Endoscope stabilization tools and related methods of use

Abstract

An endoscope stabilization tool and related methods of use. A system includes a component having a cavity; and a stabilizer located at a distal end of the lumen, wherein: the stabilizer comprises at least two radially inward protruding portions circumferentially spaced apart from each other at the distal end of the lumen; the at least two radially inward projections define an opening at the distal end of the lumen; and the cross-sectional area of the opening is smaller than the cross-sectional area of the cavity.

Description

This application is a divisional application of invention patent 202080009066.0. CROSS-REFERENCE TO RELATED APPLICATIONS

[0001] This application claims the benefit of priority to U.S. Provisional Application No. 62 / 792,579, filed on January 15, 2019, which is incorporated herein by reference in its entirety. Technical Field

[0002] Various aspects of the present invention generally relate to endoscopic devices. More particularly, the present invention relates to endoscope stabilization and related methods of use. Background Art

[0003] During both diagnostic and therapeutic endoscopic procedures, accessory devices can be passed through the working channel of the endoscope. The outer diameter of the accessory device should be adapted to the inner diameter of the working channel. Endoscopes used only for diagnostic procedures usually have smaller working channels compared to endoscopes used for combined (diagnostic and therapeutic) or single therapeutic procedures. For example, diagnostic and therapeutic gastroscopes usually have working channel inner diameters of 2.8 mm and 3.7 mm, respectively. Accessories designed for diagnostic scopes are usually also adapted to therapeutic scopes. However, when used with therapeutic scopes, accessory devices designed for diagnostic scopes may be undersized, resulting in a loose fit in the working channel.

[0004] This loose fit can lead to instability of the attachment when the scope is articulated throughout the operation. As seen under direct visualization, instability of the attachment during surgery may cause the orientation of the device within the working channel to change. Although the instability of the device may not be a problem during some operations, it may be a problem during more precise operations (such as, for example, intracavitary surgery). During intracavitary surgical procedures, a cutting knife can be used to remove tissue. Some existing cutting knives do not have articulation capabilities, and the cutting action performed by the physician is controlled by the articulation of the scope. In the case where the cutting knife is undersized relative to the inner diameter of the endoscope's working channel, there is a loose fit between the knife and the working channel, and therefore when the physician articulates the scope, the knife may move unexpectedly. This brings a certain degree of unpredictability to the physician performing the operation and potential risks to the patient. Summary of the invention

[0005] A system includes a component having a cavity; and a stabilizer located at a distal end of the cavity, wherein: the stabilizer includes at least two radially inward projections circumferentially spaced from each other at the distal end of the cavity; the at least two radially inward projections define an opening at the distal end of the cavity; and a cross-sectional area of ​​the opening is smaller than a cross-sectional area of ​​the cavity.

[0006] Each of the at least two protrusions is a ramp extending from the proximal end toward the distal end and having an increased radial dimension extending from the proximal end toward the distal end. The stabilizer includes an annular support fixed in the cavity, and each of the ramps extends from the annular support into the cavity. The stabilizer includes a cap configured to extend above the distal end of the mirror. The stabilizer includes a first ring located in the cavity, and a second ring located in the first ring and rotatable relative to the first ring; and the ramp extends from the second ring into the cavity. The system includes a working tool that can be inserted into the cavity. The first ring includes a circumferential flange; and the ramp is configured to push the working tool against the circumferential flange. Rotation of the working tool in a first direction causes the working tool to rotate along the circumferential flange and around the cavity in a second direction opposite to the first direction. Rotation of the working tool in the first direction causes the second ring to rotate in the second direction. When the first direction is clockwise, the second direction is counterclockwise; and when the first direction is counterclockwise, the second direction is clockwise. The ramp is configured to rotate around the central longitudinal axis of the cavity. The stabilization tool includes one or more gears configured to rotate the ramp. The system includes a twistable member extending from a proximal end of the member to one of the gears, wherein rotation of the twistable member is configured to rotate each of the gear and the ramp. A free end of each of the radially inward projections is configured to flex distally away from a distal end of the member. The system includes a working tool insertable into the cavity, wherein: the radially inward projection extends from a first side of the cavity into the cavity; is configured to flex distally by the working tool; and biases the working tool toward a second side of the cavity, the second side passing through a central longitudinal axis of the cavity from the first side.

[0007] A system includes a component having a cavity; and a flexible stabilizer fixed to the distal end of the cavity, wherein: the flexible stabilizer is movable from a collapsed position to an expanded position extending distally away from the distal end of the cavity; the flexible stabilizer includes a central longitudinal axis; and the flexible stabilizer is biased toward the collapsed position and toward the central longitudinal axis of the flexible stabilizer to define an instrument receiving space having a cross-sectional size less than a diameter of the cavity.

[0008] The flexible stabilizer is a coil, spring or ribbon and the cavity includes a central longitudinal axis that is offset from a central longitudinal axis of the coil, spring or ribbon.

[0009] A system includes a component having a cavity; and a first sleeve sized to be received within the cavity; and a first magnet disposed within or near a distal end of the cavity, wherein: the distal end of the first sleeve includes a second magnet or a ferromagnetic material; the proximal end of the first sleeve is non-magnetic; and the first sleeve includes a cavity configured to receive a work tool.

[0010] The first magnet is a ring around the cavity. The second magnet or ferromagnetic material of the first sleeve extends only partially around the circumference of the first sleeve, and rotation of the first sleeve in the first direction causes the first sleeve to rotate around the cavity in the first direction. BRIEF DESCRIPTION OF THE DRAWINGS

[0011] The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate exemplary aspects of the present invention and, together with the description, serve to explain the principles of the present invention.

[0012] Figure 1 is a stereoscopic view of an endoscope and stabilization tools.

[0013] Figure 2 yes Figure 1 A side view of a stabilization tool showing the internal components through the exterior surface of the endoscope working channel.

[0014] Figures 3 to 6 is a side view of an endoscope and stabilization tool according to another embodiment, wherein the internal components are shown through the outer surface of the endoscope.

[0015] Figure 7 yes Figures 3 to 6 Front view of the distal end of the endoscope and stabilization tool.

[0016] Figures 8 to 11 is a side view of an endoscope and stabilization tool according to yet another embodiment, wherein internal components are shown through the outer surface of the endoscope.

[0017] Fig.12 is a front view of the distal end of an endoscope according to yet another embodiment.

[0018] Fig.13 and Fig.14 is a perspective view of an endoscope and a stabilization tool according to yet another embodiment.

[0019] Fig.15 and Fig.16 is a perspective view of an endoscope and a stabilization tool according to yet another embodiment.

[0020] Fig.17 yes Fig.15 and Fig.16 Stereoscopic cross-sectional view of the endoscope and stabilization tool.

[0021] Fig.18 is a perspective view of an endoscope and a stabilization tool according to yet another embodiment of the present invention.

[0022] Fig.19 is a perspective view of an endoscope and a stabilization tool according to yet another embodiment of the present invention.

[0023] Fig. 20is a perspective view of an endoscope and a stabilization tool according to yet another embodiment, wherein the internal components are shown through the outer surface of the endoscope.

[0024] Fig.21 is a perspective view of an endoscope and a stabilization tool according to yet another embodiment.

[0025] Fig. 22 yes Fig.21 Schematic diagram of a portion of a stabilization tool. DETAILED DESCRIPTION

[0026] Reference will now be made in detail to various aspects of the present invention, examples of which are shown in the accompanying drawings. Whenever possible, the same or similar reference numerals will be used in all drawings to refer to the same or similar parts. The term "distal" refers to the part farthest from the user when the device is introduced into the patient's body. Conversely, the term "proximal" refers to the part closest to the user when the device is placed in the patient's body. As used herein, the terms "include", "comprise" or any other variation thereof are intended to cover non-exclusive contents, so that the process, method, article or device including a list of elements not only includes those elements, but may include other elements that are not explicitly listed or are not inherent to such process, method, article or device. The term "exemplary" is used in the sense of "example" rather than "exemplary". In addition, relative terms such as, for example, "approximately", "substantially", "about" etc. are used to indicate possible changes of ±10% of the numerical value or range.

[0027] Embodiments of the present invention seek to improve the stability of an accessory device (e.g., a working tool) within a lumen or working channel of a scope, such as an endoscope, particularly a tool that is undersized relative to the lumen. Similar to the elevator assembly in a duodenoscope, a steerable assembly may be included in some embodiments to give the user additional degrees of freedom when manipulating a tool at the distal end of the scope.

[0002] Figure 1 and Figure 2 Scope 100 is shown extending from a proximal end (not shown) to a distal end 102. Distal end 102 may include a distally facing surface 104 having a lumen 106 (e.g., a working channel). Scope 100 may be any suitable endoscopic member, such as, for example, an endoscope, a ureteroscope, a nephroscope, a colonoscope, a hysteroscope, a hysteroscope, a bronchoscope, a cystoscope, a duodenoscope, a sheath, or a catheter. Scope 100 may include one or more additional lumens configured to allow passage of various therapeutic or diagnostic equipment, including, but not limited to, imaging devices and tools for irrigation, vacuum aspiration, biopsy, and drug delivery. It is contemplated that distally facing surface 104 may include an imaging device (e.g., a camera) embedded therein or otherwise secured thereto. At least a portion of scope 100 may be radiopaque.

[0028] A stabilizer or stabilization tool 108a can be disposed in the distal end of the cavity 106. The stabilization tool 108a can be configured to stabilize and guide a working tool 120 that can be moved through the cavity 106. The stabilization tool 108a can include an annular support that can be removably secured within the distal end of the cavity 106, or the annular support can be secured to the body of the scope 100. When the stabilization tool 108a is removable relative to the cavity 106, the stabilization tool 108a can be secured within the cavity 106 by a friction fit or an interference fit or another suitable fit. In another embodiment, the stabilization tool 108a can be disposed in a cap configured to surround the distal end 102 of the scope 100 (see, e.g., below with respect to Figures 8 to 11 The stabilizing tool 108a can be configured to accommodate and stabilize a single (exactly one) working tool 120 at a time by reducing the effective diameter of the cavity 106 at the distal end 102. For example, the stabilizing tool 108a can create a reduced diameter opening 109 at the distal end of the cavity 106. The cross-sectional area of ​​the opening 109 can be less than the cross-sectional area of ​​the cavity 106. The cross-sectional area of ​​the opening 109 can be, for example, about 5% to about 95% of the cross-sectional area of ​​the cavity 106.

[0029] The stabilization tool 108a may include one or more ramps 110 extending radially from the inner peripheral surface of the stabilization tool 108a to the cavity 106. In some embodiments, the stabilization tool 108a may include at least two ramps 110. Figure 1 The embodiment in includes three ramps 110. The ramps 110 can be circumferentially spaced apart from each other, and each ramp 110 can protrude toward the center of the cavity 106 and the opening 109. The ramps 110 can extend from the proximal end 112 toward the distal end 114, and can have an increasing radial dimension moving from the proximal end 112 toward the distal end 114. In other words, the ramps 110 taper in radial dimension toward the proximal end 112. The ramps 110 can help guide a given working tool 120 distally through the cavity 106 to the reduced diameter opening 109. The ramps 110 can extend radially into the cavity 106 at a maximum amount at the distal end 114 (e.g., Figure 2 In addition, the distal end 114 of the ramp 110 can be disposed at the most distal portion of the cavity 106, or slightly proximal to the most distal portion of the cavity 106. Figure 1106 . A plurality of ramps 110 are shown, but the stabilizing tool 108a may alternatively have a single ramp that extends partially around the circumference of the cavity 106 (e.g., between 5 degrees and 355 degrees around the cavity 106). This range is exemplary only, and other suitable ranges may also be contemplated. The ratio of the total cross-sectional area of ​​the distal end 114 to the cross-sectional area of ​​the cavity 106 may be less than about 0.5, less than about 0.4, less than about 0.3, less than about 0.2, or less than about 0.1. In other words, the total cross-sectional area of ​​the ramp 110 may cover only a small portion of the total cross-sectional area of ​​the cavity 106. However, it is also contemplated in some embodiments that the total cross-sectional area of ​​the distal end 114 may cover a majority of the cross-sectional area of ​​the cavity 106 (e.g., a ratio greater than 0.5). The ramp 110 may be rigid, or may have some flexibility.

[0030] The components of the stabilizing tool 108a can be fixed relative to each other, and thus the stabilizing tool 108a can be configured to accommodate and stabilize tools 120 within a small diameter range (e.g., tools having only one diameter). For example, if the stabilizing tool 108a has a reduced diameter opening 109 having a diameter of 2 mm, then the stabilizing tool 108a can be configured to only receive tools 120 having a diameter of approximately 2 mm (while in this example, the stabilizing tool 108a can receive tools 120 having a smaller diameter, this arrangement may result in poor stability). For working tools 120 having larger diameters (e.g., 3 mm or 5 mm diameters), two different stabilizing tools 108a (having respective diameters of 3 mm and 5 mm) may be required. In some embodiments, the stabilizing tool 108a can be removed from the cavity 106 by applying a distally directed force to the proximal end of the ramp 110 or to another portion of the stabilizing tool 108a. In one embodiment, the stabilizing tool 108a can include a flat and proximally facing surface against which a distally directed force can be applied.

[0031] One or more portions of the stabilizing tool 108a may include a viscous coating to help secure the working tool 120 at the distal end 102. In some embodiments, the distal portion of the stabilizing tool 108a may include a viscous coating, while the proximal portion of the stabilizing tool 108a may not have a coating or a lubricating coating to allow the tool 120 to slide relative to the tool 108a, such as on the ramp 110 of the tool 108a. The viscous coating may include a viscous silicone, such as, for example, a moisture-cured silicone or polydimethylsiloxane. Other viscous polymer materials may be used, such as, for example, styrene block copolymers (e.g., styrene-isobutylene-styrene (SIBS), styrene-ethylene / butylene-styrene (SEBS), styrene-ethylene / propylene-styrene (SEPS), and styrene-isoprene-styrene (SIS)), acrylic resins, polyvinyl ethers, polyurethanes, and ethylene copolymers, etc. For surfaces of the tool 108a with less friction, such as the radially inward surface ramp 110, various hydrophilic and lubricating coatings may be used.

[0032] Working tool 120 can be any tool known to those skilled in the art. For example, the tool can include a grasper, forceps, snare, scissors, knife, dissector, clamp, endoscopic stapler, tissue loop, clip applier, suture delivery instrument or energy-based tissue coagulator or cutter.

[0033] Figures 3 to 7 An endoscope 100 is shown having a stabilization tool 308 positioned within a cavity 306. The stabilization tool 308 may include an insert 309 insertable into the distal end of the cavity 106, or may include a cap configured to be positioned over the entire distal side 104 of the scope 100 (such as, for example, as described below with reference to Figures 8 to 11 The stabilization tool 308 may also include a flange 310 configured to abut against the distal side 104; and an expandable member 311 that may be expanded from a collapsed position (e.g., Figure 3 and Figure 6 ) to one or more expanded locked configurations (e.g., Figure 4 and Figure 5 ). The insert 309 may have a diameter slightly smaller than the diameter of the cavity 106 , while the flange 310 may have a diameter larger than the diameter of the cavity 106 .

[0034] The expandable member 311 can be a coil, a spring, or a ribbon, and can include stainless steel, nitinol, or a flexible polymer. The expandable member 311 can also include any suitable material to create friction and clamping between the working tool 120 and the expandable member 311. For example, the inner radial surface of the expandable member 311 can include a sticky coating, and the outer radial surface of the expandable member 311 can include a lubricious coating. Similar to the stabilizing tool 108a, the stabilizing tool 308 can be configured to accommodate and stabilize a working tool 120 having a single approximate diameter. However, the expandable member 311 can have some flexibility due to its material thickness, shape, etc., so that the stabilizing tool 308 can accommodate working tools 120 of different sizes and diameters.

[0035] The stabilization tool 308 can divide the cavity 106 into a retention region 320 and a non-retention region 322. The expandable member 311 can radially surround the retention region, and the non-retention region 322 can include the remaining portion of the cavity 106 that is not surrounded by the retention region 320. Therefore, the combined cross-sectional area of ​​the retention region 320 and the non-retention region 322 can be substantially equal to the cross-sectional area of ​​the cavity 106. The central longitudinal axis 330 of the retention region 320 can be offset from the central longitudinal axis 332 of the cavity 106. The retention region 320 can be disposed adjacent to the periphery of the cavity 106. In one embodiment, the retention region 320 can be adjacent to the inner circumferential surface of the mirror 100 that defines the cavity 106. At least a portion of the expandable member 311 that defines the retention region 320 can include a radially inwardly directed biasing member toward the central longitudinal axis 330 to help secure the working tool 120 disposed in the retention region 320. The expandable member 311 can also be directed toward Figure 3 and Figure 6 The collapsed position offset.

[0036] When positioned within the retention region 320, the work tool 120 may be secured within the cavity 106. When the work tool 120 is advanced to and through the non-retention region 322, the work tool 120 is not stable within the cavity 106 (eg, is loose and unrestrained within the cavity 106). Figure 7 , when the working tool 120 is disposed within the non-retention region 322, rotation of the working tool 120 by a user at its proximal end about its axis can cause the working tool 120 to move around the circumference of the cavity 106. This rotation can be performed until the working tool 120 enters the retention region 320 via the side-facing opening 324 and is locked or otherwise secured into the retention region 320. It should be noted that rotation in only one of the two directions will cause the working tool 120 to move into the retention region 320. A lubricious coating on the outer radial surface of the expandable member 311 (and / or the surface defining the cavity 106) can facilitate such rotation.

[0037] In use, the working tool 120 can be inserted through the cavity 106 into the proximal portion of the cavity 106 and then used to push the expandable member 311 distally away from the distal end of the mirror 100. In particular, when the working tool 120 extends distally through the retention area 320, the inner radial surface of the expandable member 311 can be clamped on the outer surface of the working tool 120, thereby causing the expandable member 311 to extend distally. In some embodiments, when the working tool 120 is retracted from the mirror 100, the stabilization tool 308 can be retracted (e.g., rebounded) to the collapsed position. In some embodiments, the stabilization tool 308 can be a disposable device. For example, after the working tool 120 passes through the retention area 320 and the expandable member 311 extends distally, the deformation experienced by the expandable member 311 can prevent subsequent use. However, in other embodiments, the stabilization tool 308 can be suitable for a variety of uses.

[0038] refer to Figures 8 to 12 , the endoscope 100 is shown having a stabilization tool 808 that is configured to accommodate and stabilize working tools 120 having different diameters. The stabilization tool 808 may include a cap 800 that is configured to be attached to the distal end 102 of the scope 100 by, for example, a friction fit or an interference fit. A flexible member 810 may extend radially inward from an inner circumferential surface of the cap 800. When the cap 800 is mounted on the scope 100, the flexible member 810 may extend from one side of the cavity 106 toward (and in some embodiments, through) the central longitudinal axis 180 of the cavity 106 to an opposite side of the cavity 106. The flexible member 810 may be configured to flex or bend in one or more directions. For example, as Figures 8 to 11 As shown, the flexible member 810 can be pushed distally by the working tool 120. The flexed state of the flexible member 810 and its Figure 8 The biasing of the state shown can push the working tool 120 toward the opposite side of the cavity 106 while securing the working tool 120 on the opposite side. Based on the diameter of the working tool 120, the flexed position of the flexible member 810 in the locked configuration may be different. For example, when the working tool 120 has a first diameter (e.g., Figures 8 to 11 ), the flexible member 810 can exhibit relatively little deflection in the locked configuration. Figures 8 to 11 When the flexible member 810 is in the locked configuration, it can exhibit more flexure. Figures 8 to 11 In the embodiment shown in FIG. 8 , a single flexible member 810 is shown. Fig.12 As shown, multiple flexible members 1210 may be used instead. Multiple flexible members 1210 may be spaced circumferentially around the cap 800 and cavity 106. Since its distal opening is less covered, Fig.12The illustrated embodiment may allow for additional suction through lumen 106 .

[0039] Embodiments of the present invention may act as a displacement tool to securely position a working tool 120 within the cavity 106 of the mirror 100. Secure positioning of the working tool 120 by the various stabilizing tools described above may allow for increased user control of the working tool 120 in an oversized cavity 106. Although the working tool 120 may be precisely positioned at the distal end 102, the stabilizing tool may allow the working tool 120 to freely move within the cavity 106 at the proximal end of the mirror 100 and the cavity 106. The stabilizing tool may be disposable or integrated into the mirror 100. In the case of a disposable application, the stabilizing tool may include a cap inserted above the distal end 102 (e.g., cap 800) of the mirror 100, or the stabilizing tool may be inserted directly into the cavity 106. The stabilizing tool may position the tool 120 at various different locations within the cavity 106 (e.g., the center of the cavity or along its edge). The selected positioning may depend on the user's preferred visualization and placement of the working tool 120 at the distal end 102. The stabilization tool can position the tool 120 via discrete contact points or continuous circumferential contact. In some embodiments, the long circumferential member may obscure the suction capability of the mirror 100, and thus discrete contact points may be advantageous in applications where the cavity 106 is used for fluid suction or fluid delivery. The size and location of the contact points can be optimized to achieve the desired positioning and suction capability of the tool 120.

[0040] exist Fig.13 and Fig.14In the illustrated embodiment, the stabilizing tool 1308 can divide the cavity 106 into a tool channel 1310 and a suction channel 1312, thereby creating a parallel tube (double tube) configuration. The tool channel 1310 can be disposed in the suction channel 1312 and can be fixed relative to the suction channel 1312. The tool channel 1310 can help provide stability for the working tool 120 and separate the working tool 120 from the dedicated suction channel 1312. The tool channel 1310 can have a slightly larger diameter than the working tool 120 to allow the working tool 120 to slide through the channel 1310, but otherwise remain fixed in the channel. The suction channel 1312 can extend through the length of the mirror 100 and can be connected to an external waste container (not shown) outside the mirror 100. The tool channel 1310 can extend through the cavity 106 to the biopsy port at the handle (not shown) of the mirror 100. The double tube stabilizing tool 1308 itself can also move in the cavity 106. In some embodiments, suction may be applied without placing distal end 102 of scope 100 directly in the liquid to be aspirated. For example, to aspirate a fluid located distal to distal end 102, the entire stabilization tool 1308 may extend distally from distal end 102 into the liquid such that distal end 102 is spaced apart from the liquid. This may enable a user to maintain visualization while applying suction, as the imaging tool of scope 100 may not be submerged in the liquid during the aspiration procedure.

[0041] The stabilization tools of the present invention can be passive (e.g., not requiring any additional user intervention to stabilize the working tool other than insertion of the working tool 120) or active (e.g., requiring or allowing additional user action to secure the working tool 120 or provide additional operator control - examples of which are described below). Active displacement tools can include on / off and / or directional controls. Directional control of the active displacement tool can allow a user, such as a physician or other practitioner, to manipulate the tool 120 within the cavity 106 of the scope 100 at the distal end 102, similar to the elevator action in a duodenoscope. Directional control of the active displacement tool can be achieved via mechanical power (e.g., twisting of the working tool 120 or a knob by a user) or electricity (e.g., a servo motor).

[0042] Figures 15 to 17Stabilizing tool 1508 is shown, where the rotation of tool 120 itself about its own axis is configured to rotate tool 120 around cavity 106. Stabilizing tool 1508 may include a first ring 1506 and a second ring 1507. The first ring 1506 and the second ring 1507 may be concentric, and the first ring 1506 may surround the second ring 1507. The first ring 1506 may be fixed to the cavity 106 by a friction fit or an interference fit, and the second ring 1507 may be configured to rotate relative to the first ring 1506. For example, the first ring 1506 and the second ring 1507 may include corresponding features that are configured to fix the first ring 1506 and 1507 and still provide relative rotation. Complementary features include, but are not limited to, flanges, tracks, recesses, guides, bearings, etc. In addition, the inner surface of the first ring 1506 and the outer surface of the second ring 1507 that contact each other may be coated with a lubricant and / or may include a lubricating coating.

[0043] The second ring 1507 may include features similar to the stabilization tool 108a discussed above. For example, the second ring 1507 may include one or more ramps 1510 that are substantially similar to the ramps 110 discussed above. Fig.17 , the ramp 1510 can push the work tool 120 toward the periphery of the cavity 106 and into contact with the circumferential flange 1506a of the first ring 1506. The flange 1506a can include a sticky coating or be formed of rubber or another suitable material that forms a high coefficient of friction with the outer surface of the work tool 120. Rotation of the work tool 120 itself about its own central axis can cause the tool 120 to rotate around the cavity 106. For example, rotating the work tool 120 (in direction 1530) can cause the tool 120 to rotate along the flange 1506a (e.g., the inner edge) of the first ring 1506 in a direction 1532 opposite to the direction 1530. As the work tool 120 moves around the cavity 106 in direction 1532, it can push the second ring 1507 riding inside the first ring 1506 (particularly against the ramp 1510 of the second ring 1507), thereby causing the second ring 1507 to rotate in direction 1532. In this embodiment, the material selection of the first ring 1506, the second ring 1507 and the working tool 120 may be important because the second ring 1507 can rotate freely relative to the first ring 1506 (low friction coefficient), while the working tool 120 and the first ring 1506 (flange 1506a) must not slide (high friction coefficient). The surface of the flange 1506a where the contact between the flange 1506a and the working tool 120 is made can be coated with an elastomer, such as neoprene, rubber, silicone or similar materials. The first ring 1506 is a polymer to which the elastomer can adhere while still maintaining a rigid shape. The second ring 1507 can include PTFE or a material with similar lubricity.

[0044] Fig.18 An endoscope 100 is shown with a stabilization tool 1808 having an endoscope cap 1806, a gripping insert 1809, and a twistable member 1810. The gripping insert may include one or more ramps 1812 (having any of the features described in other embodiments with ramps) and may secure a working tool 120 in a manner substantially similar to the ring 1507 described above. The gripping insert 1809 may include one or more portions that are inserted into the cavity 106 of the scope 100. Rotation of the twistable member 1810 (about a central longitudinal axis of the twistable member 1810) may cause the gripping insert 1809 (and the working tool 120 disposed within the gripping insert 1809) to rotate about the cavity 106. The twistable member 1810 may be a string, wire, cable, etc. that extends parallel to the length of the scope 100. The twistable member 1810 may be rotated manually by a user (via, for example, a crankshaft) or automatically (via, for example, a servo motor). The stabilization tool 1808 may include one or more gears that are coupled to the cap 1806 to assist in achieving rotation of the working tool 120. The gears may be positioned distal to the distal side 104. For example, when the endoscope cap 1806 is positioned on the distal end 102 of the scope 100, portions of the gears may abut the distal side 104. The first gear 1820 may be directly coupled to the distal end of the twistable member 1810. Twisting of the member 1810 may cause the first gear 1820 to rotate in a first direction 1840. The teeth of the first gear 1820 may be configured to interact with the teeth of the second gear 1822, thereby causing the second gear 1822 to rotate in a second direction 1842 that is opposite to the first direction 1840. The teeth of the second gear 1822 may be configured to interact with the teeth of the clamping insert 1809 (and the tool 120 disposed therein) and cause it to rotate in the first direction 1840. It is contemplated that any suitable number and type of gears may be utilized in any configuration to convert a rotational force applied to the twistable member 1810 into rotation of the clamp insert 1809. For example, in some embodiments, such as when there is no second gear 1822, or when there is an even number of intermediate gears between the first gear 1820 and the clamp insert 1809, rotation of the twistable member 1810 in a first direction 1840 may cause the clamp insert 1809 and the tool 120 to rotate in a second direction 1842.

[0045] The twistable member 1810 may also be disposed within the lumen 106, extending through a biopsy port at the proximal end of the scope 100. In this alternative embodiment, rotation of the twistable member 1810 about its central longitudinal axis may transmit the rotation to the stabilization tool 1808 via the first gear 1820. Due to spacing, the second gear 1822 may or may not be incorporated. Alternative embodiments may require a larger working channel, such as a 6 mm working channel of a gastroscope.

[0046] Fig.19 A stabilization tool 1908 is shown that utilizes one or more balloons 1910 filled with liquid and / or gas. Expansion of the one or more balloons 1910 into the cavity 106 can secure the working tool 120 within the cavity 106. Fig.19 In the illustrated embodiment, the balloon 1910 secures the working tool 120 against the periphery of the cavity 106. However, it is contemplated that the balloon 1910 may be annular and extend around the cavity 106. In this embodiment, the expansion of the balloon 1910 may secure the working tool 120 in the center of the cavity 106 (or otherwise securely in the interior), rather than at its periphery. The stabilization tool 1908 may be integrated into the cap 1906, which is configured to be attached to the distal end 102 of the scope 100. The balloon 1910 may be retrofitted as part of the cap 1906. In some embodiments, the balloon 1910 is not completely positioned within the cavity 106, but is partially disposed within the distal exit of the cavity 106 or blocks a portion thereof. The stabilization tool 1908 may include a single (exactly one) balloon 1910 or multiple balloons 1910. The balloon 1910 can be filled with a lens cleaning fluid or spraying fluid of the mirror 100, and the balloon 1910 can be connected to a pressure relief valve (not shown) to help achieve a desired fill level or pressure of the filling fluid (e.g., lens cleaning fluid or spraying fluid). Once the balloon 1910 has been filled to a sufficient amount, the pressure relief valve can divert excess fluid out of the mirror 100 instead of entering one or more balloons 1910. In a mirror 100 with forward water spraying capability, a forward water sprayer 1920 (disposed in the mirror 100) can be used to fill the balloon 1910. When the forward water sprayer 1920 is activated by the user, a portion of the water can be deflected through a channel 1922 (positioned distally of the distal face of the mirror 100) and enter the displacement balloon 1910 located within the cavity 106. The balloon material can be flexible (e.g., latex). The balloon 1910 can be shaped in a variety of different ways (e.g., round, cylindrical, or another suitable shape) to achieve a desired placement within the cavity 106. The balloon 1910 can be expanded and contracted by applying suction to the channel 1922. The balloon 1910 can also be expanded and contracted due to its own elasticity. For example, when the forward water jet 1920 is engaged, a portion of the flow can be diverted to inflate the balloon 1910. Once the forward water jet 1920 is stopped, the balloon 1910 can return to its original expanded state.

[0047] The balloon 1910 can also be filled with an external supply of liquid (e.g., using a syringe) or gas (e.g., compressed gas with a pressure / flow regulator). Alternatively, the interior of the balloon 1910 can also include an electroactive polymer. Passing an electric current through the electroactive polymer can cause the polymer chains to expand and subsequently inflate the balloon. Replacing electrical wiring with fluid piping may be beneficial in managing spatial constraints at the distal end 102 of the scope 100.

[0048] Figure 20 to Figure 22 An embodiment is shown that incorporates a magnetic system for positioning work tool 120 within cavity 106. A combination of ferromagnetic material and magnets may be used to properly position work tool 120 within cavity 106.

[0049] refer to Fig. 20 In an embodiment of the present invention, the stabilization device 2008 may include a first sleeve 2010 that is movable through the cavity 106. The first sleeve 2010 may include a cavity (not shown) configured to receive the working tool 120. The first sleeve 2010 may be fixed to the working tool 120, or may be manufactured as part of the working tool 120. The first sleeve 2010 may include one or more regions (e.g., a distal portion 2010a) having a magnetic material and one or more non-magnetic regions (e.g., a proximal portion 2010b). When the first sleeve 2010 is within the range of the magnetic material of the second sleeve 2012 or otherwise adjacent to it, the magnetic attraction force may help to fix the working tool 120 throughout the procedure. The second sleeve 2012 may be inserted into the cavity 106 and may include a magnetic material at its distal end. Alternatively, the second sleeve 2012 may be integral with the scope 100 and may include a portion of the scope 100 that defines the cavity 106. The strength of the magnet may determine the adhesion force and may reflect the force requirements of the procedure. To remove the working tool 120, the magnetic field can be broken by pulling the first sleeve 2010 (and / or the working tool 120) and shearing the magnetic field. The magnetic system can include two magnets (both the first sleeve 2010 and the second sleeve 2012) close to the distal end 102 of the mirror 100, or one magnet and a ferromagnetic material (a ferromagnetic second sleeve 2012 and a magnetic first sleeve 2010, or a magnetic second sleeve 2012 and a ferromagnetic first sleeve 2010). In one embodiment, the magnet 2020 is disposed in or adjacent to the second sleeve 2012, and the first sleeve 2010 can be ferromagnetic at its distal end. In some embodiments, the magnetic or ferromagnetic second sleeve 2012 can be integrated into a cap (e.g., cap 800) placed on the distal end 102 of the mirror 100 and inserted directly into the cavity 106. The magnetic or ferromagnetic first sleeve 2010 can be disposable and optimized to securely hold the working tool 120. In some embodiments, the first sleeve 2010 and / or the second sleeve 2012 may include a ferromagnetic infused polymer shaft.

[0050] Stabilization tool 2008 can position working tool 120 at various locations within lumen 106 (eg, the center of the lumen or along an edge thereof). The precise positioning of tool 120 can be adjusted for preferred visualization and accessory placement at distal end 102.

[0051] The magnetic field of the magnet can be generated using a rare earth alloy (e.g., neodymium) or an electric current (electromagnet). The magnets of the first sleeve 2010 and / or the second sleeve 2012 can have a variety of different shapes, including but not limited to, rings, rods, and disks. The first sleeve 2010 and / or the second sleeve 2012 can be ferromagnetic around their respective entire circumferences, or can be ferromagnetic or magnetic only at discrete points, so that the rest of the sleeve circumference can be composed of non-magnetic materials or polymers. By doing so, the work tool 120 can be placed at the periphery of the cavity 106, closest to the magnetic material.

[0052] The magnetic system can be passive or active. In the case of a passive magnetic system, once the working tool 120 is inserted into the mirror 100, the positioning of the working tool 120 can be achieved without intervention. In a passive system, once the working tool 120 is fixed by the magnetic attraction discussed above, the user may only be able to manipulate the working tool 120 by manipulating the mirror 100, or by completely removing the working tool 120 from the mirror. However, in the case of an active magnetic system, the positioning of the working tool 120 may require additional intervention from the user. For example, an active magnetic system can have directional control, which enables a user (e.g., a physician) to manipulate (e.g., place) the working tool 120 around the cavity 106 at the distal end 102 (e.g., in a manner similar to the action of a lifter in a duodenoscope). Directional control of the active magnetic system can be achieved via mechanical power (e.g., the working tool 120 or the knob is twisted by the user) or electricity (e.g., a servo motor).

[0053] exist Fig.21 and Fig. 22 An active magnetic stabilization tool 2108 is shown in FIG. Stabilization tool 2108 may include a partially ferromagnetic first sleeve 2110 and a magnetic second sleeve 2112. Second sleeve 2112 may include an annular magnet and may be designed for single use. A portion of first sleeve 2110 may be ferromagnetic or magnetic (2110a), while another portion may be non-magnetic (2110b). The magnetic attraction between the annular magnet of second sleeve 2112 and the ferromagnetic portion of first sleeve 2110 securely secures working tool 120 to the wall surrounding cavity 106. Fig.21 and Fig. 22Embodiments may also allow for directional control by the user. Rotation of the first sleeve 2110 in direction 2130 (e.g., clockwise) may move the first sleeve around the inner edge of the annular magnet within the second sleeve 2112 in the same direction 2130 (e.g., clockwise) because the ferromagnetic material continually loses and regains contact with the annular magnet. This may also give the physician tactile confirmation as well as visual feedback that he has reached the distal end 102 with the working tool 120. The first sleeve 2110 may be magnetic / ferromagnetic along only a portion of its circumference. For example, the magnetic / ferromagnetic material may extend around, for example, 5% to 95% of the circumference of the first sleeve 2010 to promote shearing of the magnetic field when the first sleeve 2110 rotates. However, it is also conceivable that at least some portions of the first sleeve 2010 are magnetic / ferromagnetic around its entire circumference.

[0054] It will be apparent to those skilled in the art that various modifications and variations may be made to the disclosed apparatus and methods without departing from the scope of the invention. Other aspects of the invention will be apparent to those skilled in the art from consideration of the description and practice of the features disclosed herein. It is intended that the description and examples be considered exemplary only.

Claims

1. A medical system comprising: A member having a cavity; as well as a stabilizer positioned within the distal end of the lumen, wherein: the stabilizer comprises (a) a ring rotatable relative to the lumen of the member and (b) one or more radially inward projections circumferentially spaced from one another; The one or more radially inward projections each extend from an inner circumferential surface of the ring, the one or more radially inward projections defining an opening at the distal end of the cavity.

2. The medical system according to claim 1, further comprising: A working tool extends through the lumen, wherein rotation of the working tool about its longitudinal axis in a first direction causes the ring to rotate in the same direction. 3 . The medical system of claim 1 , wherein the ring is a second ring and the stabilizer comprises a first ring surrounding the second ring. The medical system of claim 3 , wherein the first ring and the second ring are concentric.

5. The medical system of claim 3 or 4, wherein the second ring is rotatable relative to the first ring.

6. The medical system of claim 3 or 4, wherein the first ring is an interference fit within the lumen and the second ring is rotatable relative to the first ring.

7. The medical system according to claim 3 or 4, further comprising: a working tool extending through the lumen; Each of the one or more radially inward protrusions is a ramp extending inward from a proximal end to a distal end thereof, the first ring includes a circumferential flange, and the ramp is configured to push the working tool against the circumferential flange.

8. The medical system of claim 7, wherein rotation of the working tool in a first direction causes the working tool to rotate along the circumferential flange and rotate about the lumen in a second direction opposite the first direction.

9. The medical system of claim 8, wherein rotation of the working tool in the first direction causes the first ring to rotate in the second direction.

10. The medical system of claim 8 or 9, wherein rotation of the working tool in a second direction causes the second ring to rotate in the second direction.

11. The medical system of any one of claims 7 to 9, wherein the circumferential flange or the working tool comprises a coating configured to prevent translation of the working tool along a surface of the circumferential flange.

12. The medical system of claim 1, wherein each of the one or more radially inward projections is a ramp extending from a proximal end to a distal end thereof, and the stabilizer comprises one or more gears configured to rotate the ramp.

13. The medical system of claim 12, further comprising a twistable member extending from a proximal end of the member to one of the gears, wherein rotation of the twistable member is configured to rotate each of the gear and the ramp.

14. The medical system according to claim 12 or 13, further comprising: A work tool extends through the inner cavity, wherein rotation of the ramp in one direction causes the work tool to rotate in the same direction.

15. The medical system of claim 12 or 13, wherein the stabilizer further comprises a cap.

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