ENDOSCOPE HEAD

Abstract

Endoscope head (1) with an endoscope head body (11A, 11B) in which at least one working channel (13) is formed, wherein a pivotable working channel end piece (30) is provided at the distal working channel end section; wherein the working channel end piece (30) is pivotally arranged relative to the endoscope head body (11A, 11B); wherein a working channel end element (33) is arranged at the distal end of the pivotable working channel end piece (30); wherein a cable pull body (7) is anchored in the working channel end element (33), and a pivoting element (5; 6) is arranged on the proximal side of the working channel end element (33), which pivoting element is supported on its proximal side on the endoscope head body (11A, 11B); wherein the pivoting element is designed as a spiral spring (5); wherein a spring holder (31, 36) is provided on the endoscope head body (11A, 11B), against which a proximal end of the spiral spring (5) rests, the distal end of the spiral spring (5) resting on the working channel end element (33); wherein at least one support wire (52) is provided parallel to the longitudinal extension of the spiral spring (5) between the spring holder (31, 36) and the working channel end element (33); wherein the spring holder (31, 36) has a proximal ring element (31) and a distal projection (36) projecting distally from the proximal ring element (31); and the proximal longitudinal end of the spiral spring (5) rests against the proximal ring element (31), and at least one turn on the proximal side of the spiral spring (5) is arranged around the outer circumference of the distal projection (36), wherein the working channel end element (33) forms a distal ring element (33), and the distal ring element (33) has a proximal projection (35) extending in the proximal direction, and the proximal longitudinal end of the coil spring (5) bears against the proximal ring element (31), and the distal longitudinal end of the coil spring (5) bears against the distal ring element (33), and at least one turn on the proximal side of the coil spring (5) is arranged around the outer circumference of the distal projection (36), and at least one turn on the distal side of the coil spring (5) is arranged around the outer circumference of the proximal projection (35).

Description

The present invention relates to an endoscope head having an endoscope head body in which at least one working channel is formed, wherein a pivotable albaran lever is provided on the distal side of the endoscope head body.Such an endoscope head body can be applied to a duodenal endoscope, i.e. an endoscope for examining, for example, the esophagus or else the duodenum, the bile duct, the bile duct, the pancreatic duct, the pancreas, etc.With the aid of the duodenal endoscope it is possible to pass through the esophagus, stomach and stomach outlet into the duodenal cavity.The duodenum has a laterally directed (lateral) optic (illumination device and camera). This can make it difficult to insert and advance through the esophagus, since a "forward" viewing is not readily possible. Only in the stomach or in the duodenum is there sufficient space to angle the distal end of the duodenum by approximately 90° so as to be able to look forwardly.The duodenum also has an albaran lever at the exit of the working channel, which lever allows a specific deflection of the tools, which are pushed through the working channel, by pivoting.After the use of the duodenal endoscope, the latter is subjected to a processing. This must reliably exclude the transfer of all microorganisms such as bacteria, viruses, fungi, worms, but also spores. In the preparation, the duodenum is first manually cleaned to remove organic material or chemical residues without residue. After cleaning, machine disinfection or sterilization takes place.U.S. Pat. No. 5,460,168 A discloses an endoscope. In this endoscope, an endoscope head body has a working channel end piece. Furthermore, a lifting device serves to lift an instrument guided in the working channel. The lifting device is operated by cable. In one variant, a working channel end piece is provided with lateral V-grooves. Here, the cable pull engages the distal end of the working channel end piece. In a further variant, a working channel end piece is provided with a spiral element on the outer circumference. Here, the cable pull also engages at the distal end of the working channel end piece.US 2007 / 0 270 638 A1 shows an albaran lever, on which a cable pull is anchored on the outer surface.DE 100 30 482 A1 shows an albaran lever on which a cable pull acts via a lever. Ring elements are inserted at a deflecting portion. An actuating wire is also shown. The actuating wire extends parallel to a working channel end piece.JP H07-184 845 A discloses an endoscope having a distal pivotable end. In the distal pivotable end, a joint is used as a pivoting element in the working channel end element.CN 2 785 537 Y discloses an endoscope having a distal pivotable end. The distal pivotable end has a spring bender assembly between an upper link and a lower link. The upper link may pivot relative to the lower link.It is the object of the present invention to provide an endoscope head having an endoscope head body that makes it difficult to adhere organic material, etc.This object is achieved by an endoscope head having an endoscope head body having the features of claim 1. An alternative endoscope head is set out in claim 2. Advantageous further developments are the subject of the dependent claims.In the endoscope head according to the invention having an endoscope head body in which at least one working channel is formed, a pivotable working channel end piece is provided at the distal working channel end portion. The working channel end piece is arranged pivotably relative to the endoscope head body. At the distal end of the pivotable working channel end piece, a working channel end element is arranged. A cable pull body is anchored in the working channel end element, and a pivot element is arranged on the proximal side of the working channel end element, which pivot element is supported on the endoscope head body on its proximal side. The cable pull body extends inside the working channel end piece.By pivoting the pivotable working channel end piece, the distal end opening of the pivotable working channel end piece can be brought into the desired angular position. Thus, the pivotable working channel end piece takes over the task of the albaran lever, i.e. by pivoting to enable a specific deflection for the tools which are pushed through the working channel.At the same time, the entire structure of the endoscope head is greatly simplified as a result. Undercuts and locations which are difficult to clean in connection with the complicated shape of the earlier albaran lever are dispensed with. Therefore, the endoscope head can be cleaned more easily. Contaminants on the endoscope head can be removed better. Patients are better protected from germs originating at an endoscope head from previous use.The endoscope head may further have a distal push-on cap. The working channel end piece can be arranged pivotably relative to the cap. The distal push-on cap may have an opening corresponding to a working channel end opening.The distal cap which can be pushed on can surround the distal end of the endoscope head and the pivotable working channel end piece in the state in which it is pushed on the endoscope head.The distal push-on cap may be suitable for disposable use. For example, it is formed from a cost-effective silicone material.By the cooperation of the endoscope head body with the working channel end piece pivotable relative thereto and the cap, a solution is created by which a good remanufacturing of the simply constructed endoscope head body and a one-time useability of the protective cap surrounding the endoscope head body are combined.The working channel end element is arranged at the distal end of the pivotable working channel end piece, wherein the cable pull body is anchored in the working channel end element, and a pivot element is arranged on the proximal side of the working channel end element, which pivot element is supported on the endoscope head body on its proximal side. The cable pull body, e.g. a nipple or a diameter extension of the cable pull, can be integrated directly on a stiffening at the distal end of the pivotable working channel end piece. The pivotable working channel end piece is bendable or elastic and can be pivoted out by simple pulling on the cable pull.The working channel end element can be an annular body, the distal opening of which forms a working channel end opening. Such an annular body is sufficiently rigid to absorb and be pulled by the cable pull body, while retaining its shape during the pulling process.The pivoting element can be designed as a helical spring. On the proximal side, the spiral spring then abuts a supporting surface of the endoscope head body, and on the distal side of the spiral spring, the cable pull engages. Due to its elasticity, the spiral spring permits a well-defined pivoting-out operation that can be easily accomplished. Moreover, due to its cylindrical configuration, the spiral spring has an inner space in the longitudinal extension, which can naturally form the working channel. In addition, the helical spring prevents the pivoting element from buckling.A spring holder can be provided on the endoscope head body, against which a proximal end of the helical spring abuts, wherein the distal end of the helical spring abuts the working channel end element. Parallel to the longitudinal extension of the spiral spring, at least one support wire can be provided between the spring holder and the working channel end element. The spring holder serves for fixing the proximal end of the helical spring in position on the endoscope head body in an invariable manner. The at least one support wire ensures a higher rigidity of the spiral spring during the outward pivoting.The pivot element can be surrounded by an elastic protective jacket. The elastic protective jacket also bends when the pivoting element is pivoted out. As a result, any undercuts of the pivot element are not exposed to the environment. Both in the non-pivoted-out and in the pivoted-out position, germs and foreign substances do not penetrate through the protective jacket into the actual pivoting element. Preferably, the protective jacket has a tubular shape. The outer surface of the protective jacket is easy to clean. Therefore, the endoscope head can be cleaned even more easily.The above-explained aspects of the present invention can be combined as appropriate.Brief Description of the DrawingsFIG. 1 shows a perspective view of an endoscope head according to the invention of a first exemplary embodiment. FIG. 2 is a side view of the endoscope head according to the present invention of the first embodiment. FIG. 3 is a view of the endoscope head according to the present invention of the first embodiment, as viewed from the distal side. FIG. 4 is a side view of the endoscope head according to the present invention of the first embodiment, with the outer tube 32 and the inner tube 34 omitted for clarity of illustration. FIG. 5 shows a side view of the endoscope head according to the invention of the first exemplary embodiment, similar to FIG. 4, wherein FIG. 5 shows a pivoted position. FIG. 6 shows a side view of an endoscope head of a second exemplary embodiment, which is not according to the invention. FIG. 7 is a side view showing a modification of the endoscope head according to the present invention of the second embodiment. FIG. 8 is a side view showing another modification of the endoscope head according to the present invention of the second embodiment. FIG. 9 shows a perspective view of the endoscope head according to the invention with a protective cap 4.Hereinafter, the present invention will be described in detail with reference to the drawings by way of embodiments.Embodiment 1First, referring to Figs. 1 to 5, a first embodiment of the present invention will be described.FIGS. 1 to 3 are views showing the general structure of the first embodiment of the endoscope head 1 according to the present invention.An endoscope head 1 has an endoscope head body 11 composed of a cylindrical base body 11A on the proximal side and an extension 11B running from the base body 11A in the distal direction.In the extension 11B, a camera 16 and an illumination device 17 are provided in a known manner so as to be aligned laterally. At the distal end piece, the extension 11B has a rounded end face 14.In the cylindrical base body 11A, at least a working channel, a cable pull channel and lines for supplying the camera 16 and the lighting device 17, etc. are provided.At least the working channel and the cable pull channel each extend along the longitudinal direction of the base body 11A and parallel to each other. The cable channel carries a cable 7 described below for actuating a pivotable working channel element 30. the working channel carries micro-tools for examining e.g. the esophagus or also the duodenum, the bile duct, the bile, the pancreatic duct, the pancreatic duct etc.The base body 11A has a distal surface 18 on which the extension 11B is integrally formed therewith. On the distal surface 18 there is arranged the pivotable working channel element 30, which extends parallel to the extension 11B in the distal direction.During operation, a cap, not shown in FIGS. 1 to 3, can be placed on the endoscope head 1, which cap surrounds the extension 11B and the pivotable working channel element 30 and can be releasably fastened, for example latchingly, on the outer periphery of the base body 11A. The cap has a side window through which the camera 16, the lighting device 17, and at least the distal end portion of the pivotal working channel member 30 are exposed to the outside. On its outer circumferential surface, the base body 11A may be provided with a groove extending parallel to a proximal end side of the base body 11A, which may be used as a snap groove for the cap.The pivotable working channel element 30 is arranged pivotably relative to the endoscope head body 11. The pivotable working channel element 30 has a cylindrical longitudinal extension, wherein a working channel 13 is formed in its interior. On the proximal side, the pivotable working channel element 30 is placed on the distal surface 18 of the base body 11A at a location at which the working channel section running in the base body 11A opens distally. On the proximal side, the pivotable working channel member 30 may have a proximal ring member 31 adhered, clamped, screwed, hooked, screwed or otherwise secured to the distal surface 18, see Figure 4.The proximal ring member 31 has a distal protrusion 36 extending in the distal direction. The proximal ring member 31 and the distal protrusion 36 function as a spring retainer for a coil spring 5 described below. the proximal ring member 31 has a cable passage extending parallel to the central axis of the endoscope head body, which is aligned with the cable passage of the base body 11A and extends it toward the distal side.On the distal side, the pivotable working channel element 30 has a distal ring element 33 with an inner opening which forms the distal outlet of the working channel 13. The ring element 33 thus forms a working channel end element. The ring element 33 is formed, for example, in a shape as a ring element with two radially opposite extents.The ring element 33 can also have a circular shape, an elliptical shape, an oval shape or similar shape, wherein even a heart curve shape or a polyhedron can be used. The proximal ring element 31 and the distal ring element 33 are preferably constructed as geometrically similar bodies which define the outer shape of the pivotable working channel element 30.A cable pull end 71 is integrated in the distal ring element 33 such that the cable pull 7 runs parallel to the central axis of the pivotable working channel element 30. The cable end 71 can be designed as a nipple or as a diameter extension of the cable 7 and is fastened in a corresponding bore on the ring element 33, e.g. in a press fit, in such a way that it does not become detached from the distal ring element 33. The proximal ring element 31 has an opening at the location corresponding to the bore at the distal ring element 33, through which the cable pull 7 passes such that the cable pull 7 extends parallel to the central axis of the pivotable working channel element 30 from the proximal ring element 31 to the ring element 33.In the interior, the ring element 33 has a cone-like inner surface tapering towards the outlet, which forms the working channel outlet surface.The ring member 33 may have, on its tapered inner peripheral surface, a V-shaped groove 33A extending toward the central axis of the pivotal working passage member 30 as a guide groove for a guide wire. Preferably, the recess 33A is attached to the ring member 33 at a position opposite to the cable end 71 with respect to the central axis.Alternatively, the inner peripheral surface of the ring member 33 may be cylindrical so that the V-shaped recess 33A extends as a guide groove parallel to the central axis of the pivotable working channel member 30.The distal ring member 33 has a proximal protrusion 35 extending in the proximal direction. The distal ring member 33 and the proximal protrusion 35 function as a spring retainer for a coil spring described below.A pivot element is arranged between the proximal ring element 31 and the distal ring element 33. In the first exemplary embodiment, the pivoting element is designed as a helical spring 5.The coil spring 5 extends parallel to the central axis of the endoscope body 1. the proximal longitudinal end of the coil spring 5 abuts against the proximal ring member 31, and the distal longitudinal end of the coil spring 5 abuts against the distal ring member 33. Thus, the coil spring 5 is delimited in the longitudinal direction by the proximal ring element 31 and the distal ring element 33. At least one turn on the proximal side of the coil spring 5 is disposed around the outer periphery of the distal protrusion 36, and at least one turn on the distal side of the coil spring 5 is disposed around the outer periphery of the proximal protrusion 35. Thereby, the coil spring 5 is supported in the radial direction.The pivotable working channel element 30 consists between the proximal ring element 31 and the distal ring element 33 of an outer tube 32, the spiral spring 5 as a pivot element and an inner tube 34, viewed from the outside to the inside. In other words, the pivot element is covered on its outer side by the outer tube 32 in the radial direction and on its inner side by the inner tube 34. The inner circumferential surface of the inner tube 34 forms a portion of the working channel 13 in the pivotable working channel member 30.The inner tube 34 is fixed to and extends between the inner periphery of the distal protrusion 36 and the inner periphery of the proximal protrusion 35 by, for example, bonding. The outer tube 32 is fixed to and extends between the outer periphery of the proximal ring member 31 and the outer periphery of the distal ring member 33, for example, by adhesion.Between the proximal ring element 31 and the distal ring element 33 a support wire 52 is arranged, which in the rest position shown in FIG. 4, in which the pivoting element is not pivoted, runs parallel to the central axis of the endoscope body and thus parallel to the cable pull 7 and to the extension direction of the helical spring 5. The support wire 52 can be seated on the outer circumference of the distal protrusion 36 and on the outer circumference of the proximal protrusion 35 and can be inserted into depressions provided in the longitudinal direction in the proximal ring element 31 and distal ring element 33.ApplicationNext, with reference to FIGS. 4 and 5, the operation and application of the endoscope head of the first embodiment of the present invention will be described.FIG. 4 shows the endoscope head in the rest position, in which the pivoting element is not pivoted. On the proximal side of the endoscope, the cable 7 is connected to a control element such as a joystick. In the rest position, no force is applied to the cable 7.When the cable 7 on the proximal side is pulled by, for example, swinging the joystick, the cable end 71 is pulled toward the proximal direction.When the cable 7 is pulled on the proximal side, the ring member 33 is pulled toward the proximal direction through the cable end 71. Due to the rigidity of the pivot element, here the spiral spring, the portion of the ring element 33 to which the cable end 71 is attached moves towards the proximal direction, while the radially opposite portion of the ring element 33 to which the depression 33A can be provided tends to maintain its location. Thus, the ring member 33 swings in the lateral direction (swing direction) of the endoscope head 1 toward which the camera 16 and the illumination 17 also face. The ring element 33 also pulls the pivotable working channel element 30 in the pivot direction.FIG. 5 shows the endoscope head in a position in which the pivoting element is pivoted by approximately 90°.The pivoting direction is predefined by the arrangement of the cable pull 7 in the pivotable working channel element 30. The pivot angle of the pivotable working channel element 30 is determined by the pulled distance of the cable pull 7. The pivot angle of the pivotable working channel element 30 can exceed 90° and can even be up to 160°.The pivot point of the pivoting operation of the pivotable working channel element 30 is located in a plane in which the cable pull 7 and the central axis of the pivotable working channel element 30 extend.AdvantagesThe endoscope head 1 is easily cleanable and reusable. Any undercuts or positions which are disadvantageous to be reached, such as arise, for example, on an albaran lever, are not present on the endoscope head 1. The rinsing liquid for cleaning can easily flow around the endoscope head 1 and remove foreign substances. Since the coil spring 5 and the cable 7 are disposed in an inner space surrounded inside by the working channel 13 (inner tube 34), outside by the outer tube 32, and distal by the distal ring member 33, the coil spring 5 and the cable 7 are protected from contaminants.In the pivot end position of the pivotable working channel element 30, the distal end of the working channel can be pivoted on the ring element 33 by more than 90° relative to the base body 11A and to the extension 11B. As a result, the user has a much greater freedom of handling. For example, insertion of a tool into, for example, the bile duct is greatly facilitated if the endoscope head body is positioned in the duodenum opposite the exit of the bile duct.Embodiment 2Next, referring to Figs. 6 to 8, a second embodiment not according to the present invention will be described. The general construction of the second embodiment is as shown in FIGS. 1 to 3.FIGS. 6 to 8 are side views of the endoscope head body of the second embodiment. The elements of the second embodiment which are the same as the elements of the first embodiment are not explained in detail and, if they are shown, have the same reference numerals.The differences from the first embodiment will be mainly described below. In contrast to the first exemplary embodiment, in the second exemplary embodiment, the pivoting element is designed as a swirl joint 6 in the pivotable working channel element 30.On the proximal side, the pivotable working channel element 30 also has a proximal ring element 31 which is fastened to the distal surface 18.The proximal ring element 31 has a distal side on which first rotating elements 62 are rotatably mounted opposite each other on the circumference. On the distal side of the proximal ring member 31, protrusions extending toward the distal side in the rest position are provided, in which first bearings 63 are formed. The first rotary elements 62 are rotatably mounted on the first bearings 63. The first rotating elements 62 are formed integrally with a second ring element 61 similar in shape and size to the proximal ring element 31.The second ring element 61 has a distal side on which second rotating elements 62' are rotatably mounted opposite each other on the circumference. At the distal side of the second ring member 61 at rest, protrusions extending to the distal side are provided, in which second bearings 63' are formed. The second rotary elements 62' are rotatably mounted on the second bearings 63'. The second rotating elements 62' are formed integrally with a third ring element 61' which is identical in shape and size to the second ring element 61.The third ring element 61' has a distal side on which circumferentially opposing third rotating elements 62" are rotatably mounted. On the distal side of the third ring member 61' are provided protrusions extending to the distal side at rest, in which third bearings 63" are formed. The third rotary elements 62" are rotatably mounted on the third bearings 63". The third rotary members 62" are integrally formed with a distal ring member 33 constructed on the distal side as in the first embodiment.The proximal ring member 31 and the distal ring member 33 function as end members of a vertebral joint construction formed of ring members and rotating members provided thereon for the next ring member, respectively.Respective cable pull channels are formed in the ring elements 31, 61, 61', 33. The respective cable pull channels correspond to the cable pull channel in the proximal ring element 31 of the first exemplary embodiment. The cable end is seated in the distal ring element 33, similar to the first exemplary embodiment.The ring members 31, 61, 61', 33 have an inner periphery on which an inner tube member similar to the inner tube member 34 of the first embodiment is disposed.The ring elements 31, 61, 61', 33 have an outer periphery on which an outer hose element is arranged, which is similar to the outer hose element 32 of the first exemplary embodiment.On the distal side, the pivotable working channel element 30 has the distal ring element 33 with an inner opening which forms the distal outlet of the working channel 13. The ring element 33 thus also forms the working channel end element here. The ring member 33 is formed in a circular shape as a ring member, for example.ApplicationThe basic principle is similar to that of the first embodiment.The pivotable working channel element 30 is formed as a swirl joint construction. When the cable 7 is pulled on the proximal side, the ring member 33 is pulled toward the proximal direction through the cable end. Due to the supports of the ring elements 61, 61', 33 on the respective rotating elements 62, 62', 62" and their rotatable bearing provided on the rotating elements 62, 62', 62", the ring elements 61, 61', 33 fold or pivot about the rotating elements 62, 62', 62". As a result, the region of the ring element 33 to which the cable end is fastened moves to the proximal direction. Thus, the ring member 33 swings in the lateral direction (swing direction) of the endoscope head 1 toward which the camera 16 and the illumination 17 also face.FIG. 6 shows the endoscope head in a position in which the pivoting element is pivoted by more than 90°. FIG. 6 shows the field of view 16A of the camera 16 and a guide wire W as a tool, which is guided through the working channel element 30. From the camera 16, it can be observed how the guide wire W enters the bile duct at the pupil (sphincter at the mouth of the bile duct to the duodenum).The pivoting direction is predefined by the arrangement of the rotary elements on the ring elements. Therefore, the rotating elements are arranged on the ring elements such that the pivotable working channel element 30 pivots in the desired lateral direction as in the first embodiment. The pivot angle of the pivotable working channel element 30 is defined by the distance of the ring elements from one another, which is in turn defined by the length (width) of the rotary elements measured in the longitudinal direction of the endoscope body. The pivot angle of the pivotable working channel element 30 can exceed 90° and can even be up to 160°.The pivot point of the pivoting operation of the pivotable working channel element 30 is located in a plane in which the cable pull 7 and the central axis of the pivotable working channel element 30 extend.Modification of FIG. 7In a modification of the structure of FIG. 6, in the structure shown in FIG. 7, the proximal ring member 31 is made longer in the direction of the central axis of the endoscope head.Thereby, a particularly large swing angle of the swingable working channel member 30 can be obtained because the distal ring member 33 can be swung even further toward the proximal side without fear of coming into contact with the base body 11A.It should be appreciated that the pivot location and distal end of the working channel on the pivotable working channel member 30 may be distal to the camera 16.Modification of FIG. 8In the modification of the structure of FIG. 8, the proximal ring member 31 is formed to be longer in the direction of the central axis of the endoscope head than in FIG. 7.Thereby, an even larger swing angle of the swingable working channel member 30 can be obtained because the distal ring member 33 can be swung even further toward the proximal side without fear of coming into contact with the base body 11A.It should be noted that the pivot location and distal end of the working channel on the pivotable working channel member 30 may be located even further distal to the camera 16.AdvantagesAdvantages similar to those in the first exemplary embodiment are obtained.In the end pivoting position of the pivotable working channel element 30, even larger exit angles for tools can be achieved. As a result, the user has a much greater freedom of handling. For example, insertion of a tool into the pupil, for example, is greatly facilitated when the endoscope head body is positioned in the duodenum opposite the exit of the bile duct.Cap 4Fig. 9 shows a cap 4 in use. In both embodiments, the cap 4 may be used.The cap 4 is formed as a bottomed cylinder. The bottom of the cap 4 is located on its distal side. In the application, the cap 4 is placed on the endoscope head body 11A, 11B. In the area of the bottom, the cap 4 is rounded so that it meets the requirements for inserting the endoscope head 1 into an object to be examined.The cap 4 has an opening 41 pointing upward in FIG. 9, and the opening 41 of the cap 3 forms a laterally open window for the camera 16 and the illumination device 17 and the tools guided through the working channel 13 when using the endoscope head 1.At the proximal end, the cap 4 has on its entire circumference an inwardly projecting latching nose which can be designed as a rounded or curved portion. This engaging projection can engage with a groove formed on the outer periphery of the base body 11A of the endoscope head body when the cap 4 is placed on the endoscope head body.The cap 4 has an intermediate wall 42 extending from the inner peripheral portion of the cap 4 opposite to the opening 41 to the opening 41. When the cap 4 is placed on the endoscope head body, the intermediate wall 42 separates the extension 11B from the pivotable working channel element 30.When the endoscope head 1 is used again, a new cap 4 is simply placed on. This makes it possible to prevent contamination on the endoscope head 1 even better. Patients are better protected from germs originating at an endoscope head from previous use.Further AlternativesFor fastening the cap to the endoscope head body, a groove on the endoscope head body is described, in which a latching nose of the cap engages. In order to allow the cap to engage on the endoscope head body, the groove can be provided circumferentially or in sections on the circumference. Instead of the groove, one or more locking recesses can also be provided on the circumference of the endoscope head body. On the proximal side of the cap, instead of a locking nose (circumferential or provided in sections), one or more radially inwardly protruding locking projections can then be provided, which are adapted with regard to position and shape to the locking depressions on the circumference of the endoscope head body. As a result, when the cap is pushed on, the exact positional relationship of the cap relative to the endoscope head body can be predefined.In the first embodiment, the pivotable working channel member 30 in Fig. 4 has a proximal ring member 31 attached to the distal surface 18. The tube element 32 is attached to the proximal ring element 31 on the outer circumference. On the inner periphery of the distal protrusion 36, the inner tube 34 is attached. In addition, the distal protrusion 36 serves to support the spring 5, and the distal protrusion 36 may be omitted when the inner tube 34 is attached to the distal end of the working channel in the endoscope head body base body 11A. A groove or elevation may be formed on the distal surface 18 to radially hold the first proximal turn of the spring 5.Additionally or additionally, the spring 5 can have a distal and / or proximal spring end angled in the spring extension direction. On the distal surface 18 of the base body 11A, a spring proximal end accommodation hole is provided, and / or on the proximal surface of the protrusion 35, a spring distal end accommodation hole is provided.In the first exemplary embodiment, the support wire 52 is inserted into the proximal ring element 31 and the distal ring element 33 in a manner resting against the outer circumference of the distal projection 36 and depressions (bores) provided in the longitudinal direction and resting against the outer circumference of the proximal projection 35. Alternatively, depressions (bores) provided in the longitudinal direction can be provided on the distal projection 36 and on the proximal projection 35, into which the support wire 52 is inserted in each case.Two, three, four or more support wires 52 may be provided, which are preferably arranged at equal intervals in the circumferential direction of the turns of the coil spring 5.The intermediate wall 42 of the cap 4 can be omitted.In the second embodiment, the pivot member is composed of a swirl joint structure having three pairs of rotary members and four rings. The invention is not limited thereto. There may be provided four pairs of rotary elements and five rings; five pairs of rotary elements and six rings, etc. Two pairs of rotary elements and three rings, etc. can also be provided.The invention is not applicable only to a duodenal scope. The principle of the invention can also be applied to an ultrasonic endoscope.In the exemplary embodiments, a working channel with an albaran lever at the end of the working channel is shown. The invention can also be applied to endoscopes which have a plurality of working channels each with an albaran lever at the end of the respective working channel.The explained alternatives can be combined and can be applied to all exemplary embodiments.List of reference characters1 Endoscope head 4 Cap 5 Spiral spring 6 Joint 7 Cable 11 Endoscope head body 11A Base body 11B Extension 13 Working channel 14 Rounded end face 16 Camera 16A Field of view of camera 17 Lighting device 18 Distal surface of base body 30 Pivotable working channel element 31 Proximal ring element 32 Outer tube 33 Distal ring element 33A Depression 34 Inner tube 35 Proximal projection 36 Distal projection 41 Opening (window) 42 Intermediate wall 52 Support wire 61 Vertebral joint ring element 62 Rotary element 63 Bearing 71 Cable end P Papillomavirus W Guide wire

Claims

Endoscope head (1) having an endoscope head body (11A, 11B) in which at least one working channel (13) is formed, wherein a pivotable working channel end piece (30) is provided on the distal working channel end portion; wherein the working channel end piece (30) is arranged pivotably relative to the endoscope head body (11A, 11B); wherein a working channel end element (33) is arranged at the distal end of the pivotable working channel end piece (30); wherein a cable pull body (7) is anchored in the working channel end element (33), and a pivot element (5; 6) is arranged on the proximal side of the working channel end element (33), which pivot element is supported on the proximal side thereof on the endoscope head body (11A, 11B); wherein the pivot element is formed as a helical spring (5); wherein a spring holder (31, 36) is provided on the endoscope head body (11A, 11B), against which a proximal end of the helical spring (5) abuts, wherein the distal end of the helical spring (5) abuts on the working channel end element (33); wherein at least one supporting wire (52) is provided between the spring holder (31, 36) and the working channel end element (33) parallel to the longitudinal extent of the helical spring (5); wherein the spring holder (31, 36) has a proximal ring element (31) and a distal protrusion (36) protruding from the proximal ring element (31) in the distal direction; and the proximal longitudinal end of the coil spring (5) abuts the proximal ring member (31), and at least one turn is disposed on the proximal side of the coil spring (5) around the outer periphery of the distal protrusion (36), the working channel end member (33) forms a distal ring member (33), and the distal ring member (33) has a proximal protrusion (35) extending in the proximal direction, and the proximal longitudinal end of the coil spring (5) abuts the proximal ring member (31), and the distal longitudinal end of the coil spring (5) abuts the distal ring member (33), and at least one turn is disposed on the proximal side of the coil spring (5) around the outer periphery of the distal protrusion (36), and at least one turn is disposed on the distal side of the coil spring (5) around the outer periphery of the proximal protrusion (35).Endoscope head (1) having an endoscope head body (11A, 11B) in which at least one working channel (13) is formed, wherein a pivotable working channel end piece (30) is provided on the distal working channel end portion; wherein the working channel end piece (30) is arranged pivotably relative to the endoscope head body (11A, 11B); wherein a working channel end element (33) is arranged at the distal end of the pivotable working channel end piece (30); wherein a cable pull body (7) is anchored in the working channel end element (33), and a pivot element (5; 6) is arranged on the proximal side of the working channel end element (33), which pivot element is supported on the proximal side thereof on the endoscope head body (11A, 11B); wherein the pivot element is formed as a helical spring (5); wherein a spring holder (31, 36) is provided on the endoscope head body (11A, 11B), against which a proximal end of the helical spring (5) abuts, wherein the distal end of the helical spring (5) abuts on the working channel end element (33); wherein at least one support wire (52) is provided between the spring holder (31, 36) and the working channel end element (33) parallel to the longitudinal extent of the helical spring (5); wherein the spring holder (31, 36) has a proximal ring element (31) and a distal protrusion (36) protruding in the distal direction from the proximal ring element (31); wherein the working channel end element (33) forms a distal ring element (33), and the distal ring element (33) has a proximal protrusion (35) extending in the proximal direction; and the support wire (52) is fitted to the outer periphery of the distal protrusion (36) and fitted to the outer periphery of the proximal protrusion (35), the support wire (52) being fitted to recesses provided in the longitudinal direction.The endoscope head (1) according to claim 1 or 2, wherein the endoscope head (1) further has a distal push-on cap (3), the working channel end piece (30) is arranged to be pivotable relative to the cap (3), the distal push-on cap (3) has an opening (31) corresponding to a working channel end opening, and the distal push-on cap (3) surrounds the distal end of the endoscope head (1) and the pivotable working channel end piece (30) in the state of being pushed on the endoscope head (1).The endoscope head (1) according to claim 3, wherein the distal push-on cap (3) is disposable.The endoscope head (1) according to any one of claims 1 to 4, wherein the working channel end member (33) is an annular body whose distal opening forms a working channel end opening.Endoscope head (1) according to one of Claims 1 to 5, wherein the cable pull body (7) is arranged in an interior space of the working channel end piece (30), which interior space is surrounded on the inside by the working channel (13), on the outside by an outer tube (32) and distally by the working channel end element (33).Endoscope head (1) according to one of Claims 1 to 6, wherein the pivoting element (5; 6) is surrounded by an elastic protective sheath (32).

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