Ureteroscope configured to alter hardness of catheter distal end region and methods of use thereof

Abstract

An exemplary ureteroscope includes a handpiece having a catheter end and a control end. The ureteroscope also includes a catheter extending from the catheter end of the handpiece. The ureteroscope is configured to selectively alter the hardness of the distal region of the catheter. For example, the ureteroscope is configured to increase the stiffness of the distal end of the catheter.

Description

Background Art

[0001] Many industrial and medical applications require small-sized endoscopes. For example, when the body's natural orifices and lumens are small, a small endoscope can be used to insert through the orifices and lumens to the target location in the body. For single-incision laparoscopy, a smaller endoscope is preferred to provide an in vivo view of the surgical site, especially when the size of the incision itself is small. Sometimes, patients may feel pain when the endoscope is inserted into their body, and a smaller endoscope can alleviate this unpleasant experience and minimize trauma to the patient. In addition, doctors can use smaller endoscopes to improve diagnostics and surgical plans. For example, transnasal endoscopy can sometimes replace transoral endoscopy. Summary of the invention

[0002] Embodiments relate to ureteroscopes, endoscopic systems including ureteroscopes, and methods of using the same. In one embodiment, a ureteroscope is disclosed. The ureteroscope includes a handpiece. The handpiece includes a catheter end, a control end, a working assembly configured to receive one or more surgical instruments, and a steering controller configured to bend at least a portion of the catheter. The ureteroscope also includes a catheter extending from the catheter end of the handpiece. The catheter includes a proximal region and a distal region, the distal region being farther from the handpiece than the proximal region. At least one of the following is true: the working assembly includes a first movable portion configured to move relative to the catheter end of the handpiece, or the steering controller includes a second movable portion configured to move relative to the catheter end of the handpiece. Movement of the first movable portion relative to the catheter end of the handpiece changes the stiffness of at least a portion of the catheter. Movement of the second movable portion relative to the catheter end of the handpiece changes the stiffness of at least a portion of the catheter.

[0003] In one embodiment, a method for using a ureteroscope is disclosed. The method includes providing a ureteroscope. The ureteroscope includes a handpiece. The handpiece includes a catheter end, a control end, a working assembly configured to receive one or more surgical instruments, and a steering controller configured to bend at least a portion of the catheter. The ureteroscope also includes a catheter extending from the catheter end of the handpiece. The catheter includes a proximal region and a distal region, and the distal region is farther from the handpiece than the proximal region. At least one of the following is true: the working assembly includes a first movable portion configured to move relative to the catheter end of the handpiece, or the steering controller includes a second movable portion configured to move relative to the catheter end of the handpiece. The method also includes moving at least one of at least a portion of the first movable portion or at least a portion of the second movable portion relative to the catheter end of the handpiece of the ureteroscope to adjust the hardness of at least a portion of the catheter.

[0004] Any features in the disclosed embodiments may be used in combination with each other without restriction. In addition, other features and advantages of the present disclosure will become apparent to those of ordinary skill in the art by considering the following detailed description and accompanying drawings. BRIEF DESCRIPTION OF THE DRAWINGS

[0005] The drawings illustrate several embodiments of the present disclosure, wherein like reference numerals refer to the same or similar elements or features in different views or embodiments shown in the drawings.

[0006] Figure 1A is an isometric schematic diagram of an endoscopy system according to one embodiment.

[0007] Figure 1B is a cross-sectional view of a portion of a ureteroscope taken along plane 1B-1B.

[0008] Figure 1C is a side view of the tip of the distal region of a catheter according to one embodiment.

[0009] Figure 1D and Figure 1E is an enlarged view of a ureteroscope illustrating a method of selectively varying the stiffness of at least a portion of a catheter using an actuator according to one embodiment.

[0010] Figure 2A and Figure 2B is a side view of a ureteroscope configured to use a steering control to vary the stiffness of at least a portion of a catheter, according to one embodiment.

[0011] Figure 3 is a side view of a catheter shaft that may be used with any of the catheters disclosed herein, according to one embodiment. DETAILED DESCRIPTION

[0012] Embodiments relate to ureteroscopes, endoscopic systems including ureteroscopes, and methods of using the same. An exemplary ureteroscope includes a handpiece having a catheter end and a control end. The ureteroscope also includes a catheter extending from the catheter end of the handpiece. The handpiece also includes a working assembly configured to engage with one or more surgical instruments, and a steering controller configured to selectively bend at least a portion of the catheter. The ureteroscope is configured to selectively change the hardness of at least a portion of the catheter. In one embodiment, at least one of the following is true: the working channel port includes a first movable portion, or the steering controller includes a second movable portion. The first movable portion and / or the second movable portion are configured to move relative to a portion of the handpiece (e.g., the catheter end). Moving the first movable portion and / or the second movable portion relative to a portion of the handpiece can selectively change the hardness of at least a portion of the catheter.

[0013] Some ureteroscopes include catheters with flexible distal regions (i.e., regions of the catheter distal to its handpiece). The flexible distal regions of such catheters allow the catheter to be moved through tortuous paths within the human or animal body. The flexible distal regions of such catheters also allow the shape (e.g., curvature) of the catheter to be selectively changed to manipulate the catheter through bends in a tortuous path or to select a passage through which the catheter is moved. However, the flexible distal ends of the catheters of such ureteroscopes may bend due to their flexibility or fail to pass through narrow passages or at least partially blocked passages.

[0014] Unlike the ureteroscope discussed in the previous paragraph, the ureteroscope disclosed herein is capable of selectively changing the hardness of at least a portion of its catheter. For example, the ureteroscope disclosed herein may include a catheter having a flexible distal region during normal use. However, when the path through the body becomes narrowed, the passage is at least partially blocked, or for any other reason, the hardness of the distal region of the catheter can be selectively increased (i.e., the flexibility of the distal region can be selectively reduced). Increasing the hardness of the distal region of the catheter allows the distal region of the catheter to squeeze through a narrow path or push an obstacle away. After the distal region of the catheter is moved through a narrow path or pushed away an obstacle, the hardness of the distal region of the catheter can be selectively reduced (i.e., the flexibility of the distal region can be selectively increased).

[0015] Figure 1A is an isometric schematic diagram of an endoscope system 100 according to one embodiment. The endoscope system 100 includes a ureteroscope 102. Figure 1B 1 is a cross-sectional view of a portion of a ureteroscope 102 taken along plane 1B-1B. The ureteroscope 102 includes a handpiece 104 and a catheter 106 extending from the handpiece 104. The catheter 106 includes a proximal region 108 adjacent to or within the handpiece 104 and a distal region 110 opposite the proximal region 108. The ureteroscope 102 is configured to selectively change the stiffness of at least a portion of the catheter 106 (e.g., the distal region 110 of the catheter 106).

[0016] The handpiece 104 can be elongated and include a catheter end 112 and a control end 114. The catheter end 112 is proximal to the catheter 106, and the control end 114 is opposite or distal to the catheter end 112. Since the control end 114 is opposite to the catheter end 112, the control end 114 and the catheter end 112 are located at different ends of the handpiece 104 and can face different directions relative to each other. The control end 114 can include a generally spherical shape, and the handpiece 104 can taper between the control end 114 and the catheter end 112.

[0017] Since the control end 114 is opposite or distant from the catheter end 112, the handpiece 104 includes an intermediate portion or center portion 116 positioned between the catheter end 112 and the control end 114. The center portion 116 includes a first surface or top surface 118, a second surface or bottom surface 120, and two opposing side surfaces 122 positioned between the top surface 118 and the bottom surface 120. In one embodiment, the top surface 118 and the bottom surface 120 of the center portion 116 are rounded, and the side surfaces 122 are substantially flat.

[0018] In one embodiment, both the catheter 106 and the handpiece 104 are disposable. In some embodiments, the catheter 106 is manufactured as an integral component with the handpiece 104, or the catheter 106 is fixed to the handpiece 104 via a handpiece-catheter connector 124. Alternatively, only the catheter 106 is disposable, while the handpiece 104 can be sterilized and reused multiple times. In this case, the catheter 106 is detachably connected to the handpiece 104 and the catheter end 112 via the handpiece-catheter connector 124.

[0019] As previously described, the catheter 106 includes a proximal region 108 and a distal region 110 spaced apart from the proximal region 108. The proximal region 108 is attached to, integrally formed with, or disposed in the catheter end 112 (e.g., the handpiece-catheter connector 124). The distal region 110 can be configured to be disposed in the urethral opening of an individual. Figure 1C is a side view of the tip of the distal region 110 of the catheter 106 according to one embodiment.

[0020] The ureteroscope 102 includes a working assembly 125. The working assembly 125 includes a working channel port 126 defined by the handpiece 104 and a working channel 127 defined by or disposed within the catheter 106. Figure 1C). The working channel 127 extends from the proximal region 108 of the catheter 106 to the distal region 110. The working channel port 126 is connected to the working channel 127 (directly or indirectly). The working channel port 126 and the working channel 127 are configured to engage with various surgical instruments and flushing devices as needed to perform operations such as lithotripsy and stone removal. For example, various surgical instruments can be inserted through the working channel port 126 and the working channel 127, so that various surgical instruments can be used at the distal region 110 of the catheter 106. The working assembly 125 may also include at least one of a working channel connector 128 or at least one conduit 130, the working channel connector 128 is connected or attached to the working channel port 126, and at least one conduit 130 indirectly connects the working channel port 126 to the catheter 106. In one embodiment, as shown in the figure, the conduit 130 may extend within the catheter 106 and define at least a portion of the working channel 127. In such an embodiment, the conduit 130 can extend through the catheter 106 and be rigidly (eg, non-removably) attached to at least the distal region 110 of the catheter 106. In an embodiment, the conduit 130 does not extend within the catheter 106, but rather the catheter 106 defines the working channel 127.

[0021] The working channel port 126 can be positioned proximate to the catheter end 112 of the hand piece 104. For example, the working channel port 126 can be positioned less than half the distance from the catheter end 112 to the control end 114, less than one-third the distance from the catheter end 112 to the control end 114, less than one-quarter the distance from the catheter end 112 to the control end 114, or less than one-fifth the distance from the catheter end 112 to the control end 114. Positioning the working channel port 126 proximate to the catheter end 112 can improve the ergonomics of the hand piece 104 because the working channel port 126 and any surgical instruments extending therefrom are less likely to interfere with the use of the ureteroscope 102.

[0022] The ureteroscope 102 includes a steering controller 132 configured to control one or more steering wires 134 connected to an active bending portion (e.g., the distal region 110) of the catheter 106 to deflect the active bending portion of the catheter 106 to a desired position. Thus, a user can use the steering controller 132 to bend or flex the catheter 106 (e.g., bend or flex the distal region 110).

[0023] The steering controller 132 may include a driver 136 coupled to the steering wire 134. The driver 136 is configured to move the steering wire 134 so as to bend the catheter 106. For example, the driver 136 is configured to rotate about a rotation axis. The rotation axis may extend substantially perpendicular to the longitudinal axis of the hand piece 104. The steering wire 134 may be attached to opposite sides of the driver 136. In this way, the rotation of the driver 136 about the rotation axis may cause at least one steering wire 134 to move closer to or further away from the catheter end 112 of the hand piece 104. In one embodiment, when the steering wire 134 includes two steering wires 134, as shown in the figure, the rotation of the driver 136 may cause one of the steering wires 134 to move closer to the catheter end 112, while the other steering wire 134 moves away from the catheter end 112. In such an embodiment, the steering wire 134 moving closer to the catheter end 112 is not tensioned, while the steering wire 134 moving away from the catheter end 112 is tensioned. Selectively tensioning one of the two steering wires 134 causes selective bending of at least a portion of the catheter 106. Notably, the principle of selectively tensioning one or more steering wires 134 is what causes the catheter 106 to selectively bend or flex, regardless of whether the ureteroscope 102 includes one or three or more steering wires 134.

[0024] In one embodiment, the driver 136 can exhibit a generally cylindrical shape, which allows the driver 136 to fit within the generally spherical control end 114. However, it is noted that the driver 136 can exhibit other shapes.

[0025] In one embodiment, as shown, the driver 136 is disposed within the interior of the handpiece 104. In one embodiment, the driver 136 is at least partially disposed on the exterior of the handpiece 104 or is otherwise accessible from the exterior of the handpiece 104.

[0026] It is worth noting that the steering controller 132 may include one or more elements other than the actuator 136 that are configured to selectively move the steering wire 134 relative to the catheter end 112. For example, the steering controller 132 may include one or more elements configured to move on a track, and each element is attached to a corresponding one of the steering wires 134. Moving the elements along the track causes the steering wire 134 to move relative to the catheter end 112, thereby causing the catheter to selectively bend. For the sake of simplicity and brevity, only the actuator 136 will be discussed here. However, it is worth noting that the mechanism for moving the actuator 136 (such as will be described for Figure 2A and Figure 2B ) will apply to any other element configured to move the steering wire 134 relative to the catheter end 112.

[0027] When the driver 136 is disposed inside the handpiece 104, the steering controller 132 may include a mechanism located on the outside of the handpiece 104 that can be manipulated by the user to rotate the driver 136. As shown, in one embodiment, the steering controller 132 includes a rod 138 attached to the driver 136. The rod 138 extends along the outside of the handpiece 104. The rod 138 is configured so that movement of the rod 138 relative to the control end 114 causes the driver 136 to rotate, thereby selectively bending at least a portion of the catheter 106. In one embodiment, instead of or in addition to the rod 138, the steering controller 132 includes one or more gears attached to the driver 136 and configured to rotate the driver 136. The gears can be attached to a disk-shaped device that is at least partially exposed to the outside of the handpiece 104. Rotation of the disk-shaped device by the user can cause the driver 136 to rotate. In one embodiment, the steering controller 132 includes a motor, instead of or in addition to the rod 138, that is attached to the driver 136 and configured to rotate the driver 136. The motor may be controlled by the host computer 146, the computer 150, the controller 154, or other device.

[0028] The catheter 106 of the ureteroscope 102 can be used to image the inner surface of a tubular structure (e.g., an inner cavity in a human or animal body). For example, the catheter 106 can be inserted through the urethra of the subject to access various parts of the urinary tract. However, it should be understood that when the tubular structure is part of an industrial device, equipment, product, machine, production line, etc., the ureteroscope 102 can be used as an industrial endoscope. In some embodiments, the catheter 106 can be used as a tether and can include multiple scale marks or reference points so that the doctor can measure the distance traveled by the photoelectric module 140 in the tubular structure (e.g., the inner cavity of the body). Other structures can be built into the ureteroscope 102 as needed.

[0029] The ureteroscope 102 may include a photoelectric module 140 (e.g., a camera or other imager) for imaging the interior of the object. For example, the photoelectric module 140 and at least one light source 1142 may be located in the distal region 110 of the catheter 106 or other locations in the catheter 106. The photoelectric module 140 may include a micro-camera module, a micro-lens group, and a micro-illumination module having an image sensor microchip. Suitable photoelectric modules are disclosed in U.S. Pat. No. 9,942,452, the entire contents of which are incorporated herein by reference. In some embodiments, the photoelectric module 140 may be positioned in a rigid or semi-rigid shell-shaped shell at the distal region 110, which is configured to be inserted into a tubular structure to image its inner surface. For example, the photoelectric module 140 may be inserted into the patient through a natural body orifice (e.g., mouth, nose, urethra, bladder, vagina, or anus). Therefore, the ureteroscope 102 may have different configurations to be used as a gastrointestinal endoscope, a colonoscope, an endoscopic ultrasound examination (EUS), an endoscopic retrograde pancreaticocholangiopancreatography, or other suitable applications. Applications for the ureteroscope 102 include diagnostic observations related to endometrial polyps, infertility, abnormal bleeding, and pelvic pain, as well as surgical procedures such as fetal growth arrest and uterine malformations.

[0030] The ureteroscope 102 may include a communication interface 144, typically located on the exterior of the catheter 106, for receiving signals from an image sensor within the optoelectronic module 140. The communication interface 144 may be positioned within or adjacent to the handpiece 104. At least the optoelectronic module 140 may be coupled to the communication interface 144.

[0031] The endoscope system 100 may include one or more electronic devices for processing and displaying image data received from the optoelectronic module 140 of the ureteroscope 102. For example, the endoscope system 100 may include one or more of a host computer 146 having a microprocessor, a computer 150 having a microprocessor, and a display 148. The host computer 146 may be connected to one or more terminals of the computer 150 and the display 148 to further process and display the image data from the optoelectronic module 140. The host computer 146 or the computer 150 may be programmed with image processing software that takes as input the image data output by the optoelectronic module 140 of the ureteroscope 102 and generates a two-dimensional or three-dimensional reconstruction of the body cavity that can be displayed on the display 148. Thus, a processor in at least one of the host computer 146, the computer 150, or the display 148 may be programmed with software that accepts as input a plurality of still images of an object generated by the optoelectronic module 140 and then outputs a three-dimensional rendering for displaying the object based on the plurality of still images. Display 148 may include any suitable display and may be configured to display moving images (movies) or still images captured by the image sensor of optoelectronic module 140. Figure 1A140 and 141. Although shown as separate boxes in FIG. 140, host 146, computer 150, and display 148 may comprise a single device, two devices, three devices, or more than three devices.

[0032] The endoscope system 100 may also include a cable 152 configured to operably couple the ureteroscope 102 to at least one of a host computer 146, a computer 150, or a display 148. The cable 152 may electrically couple the communication interface 144 of the ureteroscope 102 to at least one of the host computer 146, the computer 150, or the display 148. The cable 152 may also allow the communication interface 144 to communicate with and receive power from the host computer 146 or other power source. The cable 152 may also be configured to allow the communication interface 144 to transmit image data captured at the optoelectronic module 140 to the host computer 146 for processing, storage, and display.

[0033] The communication interface 144 may include, for example, one or more of a processor board, a camera board and a frame grabber, or a power source. The processor board may be coupled to the host computer 146 via a cable 152 to store and retrieve images generated by the ureteroscope 102. The communication interface 144 may also be configured to communicate with and receive power from the host computer 146 or other power source via the cable 152. The communication interface 144 may also transmit image data captured at the distal region 110 to the host computer 146 for processing, storage, and display.

[0034] The ureteroscope 102 may include one or more controllers 154 positioned at or adjacent to the control end 114 of the handpiece 104. The one or more controllers 154 may include one or more of a switch, a button, a knob, a movable piece, and the like. In some embodiments, the one or more controllers 154 are configured to adjust the view presented on the display 148. For example, the one or more controllers 154 may be configured to adjust at least one of the brightness, zoom, focus, or contrast of one or more images displayed on the display 148. Thus, during use of the ureteroscope 102, the one or more controllers 154 allow the user to adjust the view displayed on the display 148 and / or computer 150 according to their preferences and as needed. In some embodiments, at least one of the one or more controllers 154 is configured to activate (e.g., turn on) or deactivate (e.g., turn off) at least one light source 1142 (e.g., light source 1142) at the distal region 110 of the catheter 106. Figure 1C In some embodiments, at least one of the one or more controllers 154 is configured to activate and deactivate the photovoltaic module 140 .

[0035] The ureteroscope 102 can be operated manually, automatically, or in a combination of both to perform or complete selected tasks. Some ureteroscope functions can be implemented using components including hardware, software, firmware, or a combination thereof. General components (such as general-purpose computers or oscilloscopes) can be used in the ureteroscope 102, and dedicated or customized components (such as circuits, integrated circuits, or software) can also be used. For example, some functions are implemented by multiple software instructions executed by one or more data processors, where the data processor is part of a general-purpose or customized computer. One or more data processors can be located in at least one of the communication interface 144, the host 146, the computer 150, or the display 148. In some embodiments, the data processor or computer 150 includes a volatile memory for storing instructions and / or data, and / or a non-volatile memory for storing instructions and / or data, such as a magnetic hard disk and / or a removable medium. In some embodiments, the implementation includes a network connection. In some embodiments, the implementation includes a user interface, typically including one or more input devices (e.g., allowing input of commands and / or parameters) and output devices (e.g., allowing reporting of operating parameters and results).

[0036] Alternatively, the handpiece 104 may also include a compact battery module for powering the optoelectronic module 140 and the at least one light source 1142. The power source in the handpiece 104 may be, for example, one or more conventional dry cell batteries, disposable batteries, or lithium-ion rechargeable batteries.

[0037] Other examples of endoscopic systems and endoscopes are disclosed in International Publication No. WO2020123588, published on June 18, 2020, and International Application No. PCT / US2022 / 015828, filed on February 9, 2022, the contents of each of which are incorporated herein by reference in their entirety.

[0038] As previously described, the ureteroscope 102 is configured to selectively change the stiffness of at least a portion of the catheter 106. For example, the ureteroscope 102 is configured to selectively change the stiffness of the distal region 110 of the catheter 106. In the illustrated embodiment, the ureteroscope 102 is configured to increase the stiffness of at least a portion of the catheter 106 using a working assembly 125. As will be discussed in more detail below, the working assembly 125 includes a first movable portion. As used herein, "first movable portion" refers to a portion of the working assembly 125 that is movable relative to the handpiece 104, such as relative to the catheter end 112 of the handpiece 104. The first movable portion may include all of the working assembly 125 or a portion of the working assembly 125. The first movable portion of the working assembly 125 is configured to move at least relative to the catheter end 112 of the handpiece 104. Moving the first movable portion of the working assembly 125 relative to the catheter end 112 may tension at least a portion of the working assembly 125. Tensioning at least a portion of the working assembly 125 causes the working channel 127 to apply a compressive force to the catheter 106 (e.g., pulling the distal region 110 of the catheter 106 directly back toward the handpiece 104). The compressive force applied to the catheter 106 causes an increase in the stiffness of at least a portion of the catheter 106. For example, the compressive force applied to the catheter 106 causes at least a portion of the catheter 106 located at or near the distal region 110 to exhibit an increased stiffness.

[0039] The hand piece 104 includes an actuator 156 coupled (e.g., attached) to a portion of the working assembly 125. The actuator 156 is configured to move relative to the remainder of the hand piece 104 (e.g., relative to the catheter end 112) in response to manipulation by a user. Movement of the actuator 156 relative to the catheter end 112 causes at least a portion of the working assembly 125 to also move relative to the hand piece 104. For example, movement of the actuator 156 may cause at least one of at least a portion of the working channel port 126, at least a portion of the working channel 127, at least a portion of the working channel connector 128, or at least a portion of the conduit 130 to move relative to at least a portion of the hand piece 104. The first movable portion of the working assembly 125 includes the actuator 156 and other portions of the working assembly 125 that move due to movement of the actuator 156.

[0040] The actuator 156 may have a first position (i.e., an initial position) relative to the remainder of the hand piece 104. Manipulation (e.g., rotation, pushing, pulling, etc.) of the actuator 156 by an individual may move the actuator 156 to a second position relative to a portion of the hand piece 104 (e.g., the catheter end 112), the second position being different from the first position. The second position may be further away from or closer to a portion of the hand piece 104 (e.g., further away from or closer to the catheter end 112) than the first position. After moving the actuator 156 to the second position, the user may optionally further manipulate the actuator 156 to return the actuator 156 to the first position or to one or more additional positions different from the first position and the second position.

[0041] In one embodiment, when the actuator 156 is in the first position, the first moving portion of the working assembly 125 may be in a first state (i.e., an initial state). When the first moving portion is in the first state, substantially no pulling force or tension is applied to at least a portion of the working assembly 125. Moving the actuator 156 from the first position to the second position causes the first moving portion to switch to a second state different from the first state. When substantially no pulling force is applied to at least a portion of the working assembly 125 when the first moving portion is in the first state, pulling force may be applied to at least a portion of the working assembly 125 when the first moving portion is in the second state. When pulling force is applied to at least a portion of the working assembly 125 when the first moving portion is in the first state, a different pulling force (e.g., greater or lesser) or substantially no pulling force is applied to at least a portion of the working assembly 125 when the first moving portion is in the second state. Moving the actuator 156 to one or more additional positions may cause the first moving portion to exhibit one or more different states. Notably, as used herein, the first state, the second state, and one or more additional states may refer to different positions of the first movable portion relative to a portion of the handpiece 104 (e.g., relative to the catheter end 112) and / or tensions applied thereto.

[0042] In one embodiment, at least a portion of the actuator 156 is readily accessible by a user of the ureteroscope 102. For example, when at least a portion of the actuator 156 is positioned on or extends from an exterior of the handpiece 104, at least a portion of the actuator 156 is readily accessible. When at least a portion of the actuator 156 is readily accessible, the user is able to directly manipulate (e.g., rotate, press, pull, etc.) the actuator 156. The user's manipulation of the actuator 156 allows the actuator 156 to move relative to the rest of the handpiece 104. In one embodiment, as shown, at least a portion of the actuator 156 can be attached to, positioned at, or otherwise coupled to the working channel port 126. Since the working channel port 126 is positioned on the exterior of the handpiece 104, positioning the actuator 156 to be attached to, positioned at, or otherwise coupled to the working channel port 126 can allow at least a portion of the actuator 156 to be readily accessible.

[0043] In one embodiment, the actuator 156 is not accessible. For example, when the actuator 156 is disposed within the handpiece 104 (e.g., at least a portion of the actuator 156 is attached to, disposed in, or otherwise coupled to the working channel 127 or the optional conduit 130), the actuator 156 may be not accessible. When the actuator 156 is not accessible, the actuator 156 can be indirectly manipulated by a user. Indirect manipulation of the actuator 156 can include controlling the actuator 156 using one or more components of the endoscope system 100 (e.g., the host computer 146, the computer 150, or the controller 154). For example, manipulation of a component of the endoscope system 100 (e.g., pressing a button on the computer 150, pressing or otherwise moving the controller 154) can indirectly cause the actuator 156 to move relative to the rest of the handpiece 104.

[0044] The actuator 156 may include any actuator configured to move relative to a portion of the handpiece 104. As shown, in one embodiment, the actuator 156 is a threaded element attached to a portion of the handpiece 104. In such an embodiment, manipulation of the actuator 156 includes rotating an accessible portion of the actuator 156 relative to the handpiece 104. Rotating the actuator 156 in a first direction (e.g., counterclockwise) may cause the actuator 156 to move away from the remainder of the handpiece 104, while rotating the actuator 156 in a second direction (e.g., clockwise) may cause the actuator to move toward the remainder of the handpiece 104. In an embodiment not shown, the actuator 156 includes a plunger that can pull outward or push inward a portion of the handpiece 104. In one embodiment, the actuator 156 includes an element attached to a track, and moving the actuator 156 relative to a portion of the handpiece 104 includes moving the element along the track. In one embodiment, the actuator 156 includes an electric motor, a pneumatic press, a hydraulic press, or other actuator.

[0045] Figure 1D and Figure 1E 1 is an enlarged view of the ureteroscope 102 illustrating a method of selectively changing the stiffness of at least a portion of the catheter 106 using the actuator 156 according to one embodiment. Figure 1D , the actuator 156 can be initially set in the first position. In the first position, the actuator 156 can be fully screwed into the working channel port 126 so that the actuator 156 is as close to the catheter end 112 as possible. Figure 1B The actuator 156 of the embodiment of the present invention is attached to at least one or more of the working channel connector 128 or the optional conduit 130. Figure 1E , the actuator 156 may be rotated (e.g., counterclockwise) to move the actuator 156 to a second position, which in this embodiment is away from a portion of the handpiece 104 (e.g., away from the catheter end 112). Moving the actuator 156 to the second position moves the first moving portion of the working assembly 125 (e.g., the working channel connector 128, at least a portion of the optional tubing 130, and optionally at least a portion of the working channel 127) from the first state to the second state. In the illustrated embodiment, moving the first moving portion to the second state increases the tension applied to the working assembly 125. In this manner, the working channel 127 applies a compressive force to the catheter 106, thereby increasing the stiffness of at least a portion of the catheter 106. Moving the actuator 156 back to the first position may switch the first moving portion of the working assembly 125 back to its first state, thereby reducing the stiffness of at least a portion of the catheter 106.

[0046] In addition to or in addition to the working assembly 125, other portions of the ureteroscope disclosed herein can be used to change the stiffness of the catheter. For example, Figure 2A and Figure 2B 2 is a side view of a ureteroscope 202 according to one embodiment, the ureteroscope 202 being configured to change the stiffness of at least a portion of a catheter 206 using a steering controller 232. Unless otherwise disclosed herein, the ureteroscope 202 is the same or substantially similar to any ureteroscope disclosed herein. For example, the ureteroscope 202 can include a handpiece 204, a catheter 206, a working assembly 225 (e.g., at least a working channel port 226 and a working channel), and a steering controller 232. The ureteroscope 202 can be used in any endoscopic system disclosed herein.

[0047] As previously described, the ureteroscope 202 is configured to selectively change the stiffness of at least a portion of the catheter 206 (e.g., the distal region of the catheter 206). For example, the ureteroscope 202 is configured to increase the stiffness of at least a portion of the catheter 206 using at least a portion of the steering controller 232. As will be discussed in more detail below, the steering controller 232 includes a second movable portion. As used herein, "second movable portion" refers to the portion of the steering controller 232 that is movable relative to the handpiece 204. The second movable portion may include all of the steering controller 232 or a portion of the steering controller 232. The first movable portion of the steering controller 232 is configured to move relative to the catheter end 212 of the handpiece 204. By moving the second movable portion of the steering controller 232 relative to the catheter end 212, at least a portion of the steering wire (e.g., Figure 1B The steering wire is rigidly (i.e., non-movably) attached to the distal region of the catheter 206. Thus, tensioning at least a portion of the steering wire causes the steering wire to apply a compressive force to the catheter 206 (e.g., pulling the distal region of the catheter 206 directly back toward the handpiece 204). The compressive force applied to the catheter 206 causes the stiffness of the catheter 206 to increase.

[0048] The handpiece 204 includes an actuator 256, which is not associated with the handpiece 204 unless otherwise disclosed herein. Figures 1A to 1E The second movable portion of the steering controller 232 includes the actuator 256 and the other portions of the steering controller 232 that move due to the movement of the actuator 256.

[0049] The actuator 256 can have a first position (ie, an initial position) relative to the remainder of the handpiece 204, such as Figure 2A Individual manipulation of the actuator 256 may move the actuator 256 to a second position relative to the remainder of the handpiece 204, the second position being different from the first position, such as Figure 2B The second position can be further away from or closer to a portion of the handpiece 204 (e.g., further away from or closer to the catheter end 212) than the first position. After moving the actuator 256 to the second position, the user can optionally further manipulate the actuator 256 to return the actuator 256 to the first position or to move the actuator 256 to one or more different positions different from the first position and the second position.

[0050] Moving the actuator 256 relative to the catheter end 212 moves at least a portion of the steering controller 232. In other words, moving the actuator 256 causes the second movable portion of the steering controller 232 to move relative to the handpiece 204. When the actuator 256 is in the first position, the second movable portion of the steering controller 232 can be in a first state (i.e., an initial state), and when the actuator 256 is in the second position, the second movable portion of the steering controller 232 can be in a second state different from the first state. As previously described, the second movable portion can also exhibit one or more additional states when the actuator 256 is in one or more additional positions.

[0051] In one embodiment, at least a portion of the actuator 256 is easily accessible by a user of the ureteroscope 202. For example, when at least a portion of the actuator 256 is positioned on or extends from an exterior of the handpiece 204, at least a portion of the actuator 256 is easily accessible. In one embodiment, as shown, the actuator 256 can include a bump 258 positioned on the exterior of the handpiece 204, thereby allowing easy access to the bump 258. In one embodiment, the actuator 256 is not easily accessible. For example, when the actuator 256 is disposed within the handpiece 204 (e.g., at least a portion of the actuator 256 is attached to, disposed on, or otherwise coupled to a driver), the actuator 256 may not be easily accessible. When the actuator 256 is not easily accessible, the actuator 256 can be indirectly manipulated by the user.

[0052] As previously described, in one embodiment, the actuator 256 includes a protrusion 258. The protrusion 258 can be directly attached to the second moving portion, or can include at least one additional element extending from the protrusion 258 to the steering control 232. The portion of the actuator 256 attached to the steering control 232 can be rotatably attached to the steering control 232, thereby allowing a driver (not shown) to rotate. The handpiece 204 can define a slot 260 to allow the protrusion 258 to move left and right. Moving the protrusion 258 left and right along the slot 260 allows the actuator 256 to move at least a portion of the steering control 232. In one embodiment, the actuator 256 can include any other actuator disclosed herein, such as a threaded attachment, a plunger that can pull outward or push inward a portion of the handpiece 204, a motor, a pneumatic press, a hydraulic press, or other actuator.

[0053] See also Figure 2A , the actuator 256 may be initially set in the first position. Figure 2B , the actuator 256 can be moved to a second position, which in this embodiment is farther from the catheter end 212. Moving the actuator 256 to the second position causes the second movable portion of the steering controller 232 to move from the first state to the second state. Moving the second movable portion to the second state increases the tension applied to the steering wire. The steering wire applies a compressive force to the catheter 206, thereby increasing the stiffness of at least a portion of the catheter 206. Moving the actuator 256 back to the first position can switch the second movable portion of the steering controller 232 back to its first state, thereby reducing the stiffness of at least a portion of the catheter 206.

[0054] It is worth noting that other components of the ureteroscope disclosed herein can be used to change the stiffness of at least a portion of the catheter. In one embodiment, the ureteroscope disclosed herein can include one or more actuators configured to directly apply tension to the steering wire with or without moving the steering controller. In one embodiment, the ureteroscope disclosed herein can include one or more actuators configured to directly apply tension to the steering wire with or without moving the steering controller. Figure 1C The optoelectronic module 140 and / or the light source 142 of the embodiment of the present invention may be configured to apply tension to the line extending therefrom to apply a compressive force to the catheter. In one embodiment, the ureteroscope disclosed herein may include a laser fiber and / or a laser fiber channel configured to receive a laser fiber, as disclosed in International Application No. PCT / US2022 / 015828 filed on February 9, 2022, the disclosure of which has been previously incorporated herein. In such an embodiment, one or more actuators may be configured to apply tension to the laser fiber and / or the laser fiber channel, thereby applying a compressive force to the catheter.

[0055] The catheter shaft is typically included at least in the distal region of the catheter. The catheter shaft is included in the catheter to provide support to these regions of the catheter and better control the bending of the catheter. In one embodiment, the catheter disclosed herein may include a catheter shaft that is configured to facilitate changing its stiffness. For example, Figure 3 370 is a side view of a catheter shaft 370 that can be used for any catheter disclosed herein according to an embodiment. The catheter shaft 370 includes a plurality of connectors 372. The plurality of connectors 372 can be substantially hollow (e.g., generally annular) so that the working channel, steering wire, and other components of the catheter can be positioned through it. The connector 372 can be pivotally attached to an adjacent connector 372, thereby allowing the catheter shaft 370 to pivot when the catheter is bent. For example, each connector 372 can include a body 374. At least some of the connectors 372 also include an attachment portion 376 extending from the body 374. The attachment portion 376 can be attached to an adjacent body 374 in a manner that allows the adjacent bodies 374 to move relative to each other (e.g., pivot). In one embodiment, as shown, the attachment portion 376 can be attached to an adjacent body 374 using a hinge 377. In one embodiment, the attachment portion 376 is integrally formed with the body 374 of the adjacent connector 372 or rigidly attached to the body 374. In such an embodiment, the attachment portions 376 are resilient, thereby allowing adjacent bodies 374 to pivot relative to each other by deforming the attachment portions 376 .

[0056] At least a portion of each adjacent connector 372 is spaced apart from each other by a gap 378. For example, the gap 378 may be located between adjacent bodies 374. The catheter shaft 370 may be configured so that the size of the gap 378 between adjacent connectors 372 (i.e., the distance between adjacent connectors 372) can be changed. In one embodiment, as shown, the attachment portion 376 defines an elongated slot 380 that is configured to change the size of the gap 378. Specifically, the hinge 377 can be disposed in the slot 380 and can move forward and backward in the slot 380, thereby increasing or decreasing the size of the gap 378. In one embodiment, the attachment portion 376 can be configured to deform to change the size of the gap 378.

[0057] Changing the size of the gap 378 can increase or decrease the stiffness of the catheter shaft 370. For example, movement between the connectors 372 can be limited by adjacent bodies 374 contacting each other. Increasing the size of the gap 378 increases the amount of movement between adjacent bodies 374 before the adjacent bodies 374 contact each other. In other words, because the allowable movement between adjacent bodies 374 increases, increasing the size of the gap 378 decreases the stiffness of the catheter shaft 370 (i.e., increases flexibility). However, decreasing the size of the gap 378 decreases the amount of movement between adjacent bodies 374 before the adjacent bodies 374 contact each other. In other words, because the allowable movement between adjacent bodies 374 increases, decreasing the size of the gap 378 increases the stiffness of the catheter shaft 370 (i.e., decreases flexibility).

[0058] The size of gap 378 may depend on whether compressive forces are applied to the catheter. For example, applying compressive forces to the catheter reduces the size of gap 378, thereby increasing the stiffness of catheter shaft 370. Increasing the stiffness of catheter shaft 370 increases the stiffness of the portion of the catheter including catheter shaft 370. Reducing or eliminating the compressive forces applied to the catheter increases the size of gap 378, thereby reducing the stiffness of catheter shaft 370 and the portion of the catheter including catheter shaft 370.

[0059] The catheter shaft 370 can be configured to increase the size of the gap 378 when the compressive force applied to the catheter is reduced or eliminated. In one embodiment, the catheter shaft 370 can include a spring 382 (at the end of the catheter shaft 370) connected to one or more connectors 372 (e.g., connectors 372 at the end of the catheter shaft 370). Figure 3 370). When the compressive force applied to the catheter is reduced or eliminated, the spring 382 can apply a biasing force that pushes the connector 372 apart. In one embodiment, the catheter shaft 370 does not include a spring. In such an embodiment, the resilience (i.e., the desire to return to the original shape) of the catheter shaft 370 and / or the catheter including the catheter shaft 370 increases the size of the gap 378 without the need for a spring.

[0060] Notably, the ureteroscopes disclosed herein can be used for endoscopic procedures that do not involve the urinary tract (e.g., at least one of the urethra, bladder, ureters, or kidneys). For example, the ureteroscope can be used for endoscopic procedures involving the gastrointestinal tract, respiratory tract, ear, reproductive system, abdominal or pelvic cavity, inside a joint, chest organs, fetus, hand, or any other location instead of or in addition to the urinary tract.

[0061] While various aspects and embodiments have been disclosed herein, other aspects and embodiments may be contemplated. The various aspects and embodiments disclosed herein are for purposes of illustration and are not intended to be limiting.

[0062] Terms of degree (e.g., "about," "substantially," "generally," etc.) indicate insignificant changes in structure or function. In one example, when a term of degree is included in a term indicating a quantity, the term of degree is interpreted as indicating ±10%, ±5%, or +2% of the term indicating the quantity. In one example, when a term of degree is used to modify a shape, the term of degree indicates that the shape modified by the term of degree has the appearance of the disclosed shape. For example, a term of degree may be used to indicate that a shape may have rounded corners rather than sharp corners, curved sides rather than straight sides, one or more protrusions extending therefrom, be oblong, be the same as a disclosed shape, etc.

Claims

1. A ureteroscope, comprising: A handpiece comprising: catheter end; Control terminal; a working assembly configured to receive one or more surgical instruments; and manipulating a controller configured to bend at least a portion of the catheter; and a catheter extending from the catheter end of the handpiece, the catheter comprising a proximal region and a distal region, the distal region being farther from the handpiece than the proximal region; Wherein, at least one of the following is true: The working assembly includes a first movable portion configured to move relative to the catheter end of the handpiece, and wherein movement of the first movable portion relative to the catheter end of the handpiece changes the stiffness of a portion of the catheter; or The steering controller includes a second movable portion configured to move relative to the catheter end of the handpiece, and wherein movement of the second movable portion relative to the catheter end of the handpiece changes the stiffness of a portion of the catheter.

2. The ureteroscope according to claim 1, wherein: As at least one of at least a portion of the first movable portion or at least a portion of the second movable portion moves further away from the catheter end, the stiffness of the distal end region of the catheter increases.

3. The ureteroscope according to any one of claims 1 or 2, wherein: The working assembly includes the first movable portion.

4. The ureteroscope according to claim 3, wherein: The first movable portion includes an actuator, and wherein movement of the actuator causes the first movable portion to move relative to the catheter end.

5. The ureteroscope according to claim 4, wherein: The actuator comprises a threaded actuator threadably attached to the handpiece, and wherein rotating the threaded actuator increases or decreases a distance measured from the actuator to the catheter end of the handpiece.

6. The ureteroscope according to any one of claims 1 to 5, wherein: The manipulation controller includes the second movable portion.

7. The ureteroscope according to claim 6, wherein: The second movable portion includes an actuator, and wherein movement of the actuator causes the second movable portion to move relative to the catheter end.

8. The ureteroscope according to claim 7, wherein: The actuator includes a projection extending from at least a portion of the steering control.

9. The ureteroscope according to any one of claims 1 to 8, wherein: The catheter includes a catheter shaft including a plurality of links, each of the plurality of links being pivotally attached to an adjacent link of the plurality of links, at least a portion of the adjacent links of the plurality of links being separated by a gap.

10. The ureteroscope according to claim 9, wherein: The plurality of connectors are configured such that the gap between adjacent connectors of the plurality of connectors decreases when at least a portion of the first movable portion or at least a portion of the second movable portion moves away from the catheter end.

11. The ureteroscope according to any one of claims 9 or 10, wherein: The catheter shaft includes at least one spring attached to at least some of the plurality of connectors.

12. A method of using a ureteroscope, the method comprising: A ureteroscope is provided, the ureteroscope comprising: A handpiece comprising: catheter end; Control terminal; a working assembly configured to receive one or more surgical instruments; and manipulating a controller configured to bend at least a portion of the catheter; and a catheter extending from the catheter end of the handpiece, the catheter comprising a proximal region and a distal region, the distal region being farther from the handpiece than the proximal region; Among them, at least one of the following is true: The working assembly includes a first movable portion configured to move relative to the catheter end of the handpiece; or The steering control includes a second movable portion configured to move relative to the catheter end of the handpiece; and At least one of at least a portion of the first movable portion or at least a portion of the second movable portion is moved relative to the catheter end of the handpiece of the ureteroscope to adjust the stiffness of at least a portion of the catheter.

13. The method according to claim 12, wherein: Moving at least one of at least a portion of the first movable portion or at least a portion of the second movable portion relative to the catheter end of the handpiece includes: moving the first movable portion or the second movable portion away from the catheter end to increase the stiffness of the distal end of the catheter.

14. The method according to any one of claims 12 or 13, wherein: Moving at least one of at least a portion of the first movable portion or at least a portion of the second movable portion relative to the catheter end of the handpiece includes: moving at least a portion of the first movable portion or at least a portion of the second movable portion toward the catheter end to reduce the stiffness of the distal end of the catheter.

15. The method according to any one of claims 12 to 14, wherein: Moving at least one of at least a portion of the first movable portion or at least a portion of the second movable portion relative to the catheter end of the handpiece includes moving at least a portion of the first movable portion relative to the catheter end.

16. The method according to claim 15, wherein: Moving at least a portion of the first movable portion relative to the catheter end includes rotating a threaded actuator attached to the handpiece.

17. The method according to any one of claims 12 to 16, wherein: Moving at least one of at least a portion of the first movable portion or at least a portion of the second movable portion relative to the catheter end of the handpiece includes moving at least a portion of the second movable portion relative to the catheter end.

18. The method according to claim 17, wherein: Moving at least a portion of the second movable portion relative to the catheter end includes moving a bump coupled to the steering controller relative to the catheter end.

19. The method of any one of claims 12 to 18, further comprising reducing a gap between adjacent ones of a plurality of connectors of a catheter shaft disposed within the catheter, each of the plurality of connectors being pivotally attached to an adjacent one of the plurality of connectors.

20. The method of claims 12 to 19, further comprising increasing a gap between adjacent ones of a plurality of connectors of a catheter shaft disposed within the catheter, each of the plurality of connectors being pivotally attached to an adjacent one of the plurality of connectors.

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