Device for improving adenoma detection

Abstract

Devices for improving adenoma detection during colonoscopy, and more particularly, to devices that are positionable at a distal end of an endoscope and are structured or configured to expand and retract upon longitudinal or rotational displacement of at least a portion of the device about the endoscope.

Description

Technical Field

[0001] This disclosure relates to a device for improving adenoma detection during colonoscopy, and more specifically to a device that can be located at the distal end of an endoscope and is constructed and / or configured to expand and retract when at least a portion of the device is longitudinally or rotatably displaced around the endoscope. Background Technology

[0002] Adenomatous polyps (adenomas) are benign polyps or growths on the inner wall of the colon or rectum that can become cancerous. Adenoma detection rate (ADR) is a measure of the consistency of an endoscopist's ability to identify gastrointestinal (GI) polyps during colonoscopy. ADR is sometimes also measured based on the number of adenomas detected per colonoscopy (APC). Institutional ADR depends on the ease of polyp identification, the tools used for the examination (colonoscope, assistive devices), and the physician's ability to identify lesions. Higher resolution video can contribute to ADR rates, as can physician experience and training. Recently, auxiliary tools / methods have been developed to improve ADR rates, including image recognition (AI)-assisted identification, mechanical magnification, and additional optical fields of view. Several studies support the possibility that ADR devices can improve ADR rates, potentially enabling earlier cancer detection and reducing treatment costs for patients and hospitals in the future.

[0003] Disclaimer regarding the description of the relevant art section: With regard to the specific patent / publication / product described above in the relevant art section or discussed in other parts of this disclosure, such discussion should not be construed as an admission that the patent / publication / product in question is prior art for patent law purposes. For example, some or all of the patent / publication / product in question may not be early enough, may not reflect a subject matter developed early enough, and / or may not constitute prior art for patent law purposes. With regard to the specific patent / publication / product described above in the relevant art section and / or discussed throughout the application, its description / disclosure is therefore incorporated in its entirety by reference to this document. Summary of the Invention

[0004] The inventors recognized that the anatomy of the colon (large intestine) varies considerably, and factors such as tortuosity, topology, prevalence, and size all affect an endoscopist's ability to identify potential malignant adenomas. When withdrawing the antegrade colonoscope during the procedure, the physician's field of vision is directed proximally along the colonic lumen, which can create blind spots behind bulges, folds, or twists in the receding anatomy. This can be further exacerbated by the colonoscope's limited field of view (approximately 140°), requiring the endoscopist to manipulate the endoscope at an angle to the axis of the lumen to achieve close-up frontal examination of the tissue. When doing so, the opposite sides of the lumen are in blind spots, meaning the endoscopist selectively loses visibility in one direction to gain visibility in another. Due to the small axial envelope, current solutions on the market may not fully contact the walls of the GI tract. Furthermore, conventional devices do not ensure uniform radial force applied to the colonic wall and may create "gaps" as the device arms can easily open. Therefore, there is a need in the art for an improved device for detecting adenomas during colonoscopy.

[0005] Therefore, the primary object and advantage of embodiments of this disclosure is to provide an apparatus for improving adenoma detection during colonoscopy, eliminating one or more of the problems / flaws / defects associated with conventional apparatus. The apparatus of the embodiments can also be used during EMR, ESD (resection and dissection) for stabilization or colonoscopy to help “reduce” scope position. Specifically, this disclosure relates to embodiments of the apparatus of the invention, which can be positioned at the distal end of an endoscope and is configured or arranged to expand and retract during longitudinal or rotational displacement around the endoscope. A non-limiting objective associated with embodiments of the apparatus of the invention is to mechanically manipulate the GI tract during colonoscopy to improve visualization and detection of adenoma and to stabilize the colonoscope (including the endpiece) during endoscopic procedures. Stabilizing the endpiece to limit movement of the endpiece relative to the GI tract wall inhibits the influence of peristalsis on the desired scope position. Furthermore, embodiments of the apparatus are configured to expand, smooth, and modulate the intestine (including colonic folds) to more easily identify abnormalities in tissue topology. Finally, the end of the device can be used as a endoscopic cap, thereby forming a longitudinally extending annular portion around the periphery of the endoscope, which can be used to aspirate or manipulate tissue during surgery.

[0006] As further described and illustrated below with reference to the accompanying drawings, embodiments of this disclosure provide an apparatus for improving visibility and stability using a helical cage structure that is fixedly and slidably coupled to an endoscope. According to one embodiment, the distal portion of the apparatus may be fixedly attached to the end of the endoscope in the manner of a cap or nozzle, extending a forward geometry (and annular ring / tube) into the field of view of a camera. The proximal portion of the apparatus may be slidably coupled to the axis of the endoscope, restricting radial displacement but allowing rotational and longitudinal (axial) movement. The main body of the apparatus may be constructed of a twisted cage that expands and retracts with longitudinal and / or rotational displacement of the rear connector relative to the front connector. The diameter of the cage may be affected by the degree of torsional deformation of the individual support members. The individual support members may be designed to elongate when the apparatus is inserted (force is applied in a distal vector to the proximal side of the cage and the apparatus) and to flip and bend when the apparatus retracts (force is applied in a proximal direction to the distal side and outer surface of the apparatus). In the preceding description, distal and proximal are defined relative to the device, which is inverted relative to the reference frame of the catheter.

[0007] Embodiments of this device can help smooth and enlarge bulges, folds, and depressions that form blind spots in the patient's colon wall; center the endoscope in the lumen to eliminate camera deviation due to tortuosity; adjust tissue tension when examining and manipulating local tissues; and use a ring cap to manipulate (by suction or direct contact) tissue located in the anterior part of the endoscope.

[0008] Additional advantages of the device described and illustrated herein over conventional devices include: consistent radial force transmission around all or substantially all (80-99%) of the device circumference; a slight torque applied by the device during retraction that helps smooth out spiral folds found in the colon; the ability to actively expand or collapse a segment of the lumen by twisting the endoscope; protection of the endoscope camera (end protector) located outside the patient; and an integrated endoscope cap that facilitates tissue aspiration and manipulation.

[0009] These and other aspects of the embodiments of this disclosure will become apparent and will be illustrated with reference to the embodiments described below. Attached Figure Description

[0010] The embodiments disclosed herein will be more fully understood and appreciated by reading the following detailed description in conjunction with the accompanying drawings. The drawings illustrate only typical embodiments of the disclosed subject matter and should therefore not be construed as limiting its scope, as the disclosed subject matter can allow for other equally effective embodiments. Reference will now be made briefly to the accompanying drawings, in which:

[0011] Figure 1AThis is a schematic side view of an apparatus for improving adenoma detection according to one embodiment.

[0012] Figure 1B This is a schematic perspective view of the distal end of a device for improving adenoma detection according to one embodiment.

[0013] Figure 2 This is a schematic diagram of the distal end of a device for improving adenoma detection according to one embodiment.

[0014] Figure 3A This is a schematic diagram of the distal end portion of a device for improving adenoma detection according to one embodiment.

[0015] Figure 3B This is a schematic side view of the distal end portion of a device for improving adenoma detection according to one embodiment.

[0016] Figure 4 This is a side-perspective transparent / semi-transparent view of a device positioned on the distal end of an endoscope according to one embodiment.

[0017] Figure 5 This is a schematic diagram of the displacement diagram of one embodiment of the device, based on finite element analysis.

[0018] Figure 6A This is a schematic diagram of the stress of a device during a flip cycle according to one embodiment.

[0019] Figure 6B This is a schematic diagram of the stress of a device during a flip cycle according to one embodiment.

[0020] Figure 6C This is a schematic diagram of the stress of a device during a flip cycle according to one embodiment.

[0021] Figure 6D This is a schematic diagram of a device attached to an endoscope during a flipping cycle, according to one embodiment.

[0022] Figure 6E This is a schematic diagram of a device attached to an endoscope during a flipping cycle, according to one embodiment.

[0023] Figure 6F This is a schematic diagram of a device attached to an endoscope during a flipping cycle, according to one embodiment.

[0024] Figure 7A This is a representation of a stress diagram in a schematic diagram of a device shown during an extension period according to one embodiment.

[0025] Figure 7BThis is a representation of a device attached to an endoscope during an extended period, according to one embodiment.

[0026] Figure 7C This is a representation of a device attached to an endoscope during an extended period, according to one embodiment.

[0027] Figure 8A This is a schematic side view of an apparatus for improving adenoma detection according to an alternative embodiment.

[0028] Figure 8B This is a schematic side view of an apparatus for improving adenoma detection according to an alternative embodiment.

[0029] Figure 8C This is a schematic side view of an apparatus for improving adenoma detection according to an alternative embodiment.

[0030] Figure 9A This is a schematic front view of an apparatus for improving adenoma detection according to an alternative embodiment.

[0031] Figure 9B This is a schematic rear view of an apparatus for improving adenoma detection according to an alternative embodiment.

[0032] Figure 10A This is a schematic side view of an apparatus for improving adenoma detection according to an alternative embodiment.

[0033] Figure 10B This is a schematic side view of an apparatus for improving adenoma detection according to an alternative embodiment. Detailed Implementation

[0034] Various aspects of this embodiment, as well as certain features, advantages, inventive features, and details thereof, are explained more fully below with reference to the non-limiting examples shown in the accompanying drawings. Descriptions of well-known structures are omitted to avoid unnecessarily obscuring the details of the inventive features of the embodiments. However, it should be understood that detailed descriptions and specific non-limiting examples (although indicating aspects of the inventive features of the embodiments) are given by way of example only and not by way of limitation. Various substitutions, modifications, additions, and / or arrangements within the spirit and / or scope of the basic inventive concept will be apparent to those skilled in the art according to this disclosure.

[0035] While embodiments of this disclosure have been specifically shown and described with reference to certain exemplary embodiments, those skilled in the art will understand that various changes in detail may be made without departing from the spirit and scope of the inventive features of the embodiments (as defined by the claims, which can be supported by the written description and the drawings). Furthermore, where exemplary embodiments are described with reference to a certain number of elements or a certain number / sequence of steps, it should be understood that exemplary embodiments may be implemented using fewer or more than a certain number of elements or a certain number / sequence of steps. If an element shown in a particular drawing discussed below is not specifically identified with respect to that drawing, then that element should be adequately identified with respect to at least one other drawing (and / or as would be understood by those skilled in the art with reference to this disclosure).

[0036] Referring now to the accompanying drawings, in which the same reference numerals always denote the same parts. Figure 1A , Figure 1B and Figure 2 These are, respectively, a side isometric view, a distal end perspective view, and a distal end view of a device 100 for improving adenoma detection according to one embodiment.

[0037] refer to Figure 1A The device 100 includes a distal end portion 1, a proximal end portion 3, and a main body portion 2 positioned between the distal end portion and the proximal end portion. The main body portion 2 includes a support member 5 constructed and / or positioned at specific (preferably static) angles α, β, θ, and φ, which control or influence certain mechanical properties / functions of the device 100. The support member 5 can be connected to the distal end portion 1 and the proximal end portion 3 (or directly fused to or integrally formed therewith) via connectors 4a and 4b, respectively. The support member 5 can be configured and adapted to deflect radially and rotatably relative to a central axis 6. Figure 1A An isometric view showing the 3D curvature of support member 5 is provided.

[0038] refer to Figure 1B The device 100 may be configured and arranged to be securely attached to the endoscope / colonoscope 200 via compression and friction applied by the open front / distal barrel 7 (or, as should be understood by those skilled in the art in conjunction with a reading of this disclosure, by heat shrinkage, adhesive or other fixation means) (see [link to endoscope]). Figure 4The device 100 is slidably coupled to an endoscope / colonoscope (each of the tubes 7 and 8 may be annular, having an inner surface, an outer surface, an anterior surface, and a posterior surface) via an open rear / proximal tube 8. The proximal tube 8 may have an internal aperture configured, constructed, and adapted to move, translate, and rotate along the outer diameter of the endoscope / colonoscope 200 (which may have a larger inner diameter relative to the distal tube 7). The fixed attachment of the distal tube 7 prevents the device 100 from prematurely disengaging from the endoscope. The distally extending portion of the distal tube 7 may be substantially circular and may (but not necessarily) protrude beyond the distal side of the endoscope / colonoscope by a sufficient amount (e.g., at least 0.1 mm) to form an annular structure around the circumference of the endoscope 200. In embodiments where the annular portion of the anterior barrel 7 is closed, it can be used to provide an extended cavity in the anterior portion of the endoscope / colonoscope, which can be used for aspiration or manipulation of tissue. The distal barrel 7 / distal portion 1 may have asymmetrical features or radial holes that facilitate tissue manipulation. According to alternative embodiments, the respective functions of the distal barrel 8 and the proximal barrel 7, as well as their relatively fixed / movable configurations, can be switched while the device as a whole continues to be configured to perform the same / similar overall functions.

[0039] refer to Figure 2 The support member 5 is attached to the distal portion 1 at an angle θ relative to a vector extending perpendicularly from the central axis 6. As described herein, a specific angle θ and associated configuration can control certain mechanical properties of the device 100. The distal cylinder 7 may be made of an elastic or plastic material (as should be understood by one of ordinary skill in the art in conjunction with a reading of this disclosure) and may be designed to have an interference fit with the outer diameter of the endoscope / colonoscope 200 for fixation.

[0040] refer to Figure 1A , Figure 1B and Figure 2Each of these, the aforementioned mechanical properties of device 100 can be determined at least in part by one or more angles α, β, θ, φ and the cross-section of support member 5. The cross-section of support member 5 can have a constant or variable thickness. The degree to which body 2 resists rotational torsion can be largely controlled by the section modulus of support member 5 and angles β and θ. In some embodiments, thickening the base 5a of the cross-section will significantly increase rotational stiffness. In some embodiments, increasing angle θ will reduce rotational stiffness in the θ direction and increase the angle of rotation during collapse or expansion. Increasing angle β can also reduce rotational stiffness and increase the angle of rotation during collapse or expansion. Increasing angles β and θ can create a larger radius 9, which increases the contact area between the control arm apex 18 and the colonic wall. Increasing angles β and θ will also reduce the radial component of the force exerted by the control arm apex 8 when the arm flips (as defined when α > 90°). The degree of radial force exerted by body 2 can be controlled by the section modulus of support member 5 and angles α, β, φ and θ. Decreasing angles β and θ will increase radial stiffness. An angle α closest to 90° maximizes radial stiffness. Increasing the thickness 5b with a section modulus of 2 increases radial drag. Increasing the radius 9 of the control arm apex 8 (overall) reduces radial drag. An angle α < 90° reduces radial stiffness but increases overturning resistance. An angle α > 90° reduces both radial stiffness and overturning resistance. Generally, decreasing the angle φ reduces radial stiffness. In one embodiment, the angle and section modulus are preferably not independent variables, and therefore lower-order interactions can also determine the mechanical properties of the device.

[0041] According to one embodiment, the values ​​of α, β, θ, φ and the section modulus of the control arm 5 and their interactions can be configured and adapted to achieve the following properties of the device 100: 1) the radial force of the body 2 is substantially constant and independent of the diameter (expansion); 2) the support member 5 is prone to overturning (collapse) when a force is applied to the body 2 in the distal direction; 3) the support member 5 is prone to extending (extension) when a force is applied to the body 2 in the proximal direction; and 4) the torque applied by the support member apex 8 is less than the radial force applied by the support member apex 18, but greater than 0.

[0042] Go to Figures 3A-3BAccording to one embodiment, a schematic diagram of the distal end portion 1 of the device 100 and a schematic diagram of the side view of the distal end portion 1 of the device 100 are shown, respectively. The distal portion 1 may incorporate an inward protrusion 10 on the front cylinder 7 to reduce the sensitivity of the hoop strength and compressive force to the diameter. This concentrates the hoop strength on a specific pawl, which increases the stress in the pawl, thereby allowing for higher deformation at the local level and less expansion of the hoop at the macroscopic level. Depending on the rigidity of the material, it may also generate some bending stress in the hoop. The front cylinder 7 may also incorporate a radial hole 11 instead of or as a supplement to the inward protrusion 10 to reduce the hoop strength.

[0043] refer to Figure 4 According to one embodiment, a side-view transparent / semi-transparent view of a device 100 positioned at the distal end of an endoscope 200 is shown. The distal portion 1 is shown as a cap configuration having the aforementioned anterior barrel 7. The proximal portion 3 is shown having its translational direction relative to the endoscope (indicated by an arrow indicating axial movement (along the central axis of the endoscope) and a separate arrow indicating rotational movement). The anterior barrel 7 extends distally to form a partially enclosed volume distal to the distal end of the endoscope 200. The anterior barrel 7 and / or the entire device 100 may be constructed of a semi-transparent material (but is not required to) to allow visualization through the device 100 itself. Referring to the endoscope portion 200, an external torque (torsion) can be applied to the endoscope, which can be translated to the device 100 via the anterior barrel 7 through a fixed attachment (e.g., friction fit, clamp, flange entry slot, etc.) to the distal portion 1, and can cause the device to expand or contract; expansion can be achieved through the mechanical properties of the body portion 2 when friction / interference is applied to the support member 5 against the colonic wall. This allows the end user to selectively expand or contract the device 100 independently of and / or in addition to its natural expansion and contraction due to axial movement (forward or backward). This can be particularly useful during procedures to stabilize or shorten the colon.

[0044] refer to Figure 5 The finite element analysis diagram shows the displacement of the device 100 in its flipped (forwardly collapsed) state in some embodiments. In some embodiments, the maximum displacement occurs at the control arm hole 8 and the proximal portion 3.

[0045] refer to Figures 6A-6C The diagram illustrates the stress profile during the flip-over cycle (retraction, active search by medical practitioners). Most of the stress occurs as bending stress at connectors 4a and 4b. The model shows the self-intersection of control arm 5, an artifact of model error.

[0046] Go to Figures 6D-6FThe diagram illustrates a representation of a device 100 attached to a speculum 200 during a flipping cycle through the colon 300. The device 100 is shown in its flipped state (collapsed forward to facilitate movement through the patient's anatomy) as it retracts from the colon 300 during active probe by the practitioner. As discussed above, a constant radial force is provided to the body 2, independent of the diameter (expansion or retraction; and this radial force can be altered via axial movement of the device within the patient and / or via the axial movement of the device), and allows the medical practitioner to perform the procedure more effectively and efficiently by further / independently altering the diameter (to expand or retract the diameter of the device 100) via axial movement.

[0047] refer to Figure 7A The diagram shows a stress profile of the device 100 during the extension cycle ("collapses" during insertion to facilitate movement through the patient's anatomy). Similarly, stress is primarily present at the connectors 4a and 4b, but also at the distal arm apex 8.

[0048] Go to Figures 7B-7C The diagram shows a representation of a device 100 attached to a speculum 200 during an extension cycle through the colon 300. The device 100 is shown in its collapsed state (retrogradely collapsed) during insertion into the colon 300 by a practitioner.

[0049] about Figures 6A-7C The stress shown does not exceed the elastic limit of the material of device 100. This material can achieve this by having some elastic properties, such as silicone resin with a Shore A hardness range of 30-100 (which has been tested and should be understood by those skilled in the art in conjunction with a reading of this disclosure).

[0050] refer to Figures 8A-8C The apparatus 100 according to the alternative embodiments is shown respectively. I 100 II and 100 III A side view schematic diagram. These alternative embodiments include differences in the number of support members 5, the thickness of the support members / control arms 5, the angles α, β, φ, and θ, and the section modulus of the control arms 5 (and such variations are described above with respect to the mechanical properties / associated functions of the device 100; see, for example, Figure 1). Each of these configurations has different radial force values, ease of flipping, and maximum diameter 12 (see...). Figure 8C ).

[0051] refer to Figures 9A-9B The apparatus 100 according to the alternative embodiments is shown respectively. IV Front and rear perspective views are schematic diagrams. (Excluding device 100)IV The proximal end portion 3 is not connected to the endoscope 200. In this configuration, the mechanical properties of the device 100 can be similar, but stability is poorer among the individual support members 5. The main body portion can have smaller radial forces and is more prone to opening or deformation. After a certain amount of flipping, where the support member 5 is pushed and flipped in the distal direction, the support member 5 can be further extended and extended to the distal side of the front cylinder 7 to become a helical arm extending distally from the distal portion of the device. These may be visible in the endoscopic view, but still have both radial and rotational aspects of motion.

[0052] refer to Figures 10A-10B The apparatus 100 according to the alternative embodiments is shown respectively. VI A side view schematic diagram. As shown, the support member 5 is attached at one end to the proximal end portion 3. This collapsible device 100 with a cage-like structure... VI This represents an alternative embodiment that is similar in many respects to the design 100 described above, wherein some differences arise from some of the structural differences illustrated. For example, the angle φ can be >90°, which may result in a different collapse mechanism that relies less on torsion and more on bending at the proximal connector 4b. This can result in less axial extension and retraction on the endoscope and can produce a design in which the body 2 and the support member 5 do not flip much or not at all during retraction. The device may take on a "donut" or "apple" shape during retraction.

[0053] While embodiments of this disclosure have been specifically shown and described with reference to certain exemplary embodiments, those skilled in the art will understand that various changes in detail may be made without departing from the spirit and scope of the inventive features of the embodiments (as defined by the claims, which are supported by the written description and the drawings). Furthermore, where exemplary embodiments are described with reference to a certain number of elements, it should be understood that exemplary embodiments may be implemented using fewer or more than that number of elements.

[0054] While various embodiments have been described and illustrated herein, those skilled in the art will readily conceive of various other devices and / or structures for performing functions and / or obtaining results and / or one or more of the advantages described herein, and each of such variations and / or modifications is considered to be within the scope of the embodiments described herein. More generally, those skilled in the art will readily understand that all parameters, dimensions, materials, and configurations described herein are intended to be exemplary, and actual parameters, dimensions, materials, and / or configurations will depend on one or more specific applications to which the teachings are applied. Those skilled in the art will recognize or be able to determine many equivalents of the particular embodiments described herein using only conventional experimentation. Therefore, it should be understood that the foregoing embodiments are given by way of example only, and that embodiments may be practiced in ways other than those specifically described and claimed within the scope of the appended claims and their equivalents. Embodiments of this disclosure relate to each individual feature, system, article, material, kit, and / or method described herein. Additionally, any combination of two or more such features, systems, articles, materials, kits, and / or methods (if such features, systems, articles, materials, kits, and / or methods are not contradictory) is included within the scope of this disclosure.

[0055] The terminology used herein is for the purpose of describing particular embodiments only and is not intended to limit the inventive features of the embodiments. As used herein, the singular forms “a” and “the” are intended to also include the plural forms unless the context clearly indicates otherwise. It should be further understood that the terms “comprise” (and any form of “comprise”, such as “comprises” and “comprising”), “have” (and any form of “have”, such as “has” and “having”), “include” (and any form of “include”, such as “includes” and “including”), and “contain” (and any form of “contain”, such as “contains” and “containing”) are open-ended connecting verbs. Thus, a method or apparatus “comprises,” “has,” “includes,” or “contains” one or more steps or elements. Similarly, the elements or steps of a device that "comprises," "has," "includes," or "contains" one or more of those features have, but are not limited to, having only those one or more features. Furthermore, the device or structure configured in a certain way is configured at least in that manner, but may also be configured in a manner not listed.

[0056] In the appended claims, all devices or steps, plus corresponding structures, materials, actions, and equivalents (if any) of the functional elements, are intended to include any structure, material, or action used to perform the function in conjunction with other claimed elements of the specific claim. The description of embodiments has been presented for purposes of illustration and description, but is not intended to be exhaustive or limited to the inventive features of the embodiments in the disclosed forms. Many modifications and variations will be apparent to those skilled in the art without departing from the scope and spirit of the inventive features of the embodiments. The embodiments were chosen and described in order to best explain the principles and practical application of one or more aspects of the inventive features of the embodiments, and to enable others skilled in the art to understand one or more aspects of the inventive features of various embodiments with various modifications to suit a particular intended use.

Claims

1. An apparatus for improving adenoma detection, the apparatus comprising: The annular distal end portion is positioned in a fixed relationship with the distal end of the endoscope, which has a central longitudinal axis positioned therethrough. The annular proximal end portion is slidably attached to an endoscope located proximal to the distal end portion; and A main body portion, positioned between the distal end portion and the proximal end portion, wherein the main body portion includes at least one support member having a first end and a second end, wherein: The first end portion is attached to the distal end portion, and the second end portion is attached to the proximal end portion; and The at least one support member is configured or constructed to deflect radially or rotatably, forming a first dynamic angle between the at least one support member and the distal end portion or the proximal end portion.

2. The apparatus according to claim 1, wherein, The support member is connected to the distal end portion at an angle θ relative to a vector extending perpendicularly from the central longitudinal axis.

3. The apparatus according to claim 2, wherein, Increasing the angle θ will reduce the rotational stiffness of the device.

4. The apparatus according to claim 2, wherein, Decreasing the angle θ will increase the rotation angle of the device.

5. The apparatus according to claim 1, wherein, The at least one support member is configured to flip relative to the body when a force is applied to the body in the direction of the distal end.

6. The apparatus according to claim 1, wherein, The at least one support member is configured to extend relative to the body when a force is applied to the body in the direction of the proximal end.

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