Lifter for medical devices and related methods

Abstract

Lifts for medical devices and related methods are described, including a lift having a first sidewall, a second sidewall, and a guide surface for contacting an accessory device. The guide surface can extend between the first sidewall and the second sidewall. A distal portion of the second sidewall can extend further upward than a distal portion of the first sidewall in a direction perpendicular to a longitudinal axis of the lift.

Description

Cross-references to related applications

[0001] This application claims priority to U.S. Provisional Application No. 63 / 624,833, filed January 25, 2024, which is incorporated herein by reference in its entirety. Technical Field

[0002] Various aspects of this disclosure generally relate to lifters for medical devices and related methods. Specifically, aspects of this disclosure relate to lifters for medical devices suitable for accessing target sites (e.g., the pancreas or bile ducts) during endoscopic procedures, among others. Background Technology

[0003] During medical procedures such as endoscopic retrograde cholangiopancreatography (ERCP), the operator can position the endoscope near the patient's greater duodenal papilla and extend one or more medical instruments through the working channel of the endoscope. An elevator may be located distal to the endoscope and may be actuable to alter the orientation of one or more medical instruments, thereby allowing the instruments to extend into the greater duodenal papilla. Summary of the Invention

[0004] Each aspect disclosed herein may include one or more aspects that combine features described in conjunction with any other disclosed aspect.

[0005] According to some aspects of this disclosure, a lifter for a medical device may include a first sidewall, a second sidewall, and a guide surface for contacting an accessory device. The guide surface may extend between the first and second sidewalls. The distal portion of the second sidewall extends further upward than the distal portion of the first sidewall in a direction perpendicular to the longitudinal axis of the lifter.

[0006] According to some aspects, the distal portion of the second sidewall may be inclined inward toward the first sidewall. In some examples, the guide surface may include a first side portion at least partially located on the first sidewall and a second side portion at least partially located on the second sidewall. The second side portion may extend further upward than the first side portion in a direction perpendicular to the longitudinal axis. In some examples, the distal portion of the second sidewall may include a surface at least partially facing the proximal direction. In some examples, the farthest end of the distal portion of the second sidewall may be adjacent to the central portion of the guide surface. The central portion may be located between the first and second side portions. In some examples, the first side portion of the guide surface may be connected to the first side surface of the first sidewall via a first side edge. The second side portion of the guide surface may be connected to the second side surface of the second sidewall via a second side edge. The height of the second side edge at the distal portion of the second sidewall may be greater than the height of the first side edge. In some examples, the distal portion of the second sidewall may form the closed end of the second side portion of the guide surface. The second side surface of the second sidewall may include a first portion and a second portion. The second portion may extend to the farthest edge of the lifter and may be inclined inward toward the first sidewall relative to the first portion. In some examples, the edge of the second portion may extend substantially perpendicularly from the farthest edge of the lifter. In some examples, a portion of the edge of the second portion may be axially aligned with the farthest edge of the lifter. In some examples, the edge of the second portion may have a second portion that curves away from the central longitudinal axis of the guide surface. In some examples, the second side edge may include an upward ramp extending toward the far end of the lifter. In some examples, the height of the first side edge and the height of the proximal portions of the second side edge may be the same. In some examples, the guide surface may include a planar side portion located at the distal portion of the second sidewall. In some examples, the first and second sidewalls may extend to a planar distal surface, which may have a "U" shape.

[0007] According to some aspects of this disclosure, a lifter for a medical device may include a first sidewall and a second sidewall. A proximal portion of the second sidewall may be generally parallel to the entirety of the first sidewall. A distal portion of the second sidewall may be curved toward the first sidewall. In some examples, the surface of the distal portion of the second sidewall may be at least partially oriented proximally. In some examples, the lifter may include a guide surface extending from the first sidewall to the second sidewall. The guide surface may include a first portion adjacent to the first sidewall, a second portion adjacent to the second sidewall, and a central portion located between the first and second portions. The first and central portions of the guide surface may have open distal ends. The second portion of the guide surface may have closed distal ends.

[0008] According to some aspects of this disclosure, a lifter for a medical device may include a first sidewall, a second sidewall, and a guide surface for contacting an accessory device. The guide surface may extend between the first and second sidewalls. The guide surface may include a first portion adjacent to the first sidewall, a second portion adjacent to the second sidewall, and a central portion located between the first and second portions. In some examples, the distal ends of the first portion and the distal ends of the central portion of the guide surface may be open. The second sidewall may form a closed distal end of the second portion. In some examples, the surface of the second sidewall may at least partially face proximally. Attached Figure Description

[0009] The accompanying drawings, which are incorporated in and constitute a part of this application, illustrate exemplary aspects of this disclosure and, together with the specification, serve to explain the principles of this disclosure.

[0010] Figure 1A and Figure 1B An exemplary medical device according to some aspects of this disclosure is shown.

[0011] Figure 2 Use according to some aspects of this disclosure is shown Figure 1A and Figure 1B An exemplary method of an exemplary medical device.

[0012] Figures 3A-3D Some aspects of this disclosure are shown. Figure 1A and Figure 1B Features of an exemplary lifter used in conjunction with an exemplary medical device.

[0013] Figure 4 Some aspects of this disclosure are shown. Figure 1A and Figure 1B Features of another exemplary lift used in conjunction with an exemplary medical device.

[0014] Figures 5A-5C Some aspects of this disclosure are shown. Figure 1A and Figure 1B Features of another exemplary lifter used in conjunction with an exemplary medical device. Detailed Implementation

[0015] The specific aspects of this disclosure are described in more detail below. In the event of any conflict between the terms and definitions provided herein and those incorporated by reference, the terms and / or definitions herein shall prevail.

[0016] As used herein, the terms “proximal” and “distal” refer to the relative positions of components of the exemplary medical device. As used herein, “proximal” refers to a position relatively closer to the outside of the body or closer to the operator using the medical device. Conversely, “distal” refers to a position relatively farther away from the operator using the medical device or closer to the inside of the body.

[0017] As used herein, the terms “comprising,” “including,” “containing,” “having,” or any other variations thereof are intended to cover a non-exclusive inclusion, such that a process, method, article, or apparatus that comprises a list of elements includes not only those elements but may also include other elements not expressly listed or inherent to such process, method, article, or apparatus. The term “exemplary” is used in the sense of “example” rather than “ideal.” Relative terms such as “about,” “substantially,” and “approximately” are used to indicate possible variations of ±10% in the stated values ​​or ranges.

[0018] Although a duodenoscopy has been referenced herein for illustrative purposes, it should be understood that this disclosure covers any suitable medical device configured to allow an operator to access and observe the internal anatomy of a subject (e.g., a patient) and / or to deliver medical instruments or accessory devices (e.g., biopsy forceps, grasping forceps, retrieval baskets, snares, probes, scissors, retrieval devices, lasers, and other tools) into the subject's body. The medical devices described herein can be inserted into various body cavities and / or chambers, such as the urinary tract or gastrointestinal tract. It should be understood that, unless otherwise stated, endoscopes, bronchoscopes, gastroscopes, endoscopic ultrasound (“EUS”) endoscopes, colonoscopes, ureteroscopes, laparoscopes, cystoscopes, aspiration endoscopes, sheaths, catheters, or any other suitable delivery device or medical device may be used in conjunction with the features described herein.

[0019] The medical device described herein features improved accessibility to various target sites within the patient's body, such as the greater duodenal papilla, bile duct, pancreatic duct, etc., among other things. Inability to access the greater duodenal papilla, bile duct, and / or pancreatic duct, or repeated attempts to do so, can lead to post-ERCP complications such as pancreatitis. According to some aspects of this disclosure, the medical device may include a lifter to, for example, alter the orientation of one or more medical devices. According to some aspects of this disclosure, the lifter may include side portions of different heights and / or shapes to facilitate tilting or orienting one or more medical devices toward a desired location. In some aspects, the lifter may include curved and / or smooth surfaces that allow one or more medical devices to move and / or slide more easily along the surface of the lifter.

[0020] In some exemplary medical procedures (e.g., ERCP), an operator can access the patient's bile duct or pancreatic duct by positioning a medical device near the greater duodenal papilla. The opening of the bile duct is typically located in the upper left quadrant of the greater duodenal papilla, for example, between 10 o'clock and 1 o'clock, relative to the distal end of the medical device and / or in a view displayed on a monitor and provided by the imager of the medical device. The opening of the pancreatic duct is typically located in the right half-quadrant of the greater duodenal papilla, for example, between 1 o'clock and 4 o'clock. In some aspects, an elevator can facilitate tilting or orienting one or more medical devices toward the bile duct. In some aspects, an elevator can facilitate tilting or orienting one or more medical devices toward the pancreatic duct.

[0021] It should be understood that references to any particular surgical procedure are provided for convenience only and are not intended to limit this disclosure. Those skilled in the art will recognize that the concepts upon which the disclosed apparatus and application methods are based can be applied to any suitable procedure, whether medical or otherwise. Examples of this disclosure, as described above and illustrated in the accompanying drawings, will now be referenced in detail. Where possible, the same reference numerals will be used throughout the drawings to refer to the same or similar parts.

[0022] Figure 1A An exemplary medical device 110 (e.g., a duodenoscope) having a handle 112 and an insertion portion 114 is depicted. Figure 1B The proximal end of the handle 112 is shown. The medical device 110 may also include an umbilical cord 116 for connecting the medical device 110 to a source such as air, water, suction, power, and an image processing and / or observation device. The insertion portion 114 may include a sheath or shaft 118 and a distal tip 120. The distal tip 120 may include an imaging device 122 (e.g., a camera) and a light source 124 (e.g., an LED or fiber optic cable). In some examples, such as... Figure 1A As shown, the distal end 120 can be lateral (i.e., side-view). That is, the imaging device 122 and the light source 124 can be arranged radially outward, vertically, substantially vertically, or laterally relative to the longitudinal axis of the axis 118 and the distal end 120.

[0023] The distal end 120 may also include a lifter 126 for altering the orientation of a medical device inserted into the working channel of the medical device 110. The lifter 126 may alternatively be referred to as a swing support, pivot support, lifting base, or any other suitable term. The lifter 126 may be rotatable via, for example, an actuation line extending from the handle 112 through the shaft 118 to the lifter 126, or another control element.

[0024] The distal portion of shaft 118 connected to distal end 120 may have a steerable segment 128. The steerable segment 128 may be, for example, a hinged joint. Shaft 118 and steerable segment 128 may include various structures known in the art or that may become known.

[0025] Handle 112 may have one or more actuator / control mechanisms 130. One or more of the control mechanisms 130 may provide control over the steerable segment 128. The one or more control mechanisms may allow the supply of air, water, suction, etc. For example, handle 112 may include control knobs 132, 134 for left, right, up, and / or down control of the steerable segment 128. For example, one of the knobs 132, 134 may provide left / right control of the steerable segment 128, while the other of the knobs 132, 134 may provide up / down control of the steerable segment 128. Handle 112 may further include a first locking mechanism 136 and a second locking mechanism 142 (e.g., a knob or lever) for preventing steering and / or braking of the steerable segment 128 in at least one of the up, down, left, or right directions. Handle 112 may include a control lever 138 (see... Figure 1B The control lever 138 can raise and / or lower the lift 126 via a connection between the control lever 138 and an actuation line extending from the control lever 138 through the shaft 118 to the lift 126. Port 140 allows a medical device to enter the working channel of the medical device 110 through the shaft 118 to reach the distal end 120.

[0026] although Figure 1A A side-viewing medical device 110 (a device having an imaging device 122 and / or a light source 124 that are generally radially outward-facing) is depicted, but it should be understood that the medical device 110 may alternatively be a front-viewing device (a device having an imaging device 122 and / or a light source 124 that are generally distally-facing). In some aspects, the medical device 110 may include both the side-viewing imaging device 122 and / or the light source 124 and the front-viewing imaging device 122 and / or the light source 124.

[0027] Figure 2The shaft 118 of the medical device 110 is shown, having been advanced through the patient's duodenum 201 and positioned near the major duodenal papilla 203. The operator can insert a medical instrument and / or accessory device 213 (e.g., a scalpel, blade, cannula, guidewire, or any other type of medical instrument) into port 140 and allow the medical instrument 213 to pass through the working channel 125 through the shaft 118 to reach the distal end 120. The medical instrument 213 can exit the working channel 125 at the distal end 120. The operator can use a control lever 138 to raise the lifter 126 and tilt the medical instrument 213 toward the major duodenal papilla 203. The operator can use the medical instrument 213 to cannulate the papilla to obtain access to the bile duct 205 or pancreatic duct 207. The operator can insert the medical instrument 213 into the bile duct 205 or pancreatic duct 207 to facilitate the medical procedure. Figure 2 In this embodiment, medical device 213 is shown extending into common bile duct 205. As described above, the lifter described herein can facilitate tilting or orienting one or more medical devices 213 toward the bile duct or toward the pancreatic duct.

[0028] Figures 3A-3D Features of an exemplary lifter 326 are shown; unless otherwise specified herein, lifter 326 may include any features of lifter 126. Features of lifter 326 may facilitate the placement of one or more medical devices along direction K (e.g., Figure 3C and Figure 3D (as shown) and / or tilted or oriented upwards toward the target site (e.g., the bile duct), and in other aspects. Figure 3A In the illustration, lifter 326 is shown within the housing of exemplary distal tip 320, which may be used in conjunction with shaft 118 of medical device 110 (e.g., in place of distal tip 120). Unless otherwise specified herein, distal tip 320 may include any features of distal tip 120.

[0029] The lifter 326 may include a body 350 and an arm 352. The arm 352 may include a connector 354 (e.g., an opening, slot, and / or other structure) for attaching a control line 365 to the arm 352. When the control line 365 moves or is pushed distally or proximally, the lifter 326 may revolve around a shaft 356 (e.g., ...). Figure 3B-3D (As shown) Rotate. For example, as Figure 3A As shown, moving the control line 365 proximally raises the bottom surface of the housing of the lifter 326 away from the distal end 320. A shaft 356 may be coupled to the proximal end 358 of the body 350 at the proximal end of the lifter 326 (e.g., the nearest side end of the lifter 326). The proximal end 358 of the body 350 may be opposite the distal end 364 of the body 350.

[0030] The body 350 may include a guide surface 360 ​​configured to contact and alter the orientation of a medical device. The guide surface 360 ​​may be on the front side of the body 350. The guide surface 360 ​​may extend between the proximal end 358 and the distal end 364 of the body 350 and between the first sidewall 366a and the second sidewall 366b. As disclosed below, the guide surface 360 ​​may also extend on the inner surface of the second sidewall 366b. The guide surface 360 ​​may have a smooth profile to allow the medical device to move and / or slide more easily along the guide surface 360. The body 350 may further include a rear face 362. The rear face 362 may be on the side of the body 350 opposite to the guide surface 360. When the lifter 326 is in a lowered configuration, the rear face 362 may face downward toward the bottom of the housing of the distal end 320. When the lifter 326 is in the lowered configuration, the guide surface 360 ​​can face upward / radially outward, approximately in the same direction as the imaging device 122 and the light source 124.

[0031] like Figure 3C Specifically, the body 350 may include a first sidewall 366a (closer to the arm 352) including a first side surface 374; and a second sidewall 366b (remote from the arm 352) including a second side surface 376. The first side surface 374 may be the outer surface of the first sidewall 366a, and the second side surface 376 may be the outer surface of the second sidewall 366b. The first sidewall 366a may be on the side of the body 350 opposite to the second sidewall 366b. The first and second side surfaces 374 and 376 may extend from the guide surface 360 ​​to the rear surface 362.

[0032] like Figure 3C Specifically, at least a portion of the second sidewall 366b may extend further upward than the first sidewall 366a in direction A. Direction A / upward direction may be a direction perpendicular to the central longitudinal axis C of the body 350. Direction A may be the direction of a vector extending from the back surface 362 toward the guide surface 360. Direction A may be opposite to direction B. Direction B may be the direction of a vector extending from the guide surface 360 ​​to the back surface 362. In other words, at least a portion of the second sidewall 366b may extend higher than the first sidewall 366a.

[0033] In some examples, the first sidewall 366a and the second sidewall 366b may have approximately the same height from the proximal end 358 of the body 350 to the intermediate portion 327. The intermediate portion 327 may be between the proximal end 358 and the distal end 364. For example, the portion of the second sidewall 366b between the proximal end 358 and the distal end 364 may be approximately parallel to the entirety of the first sidewall 366a. On the distal side of the intermediate portion 327, the second sidewall 366b may taper upward in direction A such that the height of the second sidewall 366b from the intermediate portion 327 to the distal end 364 may be greater than the height of the first sidewall 366a.

[0034] The guide surface 360 ​​may include a first side portion 378a, a second side portion 378b, and a central portion 380 located between the first and second side portions 378a and 378b. A central distal surface 382 may extend downward along direction B from the farthest end of the central portion 380.

[0035] At least a portion of the first side portion 378a may be on the first sidewall 366a. At least a portion of the second side portion 378b may be on the second sidewall 366b. Since the second sidewall 366b is higher than the first sidewall 366a, the second side portion 378b may have a greater height than the first side portion 378a. The farthest end of the first side portion 378a may taper distally toward the farthest end of the central portion 380. The farthest end of the central portion 380 may be generally straight and may extend between the farthest ends of the first side portion 378a and the second side portion 378b.

[0036] like Figure 3C and Figure 3D As shown, the distal portion 390 of the second sidewall 366b may bend or tilt inward toward the first sidewall 366a. For example, the farthest end of the distal portion 390 may be adjacent to the central portion 380. The distal portion 390 may wrap inward toward the central longitudinal axis C. The inner surface 384 of the distal portion 390 may correspondingly bend inward toward the first sidewall 366a. Therefore, the distal portion 390 may block or distally close the farthest end of the second side portion 378b of the guide surface 360. The inner surface 384 may at least partially face the proximal direction. In other words, the normal extending from the inner surface 384 may at least partially face the proximal direction.

[0037] The proximal portion of the second sidewall 366b (the proximal portion of the distal portion 390) may be approximately parallel to the central longitudinal axis C and the first sidewall 366a. For example... Figure 3C Specifically, the first side portion 378a of the guide surface 360 ​​may be open at its farthest end, while the second side portion 378b of the guide surface 360 ​​may have a closed farthest end, because the farthest portion 390 may form a closed farthest surface.

[0038] The second side surface 376 may include a first portion 376a and a second portion 376b. The second portion 376b may be located distal to the first portion 376a. The second portion 376b may be disposed on the distal portion 390 of the second sidewall 366b. The second portion 376b may be inclined inward toward the first sidewall 366a relative to the first portion 376a, consistent with the inward wrapping of the second sidewall 366b.

[0039] like Figure 3B and Figure 3DAs shown, the first side surface 374 of the first sidewall 366a can be connected to the first side portion 378a of the guide surface 360 ​​via a first edge 368a. As used herein, the term "edge" includes a surface having a non-zero width. The second side surface 376 of the second sidewall 366b can be connected to the second side portion 378b and / or the inner surface 384 of the guide surface 360 ​​via a second edge 368b.

[0040] The second edge 368b may have a first portion 369 and a second portion 371. The first portion 369 may extend from the proximal end 358 to the distal portion 390 of the second sidewall 366b. Proximal to the intermediate portion 327, the first portion 369 may be generally parallel to the central longitudinal axis C. Distal to the intermediate portion 327, the first portion 369 may extend axially and taper upward in direction A. The second portion 371 may be curved inward toward the first sidewall 366a. The shape of the second portion 371 will be described in further detail below. The second edge 368b may have a thickness that varies from the proximal end to the distal end of the second edge 368b (i.e., in the G / H direction perpendicular to both the A / B direction and the central longitudinal axis C).

[0041] The first edge 368a may extend substantially parallel to the central longitudinal axis C. The portion of the second edge 368b proximal to the middle portion 327 may have the same height along direction A as the first edge 368a. In other words, the proximal portion of the second edge 368b may be flush with the first edge 368a. The portion of the second edge 368b distal to the middle portion 327 may have a greater height than the first edge 368a.

[0042] like Figure 3CAs shown, a second portion 371 of the second edge 368b may extend between a second portion 376b of the second side surface 376 and the inner surface 384. The second portion 371 may have a first end 373a adjacent to / contacting the central distal surface 382 (which is the farthest edge of the lifter 326). The second portion 371 may have a second end 373b adjacent to / contacting the first portion 369. From the first end 373a, the second portion 371 may extend generally upward, for example, generally vertically, to an inflection point 375. For example, the first end 373a may be axially aligned with the central distal surface 382. From the inflection point 375 to the second end 373b, the second portion 371 may bend / open towards the first portion 369 in direction H. Generally, the second portion 371 may extend more in the vertical (A / B) direction than in the horizontal (G / H) direction. The first side distal edge 370 may extend from the first edge 368a to the central distal surface 382. The first distal edge 370 may extend between the first side portion 378a and the back surface 362. From the distal end of the first edge 368a, the first distal edge 370 extends distally and inwardly toward the central longitudinal axis C. The first distal edge 370 may be generally straight. The normal extending from the first distal edge 370 may extend distally and toward direction G (distally and away from the second sidewall 366b).

[0043] The first portion 369 of the first edge 368a and the second edge 368b may extend distally by approximately the same amount. The second portion 371 of the second edge 368b may extend distally further than the distal end of the first edge 368b. The second portion 371 of the second edge 368b and the distal edge 370 of the first edge may extend distally by the same amount.

[0044] During an exemplary medical procedure, shaft 118 and distal tip 320 (including lifter 326) can be positioned near a target site (e.g., the major duodenal papilla 203). The operator can allow a medical device (e.g., medical device 213) to extend through the working channel of shaft 118 and from the opening of the working channel at distal tip 320, such that medical device 213 contacts and / or rests on the guide surface 360 ​​of lifter 326, for example, at the central portion 380. The operator can engage control lever 138 to move control line 365 proximally and raise lifter 326 away from the bottom surface of the housing of distal tip 320. A second sidewall 366b (e.g., a second side portion 378b of guide surface 360) can convect medical device 213 toward direction K and / or upward. During medical procedures such as ERCP, direction K and / or upward can be toward the bile duct. In other words, the second side portion 378b can apply a force to the medical device 213 in the direction K and / or toward the bile duct.

[0045] Figure 4Features of another exemplary lifter 426 are shown; unless otherwise specified herein, lifter 426 may include any features of lifters 126, 326. Lifter 426 may be used in conjunction with distal ends 120, 320 (e.g., in place of lifters 126, 326). Similar to lifter 326, lifter 426 may include an arm 452 having a connector 454 and a shaft 456. Lifter 426 may include a body 450 having any features of a body 350.

[0046] The body 450 may include a first sidewall 466a, which may have any of the features discussed above with respect to the first sidewall 366a. The body 450 may include a second sidewall 466b having any of the features discussed above with respect to the second sidewall 366b. However, the first sidewall 366a may be on the side of the body 350 closer to the arm 352, while the first sidewall 466a may be on the side of the body 450 further away from the arm 452. And the second sidewall 366b may be on the side of the body 350 further away from the arm 352, while the second sidewall 466b may be on the side of the body 450 closer to the arm 452.

[0047] The body 450 may include a guide surface 460 on the side of the body 450 opposite to the back surface 462. The guide surface 460 may have any features of the guide surface 360, and the back surface 462 may have any features of the back surface 362. The features of the body 450 (including the guide surface 460) may be a mirror image of the features of the body 350 (including the guide surface 360) about a plane extending in the A / B direction along the central longitudinal axis of the respective bodies 350, 450.

[0048] In this example, the features of the lift 426 may facilitate the movement of one or more medical devices 213 along direction J (i.e., with...). Figures 3A-3D (The direction K shown is opposite to the direction shown) and / or tilted or oriented upward toward the target site (e.g., the pancreatic duct), and other aspects. For example, the surface of the second wall 466b may cause the medical device 213 to tilt or be oriented in the direction J and / or upward.

[0049] Lifter 426 can be used with the above-mentioned... Figures 3A-3D In a similar exemplary medical procedure as described, and instead of lifter 326, the operator can extend or move the medical device 213 along guide surface 460. When lifter 426 is raised, the surface of the second sidewall 466b or the body 450 corresponding to other portions of the surface described above for lifter 326 can urge the medical device 213 toward direction J and / or upward. During a medical procedure (e.g., ERCP), lifter 426 can apply a force toward pancreatic duct to device 213.

[0050] Figures 5A-5CFeatures of another exemplary lifter 526 are shown. Unless otherwise specified herein, lifter 526 may include any features of lifters 126, 326, 426. Lifter 526 may be used in place of lifters 126, 326 in distal ends 120, 320. Similar to lifters 326, 426, lifter 526 may include an arm 552 (having a connector 554) and a shaft 556. Features of lifter 526 may facilitate tilting or orienting one or more medical devices in direction J and / or toward a target site (e.g., pancreatic duct) in an upward direction, among other aspects. The lifter 526 may have a greater length than lifters 126, 326, 426 (i.e., in a direction parallel to the longitudinal axis of lifter 526) and may include a guide surface 560 that covers a larger surface area of ​​lifter 526 than guide surfaces 360, 460 of lifters 326, 426, thereby accommodating a larger medical device. In other words, guide surface 560 may be deeper and / or wider than guide surfaces 360, 460.

[0051] A guide surface 560 may be located on the front side of the body 550 of the lifter 526. The guide surface 560 may extend between the proximal end 558 and the distal end 564 of the body 550 and between the first sidewall 566a and the second sidewall 566b. The guide surface 560 may have a smooth profile to allow the medical device to move and / or slide more easily along the guide surface 560. The body 550 may further include a back surface 562. The back surface 562 may be located on the side of the body 550 opposite to the guide surface 560. When the lifter 526 is in a lowered configuration, the back surface 562 may face downwards toward the bottom of the housing of the distal end (e.g., distal end 120, 320). When the lifter 526 is in a lowered configuration, the guide surface 560 may face upwards / radially outwards, generally in the same direction as the imaging device 122 and the light source 124.

[0052] The body 550 may have a curved shape; for example, the body 550 may have a generally C-shaped or U-shaped cross-sectional shape, such as... Figure 5B Specifically, the body 550 may include a first sidewall 566a (more distant from the arm 552) and a second sidewall 566b (closer to the arm 552). As shown... Figure 5CAs shown, the second sidewall 566b may have a distal portion 555 on the far side of the middle portion 527 of the body 550, and a proximal portion 557 on the near side of the middle portion 527 of the body 550. The second sidewall 566b may extend further upward than the first sidewall 566a in direction A (as defined above). In other words, the distal portion 555 of the second sidewall 566b may extend higher in direction A than the first sidewall 566a. The proximal portion 557 of the second sidewall 566b may have approximately the same height as the first sidewall 566a. The first and second sidewalls 566a, 566b may extend to a distal surface 582 at the distal end 564. The distal surface 582 may be generally planar and may extend between the guide surface 560 and the back surface 562. The distal surface 582 may have a generally "C" or "U" shape.

[0053] The guide surface 560 may include a first side portion 594 on the first sidewall 566a. The guide surface 560 may include a second side portion 595 on the second sidewall 566b. Since the second sidewall 566b is higher than the first sidewall 566a, the second side portion 595 may have a greater height than the first side portion 594. Figure 5A As shown, the first side surface 584 of the first sidewall 566a can be connected to the first side portion 594 via the first side edge 568a, and the second side surface 586 of the second sidewall 566b can be connected to the second side portion 595 via the second side edge 568b. A portion of the second side portion 595 of the guide surface 560 (e.g., the portion adjacent to the second side edge 568b) may be generally planar.

[0054] The first and second side edges 568a and 568b may have approximately the same thickness in the G / H direction from the proximal end 558 to the distal end 564 of the body 550. The first side edge 568a may extend parallel to the central longitudinal axis C of the body 550. The second side edge 568b may extend approximately parallel to the central longitudinal axis C of the body 550 along the proximal portion 557 of the second sidewall 566b, and the proximal portion 557 may have the same height as the first side edge 568a. Figure 5C Specifically, the distal portion 555 of the second side edge 568b may include an upward ramp 592. For example, the second side edge 568b may slope upward (further along direction A) as it moves toward the distal end 564, such that the distal portion 555 may have a greater height than the first side edge 568a. Figure 5B and Figure 5C As shown, the distal end 593b of the second side edge 568b is located above the distal end 593a of the first side edge 568a. The distal surface 582 extends from the first distal end 593a of the first side edge 568a to the second distal end 593b of the second side edge 568b.

[0055] Lifter 526 can be used with the above-mentioned... Figure 4 In a similar exemplary medical procedure as described, and instead of lifter 426, the operator can extend or move the medical device 213 along guide surface 560. When lifter 526 is raised, second sidewall 566b (e.g., second side portion 595 of guide surface 560) can cause medical device 213 to move in direction J and / or upward. During medical procedures such as ERCP, lifter 526 can apply a force toward pancreatic duct to device 213.

[0056] Alternatively, the first sidewall 566a of the body 550 may have similar features as discussed above with respect to the second sidewall 566b, and the second sidewall 566b may have similar features as discussed above with respect to the first sidewall 566a. In this alternative, the features of the lifter 526 may facilitate tilting or orienting one or more medical devices toward a target site (e.g., the bile duct) in direction K (i.e., the direction opposite to direction J) and / or upward, among other aspects.

[0057] Depending on the type of medical procedure, the operator may select a distal tip (e.g., distal tip 120 or 320) including a lifter (e.g., lifter 126, 326, 426, or 526) and connect the selected distal tip to a shaft (e.g., shaft 118) and a handle (e.g., handle 112). For example, during ERCP, the operator may select lifter 326 to access the bile duct, or lifter 426 or 526 to access the pancreatic duct.

[0058] It will be apparent to those skilled in the art that various modifications and variations can be made to the disclosed apparatus and methods without departing from the scope of this disclosure. Other aspects of this disclosure will be apparent to those skilled in the art from the practice of the specification and the features disclosed herein. The specification and embodiments are intended to be considered as exemplary only.

Claims

1. A lifter for a medical device, comprising: First sidewall; Second sidewall; as well as Guide surface for contact accessory device The guide surface extends between the first sidewall and the second sidewall, and The distal portion of the second sidewall extends further upward in a direction perpendicular to the longitudinal axis of the lifter than the distal portion of the first sidewall.

2. The lifter of claim 1, wherein the distal portion of the second sidewall is inclined inward toward the first sidewall.

3. The lifter according to any one of the preceding claims, wherein the guide surface includes a first side portion at least partially located on the first sidewall and a second side portion at least partially located on the second sidewall, wherein the second side portion extends further upward than the first side portion in the direction perpendicular to the longitudinal axis.

4. The lifter according to any of the preceding claims, wherein the distal portion of the second sidewall includes a surface that is at least partially oriented in the proximal direction.

5. The lifter of claim 3, wherein the farthest end of the distal portion of the second sidewall is adjacent to the central portion of the guide surface, wherein the central portion is located between the first side portion and the second side portion.

6. The lifter of claim 3, wherein the first side portion of the guide surface is connected to a first side surface of the first sidewall via a first side edge, wherein the second side portion of the guide surface is connected to a second side surface of the second sidewall via a second side edge, and wherein the height of the second side edge at the distal portion of the second sidewall is greater than the height of the first side edge.

7. The lifter of claim 6, wherein the distal portion of the second sidewall forms a closed end of the second side portion of the guide surface.

8. The lifter according to any one of claims 6-7, wherein the second side surface of the second sidewall comprises a first portion and a second portion, and wherein the second portion extends to the farthest edge of the lifter and is inclined inward toward the first sidewall relative to the first portion.

9. The lifter of claim 8, wherein the edge of the second portion extends substantially perpendicularly from the farthest edge of the lifter.

10. The lifter of claim 9, wherein a portion of the edge of the second portion is axially aligned with the farthest edge of the lifter.

11. The lifter according to claim 9 or 10, wherein the edge of the second portion has a second portion that is curved away from the central longitudinal axis of the guide surface.

12. The lifter of claim 6, wherein the second side edge includes an upward ramp extending toward the distal end of the lifter.

13. The lifter according to claim 6 or 12, wherein the height of the first side edge and the height of the proximal portion of the second side edge are the same.

14. The lifter according to any of the preceding claims, wherein the guide surface includes a planar side portion located at the distal portion of the second sidewall.

15. The lifter according to any of the preceding claims, wherein the first sidewall and the second sidewall extend to a distal surface of a plane, wherein the distal surface has a "U" shape.

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