the handle 12 in a different manner. Figure 1 As stated in the text, Figure 2 A retrieval device 38 and a laser fiber 36 are shown passing through the shaft propulsion device 34 and through the first connecting tube 26 and the second connecting tube 28, respectively. Although the shaft propulsion device 34 has been described as being removably coupled to the handle 12, it is conceivable that in some embodiments, the shaft propulsion device 34 may be integral with and / or fixedly attached to the handle 12, such that the shaft propulsion device is not intended to be removed from the handle 12.

[0078] like Figure 2 As shown, the shaft propulsion device 34 can be coupled to the handle 12 via inserting its engagement feature into a slot 42 located in the proximal end region 16 of the handle 12. As will be shown in the figure... Figure 3 As shown, slot 42 can be designed to accommodate a wheel axle (such as one located on the housing component of shaft propulsion device 34) Figure 3 (As shown in the diagram). The axle is inserted into the slot 42 of the handle 12. Figure 2 Arrow 44 is depicted. In other embodiments, the shaft propulsion device 34 may include various engagement features (e.g., posts, pins, fasteners, etc.) configured to engage slots 42 of other engagement features of the handle 12. It is understood that the shaft propulsion device 34 may be packaged as a separate device that can be optionally coupled to the handle 12 when needed. For example, a clinician may choose to attach the shaft propulsion device 34 prior to procedures involving manipulation of the handle 12 and additional medical devices (such as laser fiber 36 and retrieval device 38). It is understood that the clinician can remove the shaft propulsion device 34 from the handle 12 when needed.

[0079] As mentioned above, Figure 3 The diagram shows the insertion of the axle 46 of the shaft propulsion device 34 into the slot 42 of the handle 12. Furthermore, Figure 3 The shaft propulsion device 34 is shown to further include a post (e.g., a clamp) 48, which is designed to be inserted into a recess 52 positioned along the distal end region 16 of the handle 12. It is understood that the recess 52 may be positioned adjacent to the upper region of the slot 42.

[0080] It can be further understood that the engagement of the axle 46 within the slot 42, combined with the insertion of the flat portion of the post or clip 48 into the recess 52, not only provides sufficient retention force to prevent the axle propulsion device 34 from accidentally disengaging from the handle 12 during medical procedures, but also limits the rotation of the axle propulsion device 34 when engaged with the handle 12. For example, the dimensions of the axle 46 and the post or clip 48 can be designed such that they provide a press-fit or interlocking fit within the slot 42 and the recess 52, respectively.

[0081] Figure 4 An exploded view of the aforementioned shaft propulsion device 34 is shown. For clarity, Figure 4 The first connecting shaft 26, the second connecting shaft 28, the laser fiber 36, and the retrieval device 38 have been omitted.

[0082] Figure 4 The shaft propulsion device 34 is shown to include a housing comprising an inner housing 62 (e.g., a first housing member) and an outer housing 54 (e.g., a second housing member) that can be positioned (e.g., "clamped") between a first thumb wheel 56 and a second thumb wheel 57. The first thumb wheel 56 can be coupled to the inner housing 62 via an extension of a wheel axle 64 through a hole 66 in the first thumb wheel 56. Figure 4 The axle 64 of the inner housing 62 is shown to typically be located in the central region of the inner housing 62. Furthermore, Figure 4 It is shown that the axle 64 can be roughly shaped as a hexagon. However, although Figure 4It shows including Figure 4 The axle 64 is hexagonal in shape, but it is understood that the axle 64 can include various shapes. For example, the axle 64 can include cylindrical, triangular, polygonal, square or other similar shapes.

[0083] Similarly, the second thumb wheel 57 can be driven via the axle 46 of the inner housing 62 (in... Figure 4 Invisible in the middle, but in Figure 3 (As shown in the figure) The extension through the hole 68 of the second thumb wheel 57 is connected to the inner housing 62. Figure 4 The axle 46 of the inner housing 62 is shown to typically be located in the central region of the inner housing 62. It can be understood that the axle 46 can be axially aligned with the axle 64. Furthermore, Figure 4 It is shown that the axle 46 can be roughly shaped as a cylinder. However, although Figure 4 It shows including Figure 4 The axle 46 is cylindrical in shape, but it is understood that the axle 46 can include various shapes. For example, the axle 46 can include hexagons, triangles, polygons, squares, or other similar shapes. Furthermore, it is understood that each of the first thumb wheel 56 and the second thumb wheel 57 can be press-fitted onto the axle 64 and the axle 46 respectively, while allowing the first thumb wheel 56 and the second thumb wheel 57 to rotate relative to the axle 64 and the axle 46.

[0084] Figure 4 Further illustration shows that each of the first thumb wheel 56 and the second thumb wheel 57 may include a strip of material extending circumferentially around the periphery of each of the first thumb wheel 56 and the second thumb wheel 57. For example, the first thumb wheel 56 may include a strip of material 70 extending circumferentially around the periphery of the first thumb wheel 56. Similarly, the second thumb wheel 57 may include a strip of material 72 extending circumferentially around the periphery of the second thumb wheel 57. The materials used to construct the strips 70 and 72 may be designed to generally include materials that provide grip when a user manipulates the first thumb wheel 56 and / or the second thumb wheel 57. For example, the strips 70 and 72 may include rubber, silicone, nitrile rubber, thermoplastic elastomer, neoprene rubber, or similar materials.

[0085] Furthermore, in some embodiments, material strips 70 and 72 may include an elastic material. Using an elastic material to construct material strips 70 and 72 may be advantageous because the elastic material can resist removal from the first thumb wheel 56 and / or the second thumb wheel 57. In other words, the elastic material can provide compressive force to the outer peripheral surface of the first thumb wheel 56 and / or the second thumb wheel 57. Additionally, material strips 70 and 72 may include a rough or textured surface suitable for contact with other wheels and the user's thumb.

[0086] During assembly, it is understood that the first thumb wheel 56 and / or the second thumb wheel 57 can rotate clockwise or counterclockwise about axles 64 and 46, respectively. Furthermore, as will be described in more detail below, clinicians can manually rotate the first thumb wheel 56 and / or the second thumb wheel 57 by grasping the handle 12 of the medical device 10 with their thumb (or another finger). It is understood that each of the first thumb wheel 56 and / or the second thumb wheel 57 can rotate in either direction (e.g., each of the first thumb wheel 56 and / or the second thumb wheel 57 can rotate clockwise or counterclockwise).

[0087] Figure 4 Further illustration shows that the shaft propulsion device 34 may include a first drive wheel 58. The first drive wheel 58 may be coupled to the inner housing 62 via a pin 74b extending away from the surface of the inner housing 62. It is understood that the first drive wheel 58 can rotate clockwise or counterclockwise about the axis of the pin 74b. Furthermore, Figure 4 The first drive wheel 58 is shown to include a material strip 47 extending circumferentially around its periphery. The circumferential surface of the first drive wheel 58 can directly contact the circumferential surface of the first thumb wheel 56. The material strip 47 can be similar in form and function to the material strip 70 described above. Furthermore, Figure 4 It is shown that the first drive wheel 58 can contact the first thumb wheel 56 (e.g., the material strip 70 of the first thumb wheel 56 can directly contact the material strip 47 of the first drive wheel 58).

[0088] Figure 4 Further illustration shows that the shaft propulsion device 34 may include a first roller 60. The first roller 60 may be coupled to the inner housing 62 via a pin 74a extending away from the surface of the inner housing 62. It is understood that the first roller 60 may rotate clockwise or counterclockwise about the axis of the pin 74a. Furthermore, Figure 4 The first roller 60 is shown to include a strip of material 49 extending circumferentially around its periphery. The strip of material 49 may be similar in form and function to the strip of material 70 described above. The circumferential surface of the first drive wheel 58 may be placed adjacent to the circumferential surface of the first roller 60. For example, Figure 4 It is shown that the first roller 60 may contact the first drive wheel 58 (e.g., the material strip 47 of the first drive wheel 58 may directly contact the material strip 49 of the first roller 58), or a small gap may be maintained between the first roller and the first drive wheel for placing the tubular shaft 37 of the retrieval device 38 between them.

[0089] As will be described in more detail below, because the first thumb wheel 56 is in direct contact with the first drive wheel 58, rotation of the first thumb wheel 56 will cause the first drive wheel 58 to rotate in the opposite direction to the rotation of the first thumb wheel 56. For example, clockwise rotation of the first thumb wheel 56 (viewed from the outer surface of the thumb wheel 56) will cause counterclockwise rotation of the first drive wheel 58. Similarly, because the first drive wheel 58 is in direct contact with the first roller 60, rotation of the first drive wheel 58 will cause the first roller 60 to rotate in the opposite direction to the rotation of the first drive wheel 58. For example, counterclockwise rotation of the first drive wheel 58 will cause clockwise rotation of the first roller 60. It can be further understood that rotation of the first thumb wheel 56 causes the first roller 60 to rotate in the same direction as the first thumb wheel 56 (while the first drive wheel 58 rotates in the opposite direction to both the first thumb wheel 56 and the first roller 60).

[0090] The first thumb wheel 56 may have a larger diameter than the first drive wheel 58 to provide a mechanical advantage. For example, the diameter of the first thumb wheel 56 may be two, three, or four times the diameter of the first drive wheel 58. Therefore, a full rotation of the first thumb wheel 56 can cause the first drive wheel 58 to rotate more than a full rotation. In some cases, the first thumb wheel 56 may be sized relative to the first drive wheel 58 at a ratio of, for example, 2:1, 3:1, 4:1, or 5:1.

[0091] Figure 4 Further shown is the shaft propulsion device 34, which may include a second drive wheel 59. The second drive wheel 59 can be driven via a pin ( Figure 4 (Not visible in the center) Connected to the inner housing 62, the pin extends away from the surface of the inner housing 62. It is understood that the second drive wheel 59 can rotate in either a clockwise or counterclockwise direction. Furthermore, Figure 4 The second drive wheel 59 is shown to include a material strip 51 extending circumferentially around its periphery. The circumferential surface of the second drive wheel 59 can directly contact the circumferential surface of the second thumb wheel 57. The material strip 51 can be similar in form and function to the material strip 72 described above. Furthermore, Figure 4 It is shown that the second drive wheel 59 can contact the second thumb wheel 57 (e.g., the material strip 72 of the second thumb wheel 57 can directly contact the material strip 51 of the second drive wheel 59).

[0092] Figure 4 Further illustrated, the shaft propulsion device 34 may include a second roller 61. The second roller 61 can be driven via a pin ( Figure 4(Not visible in the center) It is connected to the inner housing 62, and the pin extends away from the surface of the inner housing 62. It is understood that the second roller 61 can rotate in either a clockwise or counterclockwise direction. Furthermore, Figure 4 The second roller 61 is shown to include a material strip 53 extending circumferentially around its periphery. The material strip 53 may be similar in form and function to the material strip 72 described above. The circumferential surface of the second drive wheel 59 may be placed adjacent to the circumferential surface of the second roller 61. For example, Figure 4 It is shown that the second roller 61 can contact the second drive wheel 59 (e.g., the material strip 51 of the second drive wheel 59 can directly contact the material strip 53 of the second roller 61), or a small gap can be maintained between the second roller and the second drive wheel for placing the laser fiber 36 between them.

[0093] As will be described in more detail below, because the second thumb wheel 57 is in direct contact with the second drive wheel 59, rotation of the second thumb wheel 57 will cause the second drive wheel 59 to rotate in the opposite direction to the rotation of the second thumb wheel 57. For example, counterclockwise rotation of the second thumb wheel 57 (viewed from the outer surface of the second thumb wheel 57) will cause clockwise rotation of the second drive wheel 59. Similarly, because the second drive wheel 59 is in direct contact with the second roller 61, rotation of the second drive wheel 59 will cause the second roller 61 to rotate in the opposite direction to the rotation of the second drive wheel 59. For example, clockwise rotation of the second drive wheel 59 will cause counterclockwise rotation of the second roller 61. It can be further understood that rotation of the second thumb wheel 57 causes the second roller 61 to rotate in the same direction as the second thumb wheel 57 (while the second drive wheel 59 rotates in the opposite direction to the second thumb wheel 57 and the second roller 61).

[0094] The second thumb wheel 57 can have a larger diameter than the second drive wheel 59 to provide a mechanical advantage. For example, the diameter of the second thumb wheel 57 can be two, three, or four times the diameter of the second drive wheel 59. Therefore, a full rotation of the second thumb wheel 57 can cause the second drive wheel 59 to rotate more than a full rotation. In some cases, the second thumb wheel 57 can be sized relative to the second drive wheel 59 at a ratio of, for example, 2:1, 3:1, 4:1, or 5:1.

[0095] It is understood that one or more of the “wheels” described in this article (including references) Figure 4All the wheels (as described) do not necessarily have to be in direct contact with each other to rotate. Instead, in some examples, one or more wheels may be connected to pulleys or gears attached to the wheels via belts or chains. For example, individual wheels may each include gears, whereby each gear of two wheels is connected to each other via a drive belt or drive chain. It is understood that rotation of one wheel will cause the other wheel to rotate via a drive belt or drive chain. Furthermore, gear ratios can be used to adjust the speed / force of the drive wheels.

[0096] Figure 4 Further illustration shows that the housing of the shaft propulsion device 34 may include an outer housing 54. The outer housing 54 may be designed such that it covers a portion of the lateral (outer) surface of the first thumb wheel 56, but does not cover the corresponding lateral (outer) surface of the second thumb wheel 57. However, in other cases, if desired, the outer housing 54 may be designed to cover the lateral (outer) surface of the second thumb wheel 57. Furthermore, Figure 4 The outer casing 54 is shown to include a hole 76 through which an axle 64 can extend (e.g., the outer casing 54 can be attached to the inner casing 62 via the engagement of the axle 64 through the hole 76).

[0097] Furthermore, the outer casing 54 can be positioned above the inner casing 62, the first thumb wheel 56, the first drive wheel 58, the first roller 60, the second drive wheel 59, and a portion of the second roller 61. (Return to Reference) Figure 2-3 The outer casing 54 is shown positioned above the inner casing 62, a portion of the first thumb wheel 56, the first drive wheel 58, the first roller 60, the second drive wheel 59, and the second roller 61. (Return to Reference) Figure 2 The axle 64 is shown as a hole 76 extending through the housing 54. It can be further understood that the housing 54 may include a channel 78 designed to receive the upper head portion 80 of the inner housing 62. The upper head portion 80 of the inner housing 62 can be defined as the portion of the inner housing 62 including the first drive wheel 58, the first roller 60, the second drive wheel 59, and the second roller 61. Figure 2-3 It is understood that, during assembly, the housing 54 may cover the first drive wheel 58, the first roller 60, the second drive wheel 59, and the second roller 61, while allowing the user to approach and rotate the first thumb wheel 56 and the second thumb wheel 57.

[0098] Figure 5A A detailed view of the shaft propulsion device 34 is shown (for clarity). Figure 5A The outer shell 54 has been omitted. In particular, Figure 5A The upper head portion 80 of the inner housing 62 is shown, which includes a first drive wheel 58, a first roller 60, and a second drive wheel 59 (in... Figure 5A Invisible in the middle, but in Figure 5B (shown in) and the second roller 61 (in) Figure 5A Invisible in the middle, but in Figure 5B (As shown in the image). Furthermore, Figure 5A The first drive wheel 58 is shown to be in direct contact with the first thumb wheel 56.

[0099] also, Figure 5A The diagram shows a laser fiber 36 extending through an opening 84 formed in the inner housing 62 and a retrieval device 38 extending through the opening 84 formed in the inner housing 62. (It can be understood from the above discussion that a retrieval line 39 may extend through a tubular shaft 37 of the retrieval device 38, but...) Figure 5A (Not visible in the text). Furthermore... Figure 5A The tubular shaft 37 of the retrieval device 38 is shown to be clamped (i.e. pressed) between the first drive wheel 58 and the first roller 60 (e.g., between the material strip 47 of the first drive wheel 58 and the material strip 49 of the first roller 60).

[0100] Figure 5A Further illustration shows that the proximal end of the first connecting tube 26 can be securely attached to a housing (e.g., inner housing 62). For example, the proximal end of the first connecting tube 26 can be adhesively attached to the inner housing 62. Other attachment methods are contemplated to securely attach the proximal end of the first connecting tube 26 to the housing (e.g., inner housing 62). For example, the proximal end of the first connecting tube 26 can be flared, and the housing 62 can include a protrusion designed to engage and mate with the flared portion of the first connecting tube 26. In other examples, the proximal end of the first connecting tube 26 can be expanded on a barbed fitting of the housing 62. Furthermore, Figure 5A It is shown that after passing between the first drive wheel 58 and the first roller 60, the retrieval device 38 or other elongated shaft of the medical device can enter the lumen of the first connecting tube 26 (the retrieval device 38 is depicted via a dashed line inside the lumen of the first connecting tube 26).

[0101] Figure 5A The mechanism is shown, by which the retrieval device 38 is advanced (or retracted) into and out of the working channel of the elongated shaft 20 via the operation of the first thumb wheel 56 (as described above). As described above, clockwise rotation of the first thumb wheel 56 (depicted by arrow 85) will cause counterclockwise rotation of the first drive wheel 58 (depicted by arrow 86). The counterclockwise rotation of the first drive wheel 58 will cause the retrieval device 38 to translate in a distal direction (e.g., it will drive / push the retrieval device 38 into the lumen of the first connecting tube 26). Furthermore, it is understood that the counterclockwise rotation of the first thumb wheel 56 reverses the rotation of the first drive wheel 58, thereby retracting the retrieval device 38 proximally.

[0102] Understandably, the ability of the first drive wheel 58 to translate the retrieval device 38 relative to the working channel of the first connecting tube 26 and the elongated shaft 20 is generated by the compressive force applied to the retrieval device when it is clamped between the first drive wheel 58 and the first roller 60. It can be further understood that the first drive wheel 58 and the first roller 60 must be spaced apart from each other to allow the first drive wheel 58 to adequately advance the retrieval device 38 within the first connecting tube 26 (and the working channel of the elongated shaft 20) without slipping, while also ensuring that the tactile feedback of the first thumb wheel 56 is comfortable for the user. In some examples, the first drive wheel 58 and / or the first roller 60 may be attached to a spring, making the spacing between the first drive wheel 58 and / or the first roller 60 adjustable for elongated shafts of different outer diameters in the medical device.

[0103] Figure 5B The rotation is shown Figure 5A This is to show the laser fiber 36 extending through the opening 84 formed in the inner housing 62. Furthermore, Figure 5B It is shown that the laser fiber 36 can be sandwiched (i.e. pressed) between the second drive wheel 59 and the second roller 61 (e.g., between the material strip 51 of the second drive wheel 59 and the material strip 53 of the first roller 61).

[0104] Figure 5B Further illustration shows that the proximal end of the second connecting tube 28 can be securely attached to a housing (e.g., inner housing 62). For example, the proximal end of the second connecting tube 28 can be adhesively attached to the inner housing 62. Other attachment methods are contemplated to securely attach the proximal end of the second connecting tube 28 to the housing (e.g., inner housing 62). For example, the proximal end of the second connecting tube 28 can be flared, and the housing 62 can include a protrusion designed to engage and mate with the flared portion of the second connecting tube 28. In other examples, the proximal end of the second connecting tube 28 can be expanded on a barbed fitting of the housing 62. Furthermore, Figure 5B It is shown that after passing between the second drive wheel 59 and the second roller 61, the laser fiber 36 or other elongated shaft of the medical device can enter the lumen of the second connecting tube 28 (the laser fiber 36 is depicted via a dashed line inside the lumen of the second connecting tube 28).

[0105] Figure 5BA mechanism is shown through which the laser fiber 36 is advanced (or retracted) into and out of the working channel of the elongated shaft 20 (as described above) by the operation of the second thumb wheel 57. As described above, counterclockwise rotation of the second thumb wheel 57 (depicted by arrow 87) causes clockwise rotation of the second drive wheel 59 (depicted by arrow 88). Clockwise rotation of the second drive wheel 59 causes the laser fiber 36 to translate in a distal direction (e.g., it will drive / push the laser fiber 36 into the lumen of the second connecting tube 28). Furthermore, it is understood that clockwise rotation of the second thumb wheel 57 reverses the rotation of the second drive wheel 59, thereby retracting the laser fiber 36 proximally.

[0106] Understandably, the ability of the second drive wheel 59 to translate the laser fiber 36 relative to the working channel of the second connecting tube 28 and the elongated shaft 20 is generated by the compressive force applied to the laser fiber when the laser fiber 36 is clamped between the second drive wheel 59 and the second roller 61. It can be further understood that the second drive wheel 59 and the second roller 61 must be spaced apart from each other to allow the second drive wheel 59 to adequately advance the laser fiber 36 within the second connecting tube 28 (and the working channel of the elongated shaft 20) without slipping, while also ensuring that the tactile feedback of the second thumb wheel 57 is comfortable for the clinician. In some examples, the second drive wheel 59 and / or the second roller 61 may be attached to a spring, making the spacing between the second drive wheel 59 and / or the second roller 61 adjustable for elongated shafts of different outer diameters in the medical device.

[0107] Figure 6-10 Another example medical device 100 is shown. Medical device 100 may be similar in form and function to medical device 10 described above. For example, medical device 100 may include a handle 112 having a distal end region 114, a proximal end region 116, and an intermediate region 118. Handle 112 may further include an elongated shaft 120 extending distally away from the distal end region 114 of handle 112. Elongated shaft 120 may be similar in form and function to elongated shaft 20 described above.

[0108] In addition, the handle 112 may include an access port 130 (including a first hub 132a and a second hub 132b), a first connecting tube 126, a second connecting tube 128, a retrieval device 138 extending within the first connecting tube 126, and a laser fiber 136 extending within the second connecting tube 128, all of which are similar in form and function to the access port 30 (including a first hub 32a and a second hub 32b), the first connecting tube 26, the second connecting tube 28, the laser fiber 36, and the retrieval device 38 described above with respect to the medical device 10. Figure 6A retrieval device 138 is further shown, extending through the lumen of the elongated shaft 120 and extending beyond its distal end, while the distal end of the laser fiber 136 is shown in dashed lines for illustrative purposes only. Therefore, it can be understood that during a medical procedure, only one or the other of the laser fiber 136 or the retrieval device 138 (including the retrieval line 139 positioned within the lumen of the tubular shaft 137 of the retrieval device 138) may occupy the working channel of the elongated shaft 120, while the other of the laser fiber 136 and the retrieval device 138 may be positioned proximal to the access port 130 within the first connecting tube 126 or the second connecting tube 128. In other cases, the laser fiber 136 may occupy the first working lumen of the elongated shaft 120, while the retrieval device 138, including the tubular shaft 137 through which the retrieval device 138 extends and the retrieval line 139 extending therethrough, occupies the second working lumen of the elongated shaft 120. Understandably, in some examples, each of the first connecting tube 126 and the second connecting tube 128 may be transparent or translucent, thereby allowing clinicians to see the distal end of the laser fiber 136 or the distal end of the retrieval device 138 located therein when withdrawn from the working channel of the elongated shaft 120, thus allowing another device to occupy the working channel of the elongated shaft 120. When the other of the retrieval device 138 and the laser fiber 136 is advanced distally into the working channel of the elongated shaft 120, the clinician may want to be able to visually confirm that the distal end of the retrieval device 138 or the distal end of the laser fiber 136 is located in the first connecting tube 126 or the second connecting tube 128, respectively. Furthermore, Figure 6 A retrieval line 139 is shown, which includes a retrieval basket 150 that extends through the lumen of the tubular shaft 137 of the retrieval device 138 and extends distally beyond the tubular shaft 137 of the retrieval device 138.

[0109] Furthermore, the handle 112 may include a shaft propulsion device 134. The shaft propulsion device 134 is similar to, but not the same as, the shaft propulsion device 34 described above. For example, the shaft propulsion device 134 may be removably attached (or fixedly attached) to the handle 112, as described above regarding the shaft propulsion device 34. Furthermore, although in Figure 6 Not visible in the image, but the shaft propulsion device 134 may include a first thumb wheel that can be used for propulsion / retraction retrieval device 138 (in... Figure 6 (not visible in the middle) and a second thumb wheel for advancing / retracting the laser fiber 136 (in the middle) Figure 6 (Not visible in the middle).

[0110] However, as will be described in detail below, the shaft propulsion device 134 further includes a rotatable cap 186 or other actuation mechanism attached to a housing, such as housing 154 (housing 154 may be similar in form and function to housing 54 described above), whereby the cap 186 can be used to advance / retract the retrieval line 139 within the tubular shaft 137 of the retrieval device 138 and longitudinally relative to the tubular shaft of the retrieval device.

[0111] Figure 7 A medical device 100 is shown, wherein a rotatable cap 186 has been removed from the outer housing 154 of the shaft propulsion device 134 to expose the lateral surface (e.g., the outward-facing surface) of the housing 154. It is understood that the rotatable cap 186 can be coupled to the housing 154 via a connector (e.g., a screw / bolt connection) that allows the rotatable cap 186 to rotate about the same axis as the axle 164 (which may be similar in form and function to the axle 64 described above). Furthermore, Figure 7 The rotatable cap 186 is shown to include one or more protrusions 188 spaced apart around the outer surface of the rotatable cap 186. It is understood that the protrusions 188 can improve the clinician's grip when the rotatable cap 186 is rotated.

[0112] also, Figure 7 The side surface of the housing 154 shown may include a channel 163. For example... Figure 7 As shown, the channel 163 can be curved and generally runs along the periphery of the housing 154 at a certain radial distance from the axle 164. Furthermore, as will be described in more detail below, the channel 163 can be designed to allow a portion of the tubular shaft 137 of the retrieval device 138 and a portion of the retrieval line 139 to be positioned therein. Specifically, the proximal end of the tubular shaft 137 of the retrieval device 138 can be fixedly attached within the channel 163 (near the upper portion of the housing 154), while the retrieval line 139 can translate freely within the channel 163 (e.g., along the channel).

[0113] Additionally, it is understood that when fully assembled, the rotatable cap 186 can rotate freely around the axle 164 and along the surface of the housing 154. Furthermore, Figure 7 Detailed views show that the proximal end 142 of the retrieval line 139 can protrude away from the channel 163 and away from the lateral surface of the housing 154 and engage with the recess 187 located on the back side of the rotatable cap 186. In other words, the proximal end 142 of the retrieval line 139 can be securely attached (e.g., via adhesive) to the back side of the rotatable cap 186. Other attachment techniques are contemplated for securingly attaching the proximal end 142 of the retrieval line 139 to the rotatable cap 186. For example, the proximal end 142 of the retrieval line 139 can be attached to the rotatable cap 186 via adhesive.

[0114] Figure 8 A perspective view of the proximal end region 116 of the aforementioned medical device 100 is shown. As described above, Figure 8 It is shown that the first thumbwheel 156 and the second thumbwheel 157 can be rotatably coupled to a housing, such as the inner housing 162. Furthermore, Figure 8 A laser fiber 136 extending through hole 184 and into second connecting tube 128, and a retrieval sleeve 138 extending through hole 186 and into first connecting tube 126 are shown. Although not all components of shaft propulsion device 134 are shown, it is understood that the operation of using first thumbwheel 156 and second thumbwheel 157 to drive (e.g., longitudinal translation) retrieval sleeve 138 and laser fiber 136 into first connecting tube 126 and second connecting tube 128 respectively can be similar in form and function to the operation of first thumbwheel 56 and second thumbwheel 57 described above. In other words, although Figure 7 As not shown, the shaft propulsion device 134 may include the arrangement and function of the aforementioned drive wheels 58 / 59 and rollers 60 / 61. Furthermore, Figure 8 The retrieval line 139 is shown positioned within the channel 163 of the housing 154.

[0115] Figure 9-10 The rotation of the rotatable cap 186 relative to the outer casing 154 is shown to advance (and retract) the retrieval line 139 within the lumen of the tubular shaft 137 of the retrieval device 138. As described above, Figure 9 The detailed view shows that the proximal end 143 of the tubular shaft 137 of the retrieval device 138 can be fixedly attached to the housing 154, for example, fixedly attached within a channel 163 of the housing 154. For example, the proximal end 143 of the tubular shaft 137 of the retrieval device 138 can be adhesively glued within the channel 163. Therefore, the proximal end 143 of the tubular shaft 137 of the retrieval device 138 can remain stationary relative to the housing 154. Additionally, as described above, the detailed view shows the retrieval line 139 extending into the lumen of the tubular shaft 137 of the retrieval device 138.

[0116] Figure 9 The retriever line 139, extending along the curvature of channel 163, is further illustrated. It can be further understood that... Figure 9 A rotatable cap 186 is shown attached to the outer housing 154 of the handle 112 (for simplicity, the rotatable cap 186 is shown in dashed outline). As described above, in this configuration, the proximal end 142 of the retrieval line 139 can be understood as extending out of the page, thereby being fixedly attached to the back side of the rotatable cap 186.

[0117] Figure 10The rotation of the rotatable cap 186 is shown to cause the retrieval line 139 to be longitudinally translated relative to and within the lumen of the tubular shaft 137 of the retrieval device 138. It is understood that translating the retrieval line 139 within the lumen of the tubular shaft 137 of the retrieval device 138 can cause the retrieval basket 150 (as shown) attached to the distal end of the retrieval line 139 to be... Figure 6 (As shown) expansion and contraction. Therefore, it can be further understood that, for example, before the clinician rotates the cap 186 to unfold the retrieval basket 150, the clinician can manipulate the first thumb wheel 156 to advance or retract the retrieval device 138 (including the tubular shaft 137 and retrieval line 139 of the retrieval device 138) relative to the target site. In other words, as described above, manipulating the first thumb wheel 156 can cause the retrieval device 138, including the tubular shaft 137 and retrieval line 139 of the retrieval device 138, to move the working channel through the elongated shaft 120 of the medical device 100 (e.g., when the retrieval device 138 is manipulated by the first thumb wheel 156, the retrieval line 139 travels together with the tubular shaft 137 of the retrieval device 138). However, in order to actuate (e.g., expand or retract) the retrieval basket 150 (attached to the distal end of the retrieval line 139), the clinician can rotate the rotatable cap 186 (using the same hand), which causes the retrieval line 139 to translate within the lumen of the channel 163 and the tubular shaft 137 of the retrieval device 138 (the rotation of the rotatable cap 186 is depicted by arrow 144). In other words, because the proximal end 143 of the tubular shaft 137 of the retrieval device 138 is fixedly attached to the housing 154, rotation of the rotatable cap 186 only causes the retrieval line 139 to translate relative to the housing 154 (within the channel 163) and the tubular shaft 137 of the retrieval device 138. Figure 10 In the detailed view, arrow 145 shows the translation of the retrieval line 139 relative to the tubular axis 137 of the housing 154 and the retrieval device 138. Additionally, it should be noted that... Figure 10 This illustrates the displacement of the proximal end 142 of the retrieved line 139 after the rotatable cap 186 has been rotated.

[0118] Figure 11-15 Another example medical device 200 is shown. Medical device 200 may be similar in form and function to medical device 10 / 100 described above. For example, medical device 200 may include a handle 212 having a distal end region 214 and a proximal end region 216. Handle 212 may further include an elongated shaft 220 extending distally away from the distal end region 214 of handle 212. Elongated shaft 220 may be similar in form and function to elongated shaft 20 / 120 described above.

[0119] In addition, the handle 212 may include an access port 230 (including a first hub 232a and a second hub 232b), a first connecting tube 226, a second connecting tube 228, a retrieval device 238 or other elongated medical device extending within the first connecting tube 226 and into the working channel of the elongated shaft 220 of the medical device 200, and a laser fiber 236 extending within the second connecting tube 228 and into the working channel of the elongated shaft 220 of the medical device 200 or another working channel. These may all be similar in form and function to the access port 30 / 130 (including a first hub 32a / 132a and a second hub 32b / 132b), the first connecting tube 26 / 126, the second connecting tube 28 / 128, the laser fiber 36 / 136, and the retrieval sheath 38 / 138 as described above with respect to the medical device 10 / 100. Figure 11 A retrieval device 238 is further shown, extending through the lumen of the elongated shaft 220 and extending distally from the distal end of the elongated shaft 220, while the distal end of the laser fiber 236 is shown in dashed lines for illustrative purposes only. Therefore, it can be understood that during a medical procedure, only one or the other of the laser fiber 236 or the retrieval device 238 (including the retrieval line 239 positioned within the lumen of the tubular shaft 237 of the retrieval device 238) may occupy the working channel of the elongated shaft 220, while the other of the laser fiber 236 and the retrieval device 238 may be positioned proximal to the access port 230 within the first connecting tube 226 or the second connecting tube 228. In other cases, the laser fiber 236 may occupy the first working lumen of the elongated shaft 220, while the retrieval device 238, including the tubular shaft 237 through which the retrieval device 238 extends, occupies the second working lumen of the elongated shaft 220. Understandably, in some examples, each of the first connecting tube 226 and the second connecting tube 228 may be transparent or translucent, thereby allowing clinicians to see the distal end of the laser fiber 236 or the distal end of the retrieval device 238 located therein when withdrawn from the working channel of the elongated shaft 220, thus allowing another device to occupy the working channel of the elongated shaft 220. When the other of the retrieval device 238 and the laser fiber 236 is advanced distally into the working channel of the elongated shaft 220, the clinician may want to be able to visually confirm that the distal end of the retrieval device 238 or the distal end of the laser fiber 236 is located in the first connecting tube 226 or the second connecting tube 228, respectively. Furthermore, Figure 11 A retrieval line 239 is shown, which includes a retrieval basket 250. The retrieval line extends through the lumen of the tubular shaft 237 of the retrieval device 238 and extends distally beyond the tubular shaft 237 of the retrieval device 238.

[0120] also, Figure 12The handle 212 is shown to include a shaft propulsion device 234. The shaft propulsion device 234 is similar to the shaft propulsion device 34 described above. For example, the shaft propulsion device 234 may be removably (or fixedly) attached to the handle 212, as described above with respect to the shaft propulsion device 34 of the medical device 10.

[0121] Figure 12 A detailed view of the proximal end region 216 of the handle 212 is shown. Similar to that described above, Figure 12 The rotatable cap 286 is shown to include one or more protrusions 288 spaced apart around the outer surface of the rotatable cap 286. It is understood that the protrusions 288 can improve the clinician's grip when the rotatable cap 286 is rotated. For clarity, Figure 12 It is shown that the rotatable cap 286 is spaced apart from the handle 212.

[0122] also, Figure 12 The diagram shows a shaft propulsion device 234 including an inner housing 262, which may be similar in form and function to the inner housings 62 / 162 described above. However, unlike the inner housings 62 / 162 described above, the inner housing 262 may include only a single thumb wheel 258, or, if desired, may include a first thumb wheel and a second thumb wheel. The thumb wheel 258 may be similar in form and function to the thumb wheels 58 / 158 described above. For example, the thumb wheel 258 may be driven by a drive wheel (in... Figure 12 (Not visible in the middle) is connected to laser fiber 236. Furthermore, laser fiber 236 can extend through a hole 284 located in the inner housing 262, thereby clamping laser fiber 236 between the drive wheel and the roller (the drive wheel and the roller are in...). Figure 12 (Neither visible in the middle). Therefore, as described above, the thumb wheel 258 can be used to advance / retract the laser fiber 236 into the second connecting tube 228, and thus through the working channel of the elongated shaft 220 of the medical device 200, in a manner similar to that described above with respect to the medical device 10 / 100.

[0123] However, the difference between the shaft propulsion device 234 and the shaft propulsion devices 34 / 134 described above lies in the fact that the advancement / retraction of the retrieval device 238 and / or the retrieval line 239 of the retrieval device 238 can be achieved via a cooperative relationship between the rotating disk 265 and the rotatable cap 286. It should be noted that in some examples, the rotating disk 265 may be positioned on the shaft propulsion device 234 in the same relative position as the first thumb wheel 56 / 156 in the aforementioned medical device 10 / 100. In other words, the rotating disk 265 (which can also be considered as the thumb wheel of the shaft propulsion device 234) has been considered to replace the first thumb wheel 56 / 156 in the aforementioned medical device 10 / 100.

[0124] Figure 12 It is shown that the rotating disk 265 can be connected to the inner housing 262 via an extension of the axle 264 of the inner housing 262 through a hole in the rotating disk 265. Figure 12 The axle 264 of the inner housing 262 is shown to typically be located in the central region of the inner housing 262. It can be further understood that the rotating disc 265 can be rotated about the axle 264 via manipulation of the thumb lever 253. For example, it is understood that a clinician can use their thumb to manipulate the lever 253 and rotate the rotating disc 265 about the axle 264.

[0125] also, Figure 12 The shaft propulsion device 234 is shown to include a locking mechanism to lock the position of the retrieval device relative to the elongated shaft 220 of the medical device in one of a plurality of positions. For example, the inner housing 262 may include a plurality of teeth 251 positioned along the outer periphery of the inner housing 262 and adjacent to the rod 253. Furthermore, it is understood that the rod 253 may include a protrusion 282 that, when positioned between two adjacent teeth 251, engages the teeth 251 and locks the rotating disk 265 in a fixed position. When in the locked position, rotation of the rotating disk 265 in a clockwise and / or counterclockwise direction is prevented. For example, in Figure 12 In the example shown, the thumb lever 253 can be used to rotate the disc 265 about the axle 264. For example, a force applied to the thumb lever 253 by the user's thumb (or other finger) can bend the thumb lever 253 to disengage the protrusion 282 from between adjacent teeth 251, thereby allowing the disc 265 to rotate. However, when the disc 265 stops rotating and the force is removed, the protrusion 282 can return toward the axle 264 and engage the flat back portion of a given tooth 251, thereby preventing the disc 265 from rotating freely in a clockwise direction. It is understood that, in order to rotate the disc 265 in a clockwise direction, a clinician can press the thumb lever 253, causing the protrusion 282 to bend away from the axle 264, thereby allowing the protrusion 282 to pass over the top of the tooth 251 while the disc 265 rotates clockwise. Therefore, the locking mechanism can be used to fix the longitudinal position of the retrieval device 238, thereby preventing the tubular shaft 237 of the retrieval device 238 from moving distally as the retrieval line 239 is advanced or retracted by the rotation of the rotating cap 286, as described herein.

[0126] In the illustrated embodiment, the side surface of the tooth 251 is formed such that the protrusion 282 must be actively disengaged by pressing on the thumb bar 253, thereby causing the rotating disk 265 to rotate clockwise to prevent the retrieval device 238 from being unintentionally advanced distally. However, due to the acute angle of the tooth's side surface, counterclockwise rotation is permitted when the protrusion 282 slides along the angled side surface of the tooth. In another embodiment, the side surface of the tooth 251 may be reversed, such that the protrusion 282 must be actively disengaged by pressing on the thumb bar 253, thereby causing the rotating disk 265 to rotate counterclockwise to prevent the retrieval device 238 from being unintentionally retracted proximally. However, due to the acute angle of the tooth's side surface, clockwise rotation is permitted when the protrusion 282 slides along the angled side surface of the tooth. In another embodiment, the tooth 251 may include a "V" shape, which can be used to prevent both clockwise and counterclockwise rotation of the rotating disk 265 (when the protrusion is positioned within one of the grooves of the tooth 251).

[0127] Figure 12 This further illustrates that the proximal end region of the first connecting tube 226 can be securely attached to the housing (e.g., the inner housing 262). For example, Figure 12 The detailed view in the upper left portion shows that the proximal end of the first connecting tube 226 can be securely attached to the inner housing 262 via adhesive or other attachment methods (e.g., press fit, etc.). Furthermore, Figure 12 The detailed view in the upper left portion shows the retrieval device 238 inserted into the lumen of the first connecting tube 226. This same detailed view further shows the retrieval line 239 positioned within the lumen of the tubular shaft 237 of the retrieval device 238 (and, by extension, within the lumen of the first connecting tube 226). Because the first connecting tube 226 is fixedly attached to the inner housing 262, it is understood that the retrieval device 238, including the tubular shaft 237 and the retrieval line 239, can translate relative to and within the first connecting tube 226.

[0128] Figure 12 Further illustration shows that the inner housing 262 may include a channel 263, which may be curved and generally runs along the periphery of the rotating disk 265 at a certain radial distance from the axle 264. Furthermore, Figure 12 It is shown that portions of the tubular shaft 237 and retrieval line 239 of the retrieval device 238 can be positioned within the channel 263. Specifically, Figure 12The detailed view in the lower right corner shows the position within the channel 263, in which the proximal end region of the tubular shaft 237 of the retrieval device 238 can be fixedly attached to the rotating disk 265. Therefore, it can be understood that rotation of the rotating disk 265 (as described above) can cause the tubular shaft 237 of the retrieval device 238 and the retrieval line 239 therein to advance or retract relative to and within the first connecting tube 226.

[0129] also, Figure 12 The detailed view in the upper right corner shows the retrieval line 239 positioned within the channel 263 of the rotary disk 265. The retrieval line 239 may not be fixedly attached to the rotary disk 265. Instead, Figure 12 The detailed view in the upper right corner shows that the proximal end of the retrieval line 239 can be bent outwards, allowing it to engage and securely attach to a recess 287 positioned along the dorsal side of the rotating cap 286. Note that the retrieval line 239 can also be securely attached to the rotating cap 286 in other ways. Similar to the function of the rotating cap 186 described above with respect to the medical device 100, rotation of the rotating cap 286 allows the retrieval line 239 to be longitudinally translated within the channel 263 of the rotating disk 265 and through the lumen of the tubular shaft 237 of the retrieval device 238.

[0130] However, it can be further understood that the rotating cap 286 can engage with the rotating disk 265 such that when the rotating disk 265 rotates (e.g., via the thumb lever 253), the rotating cap 286 can rotate together with the rotating disk 265. In some examples, the back side of the rotating cap 286 may include a protrusion (in... Figure 12 (Not visible in the center), the protrusion extends toward the rotating disk 265 and is located within the channel where the spring 255 is located. The spring 255 can contact and bias the protrusion. Therefore, when the rotating disk 265 rotates, the rotating cap 286 can "travel together" with the rotating disk 265, such that there is no relative rotation between the rotating cap 286 and the rotating disk 265 when the rotating disk 265 rotates.

[0131] It can be further understood that when the rotating disk 265 rotates (and the rotating cap 286 rotates together with the rotating disk 265), the tubular shaft 237 and the retrieval line 239 of the retrieval device 238 will move together within the first connecting tube 226 and / or move longitudinally through the working channel of the elongated shaft 220. In other words, when the rotating disk 265 rotates, the rotating disk 265 can translate the tubular shaft 237 of the retrieval device 238, while the rotating cap 286 (placed on the rotating disk 265) will rotate together with the rotating disk 265, and cause the retrieval line 239 to translate at the same speed (displacement) as the tubular shaft 237 of the retrieval device 238.

[0132] However, it is understood that after the rotation of the rotating disk 265 stops and the protrusion 282 engages with the tooth 251 (thus locking the rotating disk 265 in place relative to the inner housing 262), the rotating cap 286 can rotate relative to the rotating disk 265 (and, by extension, relative to the inner housing 262). The rotation of the rotating cap 286 relative to the rotating disk 265 can advance (or retract) the retrieval line 239 relative to the tubular shaft 237 of the retrieval device 238, thereby advancing the retrieval basket 250 relative to the tubular shaft 237 of the retrieval device 238.

[0133] As mentioned above, Figure 12 The handle 212 is shown to include a spring 255 positioned within a recessed channel on the rotating disk 265. As will be described in more detail below, one end of the spring 255 may be coupled to the back of the rotating cap 265 (e.g., a similar connection technique may be used to connect the distal end of the spring 255 to the back of the rotating cap 286, as is used to connect the proximal end of the retrieval line 239 to the back of the rotating cap 286). Thus, the spring 255 may be designed to bias the rotating cap 286 to rotate counterclockwise after it is released following clockwise rotation. Therefore, the spring 255 may be implemented to bias the rotating cap 286 in a retracted configuration when the retrieval basket 250 is collapsed, and thus bias the retrieval line 239. Rotating the rotating cap 286 clockwise to overcome the force of the spring 255 causes the retrieval basket 250 to unfold (e.g., expand).

[0134] Figure 13-15 The coordinated operation of the rotating disk 265 and the rotating cap 286 is shown to advance / retract or otherwise manipulate the retrieval device 238. Figure 13 A handle configuration is shown in which the tubular shaft 237 of the retrieval device 238 and the retrieval line 239 can both be located within the working channel of the elongated shaft 220 and positioned precisely proximal to the distal end of the elongated shaft 220. For clarity, the rotating cap 286 is shown as being removed from the handle 212. However, it should be understood that for... Figure 13-15 As described above, the rotating cap 286 will be positioned on top of the rotating disk 265. Furthermore, Figure 13 It is shown that the rotating disk 265 is not rotating in the clockwise direction and the retrieval line 239 is not translated relative to the tubular axis 237 of the retrieval device 238.

[0135] Figure 14 The simultaneous rotation of the retrieval disc 265 and the rotating cap 286 is shown. As described above, the rotation of the rotating disc 265 can be achieved by manipulating the thumb lever 253 over multiple teeth 251. Figure 14As shown, in some examples, rotation of the rotating disk 265 can be limited between the first stop 259 and the second stop 254. For example, the rotating disk 265 may include a protrusion 261 that engages the first stop 259 in the fully retracted position. When the rotating disk 265 is rotated clockwise to its maximum clockwise position or fully extended position, the protrusion 261 may move to engage with the second stop 254. This engagement prevents further clockwise rotation of the rotating disk 265, thereby preventing the tubular shaft 237 of the retrieval device 238 from being further distally advanced beyond the distal end of the elongated shaft 220 or otherwise further distally advanced relative to the distal end of the elongated shaft. Figure 14 Arrow 270 depicts the rotation of the rotating disk 265 and arrow 283 depicts the rotation of the rotating cap (which occurs simultaneously with the rotating disk 265). As described above, the rotation of the rotating disk 265 can translate the tubular shaft 237 and the retrieval line 239 of the retrieval device 238 beyond the distal end of the elongated shaft 220. Figure 14 The protrusion 282 engages with the tooth 252, thus preventing the rotating disk 265 from rotating relative to the inner housing 262.

[0136] Figure 15 The independent rotation of the rotating cap 286 relative to the rotating disk 265 is shown to cause the retrieval line 239 to translate relative to the tubular shaft 237 of the retrieval device 238. (See diagram) Figure 15 As shown, the rotating cap 286 can rotate relative to the rotating disk 265 (the rotation of the rotating cap 286 is depicted by arrow 267), which causes the distal end 242 of the retrieval line 239 to translate within the channel 263 (note, Figure 14 The position of the distal end 242 of the retrieval line 239 within the channel 263 is similar to... Figure 15 The position in the middle shows the translation of line 239 within channel 263). Furthermore, because the rotating disk 265 is in... Figure 15 The basket 230 is held in place so that the tubular shaft 237 of the retrieval device 238 remains stationary, while the retrieval line 239 translates within the lumen of the tubular shaft 237 of the retrieval device 238. It is understood that this translation can cause the basket 250 at the distal end of the retrieval device 238 to unfold (e.g., expand). Furthermore, Figure 15 The diagram shows that the spring 255 is compressed when the rotating cap 286 rotates. Therefore, after the rotating cap 286 is released, the expansion of the spring 255 can cause the rotating cap 286 to rotate counterclockwise, thereby causing the retrieval line 239 to translate within the channel 263 and causing the retrieval basket 250 to collapse.

[0137] Figure 16-17Another example medical device 300 is shown. Medical device 300 may be similar in form and function to the medical device 200 described above. For example, medical device 300 may include a handle 312 having an elongated shaft 320 extending distally from a distal end away from the handle 312. The elongated shaft 320 may be similar in form and function to the elongated shaft 20 described above.

[0138] Furthermore, the handle 312 may include a first connecting tube 326, a second connecting tube 328, a retrieval device 338 or other elongated medical device extending within the first connecting tube 326 and into the working channel of the elongated shaft 320 of the medical device 300, and a laser fiber 336 extending within the second connecting tube 328 and into the working channel of the elongated shaft 320 of the medical device 300 or another working channel. These may be similar in form and function to the first connecting tube 26 / 126 / 226, the second connecting tube 28 / 128 / 228, the retrieval device 38 / 138 / 238 extending within the first connecting tube 26 / 126 / 226, and the laser fiber 36 / 136 / 236 extending within the second connecting tube 28 / 128 / 228, as described above with respect to the medical device 10 / 100 / 200.

[0139] also, Figure 16 The handle 312 is shown to include a shaft actuation device 334. Shaft actuation device 334 is similar to the shaft actuation device 234 described above. For example, shaft actuation device 334 can be removably (or fixedly) attached to handle 312, as described above with respect to shaft actuation device 234 with respect to medical device 200. Furthermore, the operation of shaft actuation device 334 can be functionally similar to the shaft actuation device 234 described above. However, as... Figure 16 As shown, the shaft propulsion device 334 may not include the teeth 251 or thumb bar 253 (including the protrusion 282) as described above with respect to the shaft propulsion device 234. Instead, the shaft propulsion device 334 may include an elongated tubular shaft 337 and a retrieval line 339 extending therein wound along the rotating disk 365. Thus, it can be understood that as the rotating disk 365 rotates (e.g., in a clockwise direction), the retrieval device 338 may be advanced within the first connecting tube 326 and / or within a working channel extending within the elongated shaft 320.

[0140] In some examples, the retrieval device 338 may be wound around a shelf (e.g., edge, lip, lug, etc.) located on the rotating disk 365. However, in other examples, for example, the retrieval device 338 may be wound within a channel extending into the surface of the rotating disk 365.

[0141] also, Figure 16It is shown that the proximal end of the retrieval line 339 can extend beyond the proximal end of the tubular shaft 337 of the retrieval device 338, and can be coupled to the dorsal side of the rotating cap 386 in a manner similar to that described above with respect to the medical device 200. Similarly, Figure 16 The shaft propulsion device 334 is shown to include a spring 355 positioned within a channel on the rotating disk 365. Similar to that described above with respect to medical device 200, rotation of the rotating cap 386 can advance the retrieval line 339 relative to the tubular shaft 337 of the retrieval device 338, thereby unfolding (e.g., expanding) the end effector (e.g., retrieval basket) at the distal end of the retrieval device 338. However, as described above, once the rotating cap 386 is released, the spring 355 can expand, causing the rotating cap 386 to rotate counterclockwise and retracting the retrieval line 339 proximally relative to the tubular member 337 of the retrieval sheath 338, thereby retracting the retrieval basket. In other words, as described above with respect to medical device 200, the spring 355 can be used to bias the retrieval basket or other end effector located at the distal end of the retrieval device 338 toward a closed, contracted configuration.

[0142] Figure 17 yes Figure 16 A perspective view of the medical device 300 shown. Figure 17 The diagram shows a shaft propulsion device 334 including an inner housing 362, which may be similar in form and function to the inner housings 62 / 162 / 262 described above. The inner housing 362 may include a single thumb wheel 358, or, if desired, may include a first thumb wheel and a second thumb wheel. The thumb wheel 358 may be similar in form and function to the thumb wheels 58 / 158 / 258 described above. For example, the thumb wheel 358 may be driven via a drive wheel (in... Figure 17 (Invisible in the middle) is connected to laser fiber 336, thereby the laser fiber 336 is sandwiched between the drive wheel and the roller (the drive wheel and the roller are in...) Figure 17 (Neither of which are visible in the middle). Therefore, as described above, the thumb wheel 358 can be used to advance / retract the laser fiber 336 into the second connecting shaft 328 in a manner similar to that described above with respect to medical device 10 / 100 / 200.

[0143] As mentioned above, Figure 17 The diagram shows that a retrieval device 338 (including a combination of a tubular shaft 337 and a retrieval line 339) can be wound around a rotating disk 365. Furthermore, it is understood that in the assembled configuration, the tubular shaft 337 of the retrieval device 338 can be positioned between a rotating cap 386 and a rotating disk 365. Additionally, the rotating cap 386 and the rotating disk 365 can be threaded onto a threaded wheel shaft 364, such that the rotating cap 386 and the rotating disk 365 can be spaced together from the inner housing by a distance "X".

[0144] In operation, it is understood that a clinician can rotate the rotary disc 365 and the rotating cap 386 clockwise, thereby advancing the retrieval device 338 through the working channel of the elongated shaft 320. When the rotary disc 365 and the rotating cap 386 are threaded onto the threaded wheel shaft 364, clockwise rotation of the rotary disc 365 and the rotating cap 386 will cause the rotary disc 365 and the rotating cap 386 to move toward the lateral surface of the inner housing 362. It is understood that the rotary disc 365 and the rotating cap 386 can rotate clockwise until the protrusion 361 on the rotary disc 365 engages the positive stop 354 on the inner housing 362. At this point, further clockwise rotation of the rotary disc 365 is prevented (this also prevents further distal translation of the tubular shaft of the retrieval device 338). However, as described above, the rotating cap 386 is still capable of rotating clockwise (thus compressing the spring 355) to advance the retrieval line 339 distally relative to the distal end of the tubular shaft 337 of the retrieval device 338, thereby opening or expanding the end effector. Furthermore, the release cap 386 allows the spring 355 to expand and rotate the rotating cap 386 counterclockwise, causing the retrieval line 339 to retract proximally relative to the distal end of the tubular shaft 337 of the retrieval device 338, thereby closing or retracting the end effector. This operating mechanism is similar to the operating mechanism described above regarding the rotating cap 286 and spring 255 of the medical device 200.

[0145] Another embodiment of the shaft propulsion device 434 is in Figure 18A and 18B As shown herein, the shaft propulsion device 434, like the other shaft propulsion devices 34 / 134 / 234 / 334 disclosed herein, can be removably or permanently attached to the handle of the medical device. In many respects, the operation of the shaft propulsion device 434 can be similar to that of the other shaft propulsion devices 34 / 134 / 234 / 334, but with some variations. Therefore, if desired, the features of the shaft propulsion device 434 can be physically incorporated into the other shaft propulsion devices 34 / 134 / 234 / 334 as described above.

[0146] like Figure 18AAs shown, the shaft actuation device 434 may include a housing 462 capable of being attached (removably or permanently) to the handle of a medical device (such as the other medical devices described above). The shaft actuation device 434 may include a thumb wheel 456 connected to the housing 462 via an extension of a wheel axle 464 through a hole in the thumb wheel 456. Thus, the thumb wheel 456 is rotatably connected to the housing 462 via the wheel axle 464, allowing the thumb wheel 456 to rotate about the axis of the wheel axle 464. Similar to the other thumb wheels described above, the thumb wheel 456 may include a material strip 470 extending circumferentially around the periphery of the thumb wheel 456. The material used to construct the material strip 470 may be designed to generally include materials that provide grip when a user manipulates the thumb wheel 456. For example, the material strip 470 may include rubber, silicone, nitrile rubber, thermoplastic elastomers, neoprene, other elastic materials, or similar materials.

[0147] During assembly, it is understood that the thumb wheel 456 can rotate clockwise or counterclockwise about the axle 464. Furthermore, as will be described in more detail below, clinicians can manually rotate the thumb wheel 456 by grasping the handle of the medical device with their thumb (or another finger). Unlike the embodiments described above, the shaft propulsion device 434 may not include a separate drive wheel; instead, the shaft propulsion device 434 may consist only of the thumb wheel 456 and the roller wheel 460, the thumb wheel also acting as the drive wheel.

[0148] Roller 460 can be coupled to housing 462 via axle 474, which extends away from the surface of housing 462. It is understood that roller 460 can rotate clockwise or counterclockwise about the axis of axle 474. Furthermore, Figure 18A The roller 460 is shown to include a strip of material 449 extending circumferentially around its periphery. The strip of material 449 may be similar in form and function to the strip of material 470 described above. The circumferential surface of the thumb wheel 456 may be positioned adjacent to the circumferential surface of the roller 460. For example, the roller 460 may contact the thumb wheel 456 (e.g., the strip of material 470 of the thumb wheel 456 may directly contact the strip of material 449 of the roller 460), or a small gap may be maintained between the roller and the thumb wheel for placing an elongated shaft 438 of a medical device (e.g., a retrieval device or laser fiber) between them.

[0149] Figure 18B A mechanism is shown through which an elongated shaft 438 is advanced (or retracted) via an actuating thumbwheel 456 into and out of the working channel of the elongated shaft of a medical device (e.g., an endoscope). Rotation of the thumbwheel 456 causes a roller 460 to rotate in the opposite direction to the rotation of the thumbwheel 456. For example, as... Figure 18B As shown, counterclockwise rotation of the thumb wheel 456 (viewed from the outer surface of the thumb wheel 456) will cause clockwise rotation of the roller wheel 460. With the elongated shaft 438 of the medical device positioned between the thumb wheel and the roller wheel, counterclockwise rotation of the thumb wheel 456 (as shown by arrow A) will cause the elongated shaft 438 to be propelled distally, as shown by arrow B. Similarly, clockwise rotation of the thumb wheel 456 will cause the elongated shaft 438 to retract proximally.

[0150] It is understood that the ability of the thumb wheel 456 to translate the elongated shaft 438 relative to the working channel of the first connecting tube (as described above) and the endoscope (as described above) is generated by the compressive force applied to the elongated shaft when the elongated shaft 438 is clamped between the thumb wheel 456 and the roller wheel 460. It is further understood that the thumb wheel 456 and the roller wheel 460 must be spaced apart from each other to allow the shaft propulsion device 434 to adequately advance the elongated shaft 438 within the working channel of the first connecting tube and the endoscope (as described above) without slippage, while also ensuring that the tactile feedback of the thumb wheel 456 is comfortable for the user. In some examples, the roller wheel 460 may be attached to a spring, making the spacing between the thumb wheel 456 and the roller wheel 460 adjustable for elongated shafts of different outer diameters in the medical device.

[0151] As mentioned above, such as in combination Figures 18A-18B As may be desired, any of the shaft propulsion devices disclosed herein can be configured to have only thumb wheels and roller wheels.

[0152] Materials that can be used for the various components of the examples disclosed herein may include materials commonly associated with medical devices. For simplicity, the following discussion refers to other components of ureteroscopic instruments and ureteroscopes. However, this is not intended to limit the devices and methods described herein, as the discussion can be applied to other similar tubular components and / or components of tubular components or devices disclosed herein.

[0153] Medical device 10 and / or its components may be made of metals, metal alloys, polymers (some examples of polymers are disclosed below), metal-polymer composites, ceramics, combinations thereof, or other suitable materials. Some examples of suitable polymers may include polytetrafluoroethylene (PTFE), ethylene tetrafluoroethylene (ETFE), fluorinated ethylene propylene (FEP), and polyoxymethylene (POM, for example, available from DuPont). Polyether block esters, polyurethanes (e.g., polyurethane 85A), polypropylene (PP), polyvinyl chloride (PVC), polyether esters (e.g., available from DSM Engineering Plastics) ), ether or ester copolymers (e.g., butene / poly(alkylene ether) phthalates and / or other polyester elastomers, such as those available from DuPont) ), polyamide (e.g., available from Bayer) Or available from Elf Atochem ), elastic polyamide, block polyamide / ether, polyether block amide (PEBA, for example, can be found in the trademark name) (Obtained from), ethylene vinyl acetate copolymer (EVA), silicone, polyethylene (PE) High-density polyethylene, Low-density polyethylene, linear low-density polyethylene (e.g., Polyester, polybutylene terephthalate (PBT), polyethylene terephthalate (PET), polypropylene terephthalate, polyethylene naphthalate (PEN), polyetheretherketone (PEEK), polyimide (PI), polyetherimide (PEI), polyphenylene sulfide (PPS), polyphenylene ether (PPO), polyterephthalamide (e.g., Polysulfone, nylon, nylon-12 (e.g., available from EMS American Grilon) Perfluoropropyl vinyl ether (PFA), ethylene-vinyl alcohol, polyolefins, polystyrene, epoxy resins, polyvinylidene chloride (PVdC), poly(styrene-b-isobutylene-b-styrene) (e.g., SIBS and / or SIBS 50A), polycarbonate, ionomers, biocompatible polymers, other suitable materials, or mixtures, combinations, copolymers, polymer / metal composites thereof. In some embodiments, the sheath may be blended with a liquid crystal polymer (LCP). For example, the blend may contain up to about 6 percent LCP.

[0154] Some examples of suitable metals and metal alloys include: stainless steels such as 304V, 304L, and 316LV stainless steels; mild steels; nickel-titanium alloys such as linear elastic and / or hyperelastic nickel-titanium alloys; other nickel alloys such as nickel-chromium-molybdenum alloys (e.g., UNS:N06625, for example...). 625, UNS:N06022, for example UNS:N10276, for example other alloys, etc.), nickel-copper alloys (e.g., UNS:N04400, for example). 400 400 400, etc.), nickel-cobalt-chromium-molybdenum alloys (e.g., UNS:R30035, for example). (etc.), nickel-molybdenum alloys (e.g., UNS:N10665, for example) ALLOY Other nickel-chromium alloys, other nickel-molybdenum alloys, other nickel-cobalt alloys, other nickel-iron alloys, other nickel-copper alloys, other nickel-tungsten alloys or tungsten alloys, etc.; cobalt-chromium alloys; cobalt-chromium-molybdenum alloys (e.g., UNS:R30003, for example). (etc.); platinum-rich stainless steel; titanium; combinations thereof; or any other suitable material.

[0155] As implied herein, within the family of commercially available nickel-titanium or nitinol alloys, there is a class of alloys referred to as “linearly elastic” or “non-hyperelastic”, which, while chemically similar to conventional shape memory and hyperelastic types, may exhibit unique and useful mechanical properties. The distinction between linearly elastic and / or non-hyperelastic nitinol and hyperelastic nitinol may lie in the fact that linearly elastic and / or non-hyperelastic nitinol does not exhibit a significant “hyperelastic plateau” or “signature region” in its stress / strain curve, as hyperelastic nitinol does. Instead, in linearly elastic and / or non-hyperelastic nitinol, stress continues to increase in a generally linear relationship or in a somewhat, but not necessarily perfectly, linear relationship with increasing recoverable strain until plastic deformation begins, or at least in a more linear relationship than the hyperelastic plateau and / or signature region observed in hyperelastic nitinol. Therefore, for the purposes of this disclosure, linearly elastic and / or non-hyperelastic nitinol may also be referred to as “generally” linearly elastic and / or non-hyperelastic nitinol.

[0156] In some cases, linear elastic and / or non-hyperelastic nitinol can still be distinguished from hyperelastic nitinol because linear elastic and / or non-hyperelastic nitinol can accommodate up to about 2-5% strain while remaining roughly elastic (e.g., before plastic deformation), while hyperelastic nitinol can accommodate up to about 8% strain before plastic deformation. Both materials can also be distinguished from other linear elastic materials, such as stainless steel (which can also be differentiated based on its composition), which can only accommodate about 0.2% to 0.44% strain before plastic deformation.

[0157] In some embodiments, linear elastic and / or non-hyperelastic nickel-titanium alloys are alloys that do not exhibit martensitic / austenitic phase transformations detectable by differential scanning calorimetry (DSC) and dynamic metallographic analysis (DMTA) over a wide temperature range. For example, in some embodiments, in linear elastic and / or non-hyperelastic nickel-titanium alloys, martensitic / austenitic phase transformations detectable by DSC and DMTA analysis may not be present in the range of approximately -60°C to approximately 120°C. Therefore, the mechanical bending properties of such materials are generally inert to temperature over this very wide temperature range. In some embodiments, the mechanical bending properties of linear elastic and / or non-hyperelastic nickel-titanium alloys are substantially the same at ambient temperature or room temperature as at body temperature, for example, because they do not exhibit hyperelastic plateaus and / or marker regions. In other words, linear elastic and / or non-hyperelastic nickel-titanium alloys retain their linear elastic and / or non-hyperelastic characteristics and / or properties over a wide temperature range.

[0158] In some embodiments, the linear elastic and / or non-hyperelastic nickel-titanium alloy may have a nickel weight percentage ranging from about 50 to about 60, with the remainder being substantially titanium. In some embodiments, the nickel weight percentage in the composition ranges from about 54 to about 57. An example of a suitable nickel-titanium alloy is the FHP-NT alloy, which is commercially available from Furukawa TechnoMaterial Co., Ltd. in Kanagawa, Japan. Some examples of nickel-titanium alloys are disclosed in U.S. Patent Nos. 5,238,004 and 6,508,803, which are incorporated herein by reference. Other suitable materials may include ULTANIUM. TM (Available from Neo-Metrics) and GUM METAL TM (Available from Toyota). In some other embodiments, the desired properties can be achieved using a superelastic alloy (e.g., superelastic nitinol).

[0159] In at least some embodiments, other parts of the ureteroscopic instrument and / or components may also be doped with, made of, or otherwise include radiopaque materials. Radiopaque materials are understood to be materials capable of producing a relatively bright image on a fluoroscopic screen or another imaging technique during medical procedures. This relatively bright image helps the user of the component determine its location. Some examples of radiopaque materials may include, but are not limited to, gold, platinum, palladium, tantalum, tungsten alloys, polymeric materials loaded with radiopaque fillers, etc. Furthermore, other radiopaque marking strips and / or coils may be incorporated into the design of the component to achieve the same result.

[0160] In some embodiments, a degree of magnetic resonance imaging (MRI) compatibility is imparted to the examples. For example, the ureteroscope or portions thereof may be made of materials that do not substantially distort the image or produce significant artifacts (e.g., gaps in the image). For example, certain ferromagnetic materials may not be suitable because they can produce artifacts in MRI images. The ureteroscope or portions thereof may also be made of materials that can be imaged by an MRI machine. Some materials exhibiting these characteristics include, for example, tungsten, cobalt-chromium-molybdenum alloys (e.g., UNS:R30003, etc.). (etc.), nickel-cobalt-chromium-molybdenum alloys (e.g., UNS:R30035, for example) (etc.), nickel-titanium, and other materials.

[0161] It should be understood that this disclosure is illustrative in many respects only. Changes in detail may be made, particularly in terms of shape, size, and arrangement of steps, without departing from the scope of this disclosure. To the appropriate extent, this may include the use of any feature of an example embodiment used in other embodiments. The scope of this disclosure is, of course, defined by the language expressed in the appended claims.

Claims

1. An actuation mechanism for an endoscope, comprising: The housing is configured to attach to the handle of the endoscope; The first thumb wheel is connected to the housing; as well as A first connecting tube has a proximal end connected to the housing and a distal end configured to connect to an access port on the endoscope handle, the access port communicating with the working channel of the endoscope. The rotation of the first thumb wheel causes the first slender medical device to move longitudinally through the working channel of the first connecting tube and the endoscope.

2. The actuation mechanism according to claim 1, further comprising a first drive wheel coupled to the housing, wherein a first thumbwheel engages the first drive wheel, and wherein, The rotation of the first thumb wheel causes the first drive wheel to rotate.

3. The actuation mechanism according to claim 2, further comprising a first roller coupled to the housing, wherein, The outer circumferential surface of the first roller is positioned adjacent to the outer circumferential surface of the first drive wheel, such that the first elongated medical device can be positioned between the outer circumferential surface of the first roller and the outer circumferential surface of the first drive wheel, wherein rotation of the first thumb wheel causes rotation of the first drive wheel to move the first elongated medical device through the working channel of the endoscope.

4. The actuation mechanism according to claim 3, wherein, The first roller and the first drive wheel are configured to apply a compressive force in concert on the first elongated medical device to frictionally engage the first elongated medical device between the first roller and the first drive wheel.

5. The actuation mechanism according to claim 4, wherein, The first thumb wheel includes a circumferential surface, and wherein a strip of material extends around each of the first thumb wheel, the first drive wheel, and the first roller wheel.

6. The actuation mechanism according to any one of claims 3-5, further comprising a second thumb wheel coupled to the housing, a second drive wheel coupled to the housing, and a second roller coupled to the housing, wherein, The second thumb wheel engages the second drive wheel, and the rotation of the second thumb wheel causes the second elongated medical device to move longitudinally through the working channel of the endoscope.

7. The actuation mechanism according to claim 1, further comprising a first roller coupled to the housing, wherein, The outer circumferential surface of the first roller is positioned adjacent to the outer circumferential surface of the first thumb wheel, such that the first elongated medical device can be positioned between the outer circumferential surface of the first roller and the outer circumferential surface of the first thumb wheel, wherein rotation of the first thumb wheel causes rotation of the first roller to move the first elongated medical device through the working channel of the endoscope.

8. The actuation mechanism according to claim 1, wherein, The housing includes a channel extending from the outer surface of the housing into a portion of the housing wall, wherein the channel is configured to receive a proximal end of a tubular member of the first elongated medical device, and wherein the proximal end of the tubular member of the first elongated medical device is fixedly attached to the channel; and wherein the channel is configured to receive an elongated member of the first elongated medical device extending within a lumen of the tubular member of the first elongated medical device.

9. The actuation mechanism of claim 8, further comprising a rotating cap coupled to the housing, and wherein, The proximal end of the elongated member is attached to a rotating cap, and rotation of the rotating cap causes the elongated member to move within the lumen of the tubular member of the first elongated medical device.

10. An endoscopic medical device comprising: The handle has a proximal end region and a distal end region; An elongated shaft is coupled to and extends distally from the distal end region of a handle, and the elongated shaft includes a lumen defining a working channel extending distally from the distal end region of the elongated shaft through the elongated shaft to an access port. An actuation assembly coupled to a proximal end region of the handle, wherein the actuation assembly includes: case; The first thumb wheel is connected to the housing; The second thumb wheel is connected to the housing; A first connecting tube has a proximal end connected to the housing and a distal end connected to the access port; and The second connecting tube has a proximal end connected to the housing and a distal end connected to the access port. The rotation of the first thumb wheel causes the first slender medical device to translate through the working channel of the first connecting tube and the slender shaft; The rotation of the second thumb wheel causes the second slender medical device to translate through the working channel of the second connecting tube and the slender shaft.

11. The endoscopic medical device according to claim 10, wherein, The actuation assembly further includes a first drive wheel and a first roller coupled to the housing, the first drive wheel being configured to rotate by a first thumb wheel, and wherein the actuation assembly further includes a second drive wheel and a second roller coupled to the housing, the second drive wheel being configured to rotate by a second thumb wheel, and wherein the first drive wheel and the first roller are configured to cooperatively apply force on a first medical device positioned therebetween, and wherein the second drive wheel and the second roller are configured to cooperatively apply force on a second medical device positioned therebetween.

12. The endoscopic medical device according to claim 11, wherein, The rotation of the first thumb wheel causes the first drive wheel and the first roller wheel to rotate in opposite directions of rotation, so as to translate the first elongated medical device through the elongated shaft, and wherein the rotation of the second thumb wheel causes the second drive wheel and the second roller wheel to rotate in opposite directions of rotation, so as to translate the second elongated medical device through the elongated shaft.

13. An actuation assembly for an endoscope, comprising: The housing is configured to attach to the handle of the endoscope; A thumb wheel, which is connected to the housing; A connecting tube having a proximal end connected to the housing and a distal end configured to connect to an access port on the endoscope handle; The rotation of the thumb wheel causes the first elongated shaft to translate within the working channel of the connecting tube and the endoscope; and A rotating cap is connected to the housing, and the rotating cap is connected to a second elongated shaft extending within the lumen of the first elongated shaft; The rotation of the rotating cap causes the second slender shaft to move within the cavity of the first slender shaft.

14. The actuation assembly according to claim 13, wherein, The rotation of the thumb wheel causes the first and second slender shafts to move together within the working channel of the endoscope.

15. The actuation assembly according to claim 13 or 14, further comprising a drive wheel, wherein, The drive wheel has a circumferential surface that contacts both the thumb wheel and the first elongated shaft.

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