Endoscope accessory

Abstract

The present invention provides an endoscope attachment comprising: (a) a base member comprising a through opening configured to receive an endoscope; (b) a structural member coupled to the base member and enclosing an interior space within the structural member, where the structural member includes at least one movable arm configured to move between an open configuration and a closed configuration; and (c) a working tube disposed in the interior space for accommodating a surgical instrument.

Description

Technical Field

[0001] This invention generally relates to the field of surgical devices. In particular, this invention relates to accessories used with endoscopes for performing minimally invasive surgical procedures, biopsies, or other testing procedures. Background Technology

[0002] An endoscope is a long, narrow device used to visualize the inside of the body. It typically includes a light source and a means to transmit images from a target area within the body to the physician. Many endoscopes also include surgical instruments or internal channels through which these instruments can be inserted to perform procedures such as surgery or biopsies. Currently, endoscopic submucosal dissection (ESD) using endoscopes with a single working channel suffers from limitations in instrument control, triangulation, stability, and force transmission.

[0003] To stabilize and support the surgical space during endoscopic surgery, carbon dioxide (CO2) is typically blown in. However, CO2 inhalation can cause postoperative abdominal distension and patient discomfort, and there is also a risk of CO2 embolism. To enable triangulation, dual-channel endoscopes have been developed to provide the ability to carry multiple endoscopic tools. However, due to the small distance between the channels, the tools cannot move independently of the endoscope. Therefore, the degree of triangulation is insufficient. Furthermore, the additional working channel does not address the lack of force transmission at the distal end of the endoscope. Since the movement of the additional tool is controlled by the endoscope, the transmitted force will be similar to that of a single-channel endoscope, and the movement of the tool will follow the movement of the endoscope.

[0004] Therefore, there is a need for an endoscopic accessory that overcomes the shortcomings of the prior art. Furthermore, other desirable features and characteristics will become apparent from the following detailed description and appended claims, in conjunction with the accompanying drawings and the background art. Summary of the Invention

[0005] In one aspect, the present invention provides an endoscope accessory comprising: (a) a base member including a through opening configured to receive an endoscope; (b) a structural member coupled to the base member and enclosing an internal space within the structural member, wherein the structural member includes at least one movable arm configured to move between an open configuration and a closed configuration; and (c) a working tube disposed within the internal space for receiving surgical instruments.

[0006] In one embodiment, the endoscope accessory as described herein further includes an outer sleeve having a proximal end and a distal end, wherein the distal end of the outer sleeve is coupled to the end of the base member opposite to the structural member.

[0007] In one embodiment, the outer tube includes multiple rings.

[0008] In one embodiment, the outer sheath includes a main channel, and the main channel and through opening are aligned with each other for receiving an endoscope.

[0009] In one embodiment, the outer sheath includes multiple auxiliary channels for accommodating multiple cables.

[0010] In one embodiment, the outer sleeve includes an inner wall and an outer wall, wherein the inner wall defines a main channel, and wherein a plurality of auxiliary channels are disposed in the space between the inner wall and the outer wall.

[0011] In one embodiment, the endoscope accessory as described herein further includes a plurality of cables, wherein at least one of the cables terminates on a structural member for moving the structural member between an open configuration and a closed configuration, and at least one of the cables terminates on a working tube for guiding surgical instruments.

[0012] In one embodiment, the base member further includes a plurality of auxiliary through openings for accommodating a plurality of cables.

[0013] In one embodiment, the structural member includes two movable arms, wherein the two movable arms are opposite each other on either side of the interior space, and wherein the two movable arms are configured to extend outward away from a longitudinal axis extending along the length of the structural member when the arms are in an open configuration.

[0014] In one embodiment, the endoscope accessory as described herein also includes an outer sheath for covering structural members.

[0015] In one embodiment, the movement of the working tube includes translational movement of the working tube along the x-axis, y-axis, and / or z-axis, and rotational movement of the surgical instrument along the pitch axis, yaw axis, and / or roll axis.

[0016] In one embodiment, the surgical instrument is selected from any of the following: grasping tools, cauterizing tools, suturing tools, snare rings, forceps, scissors, aspiration tools, injection tools, clamping tools, and rinsing tools.

[0017] In one implementation, the endoscope accessory as described herein includes two working tubes.

[0018] In one embodiment, the endoscope accessory as described herein further includes a drive engagement located at the proximal end of the outer sleeve, wherein the drive engagement is configured to actuate a plurality of cables.

[0019] In one embodiment, the transmission coupling is configured to be manually driven to actuate multiple cables.

[0020] In one embodiment, the transmission coupling is operably connected to the actuator and configured to be driven by the actuator.

[0021] In one embodiment, the transmission coupling includes a plurality of driven members for actuating a plurality of cables, wherein each of the plurality of cables is connected to one of the plurality of driven members. Attached Figure Description

[0022] The invention will be better understood with reference to the detailed description, in which the non-limiting examples and accompanying drawings are taken into consideration, in which:

[0023] Figure 1 This is a top rear perspective view of the endoscope accessory according to this embodiment, wherein the structural member is in an open configuration. In this embodiment, the structural member includes four arms (two movable arms and two immovable arms) and has two working tubes. The proximal ends of the arms are connected to the base member, and the distal ends of the two movable arms of the structural member extend outward or pivot away from the longitudinal axis extending along the length of the structural member.

[0024] Figure 2 yes Figure 1 A frontal view of the endoscopic accessory.

[0025] Figure 3 yes Figure 1 Top view of the endoscopic accessory.

[0026] Figure 4 yes Figure 1 Side view of the endoscopic accessory.

[0027] Figure 5 This is a frontal view of an endoscopic accessory, in which the structural member is in a closed configuration. In this embodiment, the arm of the structural member is generally parallel to a longitudinal axis extending along the length of the structural member.

[0028] Figure 6 yes Figure 5 Top view of the endoscopic accessory.

[0029] Figure 7 yes Figure 5 Side view of the endoscopic accessory.

[0030] Figure 8 This is a top-frontal perspective view of the endoscope accessory including the outer sleeve according to this embodiment.

[0031] Figure 9This is a top front perspective view of the outer sleeve and transmission coupling of the endoscope accessory according to this embodiment.

[0032] Figure 10 This is a top front perspective view of the endoscope accessory's collar, outer sleeve, and transmission coupling according to this embodiment.

[0033] Figure 11 This is a top-view front perspective view of the working tube of the endoscope accessory according to this embodiment.

[0034] Figure 12 The outer sleeve-hoop joint ring of the endoscope accessory according to this embodiment is shown. A) Side view. B) Top front perspective view. C) Front view. D) Side view.

[0035] Figure 13 The first outer sleeve ring is shown. A) Side view. B) Top front perspective view. C) Front view. D) Side view.

[0036] Figure 14 The second outer sleeve ring is shown. A) Side view. B) Top front perspective view. C) Front view. D) Side view.

[0037] Figure 15 A cross-sectional view of the outer tube of the endoscope attachment when used with an endoscope is shown. Detailed Implementation

[0038] In one aspect, the present invention provides an endoscope accessory comprising: (a) A base member including a through opening configured to receive an endoscope; (b) A structural member connected to a base member and enclosing an internal space within the structural member, wherein the structural member includes at least one movable arm configured to move between an open configuration and a closed configuration; and (c) Working tube, which is set in the internal space for housing surgical instruments.

[0039] like Figure 1 and Figure 3 As shown, structural member 24 can be connected to base member 1 at the first end 25. The second end 26 of base member 1 can be connected to outer sleeve 23, as shown. Figure 8 As shown in the image.

[0040] In the implementation method, such as Figure 1As shown, the base member 1 may be generally annular in shape, and the structural member 24 connected to the annular base member 1 forms an internal space. The endoscopic accessory of the present invention is intended to be the end of a tube that first enters a body cavity or organ. Therefore, the outline of the external structural member 24 may be annular to correspond to the base member 1, and the end of the external structural member 24 may be tapered to facilitate such entry and movement.

[0041] Structural member 24 can be formed from any arm (which will be described in detail below) or plate connected around the annular end of base member 1. In an embodiment, Figure 1 Four plates are shown. One of the plates is in Figure 1 The configuration is shown in the open position.

[0042] like Figures 1 to 8 As shown in the embodiment, structural member 24 may include four arms (two movable side arms and two non-movable top and bottom arms). In an alternative embodiment, all four arms of structural member 24 may be configured to move between an open configuration and a closed configuration. When at least one movable arm 2 is as Figure 1 When the structural member 24 is pivoted or extended outward relative to the longitudinal axis, it is in an open configuration, wherein the longitudinal axis extends along the length of the structural member 24. Figures 1 to 4 Structural member 24 in an open configuration is shown, while Figures 5 to 7 Structural member 24 in a closed configuration is shown. Movement of movable arm 2 can be facilitated by a first set of clamps 3, a second set of clamps 4, and a third set of clamps 8. Clamp rods 7 connect the arms to each other to facilitate opening (i.e., outward pivoting) and closing of the arms.

[0043] The movement of arm 2 can be achieved by any suitable device, including any electrical or electrically operated mechanism, wherein a signal can be transmitted from the controller in the control panel to arm 2 to drive the arm to open and close.

[0044] Figure 11 An example of a working tube 5 is shown, which has eight entry points (i.e., cable entry points) located in two different rows. These cables will be described in detail below. Each row has four entry points spaced 90 degrees apart from each other. When the structural member 24 is in a closed configuration, the working tube 5 is disposed within an internal space 27 enclosed by the structural member 24. When the structural member 24 is in an open configuration, the working tube 5 can protrude from the internal space 27 (i.e., protrude further distally from the distal end of the arm). The working tube 5 serves as a guide for surgical instruments, thereby allowing the surgical instruments to move in any desired direction while supported within the working tube 5. Figure 3As shown, the working tube 5 is connected to a cable 17 that controls the movement of the working tube 5, thereby enabling precise positioning and manipulation of the surgical instrument.

[0045] In one implementation, such as Figure 8 As shown, the endoscope accessory described herein also includes an outer sleeve 23 having a proximal end and a distal end, wherein the distal end of the outer sleeve is coupled to the end of the base member 1 opposite to the structural member 24. For example, the distal end of the outer sleeve is coupled to a second end 26 of the base member 1.

[0046] The outer tube 23 may include an outer tube-clamp coupling ring 11, a first outer tube ring 12, and a plurality of second outer tube rings 13. The outer tube-clamp coupling ring 11 serves as a coupling between the clamp 22 and the other rings of the outer tube (i.e., the first outer tube ring 12 and the plurality of second outer tube rings 13). Embodiments of the outer tube-clamp coupling ring 11 are described in... Figure 12 As shown in the figure. In one example, the outer tube-clamp joint ring 11 can be screwed onto the clamp 22 to secure the outer tube-clamp joint ring 11 in place. The first outer tube ring 12 serves as the joint between the second outer tube ring 13 and the outer tube-clamp joint ring 11. Figure 13 An embodiment of the first outer tube ring 12 is shown. A plurality of second outer tube rings 13 may span the length of the outer tube. The second outer tube rings 13 enable the outer tube to be flexible. Figure 14 An embodiment of the second outer sleeve ring 13 is shown in the figure.

[0047] In one example, the endoscope accessory as described herein is able to accommodate the endoscope in such a manner that the distal end of the endoscope is positioned more distally along the longitudinal axis than the distal end of the structural member 24.

[0048] In one embodiment, the outer sleeve 23 includes a main channel and a through opening aligned with each other for receiving an endoscope.

[0049] In one embodiment, the outer sheath 23 includes a plurality of auxiliary channels for accommodating a plurality of cables. The auxiliary channels may also accommodate surgical instruments. In one example, the plurality of auxiliary channels of the outer sheath are generally parallel to the main channel. In one example, each of the plurality of auxiliary channels is configured to accommodate one of the plurality of cables. The auxiliary channels may also, for example, be via… Figure 15 The surgical instrument PTFE tube 20 shown receives the surgical instrument. The diameter of the auxiliary channel for receiving the surgical instrument may be larger than the diameter of the auxiliary channel for accommodating the cable that moves the working tube 5.

[0050] In one embodiment, the outer sleeve 23 includes an inner wall and an outer wall, wherein the inner wall defines a main channel, and wherein a plurality of auxiliary channels are disposed in the space between the inner wall and the outer wall.

[0051] exist Figure 15 An example of the outer cannula 23 is shown. The endoscope 21 is housed within the main channel of the outer cannula 23. The surgical tube PTFE tube 20 is housed within... Figure 15 The cable 17 is housed in two of the auxiliary channels shown on the right and left sides. The cable 17 is also housed in the other auxiliary channels of the outer sheath 23.

[0052] In one embodiment, the endoscopic accessory as described herein also includes a plurality of cables, wherein at least one of the cables terminates on structural member 24 for moving a related arm of the structural member between an open configuration and a closed configuration, and wherein at least one of the cables terminates on working tube 5 for guiding surgical instruments. Non-limiting examples of the plurality of cables include a plurality of fishing lines or braided ultra-high molecular weight polyethylene (UHMWPE) lines. The cables may be housed within PTFE tubes serving as low-friction guides for the cables. Each PTFE tube may house one cable. In one example, the cable for opening the clamp (“open cable”) is housed (e.g., by adhesive bonding) in a PTFE tube attached to a first outer sheath ring 12, such that the first outer sheath ring 12 serves as a rigid stop for these PTFE tubes. In one example, the cable for closing the clamp (“closed cable”) is housed in a PTFE tube terminating at the distal end of the movable arm 2. In one example, the cable for moving the working tube is housed (e.g., by gluing) in a PTFE tube attached to both the immovable arm and the movable arm of the sleeve.

[0053] In one example, there are four cables for opening the clamp 22 and two cables for closing the clamp 22. The four opening cables can pull four pistons 6 inside the clamp, allowing the hinge mechanism to open. In one example, the two closing cables are positioned toward the distal end of the clamp and wrap around the clamp. In one example, the closing cables terminate at the distal end of the movable arm 2. Pulling the closing cables moves the movable arm into the closed configuration.

[0054] In one embodiment, at least one of the plurality of cables terminates on a working tube for moving the working tube, thereby moving the surgical instrument. In one example, each of the immovable and movable arms has two passages. Each passage houses two PTFE tubes for guiding the working tube cables (i.e., the cables for moving the working tube 5) through the clamp 22. Each PTFE tube houses one working tube cable. In an embodiment with four arms, there are a total of eight passages and sixteen PTFE tubes for the sixteen cables used to move the working tube. It will be understood that, given that multiple cables terminate at each working tube, pulling / tensioning of the associated cable (and corresponding loosening of the cable on its antagonistic side) will cause the working tube 5 to move in the desired direction. In one example, the cable begins at a pulley located at the drive coupling 15, passes through the outer sleeve 23 and enters the clamp 22, terminating on the working tube 5.

[0055] In one example, the working tube cable (i.e., the cable for moving the working tube) and the opening cable (i.e., the cable for opening the sleeve) extending through multiple second outer sleeve rings 13 can rigidify the outer sleeve 23 when tension is applied to the cables. Alternatively, one or more additional cables terminating at the distal end of the outer sleeve 23 can be added to allow the outer sleeve 23 to move between a flexible configuration and a rigid configuration.

[0056] In one embodiment, the base member 1 further includes a plurality of auxiliary through openings for receiving a plurality of cables. The plurality of auxiliary through openings may be generally parallel to the through opening configured to receive an endoscope. The auxiliary through openings may be formed as holes in the second outer sheath ring 13. Optionally, to allow for a smaller diameter of the outer sheath 23, some of the cables may be positioned outside the second outer sheath ring 13 without passing through the auxiliary through openings.

[0057] In one embodiment, structural member 24 includes two movable arms 2, which are opposite each other on either side of the interior space. The two movable arms 2 are configured to extend outward relative to a longitudinal axis extending along the length of structural member 24 when the arms 2 are in an open configuration. In one example, when structural member 24 is in a closed position, at least one movable arm 2 is generally parallel to the longitudinal axis extending along the length of structural member 24. In one example, structural member 24 includes two immovable arms, which can be interpreted as covers, such as a top cover 9 and a bottom cover 10. The two movable arms 2 may be opposite each other.

[0058] In one embodiment, the endoscope accessory as described herein further includes an outer sheath for covering structural member 24. A non-limiting example of the outer sheath is a thermoplastic polyurethane (TPU) sheath.

[0059] In one embodiment, the endoscopic accessory as described herein also includes a surgical instrument housed in a working tube. The working tube is capable of receiving the surgical instrument in such a manner that the distal end of the surgical instrument is positioned more distally along the longitudinal axis than the distal end of the structural member 24.

[0060] In one example, the number of cables connected to each working tube is between six and eight. In a preferred embodiment, each working tube is connected to eight cables.

[0061] In one embodiment, the movement of the working tube includes translational movement of the working tube along the x-axis, y-axis and / or z-axis, and rotational movement of the working tube along the pitch axis, yaw axis and / or roll axis.

[0062] In one embodiment, the surgical instrument is selected from any of the following: grasping tools, cauterizing tools, suturing tools, snare rings, forceps, scissors, aspiration tools, injection tools, clamping tools, and rinsing tools.

[0063] In one implementation, the endoscope accessory as described herein includes two working tubes.

[0064] In one example, the endoscopic accessory as described herein also includes an image capturing device disposed on structural member 24. In one example, the image capturing device is located on the top cover 9 of the sleeve at the distal end of the sleeve.

[0065] In one example, the endoscope accessory as described herein also includes an illumination source disposed on structural member 24.

[0066] In one example, the endoscope accessory may be for single use only.

[0067] In one implementation, such as Figure 9 and Figure 10 As shown, the endoscope accessory as described herein also includes a drive coupling 15 located at the proximal end of the outer sleeve 23, wherein the drive coupling is configured to actuate a plurality of cables.

[0068] In one embodiment, the transmission coupling is configured to be driven manually or automatically to actuate multiple cables.

[0069] In one embodiment, the transmission coupling is operably connected to the actuator and configured to be driven by the actuator.

[0070] In one embodiment, the drive engagement includes a plurality of driven members for actuating a plurality of cables, wherein each of the plurality of cables is connected to one of the driven members. A non-limiting example of a driven member includes a clutch. The drive engagement can be any transmission mechanism capable of converting rotational energy into pulling energy to provide tension to the cables. In one example, the drive engagement is in the form of a disc, and the driven member is a clutch that forms an engagement between the drive engagement disc and the bedside robotic arm system. The clutch may be connected to a pulley within the drive engagement disc, and the cables are connected to the pulley. Rotation of the bedside robotic arm system motor will cause rotation of the bedside robotic arm system clutch, followed by rotation of the disc clutch, rotation of the pulley, and tensioning or loosening of the cables depending on the direction of motor rotation.

[0071] As used herein, the terms “scope” and “endoscope” are used interchangeably. The term “scope” can include other devices used for observation and / or manipulation within a human or animal body, including but not limited to laparoscopes, duodenoscopes, colonoscopes, gastroscopes, hysteroscopes, bronchoscopes, and urethroscopy. Endoscopes typically include insertable probes (also known as “endoscopic probes” for insertion into body cavities). The term “endoscope” can be used to refer to endoscopic probes.

[0072] In various examples, endoscopic accessories as described herein can be used with endoscopic probes of various sizes, such as, but not limited to, colonoscopes, gastroscopes, lateral viewers, endoscopic ultrasound, adult and pediatric, rigid and flexible, and single-channel and multi-channel. In various examples, the clamp can be adapted for use with non-GI endoscopic instruments.

[0073] Endoscopic attachments as described herein can be used in a variety of advanced endoscopic or surgical procedures. Non-limiting examples of such endoscopic procedures include endoscopic submucosal dissection (ESD), endoscopic full-thickness resection (EFTR), and peroral endoscopic myotomy (POEM).

[0074] As used herein, the term "user" can refer to any user or end-user of the endoscopic accessory of this embodiment. Non-limiting examples of users include endoscopists, surgeons, specialists, and support staff, such as nurses and technicians.

[0075] Hoop

[0076] In one embodiment, the base member 1 and structural member 24 of the endoscope accessory are collectively referred to as a "hoop". The base member 1, also called the hoop base or hoop ring, includes a through opening (e.g., a through hole) for receiving the endoscope. The endoscope can be moved into and out of the hoop 22 via the base member 1, and can even be moved slightly forward of the hoop 22 without interruption of the field of view. The structural member 24 of the hoop in this embodiment includes at least one movable arm and can be in an open or closed configuration. The hoop, structural member, or at least one movable arm of the hoop is in an open configuration when at least one movable arm extends outward or pivots. The proximal end of the structural member can be connected to the base member in various ways, such as by a hinge. The term "extend outward" can include radial extension in which the arm is generally parallel to the longitudinal axis, or pivotal extension in which one end of the arm moves away from the longitudinal axis. By "pivot outward," it means that the distal end of at least one movable arm extends away from the longitudinal axis extending along the length of the structural member. Figure 1 (Top-down rear 3D view) Figure 2 (Front view plan) Figure 3 (Top view plan) and Figure 4 The side view shows an embodiment of the clamp in an open configuration, wherein the structural members include two movable arms and two immovable arms. In the orientation shown in the figure, the two arms at the sides are movable, while the top and bottom arms are immovable. The clamp can be inserted into a human or animal body in a closed configuration. The clamp in the closed configuration... Figure 5 (Front view plan) Figure 6 (Top view plan) and Figure 7 As shown in the side view plan. Once the clamp has reached the desired target area within the body, the clamp can be opened to any dimension within its minimum and maximum width. By "clamp width," it refers to the maximum width of the distal end of the structural member. For example, if the structural member comprises two opposing movable arms and two opposing immovable arms, wherein the two movable arms pivot outward, the width of the clamp will be the distance between the distal ends of the two movable arms. The reference to the "width" of the clamp can also be considered as referring to the "diameter" of the clamp. Since the structural member is in an open configuration when at least one movable arm pivots outward, it will be understood that reference to the clamp or structural member being in an open configuration means that the movable arm is in an open configuration. The phrase "the structural member is capable of moving between an open and closed configuration" means including the clamp being manually or automatically movable to open to any width suitable for the user during surgery. In one example, the movement of the clamp from an open to a closed configuration is achieved by multiple cables terminating on the structural member.

[0077] The simple design of the clamp as described in this article allows the clamp to be sized to have a shorter width and shorter length, thus allowing the clamp to be easily manipulated inside the patient.

[0078] As used herein, the term "structural member" means comprising at least one movable arm. For example, structural member 24 may consist of at least one immovable portion and one or more movable arms. In one embodiment, the structural member comprises a total of four arms, wherein two opposing arms are immovable and the other two opposing arms are movable. It will be understood that an "arm" can be a panel, plate, wall, or any elongated structure, such as a column. In one example, the distal ends of the arms are tapered. In the context of the example where the structural member comprises four arms—where two opposing arms are immovable and the other two opposing arms are movable—the term "internal space" in the phrase "structural member encloses internal space" may refer to the area surrounded by the arms. However, it will be understood that the working space of the hoop in this embodiment includes not only the internal space but also an area further distal along the longitudinal axis that becomes accessible due to the hoop being in an open configuration. In other words, the working space includes the area extending out of the hoop. Therefore, in use, the endoscope and working tools can work not only in the internal space, but also in areas further distal along the longitudinal axis (i.e., further forward of the distal end of the arm).

[0079] In various embodiments, the structural member comprises four arms. In one embodiment, two of the arms are movable arms and two are immovable arms. In another embodiment, the two movable arms are opposite each other, and the two immovable arms are opposite each other. In various embodiments, the internal space enclosed by the arms can be circular, oval, or elliptical in shape. In various examples, the length of the arms can be between 20 mm and 60 mm.

[0080] In some examples, the clamp has a closed configuration. A closed configuration may also be referred to as an unexpanded, contracted, or folded configuration. Preferably, the width of the clamp in the closed configuration is between the inner and outer diameters of the outer sleeve 23. In various examples, the inner diameter of the outer sleeve 23 can be from 10 mm to 16 mm, and the outer diameter of the outer sleeve 23 can be from 15 mm to 30 mm. For example, when used with a gastroscope or colonoscope, the width of the clamp in the closed configuration can be between 10 mm and 30 mm.

[0081] In some examples, the clamp 22 has an open configuration. The unfolded configuration may also be referred to as an expanded or extended configuration. The width of the clamp in the open configuration can be up to 80 mm. Preferably, for colonoscopy, the clamp can be opened to a width of 50 mm to 60 mm. Because the clamp can be opened to any extent between its non-expanded width and its maximum unfolded width, the open configuration can have a diameter of 10 mm to 80 mm when used with a gastroscope or colonoscope.

[0082] The width of the clamp is a measure of the size of the clamp's workspace. The term "workspace" refers to the three-dimensional internal space encompassing the clamp (whether in an open or closed configuration) and the area extending forward from the distal end of the structural member, within which the working tube and endoscope can move. Movement of surgical instruments can be limited to movement within the workspace. In various examples, the clamp can be deployed with a range of widths between its minimum and maximum width.

[0083] In one example, the clamp can be 3D printed. The clamp can also be manufactured using CNC machining, injection molding, compression molding, or sheet metal bending, metal stamping, or a combination of the above processes.

[0084] In one example, the clamp can be made of plastic. For instance, the clamp can be made from an engineering plastic, such as polycarbonate (PC), mixed with a certain proportion of glass fiber reinforcement. Other examples of plastic materials include acrylonitrile butadiene styrene (ABS), polylactic acid (PLA), polycarbonate (PC), polytetrafluoroethylene (PTFE), or mixtures of the above materials. The clamp can also be made from a mixture of stainless steel or aluminum components.

[0085] Work Management

[0086] In one embodiment, the endoscopic accessory as described herein further includes a surgical instrument 19 releasably received in the working tube 5. In use, the surgical instrument can be guided within the working tube and moved forward (i.e., further distal to the distal end of the working tube) and backward. The surgical instrument can even be removed from the working tube. In another embodiment, the surgical instrument can be releasably attached to the working tube.

[0087] As used herein, the terms “surgical instrument,” “instrument,” “treatment instrument,” “endoscopic tool,” “surgical instrument,” “tool,” and “end-effector” are used interchangeably. In one example, the surgical instrument may be longer than 2 m to facilitate insertion into an endoscopic accessory. The activation and deactivation of the surgical instrument may be controlled by the instrument's handle. In one example, the surgical instrument's handle is inserted into a bedside robotic arm system with a fixing device to accommodate different surgical instruments of varying shapes and sizes. The controller may have a button that, when pressed, simulates hand movement and accordingly moves the surgical instrument up / down, thereby activating / deactivating the surgical instrument.

[0088] In one embodiment, the working tube 5 can serve as a guide for the surgical instrument 19 to pass through. For example, the surgical instrument can move forward and backward while being supported within the working tube. In another embodiment, the working tube can control the movement of the surgical instrument. In one example, the working tube is a metal tube fitted onto the proximal end of the surgical instrument to enable control.

[0089] In one example, the working tube has an outer diameter of 4.5 mm, an inner diameter of 3 mm to 3.5 mm, and a hole spacing of 25 mm. The inner diameter of the working tube will depend on the surgical instrument, which typically has an outer diameter of 2.8 mm. Since the working tube will need to accommodate the outer diameter of the surgical instrument, it can have an inner diameter between 2.9 mm and 3.5 mm. The outer diameter of the working tube is preferably as close as possible to its inner diameter. In various examples, the outer diameter of the working tube is between 3.0 mm and 4.5 mm. In various examples, the hole spacing on the working tube can be between 10 mm and 60 mm. A 3 mm inner diameter allows the working tube to be used with a standard endoscopic tool that operates with a 2.8 mm working channel.

[0090] In one example, there are eight holes or openings (cable entry points) on the working pipe 5, which constitute eight cable mounting points. Figure 11 In the illustrated embodiment, eight holes are arranged in two rows of four holes each, with one row located at the proximal end of the working tube 5 and the other row located at the distal end of the working tube 5. Each row has four holes spaced 90 degrees apart from each other. The cable can terminate on the working tube by forming a knot between each hole and either the proximal or distal end of the working tube 5. In an alternative embodiment, sixteen holes can be present, arranged in four rows of four holes each, with two rows located at the proximal end and two rows located at the distal end. In each row, the holes are spaced 120 degrees apart, with each row offset from each other. This results in a knot being formed between two adjacent holes to create a virtual center point.

[0091] In one example, the endoscope accessory includes two working tubes 5, each housing a surgical instrument. The working tubes 5 are compatible with readily available surgical instruments such as grippers and cautery knives. In one example, the total length of the working tubes 5 is 45 mm. Each working tube 5 can be driven by eight cables. There can be sixteen holes (cable entry points) on the working tube 5, with two holes for each knot of the fishing line. These holes can be arranged such that the knots are in specific positions. The cables can be tied to the working tubes 5 using a clove knot and two thumb knots. It will be understood that each working tube can be driven by fewer or more than eight cables. In an implementation where each working tube is driven by six cables, there are five degrees of freedom. In one example, each cable mounting point has three knots. For example, the three knots could be a clove knot and two thumb knots. The number of knots at each cable mounting point can range from one to five. A higher number of knots will increase the thickness of the cable at the cable mounting point and thus increase the strength under load.

[0092] outer tube

[0093] As used herein, the terms "outer sheath" and "colonoscope sheath" are used interchangeably. The outer sheath may partially or completely wrap around the endoscope probe along its length. The outer sheath may be flexible or rigid. Figure 8 An example of a flexible outer sheath is shown. In one embodiment, the outer sheath is formed by a plurality of rings, such as a series of rings, arranged adjacent to each other. The distance between each ring can be any suitable distance, as long as it provides support and accommodation for the associated endoscope, tubes and conduits carrying surgical instruments and cables. Each ring may include any associated number of holes, and the positions of these holes correspond to auxiliary channels provided on the base member at the end that connects to the outer sheath. Thus, when the rings are arranged together to form the outer sheath, the holes form auxiliary channels for accommodating cables extending from one end of the outer sheath to its termination at the working tube or structural member. In another embodiment, cables may be present extending on the outer surface of the outer sheath. The rings on the outer sheath allow for flexibility because the outer sheath can follow the curvature of the endoscope. In one embodiment, the outer sheath can be rigidified once the endoscope has been inserted into the target area. One way to rigidify the outer sheath is by tensioning the plurality of cables terminating on the outer sheath to reduce the length of the cables, thereby rigidifying the outer sheath and providing stability for the endoscopic attachment. Figure 8 In the example shown, the outer diameter of the outer tube is 25 mm and the total length is 500 mm. Figure 8 The outer tube shown can be made from a single plastic-like material, which may be 3D printed, extruded, or injection molded.

[0094] As used herein, the terms "channel" and "lumen" are used interchangeably and refer to a hollow compartment formed along the length of the outer sheath along its longitudinal axis, suitable for use as a working channel, flushing channel, passageway for endoscopic tools / instruments, imaging probe channel, or therapeutic agent channel. In some examples, the channel may be formed as a longitudinal hole in a single material forming the channel. The main channel and / or auxiliary channels may be formed in a series of rings within the outer sheath, such as... Figures 12 to 14 As shown in the diagram. In some examples, the material forming the outer tube 23 can be flexible.

[0095] The term "working channel" can refer to either the main channel or the auxiliary channel. In various examples, the working channel may extend along the entire length of the endoscope. In some examples, the working channel may extend along a portion of the length of the endoscope. In some examples, the working channel may be substantially parallel to the endoscope. In some examples, the working channel may be angled relative to the endoscope, at least along a portion of its length. As a non-limiting example, the working channel may exit at an upward angle, thereby allowing for better retraction.

[0096] In one implementation, multiple auxiliary channels are parallel to the main channel.

[0097] In one implementation, each of the multiple auxiliary channels accepts one of the multiple cables.

[0098] In one example, the multiple auxiliary channels include multiple tubular tubes, such as PTFE tubes or Bowden cables. In one example, there are a total of twenty-four tubes, of which sixteen tubes house cables for the movement of the two working tubes 5 (i.e., eight cables per working tube), four tubes house cables for opening the clamp, two tubes house cables for closing the clamp, and two tubes each house a surgical instrument.

[0099] In one example, surgical instruments can be inserted from the proximal end to the distal end of the outer sheath via an auxiliary channel.

[0100] In one embodiment, the outer cannula includes an inner wall and an outer wall, wherein the inner wall defines a main channel, and wherein a plurality of auxiliary channels are disposed in the space between the inner and outer walls. For example, the inner wall is an inner jacket that allows the endoscope to pass through, and the outer wall is an outer jacket that ensures that all tubes (i.e., auxiliary channels) are enclosed therein. The main channel may also be referred to as the "colonoscope channel". In one example, the inner jacket is made of a flexible thermoplastic material, such as silicone, TPU, or PVC, with a specialized biocompatible hydrophilic coating. When wetted, the endoscope will slide inside the outer jacket with minimal friction, allowing the endoscope to move easily forward and backward. In one example, the outer jacket has a very thin TPU sheath that prevents the colon from entering the outer cannula. The TPU sheath also allows the outer cannula to slide more smoothly when in contact with the colon.

[0101] As an alternative to PTFE pipe, the outer casing may include a wiring coil, and the cables required for the actuation sleeve and working pipe are routed through this wiring coil. The wiring coil may be located inside the auxiliary channel and may extend partially or completely along the length of the auxiliary channel.

[0102] In a preferred embodiment, the first outer sheath ring 12 and the clamp are used to terminate the PTFE tube that accommodates the cable used to open the clamp. The PTFE tube accommodating the cable used to move the working tube 5 terminates on the structural member 24 of the clamp.

[0103] As an alternative to the rigid stop provided by the first outer sheath ring 12 on the PTFE tube, a cap, also known as an end cap, is provided at the proximal and / or distal ends of the outer sheath to restrict cable movement. The cap may secure the inner wall, outer wall, and auxiliary channel of the outer sheath. The cap may have slots that allow cables to pass through. Each slot may accommodate one or more cables. In one example, a tool channel is used to allow surgical instruments to pass through the outer sheath. As used herein, the term "tool channel" means including an auxiliary channel for accommodating surgical instruments. Figure 15 In the embodiment shown, the tool channel accommodates a surgical instrument PTFE tube 20, which in turn receives a surgical instrument 19.

[0104] In one example, readily available surgical instruments can be inserted into the working tube 5 via the tool channel of the outer tube. To allow the surgical instruments to be released and replaced, the working tube 5 can be aligned with the tool channel of the outer tube.

[0105] In one example, the diameter of the main channel is 16 mm. The diameter of the main channel can also be referred to as the inner diameter of the outer cannula. Those skilled in the art will generally understand that the diameter of the main channel 30 may have a range, and the diameter of the main channel will depend on the outer diameter of the type of endoscope used with the endoscopic accessory. For example, gastroscopes typically have an outer diameter of 9 mm, while colonoscopes typically have an outer diameter of 13.5 mm to 14 mm. A main channel with a diameter of 16 mm will allow the outer cannula to be fitted with a colonoscope, while a smaller main channel with a diameter of 10 mm or 11 mm can be used to fit a gastroscope. In one example, the diameter of the main channel is between 10 mm and 16 mm.

[0106] In one example, the diameter of the auxiliary channel is 1.4 mm. In another example, the diameter of the auxiliary channel is between 1 mm and 4 mm to accommodate cables and surgical instruments.

[0107] In one example, the diameter of the outer cannula is 25 mm. Those skilled in the art will generally understand that the diameter of the outer cannula may have a range, and will depend on the outer diameter of the type of endoscope used with the endoscopic accessory. For example, gastroscopes typically have an outer diameter of 9 mm, while colonoscopes typically have an outer diameter of 13.5 mm to 14 mm. In one example, the diameter of the outer cannula is between 10 mm and 30 mm.

[0108] The outer sheath is preferably made of a biocompatible material. Examples of biocompatible materials include, but are not limited to, polytetrafluoroethylene (PTFE), polyether block amide copolymers such as PEBAX, fluorinated ethylene propylene (FEP), thermoplastic polyurethane (TPU), and perfluoroalkoxy (PFA).

[0109] Cable

[0110] In one implementation, the multiple cables include multiple braided UHMWPE wires. In various examples, the multiple cables may include multiple metal wires, metal cables, or any unstretched cable.

[0111] In various embodiments, multiple cables are connected to a drive coupling that is manually driven or driven by a cable actuation mechanism. In one example, the cable actuation mechanism is a cable-driven parallel mechanism (CDPM). Advantageously, a CDPM allows larger and more controlled forces to be transmitted to the surgical instrument, thereby allowing the surgical instrument to lift greater loads and improve the motion accuracy of performing ESD. This enables the removal of larger lesions holistically rather than piecemeal, thereby reducing recurrence due to cell seeding. In various embodiments, multiple cables are connected to a drive coupling that is manually driven or driven by a cable actuation mechanism. As used herein, the terms “actuator,” “actuation mechanism,” and “actuation unit” are used interchangeably. The term “actuator” means any device that receives energy (e.g., in the form of electrical, hydraulic, or pneumatic energy) and converts that energy into mechanical force or motion (e.g., linear or rotational motion). In one example, the cable actuation mechanism is a cable-driven parallel mechanism (CDPM). Advantageously, CDPM allows for the transmission of larger and more controlled forces to surgical instruments, thereby enabling these instruments to carry greater loads and improve the precision of motion during ESD. This allows for the complete removal of larger lesions rather than piecemeal removal, thus reducing recurrence due to cell seeding.

[0112] As those skilled in the art will understand, any other method, such as a pulley, can be used to actuate the cable.

[0113] The cables from the actuation system are routed through auxiliary channels in the outer sleeve, through multiple auxiliary through openings in the base member 1, and to reach the structural member 24 and the working tube 5. For example, to open the clamp, some cables may terminate on the movable arm of the structural member. In one example, to open the clamp, four opening cables pull four pistons inside the clamp, which will allow the hinge mechanism to open. To close the clamp, two cables may be positioned toward the distal tip of the clamp and wrap around it. To move surgical instruments, cables may terminate on the working tube 5.

[0114] As used herein, the term "cable entry point" can refer to an opening or through-hole feature that allows cables to enter the structure. Cable entry points may be present on the working tube 5. In various examples, each working tube 5 may have sixteen cable entry points (eight cable mounting points). The base member 1 and structural member 24 may have multiple auxiliary through-holes for accommodating cables. The term "through-hole" means including a passage, channel, or recess for accommodating one or more cables. For example, a pair of cable entry points may serve as one cable mounting point. As used herein, the terms "cable entry point" and "cable mounting point" are used interchangeably. For example, a cable will enter from a cable entry point and terminate / mount at the entry point with a knot. In one example, the auxiliary through-hole in structural member 24 is a passage. In one example, each of the two immovable arms and two movable arms of the structural member has two passages. Each passage accommodates two PTFE tubes, and each PTFE tube accommodates one working tube cable (i.e., a cable used to move the working tube). A total of eight passages, sixteen PTFE tubes, and sixteen working tube cables exist across the four arms. It is generally known in the art that various techniques can be used to terminate cables at cable mounting points. For example, polymer fiber optic cables or braided UHMWPE cables can be terminated by a knot disposed within the cable, while metallic fiber optic cables can be terminated by crimping, spot welding, and / or barbed connections. Preferably, at least one of a plurality of cables terminates at at least one mounting point by a knot disposed within the cable. Examples of knots include the clover knot and the thumb knot. Advantageously, the clover knot allows the cable to be moved without moving the knot.

[0115] In one embodiment, at least one of a plurality of cables terminates at at least one cable mounting point via a knot disposed in the cable.

[0116] In one example, the cable terminating on working tube 5 is used to actuate the working tube in a controlled manner.

[0117] In one example, the working tubes 5—each connected to eight cables—are capable of six degrees of freedom (DOF), including translational movements in the x, y, and z directions, and rotational movements along the pitch, yaw, and roll axes. If the DOF of the tool, i.e., its activation / deactivation or deactivation / disabling, is included, the total DOF can be seven or eight. Due to the counteracting nature and configuration of the cables, the cables are able to exert high forces across six DOFs while simultaneously ensuring control and stability of the surgical instrument. Advantageously, the configuration of multiple cables connected to each working tube 5 allows the working tubes to move in any desired direction, including outward movement and beyond the internal space of the structural member 24. This ability of movement of the working tubes 5 allows surgical instruments positioned within the working tubes 5 to reach positions both outside and beyond the internal space of the endoscope attachment. This is advantageous because it allows the user greater flexibility to manipulate within the confined spaces of body cavities or organ lumens.

[0118] In any case, this invention (when used with an endoscope) allows for the provision of additional access channels, enabling the user to perform endoscopic examinations to visualize the interior of a lumen or cavity, and simultaneously perform any desired or anticipated surgical procedures without having to release access channels occupied by other instruments. Furthermore, surgical instruments used in conjunction with this endoscopic accessory can be controlled independently of the endoscope. This allows for greater maneuverability and control of the instruments used in endoscopic surgery.

[0119] Advantageously, the endoscopic accessory of the present invention can be used with any commercially available endoscope and surgical instrument.

[0120] In one implementation, six cables are connected to the working tube 5. This achieves five degrees of freedom (DOF). The number of cables connected to the working tube 5 can be more than six. For example, eight cables per working tube 5 would provide six DOFs. By properly manipulating the cables, any desired angle and position of the surgical instrument can be achieved.

[0121] In one embodiment, the movement of the working tube and thus the surgical instrument includes translational movement of the working tube along the x-axis, y-axis, or z-axis.

[0122] Advantageously, the present invention reduces the difficulty of performing endoscopic submucosal dissection (ESD) in several ways. First, one or more working tubes 5 provide one or more additional endoscopic tools. For example, in an embodiment with two working tubes 5, the user will be able to work with two endoscopic tools in addition to a possible third endoscopic tool from the endoscopic working channel. This translates to a faster process because multiple endoscopic tools can be operated simultaneously. This also allows for a shorter learning curve compared to conventional ESD. Second, the cable-actuated working tubes 5 provide control of up to six degrees of freedom (DOF) for one or more additional endoscopic tools. The arrangement of the working tubes 5 also allows for the application of strong forces to the endoscopic tools and allows for well-controlled, stable movement. This enables improved control and thus reduces the risk of perforation, resulting in a safer process. Third, the clamps that can be held in the open configuration provide support and stability to the working site. Fourth, the independent movement of the endoscope and tools provided by the separate main and auxiliary channels in the outer tube allows for the elimination of the coupled endoscope and tool movements found in conventional ESD.

[0123] Creating and maintaining submucosal spaces or tunnels is both laborious and risky. The use of expandable clamps with endoscopic attachments, as described herein, to mechanically expose and reliably maintain this workspace offers a practical solution. Alternatively, endoscopic attachments can also be used to aspirate or insert tissue for resection and to protect tissue for safe sample retrieval. Finally, the clamp design provides numerous imaging opportunities, allowing endoscopic attachments to be well-suited for use as image acquisition and display devices, ranging from multiple moving camera positioning, improved illumination of the operating area, and real-time in-situ image-guided dissection using the clamp as a probe, such as a wide radial array ultrasound probe.

[0124] In one embodiment, the expandable clamp also includes an outer sheath.

[0125] As used herein, the term "outer sheath" refers to a layer of material configured to completely or partially enclose or cover the clamp. For example, an outer sheath may cover the outer surface of a structural member to minimize contact between the structural member and tissue. The outer sheath forms a protective layer around the clamp and acts as a barrier between the clamp component and the patient's tissue. In various examples, the outer sheath may cover both the clamp and the outer sheath. The outer sheath may consist of one component covering the clamp and another covering the outer sheath, or it may consist of one component covering both the clamp and the outer sheath. In various examples, the outer sheath may be made of thermoplastic polyurethane (TPU), polytetrafluoroethylene (PTFE), polyether block amide copolymers such as PEBAX, silicone, or combinations of these materials.

[0126] In one embodiment, the endoscopic accessory as described herein also includes an image capture device disposed on an expandable sleeve. For example, a camera may be housed at the proximal end of a structural member, such as on the "top" arm, to provide a bird's-eye view of the target area.

[0127] Advantageously, compared to existing dual-channel endoscopes, the endoscopic accessory described herein offers improved triangulation because it allows instruments to move independently of the endoscope. The term "triangulation" refers to the arrangement of cameras between two surgical instruments (in the case of two working tubes 5) and relates to the size of the workspace in which the placement of the cameras relative to the placement of the instruments is critical. Triangulation also takes into account the importance of camera movement and the independent movement of each instrument.

[0128] In one implementation, the endoscope accessory as described herein also includes an illumination source disposed on the expandable sleeve. For example, the lamp may be housed at the proximal end of the structural member to provide uniform illumination for the target area. In another example, point illumination may be provided using an existing light source of a reflector / diffuser mirror (similar to an umbrella-shaped flash reflector).

[0129] In one implementation, the endoscopic accessory as described herein is for single use only.

[0130] Advantageously, endoscopic accessories can be composed entirely of mechanical parts, thereby eliminating the risk of patient injury caused by stray currents. In other words, the base components, structural components, working tube, outer tube, and transmission couplings can all be composed entirely of mechanical parts.

[0131] Advantageously, the endoscopic accessory described herein can be used with existing endoscopes. For example, existing endoscopes can be modified to include the endoscopic accessory of this embodiment as an add-on. Additionally, this endoscopic accessory can use readily available endoscopic tools. This is advantageous compared to robotic systems that create their own endoscopic examination systems. Such robotic systems are intended to have their own endoscopes and tools, which increases development costs and time, leading to increased costs for the final product. Since the tools in such robotic systems are expensive, they need to be made reusable and re-sterilizable. Furthermore, such robotic systems will need to compete with existing endoscopic systems that already dominate the endoscope industry.

[0132] In various examples, the endoscopic accessory of this embodiment can be used with flexible or rigid endoscopes. The endoscopic accessory can be used in surgical procedures, including inserting the endoscopic accessory into a human or animal body and deploying the clamp, then operating the surgical instrument via control cables.

[0133] system

[0134] Those skilled in the art will generally understand that tension applied to the relevant cable will enable movement of the movable arm and the working tube. By "tension," it is meant to refer to any tightening or stretching of the relevant cable by applying a force, such as a pulling motion. In various embodiments, tension of the relevant cable (and corresponding loosening of the cable on its antagonistic side) will cause movement of the structural member wall and / or the working tube in the desired direction.

[0135] The endoscope accessory described herein may include a drive coupling 15 disposed at the proximal end of an outer sheath, wherein the drive coupling is configured to actuate a plurality of cables. The drive coupling may serve as an intermediary between an actuating motor and the plurality of cables on a bedside robotic arm system. The drive coupling 15 includes a plurality of driven members for actuating the plurality of cables, wherein each of the plurality of cables is connected to one of the driven members. An example of a driven member is a clutch. For example, the drive coupling 15 may include a plurality of male clutches connected to the cables, wherein a corresponding female clutch is present on a controller trolley. The trolley may have a torque sensor that measures torsional tension in the cables to control cable tension. The male clutches on the drive coupling 15 may also be manually operated via a knob, allowing for fine-tuning of the cable length. In one example, the knob may be manually tensioned / loosened before and after operation, and automatically tensioned or loosened during operation. In one example, the male clutch may be in the form of a small, protruding square, and the female clutch may have a square-shaped recess for fitting onto the male clutch.

[0136] The endoscope accessory of this embodiment can be connected to an actuation unit and one or more controllers. In some examples, the actuation unit and controller can be used multiple times, while the outer sleeve 23, sleeve 22, working tube 5, cable, surgical instrument 19 and transmission coupling 15 can be disposable (single-use).

[0137] The endoscopic accessory of this embodiment can be used with existing endoscopes. The endoscopes can be equipped with their own endoscopic examination system, which may include a monitor, light source, camera, and controller. The back-end system includes a user console and a bedside robotic arm system. The user console includes two controllers for the user to move two working tubes and to enable / disable the surgical instruments for each working tube. In one example, the console may include a screen for graphical user interface (GUI) purposes and / or to allow the user to see visual feedback from the endoscopic examination system, as well as a PC housing the software system. The user console is physically connected to the bedside robotic arm system via cables. The bedside robotic arm system consists of motors, motion controllers, a power supply, a custom PCBA, and other components to move the cables according to the movement of the controllers, which in turn move the working tubes.

[0138] In various examples, the controller can be designed using a serial arm concept. Moving the controller in space affects the same movement of the end effector. In various examples, the serial arm has three potentiometers to identify the position of the end effector in the X, Y, and Z planes. In various examples, the end effector has three additional potentiometers that control the pitch, yaw, and roll of the working tube 5. It also includes two buttons to control the actions of the tool itself, such as opening or closing the gripper, or enabling or disabling the soldering iron. Enabling and disabling the end effector can be gradual and controlled.

[0139] The controller may include a back strap for fitting around the user's hands to keep the controller supported. This gives the user the impression that the controller is weightless.

[0140] In one example, the actuation unit controls the movement of the working tube 5 by pulling and thus changing the length of the cables attached to it at different points. This can be accomplished using a cable-driven parallel mechanism (CDPM). The actuation unit can be used to pull different cables (i.e., cause longitudinal displacement of the cables) so that the working tube 5 can move in the desired direction. It also monitors the tension on each cable to ensure that the cables do not break due to excessive load.

[0141] In one example, the actuation unit can control the movement of the sleeve, outer sleeve, and working tube via a transmission coupling. The transmission coupling can be in the form of a disc with multiple male clutches connected to the cable, wherein corresponding female clutches are located on a controller trolley. In this embodiment, a torque sensor on the trolley measures the torsional tension in the cable to control the cable tension. The male clutches on the disc can also be manually operated. For example, the male clutches can be in the form of knobs that can be manually turned to lengthen or shorten the cable. The disc may also include a sealing gasket to minimize CO2 leakage during CO2 blowing.

[0142] Any suitable transmission coupling can be used to manipulate multiple cables to achieve the desired result or movement of the arm of the working tube and structural member.

[0143] In one example, the actuation unit includes eight and nine rows of opposing linear actuators, respectively. These linear actuators correspond to the seventeen lines required for the movement of the two working tubes 5 and the expansion and closure of the surgical clamp attachment. In another example, the actuation unit includes twenty-two linear actuators, with eleven linear actuators on each side, to provide sixteen lines required for the movement of the two working tubes 5, plus four lines for expansion and two lines instead of one line for closing the clamp. In yet another example, the actuation unit includes two additional lines for each working tube 5 to control the rolling of the working tube 5. This corresponds to twenty-one or twenty-two linear actuators.

[0144] In one example, the linear actuators are ball screw assemblies, where a motor controls each ball screw to produce linear movement of a slider along a horizontal axis. The slider is supported by two additional guide rails, with sliding bearings at the joint between the slider and the guide rails. The ball screw also has thrust bearings at each end to reduce axial frictional loads and support the ball screw. The motor is connected to the ball screw via a cross-slider coupling, which reduces axial misalignment and makes the movement smoother. A load sensor is mounted on each slider. The cable from the working tube 5 terminates at the load sensor, allowing real-time monitoring of the tension on each cable. The data lines on the load sensor are neatly arranged and protected against bending wear using a traction chain. Limit switches mounted at the ends of the ball screw supports define the maximum travel position of each linear actuator in the linear actuator assembly. A hard stop for the Bowden cable is also present on the distal support, aligned with each linear actuator.

[0145] The drive coupling can be connected to a control panel similar to that used for endoscopes. Such a control panel, connected to a power source, may include: a monitor screen for viewing images captured by an endoscope coupled to or used with the endoscope accessory of the present invention; any suitable image management (including recording devices) or enhancement modules for adjusting the captured images; any water or air supply necessary for performing endoscopic examinations or any surgical procedures performed by means of surgical instruments; a controller for controlling surgical tools or instruments, etc. In one example, linear actuators are also present on the side of a bedside robotic arm system for controlling endoscopic tools. These linear actuators consist of a lead screw and a pair of guide rails for each actuator. These actuators are similar to those described above, having force sensing capability and a maximum displacement sensor. For interaction with endoscopic tools, they have a universal compliance mechanism that allows the user to simply clamp their desired tools onto the trolley to convert them into automatically controlled tools.

[0146] The invention described herein by way of example may be suitably practiced without the presence of any one or more elements or limitations not specifically disclosed herein. Therefore, terms such as “comprising,” “including,” and “containing” should be understood broadly and without limitation. Furthermore, the terminology and expressions used herein are descriptive rather than limiting, and their use is not intended to exclude any equivalent forms or portions thereof of the shown and described features, but rather to recognize that various modifications can be made within the scope of the claimed invention. Therefore, it should be understood that although the invention has been specifically disclosed by way of preferred embodiments and optional features, modifications and alterations can be made to the invention embodied herein by those skilled in the art, and such modifications and alterations are considered to be within the scope of the invention.

[0147] The present invention has been described broadly and generally herein. Each narrower group of substances and subclasses falling within the scope of the general disclosure also forms part of the invention. This includes a general description of the invention with any attached conditions or negative limitations (removal of any subject matter from that genus), regardless of whether the removed content is specifically described herein.

[0148] Although embodiments of the invention have been clearly shown and described with reference to specific examples, those skilled in the art will understand that various changes in form and detail may be made to the invention without departing from the scope of the invention as defined by the appended claims. Therefore, the scope of the invention is specified by the appended claims and is thus intended to cover all changes falling within the meaning and scope of equivalents of the claims.

Claims

1. An endoscope accessory, comprising: (a) A base member, the base member including a through opening configured to receive an endoscope; (b) A structural member connected to the base member and enclosing an internal space within the structural member, wherein the structural member includes at least one movable arm configured to move between an open configuration and a closed configuration; as well as (c) A working tube disposed in the internal space for accommodating surgical instruments.

2. The endoscopic accessory according to claim 1 further includes an outer sheath, the outer sheath having a proximal end and a distal end, wherein, The distal end of the outer sleeve is connected to the end of the base member opposite to the structural member.

3. The endoscopic accessory according to claim 2, wherein, The outer tube is formed by multiple rings.

4. The endoscopic accessory according to claim 2 or 3, wherein, The outer sheath includes a main channel, and the main channel and the through opening are aligned with each other to accommodate the endoscope.

5. The endoscopic accessory according to any one of claims 2 to 4, wherein, The outer sheath includes multiple auxiliary channels for accommodating multiple cables.

6. The endoscopic accessory according to claim 5, wherein, The outer sleeve includes an inner wall and an outer wall, wherein the inner wall defines the main channel, and wherein the plurality of auxiliary channels are disposed in the space between the inner wall and the outer wall.

7. The endoscope accessory according to claim 5 or 6, further comprising the plurality of cables, wherein, At least one of the plurality of cables terminates on the structural member for moving the structural member between the open configuration and the closed configuration, and wherein at least one of the plurality of cables terminates on the working tube for guiding the surgical instrument.

8. The endoscopic accessory according to any one of claims 1 to 7, wherein, The base component also includes multiple auxiliary through openings for accommodating the plurality of cables.

9. The endoscopic accessory according to any one of claims 1 to 8, wherein, The structural member includes two movable arms that are opposite each other on either side of the interior space, wherein the two movable arms are configured to extend outward away from a longitudinal axis extending along the length of the structural member when the arms are in the open configuration.

10. The endoscopic accessory according to any one of claims 1 to 9, wherein, The endoscope accessory also includes an outer sheath for covering the structural member.

11. The endoscopic accessory according to any one of claims 1 to 10, wherein, The movement of the working tube includes the movement of the working tube along the x-axis, y-axis and / or z-axis, as well as the rotational movement of the working tube along the pitch axis, yaw axis and / or roll axis.

12. The endoscopic accessory according to any one of claims 1 to 11, wherein, The surgical instrument is selected from any of the following: grasping tools, cauterizing tools, suturing tools, snare rings, forceps, scissors, aspiration tools, injection tools, clamping tools, and rinsing tools.

13. The endoscope accessory according to any one of claims 1 to 12, comprising two working tubes.

14. The endoscopic accessory according to any one of claims 4 to 13, further comprising a transmission engagement disposed at the proximal end of the outer sleeve, wherein, The transmission coupling is configured to actuate the plurality of cables.

15. The endoscopic accessory according to claim 14, wherein, The transmission coupling is configured to be manually driven to actuate the plurality of cables.

16. The endoscopic accessory according to claim 14, wherein, The transmission coupling is operably connected to the actuator and configured to be driven by the actuator.

17. The endoscopic accessory according to any one of claims 14 to 16, wherein, The transmission coupling includes a plurality of driven members for actuating the plurality of cables, wherein each of the plurality of cables is connected to one of the plurality of driven members.

Images