Improvements in endoscope bite blocks

Abstract

An endoscope bite block includes a body having a bite barrier portion located between upper and lower teeth of a patient when the bite block is in an assembled position, the body having a channel therethrough for insertion of an endoscope, the channel extending between an opening at a first end of the body and an opening at a second end of the body, at the assembly position of the occlusion block, the first end is positioned behind the teeth of the patient, and the second end is positioned in front of the teeth of the patient; and a holding device configurable between an assembly position or configuration that facilitates assembly of the bite block to the assembly position and a holding position or configuration that facilitates holding of the bite block in the assembly position.

Description

TECHNICAL FIELD

[0001] The present invention relates to endoscope bite blocks and related components for use during procedures in which an endoscope, such as a gastroscope or bronchoscope, is inserted into a patient's mouth, as well as assemblies and methods comprising them. BACKGROUND

[0002] The reference in this specification to any prior publication (or information derived from it), or to anything otherwise known, is not, and should not be taken as, an acknowledgment or admission that the prior publication (or information derived from it) or anything otherwise known forms part of the common general knowledge in the field of endeavour concerned by this specification.

[0003] Endoscopes are used to provide images of internal body cavities and organs. They comprise a camera mounted at the end of an elongate tube which is inserted into a natural orifice or surgical opening. Captured image data is transmitted through wires in the tube to a real-time display or computer memory for later viewing. Endoscopes come in many forms, with their function and characteristics varying according to the site of insertion and the clinical examination required. In some cases, such as for gastroscopy or bronchoscopy, the endoscope is inserted into the mouth.

[0004] Patients undergoing endoscopy through the mouth are typically anaesthetised and the endoscope is fed through a bite block placed between their teeth to prevent them from inadvertently biting the endoscope. Biting the endoscope can damage the patient's teeth as well as the endoscope.

[0005] These bite blocks typically comprise a bite barrier portion which sits between the patient's teeth and a front frame which overlies the patient's lips. To aid secure fitting of the bite block, an elastic band is often attached to the frame and extended around the patient's head (see, for example, US 2016 / 0123398 Figure 1 ).

[0006] Endoscopy through the mouth faces several problems. Firstly, securing the bite block with an elastic band sometimes does not work well, resulting in the bite block being dislodged from between the patient's teeth. If the patient bites the endoscope, this exposes the endoscope to the risk of damage. Secondly, the nature of these procedures requires the mouth to be kept open. When the mouth is open, air is inhaled through the mouth, not the nose, when the patient breathes in, due to increased nasal cavity resistance. It will be appreciated that there is a significant airway obstruction in the mouth during these procedures, for example the endoscope, which can be exacerbated by the position of the head and neck. Other factors can also contribute to the obstruction, for example, pre-existing sleep apnoea (the tongue can tilt towards the pharyngeal wall or the palate), or the patient can have a large tongue. These factors / obstructions can result in a reduction in the patient's oxygen uptake, which is exacerbated by the already reduced tidal volume caused by the anaesthesia. Thus, there is an increased risk of hypoxia for patients undergoing these mouth-entry endoscopy procedures. SUMMARY

[0007] According to an aspect, there is disclosed an embodiment of an endoscopy bite block comprising:

[0008] a body having a bite barrier portion that is positioned between the upper and lower teeth of a patient when the bite block is in an assembled position, the body having a passage therethrough for insertion of an endoscope, the passage extending between an opening at a first end of the body and an opening at a second end of the body, and in the assembled position of the bite block, the first end is positioned behind the teeth of the patient and the second end is positioned in front of the teeth of the patient; and

[0009] a retention device that is configurable between an assembled position or configuration that facilitates assembly of the bite block into the assembled position and a retained position or configuration that facilitates retention of the bite block in the assembled position.

[0010] In certain embodiments, the retention device is a retention member that is coupled to the body such that it is rotatable relative to the body between the assembled position and the retained position.

[0011] In certain embodiments, the retention member provides an anchoring portion at the first end of the body.

[0012] In certain embodiments, the anchoring portion is in the form of an elongate element.

[0013] In certain embodiments, the elongate element has two end portions, each extending in a generally opposite direction transversely relative to a direction from the first end to the second end of the body.

[0014] In certain embodiments, the end portions of the elongate element are curved in a direction away from the body.

[0015] In certain embodiments, the end portions of the elongate element provide tab portions.

[0016] In certain embodiments, the passage includes a bulkhead and / or an end closure therein, the bulkhead and / or end closure having an expandable opening for receiving the endoscope therethrough to thereby provide a substantial seal around the endoscope when inserted.

[0017] In certain embodiments, the passage includes a bulkhead and / or an end closure therein, the bulkhead and / or end closure being configured to be openable to allow insertion of the endoscope through the passage and further configured to be closed after the endoscope is removed.

[0018] In certain embodiments, the bulkhead and / or end closure provides a substantial seal around the endoscope when inserted.

[0019] In certain embodiments, the passage is substantially cylindrical.

[0020] In certain embodiments, the retaining member comprises a substantially tubular portion that fits concentrically within the channel such that it can rotate therein.

[0021] In certain embodiments, the inner wall surface of the channel and the outer wall surface of the tubular portion have cooperating structures thereon that prevent excessive rotation of the retaining member beyond the fitted position and the retaining position.

[0022] In certain embodiments, the body further comprises a wall portion configured to be positioned between the patient's teeth and lips when the bite block is in the fitted position.

[0023] In certain embodiments, the wall portion is shaped to provide a sealing effect relative to the patient's mouth opening.

[0024] In certain embodiments, the wall portion extends laterally from the bite barrier portion at the second end of the body, relative to a direction from the first end of the body to the second end of the body.

[0025] In certain embodiments, the wall portion is substantially U-shaped or C-shaped, providing opposing arms that initially extend laterally from the bite barrier portion at the second end of the body and then extend in the direction of the first end of the body.

[0026] In certain embodiments, one of the arms comprises an aperture therein.

[0027] In certain embodiments, the wall portion comprises a main face that is solid except for the aperture.

[0028] In certain embodiments, the bite block comprises a connector at the aperture.

[0029] In certain embodiments, the connector is a tubular extension that extends from an edge of the aperture.

[0030] In certain embodiments, in the fitted position of the retaining member, the elongate element has an elongation direction that is within the plane of the opposing arms of the wall portion, and in the retaining position of the retaining member, the elongate element has an elongation direction that is angled relative to the plane of the opposing arms of the wall portion.

[0031] In certain embodiments, in the retaining position of the retaining member, the elongate element has an elongation direction that is substantially perpendicular to the plane of the opposing arms of the wall portion.

[0032] In certain embodiments, relative to the fitted position of the bite block, when the retaining member is in the fitted position, the elongate element has an elongation direction that is parallel to the patient's transverse plane, and when the retaining member is in the retaining position, the elongate element has an elongation direction that is perpendicular to the patient's transverse plane.

[0033] In certain embodiments, the bite barrier portion includes a substantially parallel top outer bite surface and a bottom outer bite surface.

[0034] In certain embodiments, the retaining member includes a handle portion that extends from the tubular portion at the second end of the body and is located outside the channel.

[0035] In certain embodiments, the bite block includes a funnel at the second end of the body to guide insertion of the endoscope into the channel opening at the second end of the body.

[0036] In certain embodiments, the funnel is part of a funnel member.

[0037] In certain embodiments, the funnel member includes a tubular portion that fits concentrically within the tubular portion of the retaining member.

[0038] In certain embodiments, the funnel member includes an aperture in its wall.

[0039] In certain embodiments, the funnel member includes a neck region that protrudes from the second end of the body.

[0040] In certain embodiments, the aperture in the wall of the funnel member is provided at the neck region of the funnel member.

[0041] In certain embodiments, the funnel member includes a connector at the aperture in the wall of the funnel member.

[0042] In certain embodiments, the connector is a tubular extension that extends from the edge of the aperture in the wall of the funnel member.

[0043] In certain embodiments, the retaining device includes at least one arm that is movable between a retracted position and a deployed position, wherein the retracted position provides an assembly position or configuration and the deployed position provides a retaining position or configuration.

[0044] In certain embodiments, in the retracted position, the at least one arm extends into the channel.

[0045] In certain embodiments, the at least one arm is biased to the retracted position.

[0046] In certain embodiments, the at least one arm is provided by a tab formed in the wall of the channel.

[0047] In certain embodiments, in the deployed position, at least a portion of the at least one arm extends outwardly from the body.

[0048] In certain embodiments, the bite barrier portion provides an upper outer bite surface and a lower outer bite surface and the at least one arm is formed in the upper outer bite surface and / or the lower outer bite surface.

[0049] In certain embodiments, the at least one arm is curved at its free end to provide an area of overhang of the at least one arm relative to the upper and lower outer bite surfaces when the at least one arm is in the deployed position, the remainder of the at least one arm being substantially flush with the upper and / or lower bite surfaces.

[0050] In certain embodiments, the at least one arm is two arms.

[0051] In certain embodiments, the bite block comprises an insert receivable in the channel such that the at least one arm is held in the deployed position when inserted.

[0052] In certain embodiments, the insert is an endoscope guide.

[0053] In certain embodiments, the insert is elongate and tubular.

[0054] In certain embodiments, the insert comprises a trailing end that protrudes from the second end of the body when inserted therein.

[0055] In certain embodiments, the insert has a funnel at the trailing end to guide insertion of the endoscope.

[0056] In certain embodiments, the insert comprises an aperture in the sidewall of the trailing end.

[0057] In certain embodiments, the insert comprises a connector at the aperture in the sidewall of the trailing end.

[0058] In certain embodiments, the connector is a tubular extension extending from the edge of the aperture.

[0059] In certain embodiments, the insert comprises a leading end that protrudes from the first end of the body when inserted therein.

[0060] In certain embodiments, the insert is substantially straight along its length.

[0061] In certain embodiments, the leading end is open to the side relative to the longitudinal axis of the insert.

[0062] In certain embodiments, the insert comprises a bulkhead and / or end closure therein, the bulkhead and / or end closure having an expandable opening for receiving the endoscope therethrough, thereby providing a substantial seal around the endoscope when inserted.

[0063] In certain embodiments, the insert comprises a bulkhead and / or end closure therein, the bulkhead and / or end closure being configured to be openable to allow insertion of the endoscope therethrough, and further configured to close after the endoscope is removed.

[0064] In certain embodiments, the partition and / or the end closure provide a substantial seal around the endoscope when inserted.

[0065] In certain embodiments, the channel is substantially cylindrical and the insert fits concentrically within the channel when inserted, such that it can rotate therein.

[0066] In certain embodiments, the body and the insert each have a mating structure that limits rotation of the insert when inserted into the body.

[0067] In certain embodiments, the body further comprises a wall portion configured to be positioned between the patient's teeth and lips when the bite block is in the fitted position.

[0068] In certain embodiments, the wall portion is shaped to provide a sealing effect relative to the patient's mouth opening.

[0069] In certain embodiments, the wall portion extends laterally from the bite barrier portion at the second end of the body, relative to a direction from the first end of the body to the second end of the body.

[0070] In certain embodiments, wherein the wall portion is substantially U-shaped or C-shaped, opposing arms are provided that initially extend laterally from the bite barrier portion at the second end of the body and then extend in the direction of the first end of the body.

[0071] According to another aspect, an embodiment of an endoscope bite block is disclosed, comprising a body having a bite barrier portion positioned between the patient's upper teeth and lower teeth when the bite block is in a fitted position, the body having a channel therethrough for insertion of an endoscope, wherein the channel extends between an opening at a first end of the body and an opening at a second end of the body, and in the fitted position of the bite block, the first end is positioned behind the patient's teeth and the second end is positioned in front of the patient's teeth, the body further comprising a wall portion configured to be positioned between the patient's teeth and lips when the bite block is in the fitted position.

[0072] In certain embodiments, the wall portion is shaped to provide a sealing effect relative to the patient's mouth opening.

[0073] In certain embodiments, the wall portion comprises an aperture therein.

[0074] In certain embodiments, the wall portion comprises a main face that is solid except for the aperture.

[0075] In certain embodiments, the bite block comprises a connector at the aperture.

[0076] In certain embodiments, the connector is a tubular extension extending from an edge of the aperture.

[0077] In certain embodiments, the wall portion extends laterally from the bite barrier portion at the second end of the body, relative to a direction from the first end of the body to the second end of the body.

[0078] In certain embodiments, the wall portion is substantially U-shaped or C-shaped, providing opposing arms that initially extend laterally from the bite barrier at the second end of the body, and then extend in the direction of the first end of the body.

[0079] In certain embodiments, one of the arms includes an aperture therein.

[0080] In certain embodiments, the bite block includes a funnel at the second end of the body to direct insertion of the endoscope into the passage opening at the second end of the body.

[0081] In certain embodiments, the funnel is part of a funnel member that fits onto the body.

[0082] In certain embodiments, the funnel member includes a tubular portion that fits concentrically within the passage.

[0083] In certain embodiments, the funnel includes an aperture in its wall.

[0084] In certain embodiments, the funnel includes a neck region that extends from the second end of the body.

[0085] In certain embodiments, the aperture in the wall of the funnel member is disposed at the neck region of the funnel member.

[0086] In certain embodiments, the funnel member includes a connector at the aperture in the wall of the funnel member.

[0087] In certain embodiments, the connector is a tubular extension that extends from an edge of the aperture in the wall of the funnel member.

[0088] In certain embodiments, the endoscope bite block further includes an insert receivable in the passage, the insert being substantially tubular and elongate, and having a trailing end that extends from the second end of the body when inserted, and wherein a sidewall of the trailing end includes an aperture therein.

[0089] In certain embodiments, the insert includes a connector at the aperture.

[0090] In certain embodiments, the connector is a tubular extension that extends from an edge of the aperture in the sidewall of the insert.

[0091] According to another aspect, there is disclosed an embodiment of an endoscope bite block assembly, comprising:

[0092] a bite block as described above; and

[0093] The bag device includes an inflatable bag, an outlet connected to a connector of a bite block, and an inlet for connecting a gas supply.

[0094] According to another aspect, an embodiment of a method for delivering oxygen to a patient during an endoscopic procedure is disclosed, wherein the endoscope is inserted through the mouth, comprising:

[0095] Fit the occlusal block assembly as described above to the patient; and

[0096] Oxygen is supplied to the patient through the inlet of the bag device.

[0097] According to another aspect, an embodiment of an endoscopic occlusive block kit is disclosed, comprising:

[0098] The bite blocks as described above; and

[0099] The bag device includes an inflatable bag, an outlet for connecting a connector to an engagement block, and an inlet for connecting a gas supply.

[0100] According to another aspect, an embodiment of an endoscope guide for insertion through an endoscope channel in an endoscope occlusal block is disclosed, the guide comprising a tubular channel extending between two end openings, the tubular channel having a wall having one or more orifices therein.

[0101] In some embodiments, the guide is elongated and is curved at least along a portion of its length.

[0102] In some embodiments, at least a portion of it is elastically deformable.

[0103] In some embodiments, the endoscope guide includes an insertable front end through an endoscope channel and a tail end, the tail end including a stop extending therefrom, the stop being configured to prevent the tail end from passing through the endoscope channel.

[0104] In some embodiments, the front end is more flexible than the tail end.

[0105] According to another aspect, an embodiment of an endoscope guide for insertion through an endoscope channel in an endoscope occluder is disclosed, the guide comprising a first portion and a second portion, wherein the first portion provides a substantially tubular channel for guiding the endoscope, and the second portion provides a stop to prevent the second portion from passing through the endoscope channel.

[0106] In some embodiments, the first portion is substantially straight along its length, but has a front end that opens laterally relative to the longitudinal axis of the first portion.

[0107] In some embodiments, the first and second portions of the guide are connected by a snap-fit ​​engagement between the first and second portions.

[0108] In certain embodiments, the first and second portions of the guide are integrally formed with one another.

[0109] According to another aspect, there is disclosed an embodiment of an endoscope guide for insertion through an endoscope channel in an endoscope bite block, the insert being elongate and substantially tubular, the insert comprising a leading end insertable through the endoscope channel and a trailing end which protrudes from the endoscope channel upon insertion.

[0110] In certain embodiments, the insert has a funnel at the trailing end to guide insertion of the endoscope.

[0111] In certain embodiments, the insert is substantially straight along its length and has a leading end which opens to the side relative to a longitudinal axis of the insert.

[0112] In certain embodiments, the side wall of the trailing end comprises an aperture therein.

[0113] In certain embodiments, the guide comprises a connector at the aperture.

[0114] In certain embodiments, the connector is a tubular extension extending from an edge of the aperture in the side wall of the insert.

[0115] According to another aspect, there is disclosed an embodiment of an endoscope bite block assembly comprising:

[0116] a bite block as described above; and

[0117] an endoscope guide as described above.

[0118] According to another aspect, there is disclosed an embodiment of an endoscope bite block kit comprising:

[0119] a bite block as described above; and

[0120] an endoscope guide as described above.

[0121] According to another aspect, there is disclosed an embodiment of an endoscope bite block assembly as described above, further comprising an endoscope guide as described above.

[0122] According to another aspect, there is disclosed an embodiment of an endoscope bite block kit as described above, further comprising an endoscope guide as described above. BRIEF DESCRIPTION OF DRAWINGS

[0123] Embodiments of the present application will be described in further detail with reference to the accompanying drawings, in which:

[0124] Figure 1 An isometric view of a prior art bite block is shown;

[0125] Figure 2An isometric view showing one embodiment of a bite block according to the present application;

[0126] Figure 3 An isometric view showing one embodiment of a bite block according to the present application; Figure 2 A side view of the bite block shown;

[0127] Figure 4 An isometric view showing one embodiment of a bite block according to the present application; Figure 3 A cross-sectional view showing the C-C section marked;

[0128] Figure 5 An isometric view showing one embodiment of a bite block according to the present application; Figure 4 A cross-sectional view showing the D-D section marked; and

[0129] Figure 6 An isometric view showing one embodiment of a bite block according to the present application; Figures 2 to 5 A sagittal view of the bite block shown when fitted in the mouth of a patient;

[0130] Figure 7 An isometric view showing a bite block assembly, including a bite block as shown Figure 2 connected with an example endoscope guide, pouch device, and funnel;

[0131] Figure 8 An isometric view showing a bite block assembly, including a bite block as shown Figure 7 connected with an example endoscope guide, pouch device, and funnel;

[0132] Figure 9 An isometric view showing an embodiment of an endoscope guide for use with a bite block as shown Figure 2

[0133] Figure 10 An isometric view showing an embodiment of an endoscope guide for use with a bite block as shown

[0134] Figure 11 An isometric view showing an embodiment of a funnel for use with a bite block as shown Figure 2

[0135] An isometric view showing one embodiment of a bite block according to the present application; Figure 12

[0136] An isometric view showing a bite block assembly, including a bite block as shown Figure 13 Figure 12 An isometric view showing a bite block assembly, including a bite block as shown

[0137] Figure 14 Figure 13 A top view of the bite block assembly shown;

[0138] Figure 15 An isometric view showing a bite block assembly, including a bite block as shown Figure 14 A cross-sectional view showing the E-E section marked; ​​​

[0139] Figure 16 A side view of the bite block assembly is shown. Figure 13 A side view of the bite block assembly is shown.

[0140] Figure 17 A side view of the bite block assembly is shown. Figure 16 A cross-sectional view of the F-F plane is shown.

[0141] Figure 18 A top view of an embodiment of an endoscope guide for use with Figure 13 A top view of an embodiment of an endoscope guide for use with

[0142] Figure 19 A side view of the bite block assembly is shown. Figure 18 A cross-sectional view of the G-G plane is shown.

[0143] Figure 20 A side view of the bite block assembly is shown. Figure 13 An exploded view of the bite block assembly is shown.

[0144] Figure 21 An isometric view of the bite block assembly is shown, including a bite block as shown Figure 12 connected with an example endoscope guide.

[0145] Figure 22 A side view of the bite block assembly is shown. Figure 21 A side view of the bite block assembly is shown.

[0146] Figure 23 A side view of another embodiment of an endoscope guide for use with Figure 21 and Figure 22 A side view of another embodiment of an endoscope guide for use with

[0147] Figure 24 A side view of the bite block assembly is shown. Figure 23 A cross-sectional view of the H-H plane is shown.

[0148] Figure 25 An isometric view of the bite block assembly is shown, including a bite block as shown Figure 2 connected with an example bag device and funnel.

[0149] Figure 26 A side view of the bag device is shown. Figure 25 A side view of the bag device is shown.

[0150] Figure 27 An isometric view of the bite block assembly is shown, including a bite block as shown Figure 2 connected with an example bag device and funnel.

[0151] Figure 28 A side view of the bag device is shown. Figure 27 A side view of the bag device is shown.

[0152] Figure 29 a bag device for use with the bite block assembly shown in Figure 13 and Figure 21 a side view of another embodiment of a bag device for use with the bite block assembly shown in

[0153] Figure 30 a bite block with a cap at the connector shown in Figure 12

[0154] Figure 31 a schematic side view of the endoscope guide shown in Figure 23 and Figure 24 a schematic side view of the endoscope guide shown in, including a sealing element, wherein the inflatable balloon portion of the sealing element is in a deflated state

[0155] Figure 32 a schematic side view of the endoscope guide and sealing element shown in, wherein the inflatable balloon portion of the sealing element is in an inflated state Figure 31

[0156] a close-up side view of an example endoscope guide end for use with the bite block assembly shown in Figure 33 and Figure 13 Figure 21 a close-up front view of the endoscope guide end shown in

[0157] Figure 34 a isometric view of another embodiment of a bite block according to the present invention, including an example insert / endoscope guide Figure 33

[0158] Figure 35 another isometric view of the bite block shown in

[0159] Figure 36 a side view of the bite block shown in Figure 35

[0160] Figure 37 a front view of the bite block shown in Figure 35 and Figure 36 a side view of the bite block shown in

[0161] Figure 38 a front view of the bite block shown in Figure 35 and Figure 36

[0162] Figure 39 an isometric view of the endoscope guide / insert of the bite block shown in Figure 35 and Figure 36

[0163] Figure 40 Figure 39 ​​​​​​​side view of the illustrated endoscope guide / insert;

[0164] Figure 41 a cross-sectional view showing Figure 40 a cross-sectional view showing the I-I section marked;

[0165] Figure 42 a top view showing Figure 35 and Figure 36 an isometric view of the bite block body shown in use with the bite block shown;

[0166] Figure 43 a front view showing Figure 42 another isometric view of the bite block body shown;

[0167] Figure 44 a top view showing Figure 42 and Figure 43 another isometric view of the bite block body shown;

[0168] Figure 45 a front view showing Figures 42 to 44 a top view of the bite block body shown;

[0169] Figure 46 a front view showing Figures 42 to 44 a front view of the bite block body shown;

[0170] Figure 47 a cross-sectional view showing Figure 46 a cross-sectional view showing the J-J section marked;

[0171] Figure 48 an isometric view showing Figure 13 the bite block assembly shown connected to an example of a connector portion of a pouch device that can be used with the bite blocks described herein;

[0172] Figure 49 a side view showing Figure 48 the bite block assembly and connector portion shown;

[0173] Figure 50 a close-up view showing Figure 49 the K portion of the bite block assembly and connector portion shown;

[0174] Figure 51 a cross-sectional view showing Figure 49 the L-L section of the bite block assembly and connector portion shown;

[0175] Figure 52 a cross-sectional view showing Figure 49 the M-M section of the bite block assembly and connector portion shown;

[0176] Figure 53An isometric view of another embodiment of the occlusal block according to the invention is shown, the occlusal block including an example insert / endoscope guide;

[0177] Figure 54 It shows Figure 53 Side view of the bite block shown;

[0178] Figure 55 It shows Figure 53 The front view of the bite block shown;

[0179] Figure 56 It shows Figure 54 A cross-sectional view of the NN section marked in the middle;

[0180] Figure 57 As shown Figure 53 Isometric view of the endoscopic guide / insertion of the occlusal block shown;

[0181] Figure 58 It shows Figure 57 Rear view of the endoscope guide / insertion shown;

[0182] Figure 59 It shows Figure 57 The front view of the endoscope guide / insertion shown;

[0183] Figure 60 It shows Figure 59 A sectional view of the OO section marked in the middle;

[0184] Figure 61 It shows how to use with, for example Figure 53 An isometric view of the bite block body used together with the bite blocks shown.

[0185] Figure 62 for Figure 61 A top view of the bite block body shown;

[0186] Figure 63 It shows Figure 61 The front view of the bite block body shown; and

[0187] Figure 64 It shows Figures 2 to 8 A cross-sectional view of the PP section marked in the middle. Detailed Implementation

[0188] A general embodiment of the invention provides an endoscopy bite block comprising a body having a bite barrier portion which, when the bite block is in an assembled position, is located between the upper and lower teeth of a patient. The body has a passage therethrough for the insertion of an endoscope. The passage extends between an opening at a first end of the body and an opening at a second end of the body. In the assembled position of the bite block, the first end is located behind the teeth of the patient and the second end is located in front of the teeth of the patient. The bite block further comprises a retaining device which is configurable between an assembled position or configuration (which facilitates assembly of the bite block into the assembled position) and a retaining position or configuration (which facilitates retention of the bite block in the assembled position).

[0189] In a first general form, the retaining device is a retaining member coupled to the body so that it is rotatable relative to the body between the assembled and retaining positions / configurations.

[0190] The bite barrier portion generally comprises substantially parallel top and bottom outer bite surfaces, but in certain forms can have curved top and bottom outer bite surfaces (e.g. which curve towards each other). It will also be appreciated that a single outer bite surface can extend around the bite barrier portion to receive / block the upper and lower teeth.

[0191] The retaining member generally provides an anchoring portion at the first end of the body which hooks behind the teeth of the patient when in the retaining position. The anchoring portion is generally in the form of an elongate element having two end portions which each extend transversely relative to the direction from the first end of the body to the second end of the body. The end portions of the elongate element generally extend in generally opposite directions. Rotation of the retaining member thus provides the assembled position / configuration (which facilitates insertion / removal) so as to allow easy insertion / removal through the space between the upper and lower teeth of the patient when the elongation direction of the anchoring portion is substantially parallel to the transverse plane of the patient with reference to the assembled position of the bite block. Conversely, when the retaining member is rotated to the retaining position (which prevents removal of the bite block), the elongation direction of the anchoring portion is substantially perpendicular to the transverse plane of the patient with reference to the assembled position of the bite block, and thus the anchoring portion hooks behind the teeth of the patient.

[0192] The end portions of the anchoring portion / elongate element can be curved in a direction away from the body of the bite block. This allows the end portions to conform to the general shape of the hard palate and lower gingival region in the retaining position, thus reducing the likelihood of injury to the patient. Furthermore, the end portions are generally in the form of or comprise tab portions to provide sufficient contact area which can rest against the hard palate / lower gingival region of the patient without cutting into or injuring the patient. The end portions can also have some degree of flexibility to assist in conforming to the hard palate / lower gingival region, again seeking to avoid / minimise injury to the patient (e.g. damage to the mucosa etc.).

[0193] Typically, the passage through the bite block body is substantially cylindrical, the retaining member comprising a substantially tubular portion which fits concentrically within the passage such that it can rotate therein. For example, the inner wall surface of the passage and the outer wall surface of the tubular portion can have cooperating formations thereon to prevent excessive rotation of the retaining member beyond the fitted position and the retaining position.

[0194] Typically, the body further comprises a wall portion configured to lie between the patient's teeth and lips when the bite block is in the fitted position. This assists in positioning the bite block during fitting and, together with the anchoring portion, helps to grip the teeth when the retaining member is moved to the retaining position.

[0195] Typically, the wall portion extends laterally from the bite barrier portion at the second end of the body (i.e. the end region) with respect to the direction from the first end to the second end of the body. The wall portion is typically substantially U-shaped, providing opposing arms, wherein the arms extend laterally from the bite barrier portion at the second end of the body and then extend in the direction of the first end of the body. In the fitted position of the retaining member, the elongate element typically has an elongate direction which lies in the plane of the opposing arms of the wall portion, and in the retaining position of the retaining member, the elongate element typically has an elongate direction which is angled (typically perpendicular) with respect to the plane of the opposing arms of the wall portion.

[0196] Typically, one of the arms comprises an aperture therein, and typically comprises a connector at the aperture. For example, the connector can be a tubular extension which extends from the edge of the aperture. For example, the connector can be configured to connect with a gas (e.g. oxygen) supply device or apparatus, such that gas / oxygen can be supplied more directly into the oral cavity through the aperture. It will be appreciated that the connector is not strictly necessary, with the gas supply device or apparatus being connected directly to the aperture.

[0197] The wall portion is generally shaped / configured to provide a seal against the patient's mouth opening. The wall portion main face is generally solid (i.e. continuous, thus without perforations through the wall portion) other than the aperture. The seal helps to prevent leakage of oxygen / gas supplied through the connector from the oral cavity. Furthermore, to further avoid leakage, the channel can include one or more partitions and / or end closures therein, which can provide a seal around the endoscope when inserted therethrough. The partitions / end closures can for example have expandable openings for receiving the endoscope therethrough, thereby providing a seal around the endoscope when inserted. For example, the partitions / end closures can comprise a flexible membrane having a stretchable aperture therein, or can comprise a flexible wall having one or more slits therein, which can intersect. Alternatively, the partitions or end closures can be configured to be openable to allow insertion of the endoscope (or other instrument / device), and can also be configured to automatically seal / close (e.g. by biasing to seal / close) upon removal of the endoscope / instrument, for example in the form of a one-way valve for the endoscope. This automatic closure / one-way valve type form can also provide a seal around the endoscope when inserted.

[0198] It will be appreciated that neither seal can be perfect (i.e. can not be completely leakproof), and thus can only provide a substantial or partial sealing effect.

[0199] The rotation retention member can comprise a handle portion extending from the tubular portion at the second end of the body and located outside the channel, such that an operator can rotate the retention member by the handle portion. Alternatively, the bite block can comprise a funnel at the second end of the body to guide insertion of the endoscope into the channel opening at the second end of the body. The funnel can be connected to the retention member such that rotation of the funnel rotates the retention member. In this way, the funnel can also act as a handle. In some examples, the funnel can be part of a funnel member comprising a tubular portion which fits concentrically within the tubular portion of the retention member.

[0200] In a second general form, the retention device comprises at least one arm movable between a retracted position and a deployed position, wherein the retracted position provides an assembly position or configuration and the deployed position provides a retention position or configuration. Typically, in the retracted position, the at least one arm extends into the channel so as to provide minimal interference between the patient's upper and lower teeth during insertion into their oral cavity. Typically, the at least one arm is biased to or in the retracted position. For example, the at least one arm can be formed in the retracted position and then flexed into the deployed position (e.g. the at least one arm can be formed from a flexible but resilient polymeric material). In one example, the at least one arm is provided by a tongue formed in a wall of the channel of the bite block body.

[0201] Generally, in the deployed position, at least a portion of the at least one arm extends outwardly from the body. As previously mentioned, the bite block portion generally provides an upper outer bite surface and a lower outer bite surface. The at least one arm is generally formed in the upper and / or lower outer bite surface. The at least one arm is generally curved at its free end to provide a region of the at least one arm that projects relative to the upper outer bite surface and the lower outer bite surface when the at least one arm is in the deployed position, with the remainder of the at least one arm being substantially flush with the upper or lower outer bite surface.

[0202] Generally, there are two arms, one of the arms being formed in the upper outer bite surface and the other arm being formed in the lower outer bite surface.

[0203] In a second general form, the bite block generally comprises an insert receivable in the channel, such that when inserted, the at least one arm is moved to and held in the deployed position. The insert can be an endoscope guide, and is generally elongate and tubular (generally having a substantially circular cross-section).

[0204] Generally, the insert comprises a trailing end that projects from the second end of the body when inserted therein. Generally, the insert has a funnel at the trailing end for guiding insertion of the endoscope. In the second general form, the insert generally comprises an aperture in a side wall thereof to allow for gas supply (as opposed to the wall portion in the first general form). Thus, the insert generally comprises a connector at the aperture to allow connection with the gas supply / device. Generally, the connector is a tubular extension extending from an edge of the aperture. However, it will also be appreciated that the gas supply / device could alternatively be connected directly to the aperture without the need for a connector.

[0205] Generally, the insert comprises a leading end that projects from the first end of the body when inserted therein. The insert is generally straight along its length. Generally, the leading end is open to the side relative to a longitudinal axis of the insert. It will be appreciated that in certain forms, the insert can not be perfectly straight and can have some degree of curvature. It will be appreciated that in certain forms, the leading end is open to the side relative to a centreline axis of the insert (the insert is generally substantially tubular with a circular cross-section). The insert can comprise a partition and / or an end closure therein as previously described, which can form a seal around the endoscope when inserted and / or close off the insert when the endoscope is removed.

[0206] As with the first general form described previously, the channel of the bite block body is generally substantially cylindrical. The insert generally fits concentrically within the channel when inserted, such that it can rotate therein. There can be cooperating structures on the body and the insert that limit rotation of the insert when inserted into the body.

[0207] As with the first form described above, in the second form the body also comprises a wall portion configured to be located between the patient's teeth and lips when the bite block is in the assembled position. The wall portion is generally shaped to provide a sealing effect against the patient's mouth opening. The wall portion generally extends laterally from the bite barrier portion at the second end of the body, i.e. the end region, with respect to a direction from the first end of the body to the second end of the body. The wall portion is generally substantially U-shaped or C-shaped, providing opposing arms which extend initially laterally from the bite barrier portion at the second end of the body and then in the direction of the first end of the body.

[0208] It will be appreciated that the retaining device can be in other forms than the two forms described above, for example, the retaining device can be a telescopic element, capable of extending / contracting, or an inflatable / deflatable air bag.

[0209] A further general embodiment of the present application provides an endoscope bite block comprising a body having a bite barrier portion which is located between the patient's upper teeth and lower teeth when the bite block is in an assembled position, the body having a passage therethrough for insertion of an endoscope, wherein the passage extends between an opening at a first end of the body and an opening at a second end of the body, and in the assembled position of the bite block, the first end is located behind the patient's teeth and the second end is located in front of the patient's teeth, the body further comprising a wall portion configured to be located between the patient's teeth and lips when the bite block is in the assembled position.

[0210] The wall portion generally comprises an aperture therein, and a connector can extend therefrom for connection to a gas supply. The connector can be, for example, a tubular extension extending from an edge of the aperture. The wall portion generally extends laterally from the bite barrier portion at the second end of the body, with respect to a direction from the first end of the body to the second end of the body. For example, the wall portion can be substantially U-shaped, providing opposing arms which extend initially laterally from the bite barrier portion at the second end of the body and then in the direction of the first end of the body. In these examples, the aperture can be located in one of the arms.

[0211] The wall portion is generally shaped / configured to provide a seal against the patient's mouth opening. In addition to the aperture, the wall portion main face is generally solid (i.e. continuous, so there are no perforations through the wall portion). The seal helps to prevent leakage of oxygen supplied through the aperture / connector from the mouth. Furthermore, to further avoid leakage, one or more of the partitions and / or end closures described previously can be included in the passage.

[0212] Some embodiments of the present invention can have the orifice in the funnel member rather than in the wall portion. In such embodiments, the funnel member typically includes a connector at the orifice configured to connect with the gas supply / device. Also typically, in such embodiments, the funnel member includes a neck region that protrudes from the second end of the body when inserted, and the orifice is provided at the neck region of the funnel member.

[0213] Similarly, in some embodiments, the bite block can include an insert receivable in the channel, the insert being substantially tubular and elongate and having a tail end that protrudes from the second end of the body when inserted. In such embodiments, the side wall of the tail end can include an orifice therein for receiving gas, and a gas supply connector can be located thereat. Again, the connector can be a tubular extension that extends from the edge of the orifice in the side wall of the tail end of the insert.

[0214] Embodiments of the bite block that include an orifice (typically through a connector) for receiving a gas supply allow for an endoscope bite block assembly (or kit for assembling the same) that includes a bite block in combination with a bag device. The bag device typically includes an inflatable bag, an outlet for connecting with the orifice / connector of the bite block, and an inlet for connecting with a gas supply. In use, the bag device can be connected to the orifice / connector of the bite block and continuously supplied with oxygen from the oxygen supply through the inlet, such that the bag is continuously inflated. When the bag is fully inflated, excess oxygen overflows into the oral cavity through the orifice (e.g. through the connector) in the wall portion. When the patient inhales, the oxygen concentration of each breath is increased, which is a combination of oxygen that has overflowed into the oral cavity and oxygen that is inhaled / sucked from the bag. As the bag is continuously inflated, the bag is fully inflated before the patient exhales, and any exhaled (oxygen-reduced) air is expelled through the nose, rather than back into the bag. This can prevent re-inhalation of exhaled air. As mentioned previously, the connector can not be strictly necessary, and the bag device can be connected directly to the relevant orifice in the bite block.

[0215] Accordingly, embodiments of the present invention also relate to a method of delivering oxygen to a patient during an endoscopy procedure, in which an endoscope is inserted through the mouth. Such a method includes fitting such a bite block assembly to the patient, and supplying oxygen to the patient through the inlet of the bag device.

[0216] Furthermore, the bite blocks described herein, as well as other bite blocks, can optionally be used with an endoscope guide that both prevents the tongue from obstructing the patient’s airway and guides the endoscope into the oropharynx behind the tongue.

[0217] The present disclosure also relates to an endoscope guide for insertion into the channel of a bite block.

[0218] In some embodiments, the endoscope guide comprises a tubular passage extending between two end openings, the tubular passage having a wall with one or more apertures therein. Such apertures enable air / gas to flow through, into and out of the passage. Typically, the guide is elongate and curved along at least a portion of its length.

[0219] At least a portion of the guide is also typically resiliently deformable in order to assist insertion into the bite block passage, which can have a slightly smaller cross-sectional area. The endoscope guide typically comprises a leading end to be inserted into the bite block passage, and a trailing end comprising a stop extending therefrom which is configured to prevent the trailing end from passing through the passage. In certain forms, the leading end can be more flexible than the trailing end. For example, the leading end can be resiliently deformable to pass through the bite block passage and then return to its undeformed state, whereas the trailing end can be more rigid and shaped to fit or closely fit the bite block passage.

[0220] In further embodiments, the endoscope guide comprises first and second portions, wherein the first portion provides a substantially tubular passage to guide the endoscope, and the second portion provides a stop to prevent the second portion from passing through the endoscope passage of the bite block. Typically, the first portion is substantially straight along its length but has a leading end which opens out to the side relative to the longitudinal axis of the first portion. In some embodiments, the first and second portions of the guide are connected by a snap-fit connection, whereas in other embodiments they can be integrally formed. In yet further embodiments, the endoscope guide can be elongate and substantially tubular (typically having a cylindrical cross-section), comprising a leading end to be inserted through the endoscope passage, and a trailing end which protrudes from the endoscope passage when inserted.

[0221] The guide can have a funnel at the trailing end for guiding insertion of the endoscope. The guide can be substantially straight along its length and have a leading end which opens out to the side relative to the longitudinal axis of the insert.

[0222] An aperture can be included in the side wall of the trailing end, and a connector for a gas supply device can be included therein. The connector can be a tubular extension extending from the edge of the aperture in the side wall of the insert.

[0223] Embodiments of the present application therefore also relate to a bite block assembly (or kit for assembling a bite block) comprising an endoscope guide as described herein.

[0224] One example form of an endoscope bite block according to the present application is as shown in Figure 6The bite block (1) includes a body (2) having a cylindrical passage (3) therethrough for receiving an endoscope (not shown). The passage (3) extends between an opening (4) at a first end (5) of the body (2) and an opening (6) at a second end (7) of the body (2). When the bite block (1) is fitted to a patient, the first end (5) is located behind the patient's teeth (104, 121) and the second end (7) is located in front of the patient's teeth (104, 122). See, for example Figure 2 , showing the fitted position within the patient's mouth. It will be appreciated that the passage (3) can not always be cylindrical and can have a non-circular cross-section.

[0225] The body (2) includes a bite barrier portion (8) and a wall portion (9). It will be appreciated that the bite barrier portion and the wall portion can be integrally formed to provide the body (2) or can be separately manufactured and secured together to form the body (2). The bite barrier portion (8) is substantially square prismatic in shape and includes substantially parallel top and bottom outer bite surfaces (10, 11) and substantially parallel lateral side surfaces (12, 13) connecting the top and bottom outer bite surfaces (10, 11). The edges between the outer top, bottom and side surfaces (10, 11, 12, 13) are rounded. In certain forms, the top and bottom surfaces (10, 11) of the bite barrier portion have a degree of softness or have a soft covering to avoid damaging the patient's teeth.

[0226] The wall portion (9) extends laterally from the bite barrier portion (8) at the second end (7) of the body (2) with respect to a direction (Y) from the first end of the body to the second end of the body. The wall portion (9) is substantially U-shaped so as to fit along the outer surfaces of the patient's teeth (104, 121) but behind the patient's lips. Thus, the ends of the U-shaped wall portion provide opposing arms (14, 15) each of which initially extends laterally from the bite barrier portion at the second end (7) of the body (2) and then extends in the direction of the first end (5) of the body (2). It will be appreciated that, as shown in Figure 5 , the arms (14, 15) thus extend in the same overall plane (P). While the embodiment shown in the figures provides a wall portion that is substantially U-shaped, other forms can have a wall portion that is substantially flat or planar. Furthermore, in certain forms, the wall portion can have a degree of curvature from top to bottom (i.e. in a direction perpendicular to the overall plane common to the arms (14, 15)). Furthermore, the arms (14, 15) can also have a degree of flexibility (albeit resilient) to assist fitting / positioning of the bite block (1).

[0227] The retaining member (16) is rotatably connected to the body (2) and provides an anchoring portion (17) at the first end (5) of the body (2). The anchoring portion (17) is connected to a tubular portion (18) which is concentrically fitted within a channel (3) of the body (2) so that it can rotate therein, thereby providing rotational movement of the retaining member (16).

[0228] like Figure 2 As shown, the inner wall (19) of the channel (3) and the outer wall (20) of the tubular portion (18) have mating structures to prevent excessive rotation of the retaining member (16) beyond the assembly and retaining positions. Specifically, the inner wall surface (19) of the channel (3) includes two recesses (21) that receive corresponding protrusions (22) on the outer wall surface (20) of the tubular portion (18) of the retaining member (16). The protrusions (22) abut against the corresponding sidewalls (21a) of the recesses (21) to prevent excessive rotation of the retaining member (16) beyond the assembly and retaining positions. In this example, the rotation of the retaining member (16) is limited to approximately 90°.

[0229] The anchoring portion (17) of the retaining member (16) is in the form of an elongated element having two ends (23, 24), each end extending laterally (relative to the direction (Y) from the first end (5) of the body (2)) in substantially opposite directions. The elongated element is substantially flange-shaped or wing-shaped to provide tab-shaped portions at both ends (23, 24). In the assembled position of the retaining member (16), the anchoring portion / elongated element (17) has a generally elongated direction in the plane of the opposing arms (14, 15) of the wall portion (9) (see, for example, see...). Figure 6 ). In maintaining position (e.g., see Figure 2 The anchoring portion / elongated element (17) has a generally elongated direction that is angled to and generally perpendicular to the plane of the opposing arms (14, 15). When the occlusal block (1) is assembled, the arms (14, 15) of the wall portion (9) extend along the outer surface of the patient's teeth (104, 121), so it can be understood that when the retaining member (16) is rotated to the retaining position, the anchoring portion (17) has an elongated direction perpendicular to the patient's cross section, thus locking the occlusal block (2) into place by hooking behind the patient's teeth (104, 121).

[0230] The end portions / tabs (23, 24) of the anchoring portions / elongate elements are curved in a direction away from the bite block body (2) so as to provide some degree of conformity with the hard palate (111) and lower gingival area (122) of the patient when moved to the retaining position. Furthermore, it will be appreciated that the fitted position of the bite block (1) is typically tight such that when the retaining member (16) is moved to the retaining position, the bite block substantially clamps the teeth (104, 121) with the tab portions (23, 24) contacting the hard palate (111) and lower gingival area (122) to draw the wall portion (9) forward of the patient's teeth (104, 121).

[0231] It will be appreciated that in other forms, the end portions / tabs (23, 24) can not be strictly curved, but can be curved or angled away from the body in other ways to facilitate conformity with the hard palate (111) / lower gingival area (122).

[0232] In typical use, the bite block is first set to the fitted position by moving the retaining member (16) so that the anchoring portions / elongate elements (17) have an elongate direction in the plane of the arms (14, 15) of the wall portion (9) (e.g. as shown in Figure 5 The retaining member (16) is then rotated to the retaining position so that the anchoring portions / elongate elements (17) hook behind the teeth (104, 121) of the patient to secure the bite block in place.

[0233] Rotation can be actuated in a number of ways. In the illustrated figures, an optional funnel member (25) is fixed to the tubular portion of the retaining member (16) so that rotation of the funnel (25) also rotates the retaining member (16). The fixing is by the tubular portion (26) of the funnel (25) fitting concentrically within the tubular portion (18) of the retaining member (16). As Figure 11As shown, the outer wall surface (27) of the tubular portion (26) of the funnel (25) has protrusions (28) shaped to fit within corresponding recesses in the inner wall surface (29) of the tubular portion (18) of the holding member (16). The funnel (25) widens from its tubular portion (26) at the second end of the body. In other embodiments that can not include a funnel, the holding member (16) can simply be turned by inserting a finger into its tubular portion (18) or include some other handle extension / portion extending from the tubular portion (18) to outside the passage (3) at the second end (7) of the body (2). While the funnel member (25) is optional, it does provide additional advantages as it helps guide the insertion of the endoscope into the passage opening (6) at the second end (7) of the body (2). As Figure 7 As shown, the funnel can include a flange (43) that prevents its over-insertion (i.e. by abutting the edge of the passage).

[0234] In addition to the above fixation advantages, the bite block (1) also includes an orifice (30) in one of the arms (15) of the wall portion (9) that allows for improved oxygen intake by the patient. A connector extends from the wall portion (9) at the orifice (30) to allow for connection of a gas supply device / equipment, particularly an oxygen supply device / device. In the embodiment shown, the connector is in the form of a tubular extension (31) that extends from the edge of the orifice (30). Optionally, an openable port (e.g. in region (Z)) can be included in the wall portion for connection of a C02 sensor, typically with an openable closure or cap for connection of the sensor. The C02 sensor can be used to monitor C02 levels in the mouth.

[0235] To facilitate oxygen uptake and reduce dilution within the oral cavity, the wall portion (9) is shaped / configured to provide a seal against the patient's mouth opening. In particular, to provide the seal, the wall portion major faces (9a, 9b) are solid (i.e. continuous, thus without perforations through the wall portion) except for the aperture (30). In embodiments including the C02sensor port, it will be appreciated that unless the C02sensor is attached, the port is normally covered by a cap / closure, such that the major faces are continuous / solid and provide the seal effect described. It will be appreciated that the seal helps to prevent leakage of oxygen supplied through the connector from the oral cavity. In certain forms (not shown), either or both of the major faces (9a, 9b) can include a protruding ridge or frame of cushioning or soft deformable material extending around the peripheral portion of the face, to increase the seal effect of the wall portion (e.g. when implemented on the teeth inside / facing the major face (9b), the cushioning material will press upwards and conform to the patient's teeth / gums when the bite block is secured). Alternatively (also not shown), to similarly provide an enhanced seal effect, an inflatable cuff or frame can extend around the peripheral portion of one or both major faces (9a, 9b). The inflatable cuff or frame is normally inflated after the bite block (1) is in the fitted position (e.g. through a guide tube or through the aperture (30)), to expand to fill the space between the wall portion and the patient's teeth and / or lips / cheeks. This form providing an enhanced seal effect is advantageous in the case that intermittent positive pressure ventilation can be applied through the connector (this will be described later).

[0236] Further, to further avoid leakage, the passageway can include a baffle and / or end closure (not shown) that can provide a seal around the endoscope when inserted. The baffle / end closure can for example have an expandable opening for receiving the endoscope therethrough to provide a seal therearound when the endoscope is inserted. For example, the baffle / end closure can include a septum having a stretchable aperture, or can include a flexible wall having one or more slits that can intersect. For example, the flexible wall can have two slits that intersect, forming an "X" shaped opening, thus providing four flexible tabs that are bent to allow insertion of the endoscope. It will be appreciated that the baffle or end closure can be configured to be openable to allow insertion of the endoscope or other instrument / device, and further configured to automatically seal / close (e.g. by a biasing seal / close) after the endoscope / instrument is removed, for example in the form of a one-way valve for the endoscope. This form (i.e. the automatic close form) can also provide a seal around the endoscope when inserted. It will be appreciated that the inclusion of a baffle / end closure further aids in preventing leakage by preventing leakage through the passageway around the endoscope, and in the case of the automatic close / one-way valve type, the passageway is completely closed / sealed once the endoscope is removed. In some embodiments, multiple baffles / end closures can be included to enhance the sealing effect, each of which can be the same or different form (e.g. one having a slit, one including a one-way valve type, etc.).

[0237] It will be appreciated that both seals (i.e. provided by the wall portion (9) or baffle / end closure) can be imperfect (i.e. can not be completely leakproof), thus can only provide a substantial or partial sealing effect. In certain cases, to provide further sealing, an additional piece of tape can be applied over the patient's lips after the bite block is fitted.

[0238] In one example (as Figures 25 to 28As shown, the bag arrangement (200) can be fitted over the tubular extension (31). The bag arrangement (200) generally has an inflatable bag portion (201), and a connector portion (204) that includes an inlet (202) for inflation and an outlet (203) that connects to the tubular extension (the inlet and outlet can be two connection points of a T-shaped connector (204), with a third connection point connecting to the inflatable bag portion (201)). In typical use, the bag arrangement (200) is continuously supplied with oxygen through the inlet from an oxygen supply, such that the bag is continuously inflated. When the bag is fully inflated, excess oxygen overflows through the orifice (30) into the oral cavity. When the patient inhales, the oxygen concentration of each breath is increased, by the combination of oxygen that has overflowed into the oral cavity and oxygen that is inhaled / sucked from the bag. As the bag is continuously inflated, the bag is fully inflated before the patient exhales, with any exhaled (oxygen-reduced) air being expelled through the nose, rather than back into the bag. It will therefore be appreciated that the bite block allows an assembly that, when combined with a suitable bag arrangement, allows a novel and improved method of oxygenating a patient during an endoscopic procedure (where an endoscope is inserted through the mouth), such that the risk of hypoxia is reduced. It will be appreciated that in other forms, the oxygen supply can be connected directly to the connector (31), without the need for a bag arrangement. It will also be appreciated that the movement / collapsing of the bag caused by the patient inhaling also provides a visual indication to an attending medical professional of the patient’s breathing.

[0239] In certain forms, as shown in Figure 25 the bag arrangement (200) can have a connector portion (204A, 204B) that further includes an additional outlet / opening (208). The additional outlet / opening (208) provides an additional passage for exhaled air to the external environment (i.e. not through the nose). The outlet / opening (208) therefore helps to avoid the build-up of CO2 in the patient and the bag arrangement (200). Furthermore, the additional outlet / opening (208) allows excess O2 (or other gas) from the bag arrangement to be released to the external environment, for example, when the bag is fully inflated. That is, excess O2 (or other gas) from the bag can also be expelled through the opening (208), rather than all overflowing into the oral cavity. In certain forms, the outlet / opening (208) can be part of a tubular extension (205A), as shown in Figure 27 and 26 or can simply be a hole (205B) in the wall of the connector portion (204B), as shown in Figure 29 and 28 Generally, the additional outlet / opening (208) is located on the connector portion (204A, 204B) further from the bag portion (201) than the inlet (202), such that gas received from an external supply can first be introduced into the bag, rather than out through the opening (208), for example, through suitable internal structure of the connector portion.

[0240] In other forms, as shown in Figure 30 the connector portion (204C) can comprise a cap or end portion (206C) at the inflation inlet (202) having an inlet opening (220C) and one or more additional openings (207C) spaced from the inlet (220C). The openings (207C) allow exhaled air to pass through them to the external environment. The cap / end portion (206C) narrows towards a tip at which the inlet opening (220C) is provided. The additional openings (207C) are spaced from the tip at a wider portion of the cap / end portion (206C). This configuration reduces the amount of oxygen / gas (i.e. received through the inlet opening (220C)) escaping through the openings (207C) but at the same time facilitates the expulsion of exhaled (oxygen-reduced) air through the openings (207C). It will be appreciated that the cap / end portion (206D) can instead be located at the end of the connector (31) of the bite block (1A), for example as shown in Figures 48 to 52 .

[0241] Another form of connector portion (204D) is shown in Figures 7 to 10 Here, the connector portion (204D) comprises an internal structure in the form of an internal wall (209) which directs gas received through the inlet (202D) (e.g. from a gas supply) in a direction towards / into the bite block / oral cavity.

[0242] Furthermore, optionally, as shown in Figure 10 the endoscope guide (300) can be used with the bite block (1) in order to guide the patient’s tongue away from obstructing the patient’s airway and to guide the endoscope into the oropharynx. The guide (300) comprises a tubular portion (301) forming a channel extending between two end openings (311, 312). The tubular portion (301) has a wall with a plurality of apertures (304) therein.

[0243] In typical use, the front end (305) of the endoscope guide (300) is inserted through the passage opening (6) at the second end (7) of the body (2) and pushed out through the through-hole opening (4) at the first end (5) of the body (2). A stop in the form of a flange (307) at the trailing end (306) of the guide (300) acts to prevent the trailing end (306) from passing through the channel (3), typically by abutting against the edge of the passage opening (6) at the second end (7) of the body (2) or the inclined wall of the funnel (25). In certain forms, the guide (300) can comprise a handle (not shown) extending from the trailing end to aid insertion / removal of the guide.

[0244] The endoscope guide (300) is elongate and curved along its length, with the degree of curvature increasing towards the forward end (305) so as to provide a guided path for the endoscope towards the oropharynx when fitted.

[0245] To facilitate insertion, the endoscope guide (300) is generally elastically deformable so that it can be squeezed into the passage (3) and then, after it exits the passage opening (4) at the first end (5) of the body (2), it returns to its original or undeformed shape. In one example, to facilitate this, the forward end (305) can be more flexible than the trailing end (306). For example, the forward end (305) can be elastically deformable to pass through the bite block passage (3) and then return to its undeformed state, while the trailing end (306) can be more rigid and can be shaped to fit or closely fit within the bite block passage (3). Alternatively or additionally, the side wall portion (303) of the tubular portion (301) can be more flexible than the upper / lower wall portions (302) thereof and can move inwardly to reduce the cross-sectional area of the guide (300). In one example (not shown), the endoscope guide can have a rigid spine extending along its length in the upper and lower wall portions, with transversely less rigid ribs extending therefrom to the side wall portion.

[0246] It will also be appreciated that the endoscope guide (300) also works as an airway tube, maintaining the patient's airway so that oxygen received through the connector has a clear path to the lungs. Since the forward end (305) of the endoscope guide (300) generally substantially fills the airway in the patient's laryngeal region, the apertures (304) in the wall of the tubular portion (301) allow gas to flow into and through the tubular portion (301). For example, gas / oxygen received from the connector / apertures in the area behind the patient's teeth can then flow through the guide (300) into the lungs, generally in the space around the endoscope. It will be appreciated that the endoscope guide (300) is shaped to have a larger diameter / cross-sectional area than the endoscope to allow sufficient gas / oxygen to flow around the endoscope. Similarly, when the patient exhales, the apertures (304) allow the exhaled gas to escape into the mouth and out through the nose, noting that the passage of the exhalation port is substantially blocked (by the sealing effect of the wall portion (9) and the seal around the endoscope).

[0247] In certain forms, see for example Figure 10As shown, the endoscope guide (300) can have an additional secondary tubular portion (308) extending along the primary tubular portion (301) to allow insertion of a gastric tube. In effect, the field of view of an endoscope (e.g. bronchoscope) inserted through the primary tubular portion (301) can be used to assist insertion / placement of a gastric tube inserted through the secondary tubular portion (308). Providing an additional passageway / tubular portion for a gastric tube is commonly used during bronchoscopy, whereas a gastroscope can already incorporate a gastric tube as part of the scope. It will be appreciated that whilst the primary and secondary tubular portions (301, 308) are shown as having a substantially circular cross-section, they could also have a non-circular cross-section. In another form, only a single primary tubular portion (e.g. 301) having two end closures (e.g. 41, 42) can be included, such that the endoscope (e.g. bronchoscope) and gastric tube pass through the same passageway but exit from separate end closures.

[0248] It will also be appreciated that in the case of using the endoscope guide (300) or funnel (25), the one or more partitions / end closures providing a seal around the endoscope, similar to that which can be included in the passageway (3), can also be provided in / at the end of the tubular portion (301) of the endoscope guide (300), and / or in / at the end of the funnel, alternatively or additionally. Figure 11 An example of an endoscope guide end closure (41) is shown, which provides a sealing effect around the endoscope when inserted. It comprises two intersecting slits to form an "X" shaped opening, which thereby provides four flexible tabs that are curved to allow insertion of the endoscope. A similar end closure (42) can also be provided at the end of the secondary additional tubular portion (308). As previously mentioned, the end closure (41 / 42) or other partition / end closure as shown can alternatively comprise a one-way valve form for the endoscope, which opens to allow insertion of the endoscope (or other instrument / device) and more fully automatically seals / closes upon removal of the endoscope / instrument. Figures 12 to 20 A typical location (44) of an end closure / partition is indicated, which as previously mentioned can be a slitted wall / membrane or one-way valve form.

[0249] It will also be appreciated that in order to facilitate a seal around the guide (300) when inserted into the passageway (3), the guide (30) is typically sized / shaped such that it must be squeezed to pass through the passageway (3) (typically with the aid of lubricant), such that its restorative force provides a sealing effect as the guide (3) seeks to return to its original shape within the passageway (3). Alternatively, the trailing end (306) can be sized to correspond to the size of the bite block passageway (3).

[0250] Another example form of an endoscope bite block in accordance with the present invention is shown in Figures 2 to 8The bite block (1A) is similar to the bite block (1) shown in Figure 4 but differs in that the connector (31) for gas supply extends from the funnel member (25A) rather than from the wall portion (9). While the funnel member (25A) similarly comprises a tubular portion (26) for insertion of the tubular portion (18) of the holding member (16), it further comprises a neck region (26a) protruding from the channel (3) / holding member (16). The neck region (26a) comprises an aperture (30) therein from which the connector (31) extends. It will be appreciated that, similar to the embodiment shown in Figure 7 , the tubular portion (26) of the funnel member (25A) has a protrusion (28) which is shaped to fit within a corresponding recess in the inner wall surface (29) of the tubular portion (18) of the holding member (16) such that rotation of the funnel member (25A) causes rotation of the holding member (6) (e.g. between the assembled and holding positions).

[0251] As previously mentioned, the connector (31) allows for the supply of gas through the aperture (30) by connection of other devices / apparatus, in particular oxygen supply devices / apparatus. For example, the bag device (200) can be assembled to the connector of the bite block (1A) in a manner similar to that shown in Figures 1 to 8 .

[0252] It will also be appreciated that, in this form, the optional openable port for connection of a CO2 sensor previously described can also be located in the neck region (26A) of the funnel member (25A) rather than in the wall portion (9) of the bite block (1) as previously described in relation to Figures 2 to 8 .

[0253] It will be appreciated that other aspects of the bite block (1A) are similar to the bite block (1) shown in Figures 13 to 24 .

[0254] Figure 18 Further examples of endoscope guides (300A, 300B) are also shown in Figure 6 which are particularly configured for use with the bite block (1A). The endoscope guides (300A, 300B) comprise first and second portions (350, 450). The first portion (350) provides a tubular portion (301) for passage of an endoscope, the second portion (450) is configured to sit within the neck region (26A) of the funnel member (25A). The second portion (450) also acts as a stop to prevent the guide (300A / 300B) from passing through the bite block (1A) on insertion.

[0255] Figure 23 and 19An example of an endoscope guide (300A) is shown in which the first and second portions (350, 450) are releasably secured to one another by a snap-fit engagement between the trailing end (306) of the first portion (350) and the leading end (405) of the second portion (450). When secured, the first and second portions (350, 450) are coupled such that rotation of the second portion results in rotation of the first portion (350). Alternatively, as shown in the form of an endoscope guide (300B) of Figures 13 to 24 and 24 the first and second portions (350, 450) can be integrally formed.

[0256] In typical use, when the bite block (1A) is fitted to a patient, the leading end (305) of the first portion (350) is inserted into the funnel member (25A) and through the passage opening (6) at the second end (7) of the body (2). The leading end of the first portion is then pushed out through the passage opening (4) at the first end (5) of the body (2). When fully inserted, the second portion (450) is substantially disposed within the neck region (26A) of the funnel member (25A) and is shaped to fit within it to prevent the second portion (450) from passing through the passage (3). As shown in Figure 10 the second portion (450) includes a handle (401) extending from the trailing end (406) of the second portion. The handle (401) can be adapted to assist with insertion and / or removal of the endoscope guide (300A, 300B).

[0257] As shown, the first portion (350) of these endoscope guides (300A, 300B) is elongate and substantially straight along its length, but is open at the side of the leading end (305) such that the passage / endoscope path therethrough is curved at the leading end (405). Thus, any endoscope inserted therein will be directed to the side relative to the longitudinal axis of the first portion (i.e. in typical use, when the endoscope guide (300A / 300B) is oriented for use within the fitted bite block (1 / 1A) to a patient, any endoscope inserted therein will be directed below the patient’s larynx). It will be appreciated that the directed path / passage of the endoscope can be adjusted by rotating the second portion (350), for example by rotating the handle (401) which ultimately rotates the opening (311) at the side of the leading end (305) of the first portion (350). As shown, the leading end is curved and is also “cut away” to provide the opening such that it has a substantially bevelled overall shape.

[0258] It should also be appreciated that the endoscope guide (300A / 300B) also works as an airway tube, maintaining the patient's airway. The second portion (450) includes one or more side wall openings (402) so as not to obstruct the gases / oxygen supplied through the port (30) / connector (31). As shown, the openings (402) accommodate various rotational positions of the endoscope guide (300A / 300B). It should be appreciated that around the inserted endoscope, there is a passageway for exhaled air as well as O2 (or other gas) from the bag device to enter the patient's lungs. For example, to get exhaled air to the additional outlet opening (208) of the connected bag device's (when implemented) connector portion (204A, 204B), the exhaled air can enter through the endoscope guide's front end opening (311), go around the endoscope, and then exit through the connector (31) on the funnel member (25A) to the opening (208). Similarly, the passageway for received gas from the connected bag device or other means would be similar but in the opposite direction. It should be appreciated that when no guide (e.g. 300A) or endoscope is inserted into the bite block, air / gas can still follow the passageway through the connector (31) on the funnel member.

[0259] It should be appreciated that in certain forms, the first portion (350) can have an additional secondary tubular portion, similar to Figure 13 shown extending along the main tubular portion (301) to allow for insertion of a gastric tube.

[0260] It should also be appreciated that as with the previously described forms, an end closure can be included that provides a seal around the endoscope. As Figure 31 , 17 , 20 and 22 show, an end closure member (500) is fitted / forming in the second portion (450) of the endoscope guide (300A / 300B) and is adapted to provide a sealing effect around the endoscope when inserted. The end closure member (500) includes two slits intersecting to form an "X" shaped opening (501), providing four flexible tabs that are curved to allow for insertion of the endoscope. The end closure can alternatively include other forms, such as a one-way valve form for the endoscope, opening to allow insertion of the endoscope (or other instrument / device) and providing a substantial seal around it, and more completely automatically sealing / closing after the endoscope / instrument is removed. It should also be appreciated that in other forms where the endoscope guide is not used, the end closure can be provided / fitted directly in the funnel member. In either case, it should be appreciated that the end closure needs to be positioned more outwardly than the port (30) in the funnel's wall (i.e. more outwardly towards the endoscope insertion end of the funnel member as shown) to provide an appropriate seal so that gases / oxygen received through the connector do not escape / leak through the main opening of the funnel.

[0261] To securely position and provide a seal around the endoscope guide (300B) after its tip (305) reaches the patient's throat, a sealing element (600) can be provided at the first portion (350) of the endoscope guide (300B). Figure 31 and 32 As schematically shown, the sealing element (600) can include an inflatable balloon or cuff (601) extending around the endoscope guide (300B) at the front end (305) of the first portion (350). The balloon or cuff is inflated to provide a seal around the endoscope guide (300B) in an effort to ensure that exhaled air flows into the front end (305) of the endoscope guide (300B). Figure 32 The deflator of the cuff (601) is schematically shown, while Figure 33 The inflation configuration of the cuff (601) is illustrated schematically. For example, inflation can be performed via a tube extending along the side of the endoscope guide (300B). In some configurations, an orifice can be included in the endoscope guide (typically its tip) to still allow exhaled air to pass through the patient's nose.

[0262] Another variation of the tip (305) of the endoscope guide described herein is as follows: Figures 35 to 47 and 34 As shown, the front end (305) widens at its tip to provide a larger mouth / opening (311) at the front end (305). Similarly, the mouth / opening (311) is located on the side of the front end (305) (relative to the elongated axis of the guide (300C)). The “closed” or “walled” side of the front end (305) includes an elongated orifice (313) therein to allow exhaled air to escape into the oral cavity and through the patient’s nose. The widened tip can also be flexible but resilient to allow insertion, secure positioning, and provide a degree of sealing (based on its resilient properties).

[0263] Another variation of the bite block according to the invention is as follows: Figure 42 As shown. In this example, the retaining device is not provided by a rotating retaining member, but includes two arms (1016a, 1016b) in the retracted position (see example). Figure 35 and 43 ) and unfolding position (see example) Figures 53 to 64 The arms (1016a, 1016b) are movable between the two. The retracted position provides an assembly position or configuration in which the arms (1016a, 1016b) extend into the channel (1003) of the occlusal block body (1002) to provide minimal interference for insertion into the patient's mouth.

[0264] Once the bite block body (1002) is in the assembled position, the arms (1016a, 1016b) are moved to a deployed position to anchor the bite block (1001) in the patient's mouth. The arms (1016a, 1016b) hook behind the patient's teeth so that the bite block is not easily dislodged. That is, the deployed position provides a holding position or configuration. It will be appreciated that in the deployed configuration at least a portion of the arms (1016a, 1016b) extend outwardly from the bite block body (1002), particularly relative to the upper and lower outer bite surfaces (1010, 1011) of the bite barrier portion (1008).

[0265] The arms (1016a, 1016b) are biased to or rest in the retracted position so that they can subsequently be flexed to the deployed position. In particular, at least at their base, they are formed of a resilient but flexing to the deployed position material, typically a polymeric material. Flexing is typically facilitated by a thinning of the region where the base of the arms (1016a, 1016b) meet the rest of the bite block body (1002).

[0266] The movement into the deployed position is actuated by the insertion of an insert in the form of an endoscope guide (1300). When the guide (1300) is inserted, the arms (1016a, 1016b) are pushed outwardly from within the channel (1003) so that the arm free ends (1017a, 1017b) project relative to the upper and lower bite surfaces (1010, 1011). When the insert (1300) is removed, the arms (1016a, 1016b) return to the retracted position to allow removal of the bite block body (1002). As previously mentioned, with respect to other embodiments, the endoscope guide (1300) also facilitates insertion of an endoscope through the bite block (1001) and also guides or directs the endoscope under the patient's larynx.

[0267] Arms (1016a, 1016b) are provided by tabs (1402a, 1402b) formed in the walls (1401) of the bite block passage (1003) at the upper and lower outer bite surfaces (1010, 1011) of the bite barrier portion (1008). As shown, the arms (1016a, 1016b) are curved outward at their free ends (1017a, 1017b) to provide overhang regions (1023, 1024) that hook behind the patient's teeth when deployed. In the deployed position, the remainder of the arms (1016a, 1016b) are substantially flush with and form part of the upper and / or lower bite surfaces (1010, 1011). In some forms (not shown), a tubular sleeve can be placed around the bite barrier portion (1008) to provide a continuous bite surface for the bite barrier portion (1008), which would otherwise be discontinuous due to the formation of the tabs (1402a, 1402b), i.e. in the upper and lower outer bite surfaces (1010, 1011). The sleeve can be formed of a material that is softer and / or more spongy than the remainder of the bite block body (1002) in an effort to more comfortably conform to the patient's teeth and avoid causing damage thereto.

[0268] The endoscope guide / insert (1300) holds the arms (1016a, 1016b) in the deployed position when inserted, and the restoring force of the arms (1016a, 1016b) supports the endoscope guide / insert (1300) to remain within the passage (1003) of the bite block body (1002).

[0269] As shown, the insert / endoscope guide (1300) is substantially elongate, tubular and straight along its length, but has a front end (1305) that opens to the side relative to the longitudinal axis of the guide (1300). As previously mentioned, this provides a curved endoscope path at the front end (1305) to assist in guiding the endoscope under the patient's throat. That is, the end wall (1310) at the front end (1305) guides the endoscope out through the side opening (1311).

[0270] The trailing end (1306) of the insertion / endoscope guide (1300), which protrudes from the second end of the body (1007) upon insertion, includes a funnel (1025) to guide the subsequent insertion of an endoscope. Further, as with other forms described previously, the insertion piece includes an aperture (1030) in the sidewall (1026) at the trailing end (1306), and a connector (1031) extending from the sidewall (1301) at the aperture for connecting a gas supply device or related equipment. The connector (1031) is a tubular extension that extends from the edge of the aperture (1030). In this way, oxygen or other gas can be applied to the patient from a gas supply device as described previously, optionally in conjunction with a bag device as described previously.

[0271] It will be appreciated that the insertion piece can take other forms, or that the arm can alternatively be used to position a medical instrument.

[0272] It will also be appreciated that other aspects common to other embodiments, such as the wall portion (9 / 1009), or the end closure (500 / 1500) provide similar functionality to the forms described previously.

[0273] For example, as with some of the earlier described forms, the end closure (1500) includes two slits that intersect to form an "X" shaped opening (1501), providing four flexible tabs that curve to allow insertion of an endoscope, and to provide a substantial seal around the endoscope upon insertion.

[0274] Also, as with other forms, the body includes a wall portion (1009) configured to be positioned between the teeth and lips of a patient when the bite block (1001) is in the assembled position. The wall portion (1009) is shaped to provide a sealing effect relative to the mouth opening of the patient. Relative to a direction from the first end (1005) of the body (1002) to the second end (1007) of the body (1002), the wall portion (1009) extends laterally from the bite barrier portion (1008) at the second end (1007) of the body (1001), i.e. the end region. The wall portion (1009) is substantially U-shaped or C-shaped, providing opposing arms (1014, 1015) that initially extend laterally from the bite barrier portion (1008) at the second end (1007) of the body (1002), and then extend in a direction towards the first end (1005) of the body (1001).

[0275] The channel (1003) and the insert (1300) are generally both substantially cylindrical, such that upon insertion, the insert / guide (1300) fits concentrically within the channel (1003) so that it can rotate therein. To limit rotation, the bite block (1001) further comprises a recess / indentation (1021) at the second end (1007) of the body (1002) which defines side walls (1021a, 1021b). The endoscope guide (1300) comprises a protrusion (1022) which is received in the recess / indentation (1021) when the guide (1300) is inserted into the body (1002). When the guide (1300) is subsequently rotated, the protrusion (1022) abuts the side walls (1021a), thereby limiting rotation. It will be appreciated that rotation allows the insert / endoscope guide (1300) to be inserted such that the front end opening (1311) does not directly face and therefore catch or hook on the patient's tongue upon insertion. Once inserted, the insert / guide (1300) can be rotated, for example, from facing the patient's cheek to facing under the patient's throat, i.e. ready for operation. Typically, rotation is limited to an angle of about 90°.

[0276] Figures 35 to 47 A further variant of a bite block (1001A) according to the present application is shown. In this form, the bite block body (1002A) and endoscope guide / embedder (1300A) have slight modifications compared to the bite block body (1002) and endoscope guide / insert (1300) shown in Figures 61 to 64

[0277] With respect to the difference, the bite block body (1002A) comprises a second recess / indentation (1029) at its second end (1007) which defines side walls (1029a, 1029b). As shown, the second recess / indentation (1029) is located opposite the first recess / indentation (1021). When the insert / guide (1300A) is inserted into the bite block body (1002A), the protrusion (1022) can instead be received in the second recess / indentation (1029) rather than the first recess / indentation (1021). Rotation of the guide (1300A) is limited by abutment of the protrusion (1022) with the side walls (1029a, 1029b) as previously described with respect to the first recess / indentation (1021). Having two recesses / indentations (1021, 1029) allows for more flexibility in the way the insert / endoscope guide can be inserted into the body (1002A), for example, to accommodate patients lying on different sides. It will be appreciated that each recess generally allows for rotation through an angle of about 90°. Figures 56 to 59

[0278] ​​The difference in the endoscope guide / insertion (1300A) is that it includes a groove (1320) configured to receive the bent portions / bent portions (1018a, 1018b) of the arms (1016a, 1016b) of the occlusal block body (1002A) when the endoscope guide / insertion (1300A) is inserted into the occlusal block body (1002A). The groove (1320) provides a more secure positioning of the insert (1300A) within the channel (1003). Once the bent portions / bent portions (1018a, 1018b) of the arms (1016a, 1016b) are positioned in the groove (1320), movement of the insert (1300A) into and out of the occlusal block channel (1003) becomes more difficult. This is often helpful during operation, as the endoscope is frequently moved in and out and shaken, thus engaging the arms (1016a, 1016b) with the groove (1320) provides additional stability and engagement between the occlusal block body (1002A) and the endoscope guide / insertion (1300A).

[0279] like Figures 53 to 64 As shown, the groove (1320) typically extends around the entire circumference of the endoscope guide / insertion (1300A). This allows the bent portions / bends (1118a, 1118b) of the arms (1016a, 1016b) to move freely along the groove (1320) as the guide / insertion (1300A) rotates. It should be understood that, in alternative forms, discontinuous / irregular grooves (i.e., partial grooves around the circumference) can be used, wherein the end of each partial groove is able to prevent excessive rotation of the endoscope guide / insertion by abutting against the bend (e.g., thus the protrusion and receiving recess / recess may not be necessary). As shown in the figure, the bent portions (1018a, 1018b) and free ends (1017a, 1017b) of the arms (1016a, 1016b) can be thickened so that in the unfolded position, when the bent portions (1018a, 1018b) are located in the groove (1320), the remaining / base portion of the arms (1016a, 1016b) remains substantially flush with the top and bottom outer engagement surfaces (1010, 1011). Furthermore, as shown in the figure, the insert (1300A) can be thickened in the area immediately before and after the groove (1320) to make the groove (1320) deeper, thereby providing a more secure engagement with the bent portions (1018a, 1018b).

[0280] It will be appreciated that in certain forms, the arms (1016a, 1016b) can not fully or completely extend into the channel (1003), i.e. the tips of the outwardly curved free ends (1017a, 1017b) (which in the deployed position form the overhanging regions that hook behind the patient's teeth) can protrude slightly from the channel, when in the retracted position or after failing to fully return to the retracted position. Thus, in Figures 35 to 47 In the forms shown, the angle of the bend in the arms (1016a, 1016b) is such that the ends (1017a, 1017b) are ramped to extend in a direction away from the second end (1007) of the body (i.e. the angle of the bend is in excess of 90º). This makes it easier for the teeth to slide along the ramp, pushing the arms (1017a, 1017b) into the channel (1003) if contacted against the back of the teeth on removal from the bite block body (1002A), to facilitate removal. The ramp also assists in removal in the event that the arms (1017a, 1017b) fail to retract from the deployed position after the insert / endoscope (1300A) is removed (e.g. if the material of the arms starts to fatigue and lose its elasticity thereafter). It will be appreciated that due to the typical resting or default position of the arms when in the retracted position, there can be some protrusion of the tips in forms where the tips are at a sharper angle / bend in the retracted position (e.g. as shown in Figures 35 to 47 where the angle can be, for example, about 90º), which will still provide this effect, albeit to a lesser extent.

[0281] It will also be appreciated that the front end opening (1311) on the insert / endoscope guide (1300A) is formed by more of a scoop cut, rather than the form shown in Figures 53-64 which is formed by more of a straight cut.

[0282] The bite block described herein, as previously mentioned, can be used with an endoscope guide and / or a pocket device, and can also be used for the application of intermittent positive pressure ventilation and / or gaseous anesthetic agents through the connector (or directly through the associated orifice in the case of not including the connector). For example, in the case of the endoscope being removed, a cap can be fitted to either of the following: the channel of the bite block body; the funnel (e.g. 25) (e.g. at location (44)); or the trailing end of the endoscope guide (e.g. 300) or insert (e.g. 1300) to prevent the escape of gas from the mouth when gas (e.g. oxygen / anesthetic agent) is applied through the connector (or through the associated orifice). Alternatively, in embodiments where the bulkhead / end closure is configured to close automatically upon removal of the endoscope, for example in the form of the one-way valve type described, no additional cap can be required due to the sufficient seal already provided. It will also be appreciated that when intermittent positive pressure ventilation and / or gaseous anesthetic agents are applied, a nasal prong is typically placed over the patient's nose to prevent the escape of gas through the nose. It will also be appreciated that exhaled gas is also typically received back into the ventilation / anesthesia machine through the connector / orifice. In some cases, to provide additional sealing, an additional piece of tape can be applied over the patient's lips.

[0283] It will also be appreciated that the bite blocks described herein typically allow for one or more of the following advantageous aspects:

[0284] - ease of insertion and not prone to falling out during operation as they are secured without the need for tape or staff to hold;

[0285] - inflation and deflation of the pocket device / air reservoir can indicate the patient's respiratory cycle and depth of breath;

[0286] - in typical use, the supplied oxygen will reach the laryngeal region within the pharynx as there are no other exits from the point of supply to the vicinity of the larynx for it to escape;

[0287] - in typical use, the oxygen-filled air reservoir is expelled into the airway at the beginning of each inhalation cycle, thereby enriching the pharynx with oxygen before air dilution occurs with air entering through the nasal cavity;

[0288] - in typical use, the oxygen concentration will remain at a high level close to the larynx throughout the operation, preventing hypoxia;

[0289] - the bite block is inexpensive to produce compared to the use of conventional high flow devices, and can only require 2-4 liters of oxygen per minute to achieve optimal oxygen saturation, as opposed to 40 liters of oxygen per minute using a high flow device. In addition to the amount of oxygen wasted by the high flow device, there are also additional costs of reusable and disposable devices and associated maintenance costs;

[0290] - no additional power source is required.

[0291] It will also be appreciated that various components of the bite block / bite block assembly as described herein, such as the bite block body, the insert / endoscope guide, are typically formed from a polymer / plastic material. For example, in embodiments of the bite block body (1002A) can be made from polypropylene, polyurethane or nylon, while the insert / endoscope guide can be formed from polyvinyl chloride, acrylonitrile butadiene styrene or polycarbonate in some examples. ​ It will also be appreciated that various components of the bite block / bite block assembly as described herein, such as the bite block body, the insert / endoscope guide, are typically formed from a polymer / plastic material. For example, in embodiments of the bite block body (1002A) can be made from polypropylene, polyurethane or nylon, while the insert / endoscope guide can be formed from polyvinyl chloride, acrylonitrile butadiene styrene or polycarbonate in some examples.

[0292] It will be appreciated by persons skilled in the art that the various elements in the different embodiments described herein can be readily combined as desired.

[0293] Throughout this specification and the following claims, unless the context requires otherwise, the word "comprise" and variations such as "comprises" or "comprising" will be understood to imply the inclusion of a stated integer or step or group of integers or steps but not the exclusion of any other integer or step or group of integers or steps.

[0294] List of reference signs

[0295] 1 bite block

[0296] 1A bite block

[0297] 2 bite block body

[0298] 3 channel

[0299] 4 first end opening

[0300] 5 first end

[0301] 6 second end opening

[0302] 7 second end

[0303] 8 bite barrier portion

[0304] 9 wall portion

[0305] 9a, 9b major face

[0306] 10 top outer bite surface

[0307] 11 bottom outer bite surface

[0308] 12, 13 lateral surface

[0309] 14, 15 opposing arms

[0310] 16 retention member

[0311] 17 anchoring portion

[0312] 18 tubular portion

[0313] 19 inner wall surface

[0314] 20 outer wall surface

[0315] 21 recess

[0316] 21a side wall

[0317] 22 protrusion

[0318] 23, 24 end tab portion

[0319] 25 funnel

[0320] 25A funnel member

[0321] 26 tubular portion

[0322] 26A neck region

[0323] 27 outer wall surface

[0324] 28 protrusion

[0325] 29 inner wall surface

[0326] 30 aperture

[0327] 31 connector / tubular extension

[0328] 41 / 42 partition / end closure

[0329] 43 funnel flange

[0330] 44 location

[0331] 101 nasal cavity

[0332] 102 upper lip

[0333] 103 lower lip

[0334] 104 lower teeth

[0335] 105 flange

[0336] 106 airway

[0337] 107 oral cavity

[0338] 108 tongue

[0339] 109 larynx

[0340] 110 trachea

[0341] 111 hard palate

[0342] 112 nasopharynx

[0343] 113 soft palate

[0344] 114 oropharynx

[0345] 115 oropharynx

[0346] 116 laryngopharynx

[0347] 117 esophagus

[0348] 118 funnel

[0349] 119 bite block body

[0350] 120 epiglottis

[0351] 121 upper teeth

[0352] 122 lower gum area

[0353] 200 pouch device

[0354] 201 inflatable pouch portion

[0355] 202 inlet

[0356] 202D inlet

[0357] 203 outlet

[0358] 204 connector portion or T-connector

[0359] 204A connector portion

[0360] 204B connector portion

[0361] 204C connector portion

[0362] 204D connector portion

[0363] 205A tubular member

[0364] 205B hole

[0365] 206C cap / end portion

[0366] 206D cap / end portion

[0367] 207C opening

[0368] 207D opening

[0369] 208 outlet / opening

[0370] 209 inner wall

[0371] 210 end closure member

[0372] 220C entry opening

[0373] 220D entry opening

[0374] 300 endoscope guide

[0375] 300A endoscope guide

[0376] 300B endoscope guide

[0377] 301 tubular portion

[0378] 302 upper / lower wall portion

[0379] 303 side wall portion

[0380] 304 aperture

[0381] 305 leading end

[0382] 306 trailing end

[0383] 307 trailing flange

[0384] 308 secondary tube portion

[0385] 311, 312 end opening

[0386] 313 elongated aperture

[0387] 350 first portion

[0388] 401 handle

[0389] 402 side wall opening

[0390] 405 leading end

[0391] 406 trailing end

[0392] 450 second portion

[0393] 500 end closure member

[0394] 501 "X" shaped opening

[0395] 600 sealing element

[0396] 601 inflatable balloon or cuff

[0397] 602 pilot cuff

[0398] 603 valve

[0399] 1001 bite block

[0400] 1001A bite block

[0401] 1002 bite block body

[0402] 1002A bite block body

[0403] 1003 channel

[0404] 1005 first end

[0405] 1007 second end

[0406] 1008 bite barrier portion

[0407] 1009 wall portion

[0408] 1010 top outer bite surface

[0409] 1011 bottom outer bite surface

[0410] 1012, 1013 lateral surface

[0411] 1014, 1015 opposing arms

[0412] 1016a, 1016b arm

[0413] 1017a, 1017b free end

[0414] 1018a, 1018b bend / curved portion

[0415] 1021 recess

[0416] 1021a, 1021b side arm

[0417] 1023, 1024 extended region

[0418] 1022 protrusion

[0419] 1025 funnel member

[0420] 1026 sidewall / tubular portion

[0421] 1029 recess

[0422] 1029a, 1029b sidewall

[0423] 1030 aperture

[0424] 1031 connector

[0425] 1300 endoscope guide / insert

[0426] 1300A endoscope guide / insert

[0427] 1305 front end

[0428] 1306 tail end

[0429] 1311 end / side opening

[0430] 1320 recess

[0431] 1401 wall of bite block passage

[0432] 1402a, 1402b tongue

[0433] 1500 end closure member

[0434] 1501 "X" shaped opening

[0435] P plane

Claims

1. An endoscopic bite block comprising: a body having a bite barrier portion that is positioned between the upper and lower teeth of a patient when the bite block is in an assembled position, the body having a passage therethrough for insertion of an endoscope, the passage extending between an opening at a first end of the body and an opening at a second end of the body, and in the assembled position of the bite block, the first end is positioned behind the teeth of the patient and the second end is positioned in front of the teeth of the patient; and a retaining device that is configurable between an assembled position or configuration that facilitates assembly of the bite block into the assembled position and a retained position or configuration that facilitates retention of the bite block in the assembled position.

2. The endoscopic bite block of claim 1, wherein the retaining device is a retaining member that is coupled to the body such that it is rotatable relative to the body between the assembled position and the retained position.

3. The endoscopic bite block of claim 2, wherein the retaining member provides an anchoring portion at the first end of the body.

4. The endoscopic bite block of claim 3, wherein the anchoring portion is in the form of an elongate element.

5. The endoscopic bite block of claim 4, wherein the elongate element has two end portions that each extend laterally, in generally opposite directions, relative to a direction from the first end to the second end of the body.

6. The endoscopic bite block of claim 5, wherein the end portions of the elongate element are curved in a direction away from the body.

7. The endoscopic bite block of claim 5 or 6, wherein the end portions of the elongate element provide tab portions.

8. The endoscopic bite block of any one of claims 2 to 7, wherein the passage includes a bulkhead and / or an end closure therein, the bulkhead and / or end closure having an expandable opening for receiving an endoscope therethrough to thereby provide a substantial seal around the endoscope when inserted.

9. The endoscopic bite block of any one of claims 2 to 8, wherein the passage includes a bulkhead and / or an end closure therein, the bulkhead and / or end closure being configured to be openable to allow insertion of an endoscope through the passage and further configured to close after the endoscope is removed.

10. The endoscopic bite block of claim 9, wherein the bulkhead and / or end closure provides a substantial seal around the endoscope when inserted.

11. The endoscopic bite block of any one of claims 2 to 10, wherein the passage is substantially cylindrical.

12. The endoscopic bite block of claim 11, wherein the retaining member includes a substantially tubular portion that fits concentrically within the passage such that it is rotatable therein.

13. The endoscopic bite block of claim 12, wherein an inner wall surface of the passage and an outer wall surface of the tubular portion have cooperating structures thereon that prevent excessive rotation of the retaining member beyond the assembled position and the retained position.

14. The endoscopic bite block of any one of claims 2 to 13, wherein the body further includes a wall portion that is configured to be positioned between the teeth and the lips of the patient when the bite block is in the assembled position. ​ 15. The endoscope bite block of claim 14, wherein the wall portion is shaped to provide a sealing effect against the patient's mouth opening.

16. The endoscope bite block of claim 14 or 15, wherein, The wall portion extends laterally from the bite barrier portion at the second end of the body, relative to a direction from the first end of the body to the second end of the body.

17. The endoscope bite block of claim 16, wherein the wall portion is substantially U-shaped or C-shaped, providing opposing arms that initially extend laterally from the bite barrier portion at the second end of the body and then extend in the direction of the first end of the body.

18. The endoscope bite block of claim 17, wherein, One of the arms includes an aperture therein.

19. The endoscope bite block of claim 18, wherein the wall portion includes a main face that is solid except for the aperture.

20. The endoscope bite block of claim 18 or 19, including a connector at the aperture.

21. The endoscope bite block of claim 20, wherein the connector is a tubular extension extending from an edge of the aperture.

22. The endoscopic bite block of any one of claims 17-21, wherein, In the assembled position of the retaining member, the elongate element has an elongation direction in the plane of the opposing arms of the wall portion, and in the retaining position of the retaining member, the elongate element has an elongation direction that is angled relative to the plane of the opposing arms of the wall portion.

23. The endoscope bite block of claim 22, wherein, In the retaining position of the retaining member, the elongate element has an elongation direction that is substantially perpendicular to the plane of the opposing arms of the wall portion.

24. The endoscopic bite block of any one of claims 5-8, wherein, Relative to the assembled position of the bite block, when the retaining member is in the assembled position, the elongate element has an elongation direction that is parallel to the patient's transverse plane, and when the retaining member is in the retaining position, the elongate element has an elongation direction that is perpendicular to the patient's transverse plane.

25. The endoscope bite block of any one of claims 2 to 24, wherein the bite barrier portion includes substantially parallel top and bottom outer bite surfaces.

26. The endoscope bite block of claim 12 or 13, wherein the retaining member includes a handle portion that extends from the tubular portion at the second end of the body and is located outside the channel.

27. The endoscope bite block of any one of claims 2 to 26, wherein the bite block includes a funnel at the second end of the body to guide insertion of the endoscope into the channel opening at the second end of the body.

28. The endoscope bite block of claim 27, wherein the funnel is part of a funnel member.

29. The endoscope bite block of claim 28, wherein the funnel member includes a tubular portion that fits concentrically within the tubular portion of the retaining member.

30. The endoscope bite block of claim 28 or 29, wherein the funnel member includes an aperture in its wall.

31. The endoscope bite block of claim 30, wherein the funnel member includes a neck region that protrudes from the second end of the body.

32. The endoscope bite block of claim 31, wherein the aperture in the wall of the funnel member is disposed at the neck region of the funnel member.

33. The endoscope bite block of any one of claims 30 to 32, wherein the funnel member includes a connector at the aperture in the wall of the funnel member.

34. The endoscope bite block of claim 33, wherein the connector is a tubular extension extending from an edge of the orifice in the wall of the funnel member.

35. The endoscope bite block of claim 1, wherein the retaining device comprises at least one arm movable between a retracted position and a deployed position, wherein the retracted position provides an assembled position or configuration and the deployed position provides a retaining position or configuration.

36. The endoscope bite block of claim 35, wherein in the retracted position the at least one arm extends into the channel.

37. The endoscope bite block of claim 35 or 36, wherein the at least one arm is biased to the retracted position.

38. The endoscope bite block of any one of claims 35 to 37, wherein the at least one arm is provided by a tab formed in a wall of the channel.

39. The endoscope bite block of any one of claims 35 to 38, wherein in the deployed position at least a portion of the at least one arm extends outwardly from the body.

40. The endoscope bite block of any one of claims 35 to 39, wherein the bite barrier portion provides an upper outer bite surface and a lower outer bite surface and the at least one arm is formed in the upper outer bite surface and / or the lower outer bite surface.

41. The endoscope bite block of claim 40, wherein the at least one arm is bent at its free end to provide an area of the at least one arm that projects relative to the upper outer bite surface and the lower outer bite surface when the at least one arm is in the deployed position, the remainder of the at least one arm being substantially flush with the upper outer bite surface and / or the lower bite surface.

42. The endoscope bite block of any one of claims 35 to 41, wherein the at least one arm is two arms.

43. The endoscope bite block of any one of claims 35 to 42, wherein the bite block comprises an insert receivable in the channel such that when inserted the at least one arm is held in the deployed position.

44. The endoscope bite block of claim 43, wherein the insert is an endoscope guide.

45. The endoscope bite block of claim 43 or 44, wherein the insert is elongate and tubular.

46. The endoscope bite block of any one of claims 43 to 45, wherein the insert comprises a trailing end that projects from the second end of the body when inserted therein.

47. The endoscope bite block of claim 46, wherein the insert has a funnel at the trailing end to guide insertion of the endoscope.

48. The endoscope bite block of claim 46 or 47, wherein the insert comprises an orifice in a sidewall of the trailing end.

49. The endoscope bite block of claim 48, wherein the insert comprises a connector at the orifice in the sidewall of the trailing end.

50. The endoscope bite block of claim 49, wherein the connector is a tubular extension extending from an edge of the orifice.

51. The endoscope bite block of any one of claims 43 to 50, wherein the insert comprises a leading end that projects from the first end of the body when inserted therein.

52. The endoscope bite block of claim 51, wherein the insert is substantially straight along its length.

53. The endoscope bite block of claim 52, wherein the front end opens laterally relative to a longitudinal axis of the insert.

54. The endoscope bite block of any one of claims 43 to 53, wherein the insert includes a partition and / or an end closure therein, the partition and / or end closure having an expandable opening for receiving an endoscope therethrough to provide a substantial seal around the endoscope when inserted.

55. The endoscope bite block of any one of claims 43 to 53, wherein the insert includes a partition and / or an end closure therein, the partition and / or end closure being configured to be openable to allow an endoscope to be inserted therethrough and further configured to close after the endoscope is removed.

56. The endoscope bite block of claim 55, wherein the partition and / or end closure provides a substantial seal around the endoscope when inserted.

57. The endoscope bite block of any one of claims 43 to 56, wherein the channel is substantially cylindrical and the insert fits concentrically within the channel when inserted such that it can rotate therein.

58. The endoscope bite block of claim 57, wherein the body and the insert each have a mating structure that limits rotation of the insert when inserted into the body.

59. The endoscope bite block of any one of claims 35 to 58, wherein the body further includes a wall portion configured to be positioned between the patient's teeth and lips when the bite block is in the fitted position.

60. The endoscope bite block of claim 59, wherein the wall portion is shaped to provide a sealing effect relative to the patient's mouth opening.

61. The endoscopic bite block of claim 59 or 60, wherein, The wall portion extends laterally from the bite barrier portion at the second end of the body.

62. The endoscope bite block of any one of claims 59 to 61, wherein the wall portion is substantially U-shaped or C-shaped, providing opposing arms that initially extend laterally from the bite barrier portion at the second end of the body and then extend in the direction of the first end of the body.

63. An endoscope bite block comprising a body having a bite barrier portion to be positioned between the patient's upper and lower teeth when the bite block is in a fitted position, the body having a channel therethrough for insertion of an endoscope, wherein the channel extends between an opening at a first end of the body and an opening at a second end of the body, and in the fitted position of the bite block, the first end is positioned behind the patient's teeth and the second end is positioned in front of the patient's teeth, the body further including a wall portion configured to be positioned between the patient's teeth and lips when the bite block is in the fitted position.

64. The endoscope bite block of claim 63, wherein the wall portion is shaped to provide a sealing effect relative to the patient's mouth opening.

65. The endoscope bite block of claim 63 or 64, wherein the wall portion includes an aperture therein.

66. The endoscope bite block of claim 65, wherein the wall portion comprises a main face that is solid except for the aperture.

67. The endoscope bite block of claim 65 or 66, comprising a connector at the aperture.

68. The endoscope bite block of claim 67, wherein the connector is a tubular extension extending from an edge of the aperture.

69. The endoscope bite block of any one of claims 63-68, wherein, The wall portion extends laterally from the bite barrier portion at the second end of the body, relative to a direction from the first end of the body to the second end of the body.

70. The endoscope bite block of any one of claims 63 to 69, wherein the wall portion is substantially U-shaped or C-shaped, providing opposing arms that extend initially laterally from the bite barrier at the second end of the body, and then in the direction of the first end of the body.

71. The endoscope bite block of claim 70, wherein, One of the arms comprises an aperture therein.

72. The endoscope bite block of any one of claims 63 or 64, wherein the bite block comprises a funnel at the second end of the body to direct insertion of the endoscope into a passage opening at the second end of the body.

73. The endoscope bite block of claim 72, wherein the funnel is part of a funnel member that fits to the body.

74. The endoscope bite block of claim 73, wherein the funnel member comprises a tubular portion that fits concentrically within the passage.

75. The endoscope bite block of claim 73 or 74, wherein the funnel comprises an aperture in a wall thereof.

76. The endoscope bite block of claim 75, wherein the funnel comprises a neck region that projects from the second end of the body.

77. The endoscope bite block of claim 76, wherein the aperture in the wall of the funnel member is provided at the neck region of the funnel member.

78. The endoscope bite block of any one of claims 75 to 77, wherein the funnel member comprises a connector at the aperture in the wall of the funnel member.

79. The endoscope bite block of claim 78, wherein the connector is a tubular extension extending from an edge of the aperture in the wall of the funnel member.

80. The endoscopic bite block of any one of claims 63 or 64, further comprising an insert receivable in the channel, the insert being substantially tubular and elongate and having a trailing end that extends from the second end of the body when inserted, and wherein, The side wall of the tail end comprises an aperture therein.

81. The endoscopic bite block of claim 80, wherein the insert comprises a connector at the aperture.

82. The endoscope bite block of claim 81, wherein the connector is a tubular extension extending from an edge of the aperture in the side wall of the insert.

83. An endoscope bite block assembly comprising: the bite block of any one of claims 20, 21, 33, 34, 49, 50, 67, 68, 78, 79, 81, or 82; and a bag device comprising an inflatable bag, an outlet connected to the connector of the bite block, and an inlet for connection of a gas supply.

84. A method of delivering oxygen to a patient during an endoscopy procedure in which an endoscope is inserted through the mouth, comprising: fitting the bite block assembly of claim 83 to the patient; and supplying oxygen to the patient through the inlet of the bag device.

85. An endoscope bite block kit comprising: the bite block of any one of claims 20, 21, 33, 34, 49, 50, 67, 68, 78, 79, 81, or 82; and the bag device of claim 83. The bite block of claim 20, 21, 33, 34, 49, 50, 67, 68, 78, 79, 81, or 82; and A bag device comprising an inflatable bag, an outlet for connecting a connector of a bite block, and an inlet for connecting a gas supply.

86. An endoscope guide for insertion through an endoscope channel in an endoscope bite block, the guide comprising a tubular passage extending between two open ends, the tubular passage having a wall with one or more apertures therein.

87. The endoscope guide of claim 86, wherein the guide is elongate and is curved along at least a portion of its length.

88. The endoscope guide of claim 86 or 87, wherein, at least a portion of which is elastically deformable.

89. The endoscope guide of any one of claims 86 to 88, wherein the endoscope guide comprises a leading end insertable through the endoscopic channel, and a trailing end comprising a stop extending therefrom, the stop configured to prevent the trailing end from passing through the endoscopic channel.

90. The endoscope guide of claim 89, wherein the leading end is more flexible than the trailing end.

91. An endoscope guide for insertion through an endoscope channel in an endoscope bite block, the guide comprising a first portion and a second portion, wherein the first portion provides a substantially tubular passage to guide an endoscope, and the second portion provides a stop to prevent the second portion from passing through the endoscopic channel.

92. The endoscope guide of claim 91, wherein, The first portion is substantially straight along its length but has a leading end that opens to the side relative to a longitudinal axis of the first portion.

93. The endoscope guide of claim 91 or 92, wherein, The first and second portions of the guide are connected by a snap fit of the first portion with the second portion.

94. The endoscope guide of claim 91 or 92, wherein the first and second portions of the guide are integrally formed with one another.

95. An endoscope guide for insertion through an endoscope channel in an endoscope bite block, the insert being elongate and substantially tubular, the insert comprising a leading end insertable through the endoscopic channel and a trailing end that protrudes from the endoscopic channel when inserted.

96. The endoscope guide of claim 95, wherein the insert has a funnel at the trailing end to guide insertion of an endoscope.

97. The endoscope guide of claim 95 or 96, wherein the insert is substantially straight along its length and has a leading end that opens to the side relative to a longitudinal axis of the insert.

98. The endoscope guide of any one of claims 95 to 97, wherein a sidewall of the trailing end comprises an aperture therein.

99. The endoscope guide of claim 98, comprising a connector at the aperture.

100. The endoscope guide of claim 99, wherein the connector is a tubular extension extending from an edge of the aperture in the sidewall of the insert.

101. An endoscope bite block assembly comprising: the bite block of any one of claims 1 to 42, 59 to 79; and the endoscope guide of any one of claims 86 to 100.

102. An endoscope bite block kit comprising: the bite block of any one of claims 1 to 42, 59 to 79; and the endoscope guide of any one of claims 86 to 100. The endoscope guide of any one of claims 86-100.

103. The endoscope bite block assembly of claim 83, further comprising the endoscope guide of any one of claims 86-100.

104. The endoscope bite block kit of claim 85, further comprising the endoscope guide of any one of claims 86-100.

Images