Endoscopic tool stabilization and related methods of use

Abstract

According to one aspect, a device may include a shaft having a distal end and a lumen terminating in a distally facing opening. The instrument may pass through the insertion shaft and may extend through the lumen and extend out of the opening. The device may also include a lifter for engaging the instrument. The lifter may include an actuator extending through at least a portion of the shaft; and the body may be coupled to the actuator. A portion of the body may be configured to extend within the lumen and to apply a force to the instrument and move the instrument into contact with a surface of the lumen when the actuator is moved.

Description

This application is a divisional application of Chinese application No. 202080064552.2 entitled “Stability of endoscopic tools and related methods of use”. Cross-references to related applications

[0001] This application claims priority to U.S. Provisional Application No. 62 / 874,242, filed July 15, 2019, the entire contents of which are incorporated herein by reference. Technical Field

[0002] Various aspects of this disclosure generally relate to endoscopic devices. More specifically, this disclosure relates to the distal end of a device for stabilizing endoscopic tools and related methods of use. Background Technology

[0003] During diagnostic and therapeutic endoscopic procedures, accessory devices can pass through the working channel of the endoscope. The outer diameter of the accessory device should be compatible with the inner diameter of the working channel. Endoscopes used only for diagnostic procedures typically have a smaller working channel compared to endoscopes used for combined (diagnostic and therapeutic) or standalone therapeutic procedures. For example, the inner diameter of the working channel for diagnostic and therapeutic gastroscopes is typically 2.8 mm and 3.7 mm, respectively. Accessory devices designed for diagnostic endoscopes are generally also compatible with therapeutic endoscopes. However, accessory devices designed for diagnostic endoscopes may be too small when used with therapeutic endoscopes, resulting in a loose fit within the working channel.

[0004] This loose fit can lead to instability of the accessory devices because the endoscope is articulated throughout the procedure. Instability of the accessory devices during surgery can cause changes in the orientation of the device within the working channel, as shown in direct visualization. While device instability may not be a problem in some procedures, it can be a concern in more precise procedures, such as endoscopic surgery. In endoscopic surgery, a scalpel is used to remove tissue. Some existing scalpels lack articulation capabilities, and the cutting motion performed by the surgeon is controlled by the articulation of the endoscope. When the inner diameter of the scalpel relative to the endoscope's working channel is too small, a loose fit exists between the scalpel and the working channel, so the scalpel may move unintentionally when the surgeon articulates the endoscope. This introduces a degree of unpredictability to the surgeon performing the procedure and poses potential risks to the patient. Summary of the Invention

[0005] Embodiments of this disclosure particularly relate to mechanisms for stabilizing medical instruments within a scope or similar device. Each embodiment disclosed herein may include one or more features described in conjunction with any other disclosed embodiments.

[0006] According to one aspect, a device may include a shaft having a distal end and a lumen terminating at a distally facing opening. An instrument can be inserted through the shaft and can extend through the lumen and extend from the opening. The device may also include a lifter for engaging the instrument. The lifter may include an actuator extending through at least a portion of the shaft; and a body may be coupled to the actuator. A portion of the body may be configured to extend within the lumen to selectively position the instrument.

[0007] In other aspects of this disclosure, the device may include one or more of the following features: A body may include a first extension, a second extension, and a proximal portion connecting the first and second extensions. An actuator may be coupled to a distal portion of the first extension, and a portion of the second extension may be configured to move within a lumen when the actuator moves proximally. When the actuator moves distally, said portion of the second extension may be configured to move out of the lumen. The longitudinal axis of the first extension may be transverse to the longitudinal axis of the second extension. The second extension may have a U-shaped body surface for engaging an instrument. The body may rotate about an axis positioned within the proximal portion when the actuator moves proximally or distally. The body may include a first extension, a second extension, a proximal portion connecting the first and second extensions, and a pivot member. The actuator may be coupled to the pivot member and may contact a curved surface of the pivot member. When the actuator moves proximally, a portion of the first extension may be configured to move within the lumen; when the actuator moves distally, a portion of the second extension may be configured to move within the lumen.

[0008] In other aspects of this disclosure, the device may include one or more of the following features: The radially inner surfaces of the first extension and the second extension may be configured to align with the radially inner surface of the cavity. An actuator may be coupled to a pivot member at a location offset from the axis of rotation of the body. The longitudinal axes of the first and second extensions may be parallel. The body may be positioned within a channel extending distally from an opening in the radially inner surface of the cavity. The channel may have a longitudinal axis transverse to the longitudinal axis of the cavity. A surface of the body may be configured to slidably engage with the channel as the actuator moves proximally or distally. As the actuator moves proximally, the body may be configured to slide proximally within the channel, move through the opening in the radially inner surface of the cavity, and enter the channel. The lifter may further include: a tab member pivotally movable relative to the cavity; and a block fixedly coupled to the shaft and including a first surface contacting a second surface of the body. The first surface may be transverse to the longitudinal axis of the cavity; the second surface may be configured to slidably engage with the first surface as the actuator moves proximally or distally. The body can be configured to move toward the inner cavity and force the tab member into the inner cavity. The tab member can be biased away from the inner cavity. The actuator can extend through a channel within the block. The inner cavity can be a first inner cavity, and the body can be a snare. The lifter may also include a support member including a second inner cavity and a channel extending circumferentially around a radially inner surface of the second inner cavity. The second inner cavity can be aligned with the first inner cavity. The channel can receive the snare; the snare can be configured to enter the second inner cavity when the actuator moves proximally.

[0009] In other aspects, the device may include a shaft having a distal end and a first cavity terminating at a distally facing opening, wherein an instrument inserted through the shaft may extend through the cavity and protrude from the opening. The device may also include a lifter for engaging the instrument. The lifter may include a first actuator extending through at least a portion of the shaft and a rotatable plate coupled to the first actuator. The rotatable plate may be angled such that a distal portion of the rotatable plate is more distal than a proximal portion of the rotatable plate. The rotatable plate may include a second cavity configured to align with the first cavity and a notch. The lifter may also include a second actuator extending through at least a portion of the shaft and a sliding member coupled to the second actuator. The sliding member may be positioned within the notch and may include a third cavity configured to align with the first cavity. The lifter may also include a frame fixedly positioned within the shaft. The rotatable plate may be rotatably coupled to the frame.

[0010] In other respects, the device may include one or more of the following features: A portion of the sliding member may be configured to extend within a first cavity and apply a force to the instrument when the second actuator moves. The sliding member may be configured to move the instrument such that the instrument contacts a radially inner surface of the first cavity. A rotatable plate may be configured to rotate relative to a frame when the first actuator moves, and the rotation of the rotatable plate may cause the sliding member to rotate. The frame may include a wall, and the wall may be configured to restrict movement of the sliding member within a recess of the rotatable plate.

[0011] In other aspects, the device may include: a shaft having a distal end and a cavity terminating at a distally facing opening, wherein an instrument inserted through the shaft may extend through the cavity and protrude from the opening; and a lifter for engaging the instrument. The lifter may include: an actuator extending through the shaft; and a body connected to the actuator and including the opening. The body may be configured to be positioned distal to the opening of the shaft and to apply a force to the instrument when the actuator rotates about a longitudinal axis of the actuator. The body may be configured to move the instrument such that the instrument contacts a radially inner surface of the cavity.

[0012] In other respects, the device may include one or more of the following features: the opening of the body may be configured to align with the inner cavity, and a biasing member may be coupled to the body and bias the body to a position where the opening of the body aligns with the inner cavity.

[0013] It is understood that, as claimed, the foregoing general description and the following detailed description are exemplary and explanatory only, and not limiting of the invention. As used herein, the terms “comprising,” “including,” or any other variations thereof are intended to cover non-exclusive inclusion, such that a process, method, article, or apparatus that includes a list of elements does not include only those elements, but may include other elements not expressly listed or elements inherent to such a process, method, article, or apparatus. The term “example” is used in the sense of “example” rather than “ideal.” The term “distal” refers to the portion furthest from the user when the device is introduced into the patient. In contrast, the term “proximal” refers to the portion closest to the user when the device is placed inside the patient. Throughout the figures, the proximal and distal directions are marked with arrows labeled “P” and “D,” respectively. Although endoscopes are mentioned herein, references to endoscopes or endoscopy should not be construed as limiting the possible applications of the disclosed aspects. For example, the disclosed aspects may be used with duodenoscopy, bronchoscopy, ureteroscopy, colonoscopy, catheters, diagnostic or therapeutic instruments or devices, or other types of medical devices. In addition, relative terms such as “approximately,” “basically,” and “about” are used to indicate possible variations of ±10% within a specified value or range. Brief description of the attached figures

[0014] The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate exemplary aspects of this disclosure and, together with the description, serve to explain the principles of this disclosure.

[0015] Figure 1 These are perspective views of an endoscope system according to aspects of this disclosure and magnified views of the distal endoscope end of the endoscope system.

[0016] Figure 2A-2D These are perspective and front views of the end of the device according to aspects of this disclosure.

[0017] Figures 3A-3B These are perspective and front views of the components at the end of the device according to aspects of this disclosure.

[0018] Figure 4A and 4B It is used for rotation Figures 3A-3B A three-dimensional diagram of the system's components.

[0019] Figure 5A and 5B These are perspective and front views of the end of the device according to aspects of this disclosure.

[0020] Figure 6A and 6B These are perspective and front views of the end of the device according to aspects of this disclosure.

[0021] Figures 7A-7C This is a side view of the internal components at the end of the device according to aspects of this disclosure.

[0022] Figure 8 Based on the aspects of this disclosure Figures 7A-7C A front view of some components at the end of the device.

[0023] Figure 9 This is a perspective view of a portion of the end of the device according to an aspect of this disclosure.

[0024] Figure 10 Based on the aspects of this disclosure Figure 9 A perspective view of the component at the end of the device shown.

[0025] Figure 11A-11D This is a front view of the component at the end of the device according to aspects of this disclosure.

[0026] Figure 12 This is a perspective view of the component at the end of the device according to aspects of this disclosure.

[0027] Figures 13A-13C 14 and 14 are included in the aspects of this disclosure. Figure 12 A three-dimensional view of the working channel at the end of the device of the component.

[0028] Figure 15A and 15B This is a front view of the end of the device according to aspects of this disclosure.

[0029] Figure 16A and 16B This is a perspective view of the end of the device according to aspects of this disclosure. Specific Implementation

[0030] Reference will now be made in detail to various aspects of this disclosure, examples of which are shown in the accompanying drawings. Where possible, the same or similar reference numerals will be used in the drawings to refer to the same or similar parts.

[0031] Embodiments of this disclosure seek to improve the stability of accessory devices (e.g., working tools) within the lumen or working channel of a scope (e.g., an endoscope) that are too small relative to the lumen. In some embodiments, maneuverable components may be included to provide the user with additional degrees of freedom when operating tools at the distal end of the scope. Embodiments of this disclosure seek to improve the ability of physicians to manipulate accessory devices within the working channel of an endoscope.

[0032] Exemplary endoscope system 100 in Figure 1 As shown in the figure. Endoscopic system 100 may include endoscope 104. Endoscope 104 may include a handle assembly 120 and a flexible tubular shaft 102. The flexibility of shaft 102 may be sufficient to allow shaft 102 to bend, facilitating the navigation of shaft 102 through a tortuous anatomical passage of the recipient. Shaft 102 may terminate at a distal end 101. Shaft 102 may include a hinge portion 122 for deflecting the distal end 101 in an up, down, left, and / or right direction. In one example, hinge portion 122 may provide full flexion (e.g., the distal end 101 rotates through an arc of 180 degrees) or only partial flexion (e.g., the distal end 101 rotates through an arc of less than 180 degrees). Endoscope 104 may also include one or more lumens extending therethrough, and one or more openings communicating with one or more lumens. For example, one or more lumens may extend through handle assembly 120 and shaft 102, and one or more openings may be on handle assembly 120 and distal end 101. Endoscope 104 can be any suitable component for insertion into a patient's body, such as an endoscope, gastroscope, ureteroscope, nephroscope, colonoscope, hysteroscope, bronchoscope, cystoscope, duodenoscope, sheath, or catheter.

[0033] One or more auxiliary devices are operatively coupled to endoscope 104. Exemplary auxiliary devices may include controller 106, imaging system 108, power supply 112, display 114, fluid source 116, and / or vacuum source 118, each of which is briefly described below. Controller 106 may include, for example, any electronic device capable of receiving, storing, processing, generating, and / or transmitting data according to instructions given by one or more programs. Controller 106 may be operatively coupled to endoscope 104 and one or more other auxiliary devices, or a portion thereof, to control one or more aspects of their operation. Power supply 112 may include any suitable power source and associated connectors (e.g., conductive wires) for providing power to the auxiliary devices and electronic components in endoscope 104. Fluid supply assembly 116 may include a reservoir, medical irrigation bag, pump, and any suitable connectors (e.g., tubing for fluidly connecting fluid supply 116 and endoscope 104). The pump can supply a pressurized fluid flow to one or more lumens in the endoscope 104, and the pressurized fluid flow can be emitted from the distal end 101 and / or used to expand the expandable component present at the distal end 101. The vacuum source 118 can provide suction or vacuum pressure to one or more lumens in the endoscope, thereby providing suction force to draw material toward and / or into the endoscope 104, and / or to deflate the expandable component.

[0034] The imaging system 108 may include imaging electronics to, for example, process signals received from the image sensor in the endoscope 104, send signals for controlling the image sensor, adjust the illumination level of the area being viewed by the image sensor, and / or facilitate the display of image sensor data on the display 114.

[0035] The distal end 101 may include one or more image sensors 129 and one or more illuminators 131, such as Figure 1 An enlarged view of the distal end 101 is shown. One or more image sensors 129 may include charge-coupled device image sensors, complementary metal-oxide image semiconductors, etc., coupled to cables or wires passing through the shaft 102 of the endoscope 104. One or more illuminators 131 may include light-emitting diodes (LEDs), etc.

[0036] Tool 127 can be inserted into the lumen or working channel 125 of endoscope 104 and can be withdrawn from the distal end of lumen 125. Tool 127 may include, for example, a guidewire, cutting or grasping forceps, biopsy device, snare, injection needle, cutting blade, scissors, retractable basket, retrieval device, ablation and / or electrophysiological catheter, stent placement device, surgical suture device, balloon catheter, laser emitting device, and / or any other suitable therapeutic or diagnostic instrument. As shown in the enlarged view of the distal end 101, the circumference of tool 127 about its longitudinal axis is smaller than the circumference about the longitudinal axis of lumen 125, and may include a smaller cross-sectional diameter compared to the diameter of lumen 125. Several aspects of this disclosure provide embodiments of medical device ends, such as distal end 101, which can facilitate the secure attachment of tools, such as tool 127, to distal end 101 such that when the user moves distal end 101, tool 127 will also move in the same direction.

[0037] Figures 2A-2D Perspective and front views of a medical device end 201 including an image sensor 229, illuminators 231, 233, an inner cavity or working channel 225, and a lifter 242 are shown. A tool 227 is shown positioned within the working channel 225. The lifter 242 provides a means for securing the tool 227 to the distal end 201 by clamping the tool 227 between the lifter 242 and the radial inner wall of the working channel 225. The lifter 242 also allows the tool 227 to move through a path of motion of the lifter 242, for example, by moving the tool 227 in a sweeping motion along the path of motion of the lifter 242. The path of the tool 227 when engaging the lifter 242 can depend on the initial position of the tool 227 when the lifter 242 is not engaged with the tool 227. In some examples, the initial position of the tool 227 can be influenced by the stiffness of the tool 227, the articulation of the distal end 201, and / or the path of motion of the medical device through the patient's anatomy. In some examples, the lifter 242 may be positioned at an angle relative to the longitudinal axis of the medical device end 201 and may be configured to adjust the position of a tool positioned within a working channel that exits the medical device end 201 at a sidewall and has a distal working channel opening located on the proximal side of the distal front face of the medical device end 201 (note that this configuration is not shown in the figures).

[0038] The lift 242 may include a U-shaped surface, as will be explained in conjunction with the second extension 246, which receives the tool 227. The lift 242 may be anchored at its proximal portion 248 to a portion of the distal end 201. The proximal portion 248 of the lift 242 may rotate about an axis substantially transverse to the longitudinal axis of the working channel 225. In some examples, the proximal portion 248 may be rotatably coupled to a portion of the distal end 201, forming a hinge and allowing the lift 242 to rotate about an axis extending through the proximal portion 248.

[0039] The lift 242 may include a first extension 244 and a second extension 246, both of which extend from the proximal portion 248. In some examples, the first extension 244 may be offset from the second extension 246 (to one side of the extension 246) and may be angled relative to the second extension 246. In some examples, the first extension 244 may be offset from the longitudinal axis of the working channel 225 such that the first extension is outside the working channel 225. In some examples, the second extension 246 is positioned adjacent to or within the working channel 225. The outer surface 252 of the second extension 246 may be configured to be substantially aligned with or otherwise flush with the radially inner surface of the working channel 225. The radially inner surface of the working channel 225 may include a recess in which the second extension 246 of the lift is located. In some examples, the distal portion of the first extension 244 may include a retaining chamber 250. The retaining chamber 250 may be configured to receive a cable or actuator 240. In some examples, the distal end of cable 240 may be rotatably coupled to the distal portion of the first extension 244, such that when cable 240 is pulled in the proximal direction, the first extension 244 is pulled proximally and pivots about an axis passing through the proximal portion 248, and a portion of cable 240 may rotate about an axis extending through the clamping chamber 250. Cable 240 may be rigid and / or incompressible, such that cable may be translated distally to move the first extension 244 distally and cause the lifter to rotate about an axis passing through the proximal portion 248. In some examples, cable 240 may be coupled to an operating lever (not shown) positioned at another proximal portion of handle 120 or endoscope 104. In some examples, lifter 242 may be positioned less than 20 mm from the distal positive end face.

[0040] In operation, the elevator 242 can be configured to... Figure 2A and 2B The first configuration shown and Figure 2C and 2DSwitching between the second configuration shown. The user can pull an operating lever on the proximal portion of endoscope 104, which pulls cable 240 proximally. When cable 240 is pulled proximally, lift 242 can rotate about an axis extending through the proximal portion 248 and can be... Figure 2A and 2B The first configuration shown is transformed to Figure 2C and 2D The second configuration is shown. In some examples, the lever can be in the open position when the lift 242 is positioned such that the working channel 225 is opened to allow the tool 227 to move within the working channel 225.

[0041] When the user moves the lever from the open position to the closed position, the cable 240 can move closer to the side, and the lift 242 (especially the second extension 246) can obstruct a portion of the working channel 225 (e.g., Figure 2C and 2D (As shown). When the lift 242 obstructs a portion of the working channel 225, the second extension 246 extends within the working channel 225 and can contact the tool 227 to push the tool 227 against the radially inner surface of the working channel 225. In some examples, when pushed against the radially inner surface of the working channel 225, the tool 227 may remain parallel to the longitudinal axis of the medical device end 201 and / or the working channel 225, and in other examples, when pushed against the radially inner surface of the working channel 225, the tool 227 may be tilted at an angle relative to the medical device end 201 and / or the longitudinal axis of the working channel 225. The user can move the lever to the closed position and / or pull the cable 240 proximally to rotate the lift 242 and push the second extension 246 against the tool 227 to hold 227 in place. The user can lock the lever in the closed position, allowing the user to move the distal end 201 and the tool 227 simultaneously and consistently without holding the tool 227 separately. By pushing the second extension 246 against the tool 227, the user can stabilize the tool 227 and prevent it from moving within the working channel 225. The position of the lift 242 can be optimized to position the tool 227 at any portion of the radially inner surface of the working channel 225 when the lift 242 engages the tool 227, for example, positioning the tool 227 at a specific position relative to the image sensor 229 and / or the illuminators 231, 233. In some examples, the lever control cable 240 can be configured to lock in a closed position to allow the user to lock the lift 242 in a position that holds the tool 227 in place. When the lever control cable 240 is configured to lock in the closed position, the user may not need to hold the proximal portion of the tool 227 at the biopsy port of the handle 120, thus potentially reducing user fatigue and allowing the user to free their hands.

[0042] Figure 3A and 3B An alternative embodiment of a lifter 302 that can be incorporated into the end of a device is shown. The lifter 302 may have any of the features previously described with respect to lifter 242. Figure 3A In the diagram, a lift 302 is shown positioned relative to a working channel 325, which may be located within an endoscope 104 or similar medical device. The lift 302 includes a first extension 304, a second extension 306, and a proximal portion 307 connecting the first extension 304 to the second extension 306. The first extension 304 may be opposite the second extension 306, and a cavity 315 may extend longitudinally along the length of the lift 302. When the lift 302 is positioned within the distal end of the device (e.g., distal end 101), the cavity 315 may be longitudinally aligned with the working channel of the device. The radially inner surfaces 310, 312 of the first extension 304 and the second extension 306 may be curved and configured to conform to the working channel 325. The proximal portion 307 may include a connecting portion 308. The connecting portion 308 may extend radially outward from the longitudinal axis of the lift 302 and may project from the radially outer surface of the lift 302. The connecting portion 308 can be configured to connect to a mechanism that allows a user to rotate the lift 302 around the connecting portion 308, such as a mechanism similar to... Figure 2A-2D The mechanism of the first extension 244 shown is illustrated. The connecting portion 308 may be positioned outside or partially outside the working channel 325 and within the distal end portion of the medical device. A tab 316 may be positioned on the radially outer surface of the lifter 302 at a portion opposite the connecting portion 308. The tab 316 may be rotatably coupled to a portion of the distal end of the medical device and may be partially positioned outside the working channel 325. In some examples, the first extension 304 and the second extension 306 may be longitudinally curved arms extending from the annular portion 307. The annular portion 307 may have a proximal opening for receiving an endoscopic tool. The first extension 304 and the second extension 306 may define two longitudinal slots 309 between them. The distal opening 311 may be at the distal end of the lifter 302 and may be configured for the tool 325 to extend through.

[0043] In some examples, the connecting portion 308 may be connected to the rotating body 452. The rotating body 452 may include a rotatable hub 454 connected to the connecting portion 308. A cable or actuator 450 positioned outside the working channel 325 may be fixedly coupled to the rotatable hub 454, offset longitudinally from the hub 454. The cable 450 may extend through an inner cavity in the rotating body 452 and may be coupled to an extension 461 extending from the rotatable hub 454. When the user moves the cable 450 distally, the extension 461 may rotate due to the force exerted by the cable 450 on the extension 461, and the rotatable hub 454 may rotate by the movement of the extension 461, thus rotating and deflecting the lift 302 via the connecting portion 308. In some examples, the deflecting lift 302 may move the first extension 304 such that the first extension 304 covers the working channel 325 and rotates toward a first side 320 of the working channel 325. When the first extension 304 obstructs the working channel 325, the first extension 304 can contact the tool 325 and push the tool 427 towards the first side 320 of the working channel 325 to hold the tool 427 between the first side 320 and the first extension 304, thereby preventing the tool 427 from moving within the working channel 325. When the user moves the cable 450 closer, the cable 450 can pull the extension 461, and the rotatable hub 454 can be rotated by the movement of the extension 461, thereby rotating the lift 302 through the connecting portion 308 and deflecting the lift 302 so that the second extension 306 obstructs the working channel 325 and rotates towards the second side 321 of the working channel 325. In some examples, when the first extension 304 or the second extension 306 blocks a portion of the working channel 325, the tool 427 can move through the working channel 325.

[0044] Cable 450 can be moved by the user in the same manner as described above with respect to cable 240. In some examples, the user may push or pull cable 450, which will cause extension 461 to rotate about rotating hub 454, and the rotation of extension 461 will cause the first extension 304 or the second extension 306 to deflect on a portion of working channel 325. Since lift 302 allows the user to position the first extension 304 within working channel 325 to hold tool 427 toward a first side 320 of working channel 325, and to position the second extension 306 within working channel 325 to hold tool 427 toward a second side 321 of working channel 325, lift 302 provides the user with the ability to hold tool 427 at multiple different locations within working channel 325. In some examples, when the longitudinal axis of the elevator 302 is parallel to the longitudinal axis of the working channel 325, the elevator 302 can be partially positioned within the working channel 325; and in other examples, when the longitudinal axis of the working channel 325 is parallel to the longitudinal axis of the elevator 302, the elevator 302 can be completely positioned outside the working channel 325. In some examples, the radially inner surfaces 310, 312 of the elevator 302 can be aligned with the radially inner surface of the working channel 325.

[0045] Figures 5A-5B Figures 6A-6B show a perspective view and a front view of another lifter 510 in the end 501 of the device. In some examples, lifter 510 may include a U-shaped convex outer surface 511 having an opposing flange 513 extending radially outward from the bottom of the U-shaped outer surface 511. In other examples, the outer surface of lifter 510 may be any suitable shape configured to extend through opening 518 to contact tool 527. Flange 513 defines the upper surface of bottom portion 515 of lifter 510. Bottom portion 515 may be positioned within and slide within a channel 514 extending from opening 518 in the radially inner surface of working channel 525. Lifter 510 and / or channel 514 may have a longitudinal axis substantially transverse to working channel 525. In some examples, channel 514 may extend distally from opening 518 in working channel 525 at an angle. In other examples (not shown), channel 514 may extend proximally from opening 518 at an angle relative to the longitudinal axis of working channel 525. Lift 510 may be configured to move within channel 514. In some examples, channel 514 may include an opening 516 extending longitudinally within channel 514. Opening 516 may be configured to receive a cable or actuator 550 and may allow the cable or actuator 550 to move within opening 516. In some examples, lift 510 may be located within an endoscope cap that can be attached to the distal end of an endoscope.

[0046] The cable or actuator 550 may be fixedly coupled to the lift 510 or rotatably coupled to the lift 510, such that the cable can rotate about the point where the cable 550 is coupled to the lift 510. In some examples, the cable 550 may extend from the lift 510 to a proximal portion of the device, allowing the user to move the cable 550 while the distal end 501 is inside the patient. The cable 550 may be rigid and / or incompressible, allowing it to be translated distally or proximally to move the lift 510 distally or proximally, resulting in movement of the lift within the channel 514. In some examples, the cable 550 may be coupled in a similar manner to that described above with respect to the lift 242 to an operating lever (not shown) located at another proximal portion of the handle 120 or endoscope 104.

[0047] Figure 5A and 5B A lift 510 is shown fully contained within channel 514, such that the lift 510 does not extend within the working channel 525. When a user moves the cable 550 proximally, for example by pulling the cable 550 proximally via the lever on actuating handle 120, the lift 510 can be moved within channel 514 and extended within the working channel 525, obstructing the working channel 525. In other examples (not shown), moving the cable 550 distally will move the lift 510 into the working channel 525. In some examples, moving the cable 550 proximally will move the lift 510 from... Figure 5A and 5B The first form shown transitions to Figure 6A and 6B The second configuration is shown. When tool 527 is positioned within working channel 525, tool 527 can be moved by moving lift 510 into working channel 525. By pulling cable 550 proximally, the user can move lift 510 within working channel 525 and clamp tool 527 between lift 510 and the radially inner surface of working channel 525 (e.g., ...). Figure 6A and 6B(As shown). When the user moves the lift 510 such that it pushes the tool 527 and holds the tool 527 between the lift 510 and the radially inner surface of the working channel 525, the tool 527 can be held in place and the user can move the distal end 501 and the tool 527 consistently without moving the tool 527 within the working channel 525. By holding the tool 527 in a specific position within the working channel 525, the lift 510 helps to stabilize the tool 527 within the working channel 525. In other examples, the angle, shape, and / or size of the lift 510 can be optimized to achieve preferred lift performance and accessory compatibility. In some examples, the lift 510 can be moved from a position within the working channel 525 to a position within the channel 514 outside the working channel 525 by moving the tool 527 through the working channel 525.

[0048] Figures 7A-7C Another embodiment of the lift system 702 is shown, which includes a wedge 706 positioned within the distal end 701 of the medical device. Figures 7A-7C A side view is shown of a distal end 701 within a working channel 725, a tool 727 positioned within the working channel 725, a wedge 706, and an opening 709 in the radially inner surface of the working channel 725. The opening 709 connects a chamber (not shown) containing the wedge 706 to the working channel 725. The wedge 706 may include a pair of surfaces substantially transverse to the longitudinal axis of the working channel 725, intersecting at an edge located near the proximal end of the wedge 706, and this pair of surfaces may form a wedge shape. In some examples, the wedge 706 may be anchored to a position positioned outside the working channel 725 by a biasing member (e.g., a spring) connected to both the wedge 706 and a portion of the distal end 701. The biasing member (not shown) may be biased to hold the wedge 706 in a position outside the working channel 725, wherein the longitudinal axis of the lift is substantially parallel to the working channel 725. In some examples, the wedge 706 may be biased away from the working channel 725 by a tab member 710. At least one inclined surface 712 of the wedge 706 can be configured to align with the inclined surface 708 of the block 707. In some examples, a biasing member, such as a helical spring, can be coupled to the hinge 751 and the helical spring can bias the hinge 751 toward the block 707 and / or the wedge 706, and pulling the cable or actuator 750 proximally can cause the wedge 706 to slide toward the tab member 710 and push the tab member 710 toward the working channel 725 against the force of the biasing member.

[0049] Block 707 may be fixedly coupled to the distal end 701 such that block 707 does not move relative to wedge 706. In some examples, the position of tab member 710 remains unchanged when wedge 706 and block 707 do not move relative to each other. Block 707 may have an inclined surface 708 that is substantially parallel to the longitudinal axis of the working channel 725 and substantially transverse to the longitudinal axis of the working channel 725. Surface 708 may be configured to align with the surface of wedge 706. Block 707 may include a channel 755 extending longitudinally through block 707 (e.g., Figure 8 (As shown). Figure 8 The diagram shows a block 707 comprising a channel 755 and a cable 750, and the positioning of the block 707 relative to the wedge 706 and the working channel 725. The tab member 710 is not shown. Figure 8 As shown in the diagram. Channel 755 can be configured to receive cable 750 and allow cable 750 to translate proximally and distally through channel 755. Channel 755 also prevents cable 750 from extending beyond the radially outermost portion of block 707 to limit the distance wedge 706 can move toward working channel 725. Cable 750 can be fixedly coupled to wedge 706 (in... Figure 8 (shown in dashed lines), such that moving the cable to the proximal side causes the wedge 706 to move to the proximal side, and moving the cable 750 to the distal side causes the wedge 706 to move to the distal side.

[0050] The tab member 710 may extend from the proximal portion of the distal end 701 to the distal portion. The tab member 710 may be rigid and may include a hinge 751 located at the proximal portion of the tab member 710. In other examples, the tab member 710 may be flexible, and the hinge 751 may be a movable hinge. In some examples, the hinge 751 may include a coil spring or other biasing member. The distal end of the tab member 710 may be positioned near the opening 709 such that the tab member 710 may extend within the working channel 725 when the tab member 710 pivots about the hinge 751. In some examples, the tab member 710 may abut the outer surface of the block 707 and the outer surface of the wedge 706. The tab member 710 may be configured to contact the tool 727 and hold the tool 727 in position within the working channel 725. Due to the hinge / coil spring 751, the tab member 710 can be biased away from the working channel 725, such that when no force is applied to the tab member 710, the tab member 710 moves to a position outside the working channel 725. The wedge 706, the tab member 710, and the block 707 can be made of any suitable biocompatible material and can be rigid enough to perform the operation as described herein.

[0051] During operation, the user can move the cable 750 proximally, thereby pulling the wedge 706 proximally. As the wedge 706 moves proximally, its inclined surface 712 can slide over the inclined surface 708 of the block 707, thus moving the wedge 706 toward the working channel 725. As the wedge 706 moves toward the working channel 725, it moves the tab member 710 toward the working channel 725. As the tab member 710 moves toward the working channel 725, it also rotates about the hinge 751. As the tab member 710 moves toward the working channel 725, it extends into the working channel 725 through the opening 709 and can contact the tool 727. Therefore, when the user pulls the cable 750 proximally, the tab member 710 moves into the working channel 725 and pushes the tool 727 toward the radially inner surface of the working channel 725. Figure 7C As shown, after the user pulls the cable 750 proximally, the tab member 710 can hold the tool 727 against the radially inner surface of the working channel 725 and prevent the tool 727 from moving within the working channel 725. The tool 727 can be deflected by the tab member 710 extending within the working channel 725. In some examples, the lever-controlled cable 750 can be configured to lock in a closed position to allow the user to lock the wedge 706 in a position where the tab member 710 holds the tool 727 against the radially inner surface of the working channel in a manner similar to that previously discussed with respect to lifters 242, 302, and 510. To release the tool 727 and allow it to move within the working channel 725, the user can move the cable 750 distally, thereby moving the wedge 706 distally. Alternatively, releasing the cable 750 from the proximal position will allow the tab member 710 to pivot about the hinge 751 to automatically move the wedge 706 distally.

[0052] Although Figures 7A-7C A wedge 706 is shown positioned within the distal end 701, but alternative embodiments (not shown) may include the wedge 706, block 707, and a distal portion positioned outside the distal and / or the body 760 of the distal end 701.

[0053] Figure 9-11D Another embodiment of the lift assembly 902 is shown, including a rotating plate 930, a slider 932, and a frame 943 that can be positioned within the distal end 901 of the medical device. Figure 11A-11D(As shown in the diagram). Plate 930 may include a circular opening or cavity 936 extending through a central portion of plate 930 and a recess 935 extending from a first side 941 of plate 930 to an opposing second side 940. In some examples, plate 930 may have a circular external shape. A cable or actuator 931 may be fixedly coupled to plate 930. Cable or actuator 931 may be configured to move plate 930, for example, by rotating plate 930 within a recess of frame 943. Recess 935 may be configured to receive slider 932 and may include opposing straight edges 941, 940 configured to slidably engage slider 932. The perimeter of cavity 936 may be configured to be greater than the perimeter of working channel 925 to allow working channel 925 to extend through cavity 936.

[0054] The slider 932 may have a generally circular external shape and may include an opening or cavity 937 extending through a central portion of the slider 932. The slider 932 may include opposing straight edges 950, 951. The opposing straight edges 950, 951 may be configured to align with opposing straight edges 940, 941 of the recess 935, such that the straight edges 950, 951 slidably engage with the straight edges 940, 941. The slider 932 may be configured to translate within the recess 935 and be restricted by the recess 935 to movement along the longitudinal axis 977 of the recess 935. In some examples, the interface between the straight edges 940, 941 and the straight edges 950, 951 may prevent the slider 932 from rotating relative to the plate 930 when a force is applied to the slider 932 via the cable 933. Figure 9 As shown, the dimensions of the cavity 937 can be designed to allow the working channel 925 to extend through the cavity 937. The slider 932 can be fixedly connected to the cable 933. In some examples, the cable 933 can be rigid and can be configured to move the slider 932 within the notch 935. Translation of the cable 933 proximally or distally can move the slider 932 along the longitudinal axis 977.

[0055] Figure 11A-11D A lift assembly 902 is shown, comprising a plate 930, a slider 932, and a frame 943. The lift assembly 902 is... Figure 11A-11DThe image shows the medical device positioned relative to tool 927; other components of the distal end of the medical device are not shown. In some examples, frame 943 may have a circular shape and may include multiple cavities 960, 961, 962 to allow components of the medical device (including components of the lift assembly 902) to extend through and move within the cavities 960, 961, 962. For example, frame 943 may include one or more cavities 960, 961 configured to allow cables from one or more image sensors and / or one or more illuminators to extend through. In some examples, frame 943 may be part of and formed within a portion of the distal end 901 of the medical device. Cavity 962 may be configured to align with a working channel (e.g., working channel 925 of device end 901). Frame 943 may be fixedly coupled to and / or integrated into the distal end 901 of the medical device. Frame 943 can be configured to hold rotating plate 930 and slider 932 such that rotating plate 930 can rotate relative to frame 943 and slider 932 can translate within recess 935. Frame 943 may include one or more supports 970, 971 configured to connect plate 930 and slider 932 to frame 943 while allowing plate 930 and slider 932 to move relative to the frame. Recess 976 can prevent slider 932 from moving beyond the radially outermost portion of plate 930. In some examples, frame 943 can limit the rotation of plate 930 to ninety degrees, for example by configuring cavity 961 to allow cable 931 to rotate plate 930 ninety degrees and stop rotation of plate 930 by contacting cable 931 with the edge of cavity 961. Frame 943 can be angled relative to the longitudinal axis of distal end 901 at the distal end, for example within distal end 901. By positioning frame 943 at an angle relative to the longitudinal axis of the distal end 901, the user can translate cable 931 proximally or distally to rotate plate 930 relative to frame 943, since plate 930 can rotate within frame 943 but not translate proximally or distally relative to frame 943. Furthermore, positioning frame 943 at an angle relative to the longitudinal axis of the distal end 901 can facilitate movement of slider 932 by pushing / pulling cable 933. For example, rotation of cable 931 can rotate plate 930. In some examples, protrusions or other "hard stop" features can be incorporated into rotating plate 930, which can interact with features on frame 943 (e.g., protrusions on frame 943) to limit rotation of plate 930 beyond a desired range.

[0056] When operating a medical device having a distal end including a lifter assembly 902, the user can first rotate the rotary plate 930 by moving the cable 931 in a proximal or distal direction. This can cause the distal end of the cable 931 to move substantially transversely to or about the longitudinal axis of the distal end 901. As the user rotates the plate 930, the axis of motion 977 of the slider 932, corresponding to the longitudinal axis of the notch 935, rotates, and the slider 932 moves to different positions relative to the working channel 925. After rotating the plate 930, the user can move the slider 932 through the notch 935 by moving the cable or actuator 933. By moving the slider 932, a portion of the slider 932 can move within the working channel 925 and contact the tool 927. The user can move the slider 932 such that it contacts the tool 927 and pushes the tool 927 against the radially inner surface of the working channel 925, which can hold the tool 927 against the radially inner surface of the working channel 925. Figure 11A-11D Various positions are shown where tool 927 can be held against the radial inner wall of a working channel (e.g., working channel 925) using the lifting assembly 902. Figure 11A-11D As shown, the user can rotate plate 930 and translate slider 932 to position tool 927 at any point along the radially inner surface of working channel 925. In some examples, lifter assembly 902 may allow the user to move tool 927 to a desired position within working channel 925 after tool 927 has been stabilized within working channel 925, for example, after tool 927 has been secured to one side of working channel 925 by slider 932 via rotating plate 930. Lifter assembly 902 may allow for the use of larger working channels and / or smaller tools because it provides the user with a means to stabilize the tool within working channel at a user-defined location and allows for greater predictability in tool orientation.

[0057] In some examples (not shown), plate 930 can be rotated by a mechanism that actuates the rotation of a knob on the medical device, and slider 932 can be translated by a mechanism that moves slider 932 by a user rotating a knob on the medical device. For example, rotation of the actuator about a pivot point within the handle of the medical device (e.g., handle 120) can push (move distally) or pull (move proximally) a cable (e.g., cable 931 or cable 933). In some examples where the movement of plate 930 or slider 932 is controlled by translating the cable, the user can rotate an operating lever about the pivot point, which can extend or retract an arm within the handle of the medical device (e.g., handle 120) to subsequently push or pull the cable. In other examples, the proximal end of the cable (e.g., cable 931 or cable 933) can be coupled to a turntable, and the turntable can be positioned such that rotation of the turntable causes the cable to rotate about the longitudinal axis of the cable.

[0058] In other examples, the lift assembly may include a slider 932 and a frame 943, without a notch for receiving the plate 930, and including a notch similar to notch 935 configured to receive the slider 932. In this example, the plate 930 may be secured to the distal end of the medical device in the same manner as the lift assembly 902, and the slider 932 may be restricted to a single axis of motion 977 because the orientation of the slider 932 and the notch in the frame are fixed. In this example of the lift assembly, a single cable would be required to move the slider 932 within the notch in the frame.

[0059] Figure 12-14 Another embodiment of the lift assembly 1270 is shown. The lift assembly 1270 may include a support block 1203, a collar 1211, and a cable or actuator 1210 connected to the collar 1211. Figure 12 A support block 1203 without the loop 1211 or cable 1210 is shown. The support block 1203 may include an inner cavity 1209 extending through a central portion of the support block 1203 and along its longitudinal axis. The inner cavity 1209 may be configured to align with a working channel 1225 at the end of the device (note that the working channel 1225 is shown in dashed lines for illustrative purposes). The inner cavity 1209 may extend from an opening in a first proximal surface 1230 of the block 1203 to an opening in a second distal surface 1231 of the block 1203. The first surface 1230 may be substantially perpendicular to the longitudinal axis of the working channel 1225, and the second surface 1231 may be substantially transverse to the longitudinal axis of the working channel 1225. In some examples, the second distal surface 1231 may be angled such that the distance between the first surface 1230 and the second surface 1231 increases as the second surface 1231 extends distally. Channel 1205 can be positioned on the radial inner surface of cavity 1209 and close to second surface 1231.

[0060] In some examples, channel 1205 may be configured to receive collar 1211. Channel 1205 may extend circumferentially around the radially inner surface of cavity 1209 and may be connected to or otherwise communicate with outlet cavity 1207. Outlet cavity 1207 may extend from channel 1205 to an opening at first surface 1230. Outlet cavity 1207 may be configured to receive collar 1211 and / or cable 1210. In some examples, outlet cavity 1207 is positioned at a portion outside working channel 1225 when positioning block 1203 causes working channel 1225 to extend through cavity 1209. Gap in the radially inner wall of working channel 1225 may be positioned near channel 1205 to allow collar 1211 to move into and out of working channel 1225. Channel 1205 may be sized to allow collar 1211 to engage with and ride within channel 1205.

[0061] Figures 13A-13C The elevator assembly 1270 is shown, wherein the snare ring 1211 is received within the channel 1205. Figure 13A The snare 1211 partially exits from channel 1205 and is positioned within working channel 1225. Figure 13B ), and the loop 1211 retains the tool 1227 against the radial inner surface of the inner cavity 1209 ( Figure 13C The snare 1211 may be externally coupled to the cable 1210 at the channel 1205, the outlet 1207, or the block 1203. The snare 1211 may be rigid enough to allow the user to translate the cable 1210 proximally to move the snare 1211 from a position outside the channel 1205 to a position inside the channel 1205. The distal end of the medical device may include a chamber within or adjacent to the working channel 1225, which may be configured to receive the block 1203 such that the block 1203 does not move proximally or distally relative to the distal end.

[0062] In some examples, cable 1210 may be coupled to an operating lever (not shown) located on the handle of the medical device (e.g., handle 120 or another proximal portion of endoscope 104). The user can pull the operating lever on the proximal portion of endoscope 104, which can pull cable 1210 proximally. When cable 1210 is pulled proximally, snare 1211 can move out of channel 1205 and into working channel 1225. In some examples, when snare 1211 is located within channel 1205 and working channel 1225 is open, the operating lever may be in an open position to allow tool 1227 to move within working channel 1225. In some examples, when snare 1211 is positioned within working channel 1225 and holds tool 1227 against the radially inner surface of lumen 1209, the operating lever may be in a closed position, thereby stabilizing tool 1227 within working channel 1225 and preventing tool 1227 from moving within working channel 1225.

[0063] In some examples, cable 1210 may include a sheath portion having an inner cavity extending therethrough, and a snare may include a proximal extension positioned within the inner cavity. In this example, a user may pull the proximal extension to deploy the snare 1211 within the working channel 1225, and a portion of the snare 1211 may be received by the sheath.

[0064] Figure 14 An alternative perspective view of the lift assembly 1270 is shown, in which the snare ring 1211 is positioned with... Figure 13C The same position in the middle.

[0065] When operating a medical device having a distal end including a lifter assembly 1270, the user can first position the tool 1227 within the working channel 1225. The user can then pull the cable 1210 proximally to pull the snare 1211 out of the channel 1205 and position the snare 1211 within the working channel 1225. As the user pulls the cable 1210 proximally, the snare 1211 will contact the tool 1227 because the proximal portion of the snare 1211 will be pulled past the oral cavity 1207. The tool 1227 can move through the working channel 1225 and can then be held against the radially inner surface of the working channel 1225. By holding the tool 1227 against the radially inner surface of the working channel 1225, the tool 1227 can be stabilized within the working channel 1225. When the user wants to release tool 1227 and create more space within working channel 1225, the user can move cable 1210 distally, thereby moving the snare within channel 1205 and out of working channel 1225. In some examples, snare 1211 slides back into channel 1225 as the user moves cable 1210 proximally. In some examples, snare 1211 may retract or quickly return to its position within channel 1225 due to its own rigidity matching the geometry of block 1203. In some examples, snare 1211 may have curvature that facilitates placement of snare 1211 within channel 1225. Block 1203 may include an inclined surface that facilitates movement of snare 1211 into channel 1225. In other examples, a biasing member, such as a spring, may be coupled to snare 1211 and may push / pull snare 1211 within channel 1225.

[0066] In some examples, the working channel 1225 may include multiple lifting assemblies (blocks 1203, lasso rings 1211, and cables 1210) positioned along the working channel 1225, each block 1203 rotating relative to the other blocks 1203. By using multiple blocks 1203 and lasso rings 1211, a user can have the ability to move the tool 1227 to different areas within the working channel 1225 and stabilize the tool 1227 in different positions.

[0067] Figure 15A-16BAnother embodiment of a lifter assembly 1502 positioned in the distal end 1501 of a medical device is shown. The lifter assembly 1502 may include a lifter 1512 and a cable or actuator 1514. The lifter 1512 may have a generally circular shape and may be positioned on the distal front end face of the distal end 1501. The lifter 1512 may include an opening or cavity 1522 extending through the lifter 1512. In some examples, the longitudinal axis of the cavity 1522 may be parallel to the longitudinal axis of the distal end 1501. The cavity 1522 may be configured to align with a working channel 1525. In some examples, the lifter 1512 may be positioned on the distal front end face 1520 such that the cavity 1522 aligns with the opening of the working channel 1525. The lifter 1512 may also include a chamber 1511 configured to receive and connect to the cable 1514. In some examples, when cable 1514 is connected to lift 1512 and positioned within chamber 1511, chamber 1511 can act as a pivot point, such that lift 1512 can rotate about the pivot point positioned in chamber 1511 when the user rotates cable 1514 about its axis.

[0068] Cable 1514 extends from lifter 1512 to the proximal portion of the medical device. Cable 1514 may be rigid, such that rotation of the proximal portion of cable 1514 causes rotation of the distal portion of cable 1514. Cable 1514 may extend through an inner lumen (not shown) in the distal end 1501. The distal portion of cable 1514 may be fixedly coupled to lifter 1512, for example, coupled to chamber 1511 and positioned within chamber 1511. The proximal portion of cable 1514 may be fixedly coupled to a knob, for example, a knob positioned on handle 120 (see...). Figure 1 Rotating the knob causes the lifting device 1512 to rotate at its distal end 1501. When the lifting device 1512 rotates, a portion of it can contact the tool 1527 and move the tool 1527 toward the radially inner surface of the working channel 1525. Therefore, rotation of the lifting device 1512 provides the user with a means to move the tool 1527 and bring it against the radially inner surface of the working channel 1525, thereby preventing the tool 1527 from moving within the working channel 1525.

[0069] In some examples, the lift 1512, cable 1514, and / or the knob connected to the cable 1514 may be connected to a biasing member, such as a spring, to bias the lift 1512 toward a position where the inner cavity 1255 is aligned with the working channel 1525, such as... Figure 15A and 16AAs shown. In some examples, the biasing member may be attached to the protrusion 1529 of the lift 1512 (e.g., a spring attached to the protrusion 1529 and the distal side 1520 of the end 1501). The user can rotate the cable 1514 to rotate the lift 1512 and cover the working channel 1525, and then when the user releases the cable 1514, the lift 1512 will be moved back to the position where the cavity 1522 is aligned with the working channel 1525 by the biasing member.

[0070] When operating a medical device having a distal end 1501 including a lifter assembly 1502, the user can first position the tool 1527 within the working channel 1525. The user can then rotate the cable 1514 via a knob or any other means to rotate the lifter 1512 and move a portion of the lifter 1512 toward the central longitudinal axis of the working channel 1525, extending a portion of the lifter 1512 through the distal opening of the working channel 1525. As the user rotates the cable 1514, the lifter 1512 contacts the tool 1527 and moves the tool 1527 toward the radially inner surface of the working channel 1525. The tool 1527 can move through the working channel 1525 and can then be held against the radially inner surface of the working channel 1525. By holding the tool 1527 against the radially inner surface of the working channel 1525, the tool 1527 can be stably positioned within the working channel 1525. When the user wants to release tool 1527, the user can rotate cable 1514 in the opposite direction, thereby moving lift 1512 to align with the distal opening of working channel 1525 and moving a portion of lift 1512 extending through the distal opening of working channel 1525 away from the central longitudinal axis of working channel 1525.

[0071] In some examples, when the cavity 1522 is aligned with the working channel 1525, rotation of the cable or actuator 1514 in a clockwise or counterclockwise direction can be prevented by a stop (not shown) within the distal end 1501 or by a protrusion extending from the distal positive end face 1520 (not shown). Preventing the lift 1512 from rotating clockwise or counterclockwise when the cavity 1522 is aligned with the working channel 1525 helps the user to position the cavity 1522 back aligned with the working channel 1525 after stabilizing the tool 1527 and the lift 1512.

[0072] In some examples, the distal end of the medical device may include multiple lifters having the same structure as lifter 1512 but with pivot points located at different positions. Using multiple lifters 1512 may allow the user to stabilize tool 1527 in multiple different positions within the working channel 1525 and / or connect tool 1527 to the distal end 1501.

[0073] Any disclosed embodiment of the lift assembly may be positioned close to the distal end of an endoscope or other medical device. For example, any disclosed embodiment of the lift assembly may be positioned close to the hinge joint and / or the hinge portion of the endoscope. Any disclosed embodiment of the lift assembly may include an adjustable locking mechanism and / or an adjustable actuator, such as a ratchet, to adjust the position of the lift and accommodate tools of different sizes.

[0074] It will be apparent to those skilled in the art that various modifications and variations can be made to the disclosed apparatus and methods without departing from the scope of this disclosure. Other aspects of this disclosure will become apparent to those skilled in the art upon consideration of the specification and the features disclosed herein. The specification and embodiments are intended to be illustrative only.

Claims

1. A lifting device assembly, comprising: slider; A frame positioned within the distal end of a medical device, wherein the frame includes a recessed portion; as well as Rotating plate, wherein the rotating plate comprises: A circular opening or cavity extending through the central portion of the rotating plate; A notch extending from the first side of the rotating plate to the opposite second side; and An actuator is fixedly connected to the rotating plate, wherein the actuator is configured to move the rotating plate within a recess in the frame.

2. The lifter assembly of claim 1, wherein the notch is configured to receive the slider and includes opposing straight edges configured to slidably engage the slider.

3. The lifting assembly according to claim 1 or 2, wherein the slider has a generally circular outer shape and includes an opening or cavity extending through the central portion of the slider.

4. The lift assembly according to any one of claims 1 to 3, wherein the slider includes a relative straight edge configured to align with the relative straight edge of the notch, such that the relative straight edge of the slider slidably engages with the relative straight edge of the notch.

5. The lifting assembly according to any one of claims 1 to 4, wherein the slider is configured to translate within the recess and is restricted by the recess to move along the longitudinal axis of the recess.

6. The lifting assembly of claim 4 or 5 further includes a cable, wherein the interface between the straight edge of the notch and the straight edge of the slider is configured to prevent the slider from rotating relative to the rotating plate when a force is applied to the slider via the cable.

7. The lifting assembly of claim 6, wherein the slider is fixedly coupled to the cable, wherein the cable is rigid and configured to move the slider within the notch.

8. The lift assembly according to any one of claims 1 to 7, wherein the frame has a circular shape and includes a plurality of cavities to allow a medical device component including a component of the lift assembly to extend through and move therein.

9. The lift assembly of claim 8, wherein the frame includes one or more cavities configured to allow cables from one or more image sensors or one or more illuminators to extend through, wherein each cavity is configured to align with a working channel, and wherein the frame is fixedly coupled to or integrated into the distal end of the medical device.

10. The lifting assembly according to any one of claims 1 to 9, wherein the frame is configured to hold the rotating plate and the slider such that (1) the rotating plate is rotatable relative to the frame, and (2) the slider is translatable within the recess.

11. The lifting assembly according to any one of claims 1 to 10, wherein the frame includes one or more supports configured to connect the rotating plate and the slider to the frame while allowing the rotating plate and the slider to move relative to the frame, wherein the recessed portion is configured to prevent the slider from moving beyond the radially outermost portion of the rotating plate.

12. The lift assembly according to any one of claims 8 to 11, wherein the frame is configured to limit the rotation of the rotating plate to 90 degrees by configuring the cavity to allow the actuator to rotate the rotating plate 90 degrees and to stop the rotation of the rotating plate by contacting the actuator via the edge of the cavity.

13. A medical device comprising: A shaft having a distal end and an inner cavity terminating at a distally facing opening, wherein an instrument can extend through the inner cavity and protrude from the distally facing opening; and A lifting device for engaging the instrument, the lifting device comprising: An actuator that extends through at least a portion of the shaft; A body, which is coupled to the actuator, wherein a portion of the body is configured to extend within the lumen for selectively positioning the instrument. A wedge-shaped element, positioned within the distal end of the medical device; A tab member that is pivotally movable relative to the inner cavity; A block, which is fixedly connected to the shaft, wherein the tab member abuts the outer surface of the block and the outer surface of the wedge; and The body is configured to move toward the inner cavity and force the tab member into the inner cavity.

14. The medical device of claim 13, wherein the tab member is biased away from the inner cavity.

15. The medical device of claim 13 or 14, wherein when the wedge moves proximally, the inclined surface of the wedge is configured to slide over the inclined surface of the block.

16. A medical device comprising: A shaft having a distal end and a first cavity terminating at a distally facing opening, wherein an instrument can extend through the first cavity and out of the distally facing opening; and A lifting device for engaging the instrument, the lifting device comprising: An actuator that extends through at least a portion of the shaft; and A body coupled to the actuator, wherein a portion of the body is configured to extend within the first lumen for selectively positioning the instrument; and A support member includes a second inner cavity and a channel extending circumferentially around a radially inner surface of the second inner cavity, wherein the second inner cavity is aligned with a first inner cavity, wherein the channel receives a loop, and wherein the loop is configured to enter the second inner cavity when the actuator moves proximally.

17. The medical device of claim 16, wherein the loop is biased toward the channel.

18. A medical device comprising: A shaft having a distal end and an inner cavity terminating at a distally facing opening, wherein an instrument can extend through the inner cavity and protrude from the distally facing opening; and A lifting device for engaging the instrument, the lifting device comprising: An actuator that extends through the shaft; as well as A body, which is coupled to the actuator and includes an opening, wherein the body is configured to be positioned distal to the opening of the shaft and to apply a force to the instrument when the actuator rotates about the longitudinal axis of the actuator, and wherein the body is configured to move the instrument such that the instrument contacts the radially inner surface of the cavity.

19. The medical device of claim 18, further comprising a working channel, wherein when the cavity is aligned with the working channel, a stop within the distal end of the medical device prevents the lifter from rotating.

20. The medical device of claim 19, further comprising a knob for rotating the lifter and extending a portion of the lifter across a distal opening of the working channel.

Images