Working channel device and endoscope system

Abstract

Disclosed are a working channel device and an endoscope system equipped with such an external working channel device, wherein an instrument inserted into the external working channel device can be controlled via a pivotable control head of the working channel device. The adjustment of the control head is preferably effected via a handle designed in the manner of a joystick, which is operatively connected to the control head via traction elements.

Description

[0001] The invention relates to a working channel device according to the preamble of claim 1 and an endoscope system equipped with such a working channel device.

[0002] Such a working channel device, also called an "Additional Working Channel (AWC)," is described in publication WO 2018 / 185 293 A1. This device allows an external working channel to be attached to an existing endoscope, which, for example, has a flexible shaft and a distal endoscope head containing functional units such as the outlet of a primary / internal working channel, an imaging optic, and / or a light source. A handle with various controls and connections for the aforementioned functional units (working channel, optic, light source) is typically located at the proximal end of the endoscope. The known external working channel device is designed to be attached to the endoscope at the handle on one side and at the endoscope head on the other, with this connection being force-fit, form-fit, or material-fit.The additional working channel then runs section by section approximately parallel to the flexible shaft of the endoscope, so that, in addition to its functional units, further instruments, such as biopsy instruments for taking tissue samples, can be introduced into the application area via the external working channel.

[0003] If the instrument guided in the external working channel needs to be controlled, the conventional solution requires the use of an endoscopic instrument with integrated control capabilities. However, such controllable instruments have the disadvantage that, firstly, they do not fit into every working channel, and secondly, they are expensive due to their complexity.

[0004] In contrast, the invention is based on the objective of creating a working channel device and an endoscope system equipped with such a working channel device, which, when the necessary control options are implemented, enables the use of conventional flexible standard instruments.

[0005] This problem is solved with regard to the working channel device by the features of claim 1 and with regard to the endoscope system by the features of dependent claim 17.

[0006] Advantageous further developments of the invention are the subject of the dependent claims.

[0007] The working channel device according to the invention is designed for external mounting on an endoscope, so that the endoscope can optionally be provided with an additional working channel. The working channel device has a working channel that is at least partially tubular or tube-shaped, with a distal tip and a proximal end section, and is provided with fastening means for fixing it to the endoscope.

[0008] According to the invention, the tip of the working channel device is equipped with a control head which is controllable, preferably by means of a handle arranged on the proximal end section, and into which the working channel opens.

[0009] This tip, which can be controlled via the handle and is equipped with the control head, thus enables the use of flexible standard instruments, whereby the respective standard instrument can be moved in the desired direction by adjusting the tip of the working channel device accordingly.

[0010] In this way, it is possible to angle the tip at a large angle in the near field of the endoscope, so that work maneuvers can take place directly in front of the endoscope head or, conversely, tissue or the like can be held as far away from the endoscope head as possible, thus enabling good preparation.

[0011] In a particularly preferred embodiment of the invention, the control head and the handle are mechanically connected, in particular via a traction element, so that actuation of the handle is essentially directly translated into a corresponding movement of the control head. In principle, this connection can also be established electronically via a signal or data link, so that the adjustment of the control head is carried out by a motor depending on the position of the handle.

[0012] In a particularly simple and compact embodiment, the traction elements are designed as flexible control filaments. Such control filaments can be, for example, multi-stranded rope or thread strands or wire strands, via which a positioning movement of the handle can be transmitted to the control head with virtually no backlash. The term "strand" or "strand" refers to a filament in which the actual filament structure is formed by a multitude of fine strands / threads / wires.

[0013] In one variant of the invention, the control head is designed with a spring that can be deflected via the traction means, by means of which the instrument can then be controlled accordingly.

[0014] A preferred solution is one in which the steering head is designed with a sectionally approximately spherical head, which is mounted in a complementarily designed bearing shell or bearing shell section and is preferably acted upon in the direction of the bearing shell via the tension means, so that on the one hand reliable mounting and on the other hand low-friction adjustability of the steering head is ensured.

[0015] Adjusting the distal control head is particularly easy if the handling is designed like a joystick with an actuating lever that essentially forms the proximal end section of the working channel and is supported by a bearing arrangement.

[0016] It is particularly preferred if the bearing arrangement is designed with an actuating ball which is mounted in a control housing of the working channel device in a sliding or ball bearing and into which an end section of the actuating lever is inserted, so that the actuating ball is adjustable according to the actuating movement of the actuating lever.

[0017] The transmission of the actuating movement of the actuating lever to the control head is particularly easy if the traction elements, especially the control filaments, are attached to the actuating ball in such a way that an actuating movement of the actuating lever is transmitted to the control head.

[0018] The technical complexity of the device is further reduced if the actuating ball and control head are operatively connected via at least three traction elements arranged at the same angular distance from each other. By using three traction elements offset from each other by an angular distance of 120°, the control is implemented with simple kinematics, since the same kinematic suspension is used on both the handle and control head sides.

[0019] In one variant of the invention, the traction elements are guided in the area between the handle and the control head in a traction element guide arrangement which extends approximately parallel to the working channel.

[0020] Guiding the traction elements is particularly simple when the traction element guide assembly uses a traction element tube or pipe, providing a lumen or cavity for each traction element. This allows the traction elements to be spaced apart, with the material selected to ensure minimal friction and a low stick-slip effect within the traction element guide assembly. This ensures a compact design for the working channel device. However, it is essential that the traction element guide assembly, while possessing sufficient flexural rigidity, remains flexible enough not to impede the movement of the endoscope.

[0021] Alternatively, a separate traction hose can be provided for each traction element.

[0022] The guidance of the instrument within the working channel is particularly precise when the head features a conical tip extending from the spherical section. This allows for a compact, radially narrow, and minimally protruding control head, thus minimizing the risk of injury during insertion.

[0023] In an advantageous further development of the invention, the head-side end sections of the traction means are guided section by section along the outer circumference of the spherical section of the head and are fixed in position in the transition area to the mouth cone.

[0024] The handle-side end sections of the tensioning elements can be guided section by section along the outer circumference and then through a bore to a spherical pole on the actuating ball on the lever side, in which clamping devices are provided to secure the tensioning elements with a preload. The tensioning elements, guided section by section through the actuating ball, ensure reliable contact of the actuating ball with its bearing section.

[0025] Ease of use can be further improved if the handle is equipped with a position fixing device that makes it possible to fix the handle in a swivel position, so that the instrument can then be operated in this setting.

[0026] This position fixing can be achieved, for example, by mounting the actuating lever in the actuating ball so that it can rotate around its longitudinal axis by a predetermined angle and has at least an actuating cam on its outer circumference which, when rotated, exerts a clamping force on the actuating ball via a control cam, thereby securing the actuating ball within the control housing.

[0027] Attaching the working channel assembly to the endoscope is particularly easy if the working channel assembly is designed with a distal mounting device for positioning the control head on an endoscope head and with a proximal mounting device for positioning the end section of the working channel assembly with the handle on the endoscope, especially an endoscope handle, whereby this positioning is variable depending on the type of endoscope. In this way, it is possible, for example, to adjust the handle relative to the endoscope handle so that the movement of the control lever can be synchronized with the movement on the image captured by the endoscope's optics, thus enabling intuitive movement and coordination of the degrees of freedom.Such variable relative positioning of the working channel device with respect to the endoscope is advantageous, since many manufacturers differ in the arrangement of the working channel and the optics.

[0028] According to an advantageous embodiment of the invention, the pivoting range of the handle, in particular the actuating lever, can be limited by a device.

[0029] The applicant reserves the right to direct separate independent patent claims to the design of the control head with the spherical controllable head and the optional conical working channel opening, as well as to the handling with an actuating lever and the associated sliding or ball-bearing actuating ball.

[0030] Examples of embodiments of the invention are explained in more detail below with reference to schematic drawings. These show: Fig. 1 a three-dimensional representation of an embodiment of a working channel device according to the invention; Fig. 2 a partial representation of an endoscope system to which a working channel device is attached according to Fig. 1 is scheduled; Fig. 3 a detailed representation of a control head of the working channel device according to Fig. 1; Fig. 4 a front view of the steering head according to Fig. 3; Fig. 5 a longitudinal section through the working channel device according to Fig. 1; Fig. 6 a sectional view of the control head of a working channel device according to Fig. 1; Fig. 7 a partial representation of a working channel device according to the invention with section planes shown; Fig. 8, Fig. 9, Fig. 10 sectional views according to the section planes in Fig. 7; Fig. 11 a partial representation of the working channel device according to Fig. 1. To illustrate the structure of a handle and Fig. 12 a detailed description of the handling according to Fig. 11.

[0031] Fig. Figure 1 shows a three-dimensional view of a working channel device designed to be attached to an endoscope. The working channel device – hereinafter referred to as AWC 1 – has a flexible working channel 2 into which an instrument 4, for example, biopsy forceps, a drill, optics, or the like, can be inserted, thus expanding the application possibilities of the endoscope. In contrast to the prior art mentioned above according to WO 2018 / 185 293 A1, this instrument 4 is controllable within the AWC 1.

[0032] For this purpose, a pivotable control head 6 is provided at the distal end section of the working channel 2, into which the working channel 2 opens. The design of this control head 6 is explained in detail below. In the area of ​​the control head 6, the AWC 1 is equipped with a distal fastening element, which in the illustrated embodiment is designed as a clip 8, by means of which the control head 6 or the end section of the working channel 2 is attached to a Fig. 1 endoscope shaft 10, indicated by a dashed line, can be attached.

[0033] In the illustrated embodiment, the adjustment of the control head 6 is effected by means of traction elements 12, each formed by a rope, a thread, or a wire. In the illustration according to Fig. In Figure 1, only one of these traction elements 12 is visible. Since these traction elements 12 are subjected to a comparatively high tensile stress, which ensures backlash-free control of the control head 6, it is preferred according to the invention to design these traction elements 12 as multi-stranded rope or thread strands or wire strands. These traction elements 12 are guided into the area of ​​a handle 16 by means of a traction element guide arrangement 14. As will be explained in more detail below, this handle 16 is designed in the manner of a joystick with an actuating lever 18, which forms, so to speak, the proximal end section of the AWC 1 and which is penetrated by the instrument 4.

[0034] The actuating lever 18 is operatively connected to the control head 6 via the traction means 12, so that a pivoting of the actuating lever 18 via the traction means 12 is directly translated into a corresponding movement of the control head 6 and thus of the instrument 4 guided therein.

[0035] The handle 16 is equipped with a control housing 20 in which – as described below – the bearing of the actuating lever 18 and the connection of the traction elements 12 to the actuating lever 18 are accommodated. As shown in Fig. 1 The control housing 20 tapers towards the working channel 2 and the traction element guide assembly 14 to a shaft 22, to which a sleeve 26 is attached via two clamping rings 24a, 24b. This sleeve 26 is designed to be attached to a Fig. The endoscope handle 34 shown in Figure 2 is to be fixed in place. The cuff 26 can be designed as a clamping cuff, which achieves clamping through its own elasticity. Alternatively or additionally, suitable clamping devices, such as hook-and-loop fasteners or the like, can be provided to ensure reliable positioning of the clamping cuff 26 and thus of the proximal end section of the AWC 1 on the endoscope. In the illustrated embodiment, the cuff 26 is designed with two actuating levers 28a, 28b, by means of which two clamping arms 30, 32 can be moved apart for attachment to the endoscope handle 34 without the use of a tool and then spring back after assembly, reliably fixing the AWC 1 in position. By appropriately positioning this cuff 26 and also the clamping rings 24, it is possible to adjust the adjustment range orto adjust the adjustment of the handle 16 relative to the endoscope handle 34 so that the direction of movement of the adjusting lever 18 can be synchronized with the movement of the image captured via the optics of the endoscope.

[0036] Fig. Figure 2 shows the handle 16 with the joystick-type actuating lever 18 in the position attached to an endoscope handle 34 of an endoscope 36, wherein the cuff 26 partially encompasses the outer circumference of the endoscope handle 34. This endoscope handle 34 is designed in a manner known per se with various actuating elements 38 and connections for attaching further functional elements, such as instruments or media connections. At the Fig. The distal end section of the AWC 1, specifically its control head 6, is then fixed in position at the endoscope tip of the endoscope shaft 10 (not shown) via the clip 8 or a similar force-fit, form-fit, or material-fit connection. As shown in the illustration in Fig. As further indicated in Figure 2, the endoscope shaft 10 and the working channel 2 or the traction element guide arrangement 14 run essentially parallel or at a slight angle to each other, with the handle 16 fixed via the cuff 26 being positioned approximately in the area of ​​the endoscope handle 34, so that the operator can comfortably operate both the actuating elements 38 of the endoscope 36 and the handle 16 of the AWC 1, whereby an actuating movement of the handle 16 or the actuating lever 18 is converted without play via the traction elements 12 into a corresponding control movement of the control head 6 and thus of the instrument 4.

[0037] Fig. 3 shows detail I from Fig. 1, from which the basic structure of the steering head 6 can be derived. Further details will follow. Fig. 4 Reference is made to a front view of the steering head 6 according to Fig. 3 shows.

[0038] As explained above, the flexible working channel 2, formed by a hose or tube, and the parallel traction element guide arrangement 14 are integrated into this control head 6. The instrument 4 with the in Fig. The pliers shown in Figure 3 extend from the AWC 1 over a working channel / control head opening 40, the angle of attack α to the working channel axis being variable according to the adjustment of the control head 6 by means of the handle 16. The control head 6 is designed according to Fig. 3 with an approximately sectionally spherical head 42, which - as will be shown below Fig. 6 explained - is pivotably mounted in a bearing shell 56 on the steering head side. The approximately spherical or convex head 42 transitions towards the steering head opening 40 into a muzzle cone 44, which is penetrated by the instrument 4.

[0039] In the area of ​​this mouth cone 44, the aforementioned traction elements 12 are fixed in position, wherein in the illustrated embodiment three traction elements 12a, 12b, 12c designed as filament structures (rope, thread strands or wire strands) (see Fig. 4) are fixed in position. In particular, Fig. 3, these three traction elements 12a, 12b, 12c, each offset by 120° from the traction element guide arrangement 14, extend out of each other through a recess 46 (only one of the three recesses 46 in Fig. 3 visible) extend from a steering head housing 48 and then run, each slightly angled with respect to the axis of the traction element guide arrangement 14, along the outer circumference of the steering head housing 48 into the area of ​​a passage 50a, 50b, 50c, via which the respective traction elements 12a, 12b, 12c are aligned towards the outer circumference of the head 42. The traction elements 12a, 12b, 12c then run section by section along an outer circumferential segment of the head 42 towards the end cone 44. On its circumferential wall, as shown in particular Fig. 4 removable, a fixing slot 52a, 52b, 52c is formed for each traction element 12a, 12b, 12c, extending into the control head opening 40, so that the traction element end sections can be inserted into the fixing slots 52a, 52b, 52c from the control head opening 40. The end sections of the traction elements 12a, 12b, 12c, which are then arranged within the head 42, are, as shown below with reference to Fig. 6 explained, fixing nipples 54 are formed, the diameter of which is larger than the width b of the fixing slots 52, so that the respective end section of the pulling means 12a, 12b, 12c is fixed in position in the associated fixing slot 52a, 52b, 52c.

[0040] The control head housing 48 also incorporates the aforementioned bearing shell 56 for pivoting the head 42, which is held in contact with the bearing shell 56 by the tensile stress generated via the tension elements 12a, 12b, 12c. The tensile stress is selected to ensure, on the one hand, virtually backlash-free actuation of the head 42, and on the other hand, to minimize sliding friction within the bearing shell area and within the guide of the tension element guide assembly 14. Accordingly, the material of the tension element guide assembly 14 and the tension elements 12a, 12b, 12c is also designed to minimize friction losses and the stick-slip effect. However, it must be ensured that the material of the traction guide arrangement 14 is flexible enough to follow the guidance of the endoscope 36, but on the other hand, sufficient buckling stiffness must also be ensured to avoid jamming of the traction means 12.

[0041] In the illustrated embodiment, according to the inset cross-section, the traction element guidance arrangement 14 is designed in a very compact manner by means of a flexible hose or a flexible tube in which three lumens 15a, 15b, 15c (cavities) arranged uniformly on a common pitch circle are formed, in each of which a traction element 12a, 12b, 12c is guided.

[0042] In the representation according to the Fig. 3 and Fig. Figure 4 also shows the clip 8 for clamping the AWC 1 to the endoscope head. This clip 8 is placed axially onto the endoscope shaft 10, with the clip design ensuring sufficient clamping force. Such fastening methods are described in the aforementioned prior art, so further explanation is unnecessary.

[0043] Fig. Figure 5 shows a longitudinal section of AWC 1 according to Fig. 1, where in detail H according to Fig. 6 the previously described structure of the control head 6 is clearly illustrated.

[0044] Accordingly, as explained above, the instrument 4 extends beyond the control head opening 40 from the muzzle cone 44 of the head 42, with the muzzle cone 44 being located in the Fig. The upper section (6) is slightly longer towards the instrument tip than the section below. As explained above, the traction elements 12 (in Fig. 6 (only the traction element 12c is visible) is guided via the traction element guide assembly 14 and the adjoining steering head housing 48 towards the head 42. The end section of the traction element 12c is guided out of the steering head housing 48 via the through-passage 50c and then enters the fixing slot 52c, where this end section is then secured in position by means of the fixing nipple 54 on a stepped extension 58 in the head 42. The guidance and positioning of the traction elements 12a, 12b is carried out accordingly, with each of them – as mentioned above – being guided out of the steering head housing 48 via a recess 46.

[0045] In the sectional view according to Fig. Figure 6 also shows the bearing shell 56 formed on the steering head housing 48, along which the pivotable head 42 with its spherical, convex, or convex bearing section is guided slidingly on the steering head housing 48. The sliding pair is optimized with regard to the most friction-free guidance possible, whereby the head 42 is preloaded into the contact position against the bearing shell 56 by the tension elements 12a, 12b, 12c.

[0046] Fig. Figure 5 also shows a section through the handle 16, whereby the cuff 26 with the associated fastening means is not shown. This section shows the central passage of the instrument 4 through the actuating lever 18, the pivoting movement of the actuating lever 18 being transmitted directly to the head 42 and thus to the instrument 4 by the mechanism according to the invention. Accordingly, a movement of the instruments guided within the actuating lever 18 leads "quasi" directly to a movement of the instruments 4 at the control head 6. As can be seen in particular in the section in Fig. The actuating lever 18, which can be removed from section 5, is inserted section by section into an actuating ball 60, which in turn is mounted in the control housing 20. In the illustrated embodiment, this is achieved by means of a ball bearing 62, so that low-friction pivoting of the actuating ball 60 is ensured depending on the adjustment of the actuating lever 18. This ball bearing 62 will be described in more detail below. Fig. 10 described in more detail. The diameter of the adjusting ball 60 is significantly larger than the effective diameter of the spherical area of ​​the head 42.

[0047] The ball bearing 62 is formed in a bearing section 64 which is extended compared to the shaft 22, as shown in the illustration. Fig. 5 approximately half of the adjusting ball 60 is accommodated. To fix the adjusting ball 60 in position within the bearing section 64, a ring cover 66 is attached to it, so that this and the bearing section 64 positively engage the outer circumference of the adjusting ball 60.

[0048] The traction elements 12, of which in the sectional view according to Fig. 5. Only the traction element 12c is visible. The traction elements 12a, 12b, 12c are guided away from the traction element guide arrangement 14 by means of guide bores 68, which are inclined relative to its axis, towards the bearing area of ​​the adjusting ball 60. In this area, the traction elements 12a, 12b, 12c emerge from the bearing section 64 and are then guided along a circumferential area of ​​the adjusting ball 60. They are then guided via an adjusting ball bore 70 each towards a ball pole 72 on the adjusting lever side, in which the respective end sections of the traction elements 12a, 12b, 12c are fixed in position with preload. Accordingly, both the adjusting ball 60 and the head 42 are preloaded into their respective bearing positions by the tensile stress of the traction elements 12a, 12b, 12c.

[0049] As shown in the illustration according to Fig. As can be further seen from Figure 5, the traction elements 12 (only traction element 12c is visible here) extend from the traction element guide arrangement 14 towards the guide bore 68 along a shaft bore 74, in which the hose-like traction element guide arrangement 14 is also supported. This is subjected to a tension force via a tension spring 76.

[0050] Accordingly, the connection between the handle 16 on the one hand and the control head 6 on the other hand is made firstly by the hose of the additional working channel 2 and secondly by the traction element guide arrangement 14, which is also designed as a pipe or hose.

[0051] According to the sectional view in Fig. In section 5, the adjusting lever 18 has a radially stepped adjusting lever section 78, which engages in a corresponding axial bore 80 of the adjusting ball 60. An annular groove 84 is formed on this adjusting lever bolt 78, into which a fixing screw 82 or a fixing bolt, screwed laterally into the adjusting ball 60 at right angles to the adjusting lever bolt axis, engages to fix the adjusting lever 18 in its axial position. However, the adjusting lever section 78 is not clamped, so that it can move, as shown below. Fig. 8 explains that it is rotatable to fix the handle 16 in a predetermined pivot position so that the user can remove the hand guiding the actuating lever 18.

[0052] In Fig. Figure 7 shows again the handle 16 of the AWC 1 according to the invention, with three section planes JJ, CC, and DD shown. Section plane JJ extends through the bearing section 64 in the transition area to the shaft 22. The further section plane CC extends through the area in which the ring cover 66 is placed on the bearing section 64, and section plane DD extends through the ring cover 66.

[0053] Fig. Figure 8 shows the section along the cutting plane DD in Fig. 7. This illustration shows the outer ring cover 66, which surrounds and overlaps the adjusting ball 60. The section plane runs centrally through the previously described adjusting lever section 78, which is guided in the axial bore 80. In the area through which the section plane passes, the adjusting lever section 78 is provided with two diametrically opposed adjusting cams 86a, 86b, which are guided along control cams 88a, 88b when the adjusting lever 18 is rotated about its longitudinal axis. The adjusting cams 86a, 86b and the associated control cams 88a, 88b are designed such that when the adjusting lever 18 is rotated, a force is exerted on the adjusting ball 60, causing it to spread open and thus clamp in the bearing. This spreading is made possible by spreading grooves 90a, 90b, which are formed in adjusting ball 60.

[0054] To release the jam, the adjusting lever 18 is then turned in the opposite direction so that the adjusting cams 86 rest on the control cams 88 without tension or are spaced apart from them.

[0055] According to Fig. 8 Three further pockets 92a, 92b, 92c distributed around the circumference are provided, along which the traction means 12a, 12b, 12c are guided on the outer circumference of the adjusting ball 60.

[0056] These three bags 92a, 92b, 92c are also in the CC section according to Fig. 9 visible. Reference numbers 94a and 94b are in Fig. 9 components of a device for limiting the swivel range of the handle 16 are provided

[0057] This device 94a, 94b each has an adjustable guide pin 108a, 108b, which can be brought into effective engagement with the adjusting ball 60 to limit the pivoting range. Further details of this device 94a, 94b are described below with reference to the Fig. 11 and Fig. 12 explained.

[0058] The JJ cut according to Fig. 10 extends through the area of ​​the bearing section 64 in which the ball bearing 62 of the adjusting ball 60 is formed. In the illustrated embodiment, this ball bearing 62 is designed with three bearing balls 96a, 96b, 96c, each of which is guided in a bearing pocket 98 on the bearing section side and a complementary bearing pocket 100 on the adjusting ball side, as shown in the illustration. Fig. Only the bearing pockets 98 and 100 of the bearing ball 96c are marked with reference symbols. These bearing balls 96 ensure virtually frictionless bearing of the adjusting ball 60 in the handle 16.

[0059] The illustrated embodiment of an AWC 1 is designed, for example, such that standard instruments up to a diameter of about 2.8 mm can be used, wherein the deflection / swivel angle of the instrument 4 in each direction is preferably about 30° to 35°.

[0060] Fig. Figure 11 shows a three-dimensional representation of the in Fig. 1 illustrated embodiment of an AWC 1, wherein the ring cover 66 of the control housing 20 described above is not shown, so that the in Fig. The optional device shown in Figure 9 for limiting the swivel range of the handle 16 is more easily recognizable.

[0061] Fig. Figure 12 shows detail L of the handle shown in Figure 16. Fig. 11. In this illustration, the traction elements 12a, 12b are also visible, which are guided section by section along the outer circumference of the adjusting ball 60, wherein, in this area, similar to the inner circumferential wall of the ring cover 66, pockets 101 are provided on the inner circumferential wall of the bearing section 64, which form a space for the passage of the respective traction elements 12a, 12b, 12c. In the illustration according to Fig. Figure 12 is just one of the 101 bags shown. As shown above. Fig. As explained in section 12, the end sections of the tensioning elements 12a, 12b, 12c are guided through each of an adjusting ball bore 70 to the flattened spherical pole 72 and fixed in position there with preload, whereby the anchoring of the other end sections of the tensioning elements 12a, 12b, 12c is each via the fixing nipples 54 (see Fig. 6) in the head 42. The position is fixed at the spherical pole 72 by three clamping screws 112a, 112b, 112c screwed into it.

[0062] On the ring end face of the bearing section 64 facing the ring cover 66 (not shown), two projections 102a, 102b are provided in which the guide pins 108a, 108b are adjustably guided. The end sections of the guide pins (see Fig. 9) each engage in grooves 104a, 104b on the outer circumference of the adjusting ball 60, with these grooves 104 extending upwards (view to Fig. 12) and downwards, i.e. into the Fig. The non-visible overlap area with the bearing section 64 is widened in a teardrop shape, so that these grooves 104 have an approximately figure-eight structure. The visible widened areas of the grooves 104a, 104b are in Fig. 12 are designated with reference numerals 106a and 106b. In the illustrated basic position of the adjusting lever 18, the guide pins 108 thus engage in the central waist, limiting the pivoting of the adjusting lever 18. When the adjusting lever 18 is pivoted such that the guide pins 108a and 108b engage in the extended areas 106a and 106b of the grooves 104a and 104b, the pivoting range of the adjusting lever 18 is increased and is essentially determined by the groove width.

[0063] To enable the actuating lever 18 to pivot in all directions, the guide pins 108a, 108b can be pulled out of the grooves 104a, 104b.

[0064] How Fig. 12. Furthermore, a coupling 110 for attaching an instrument 4 or other working equipment can be provided on the free end section of the adjusting lever 18.

[0065] In the illustrated embodiment, the control head 6 is designed with a broadly spherical head 42, which is mounted on a sliding bearing and can be adjusted by means of the tensioning elements 12. Alternatively, instead of such a control head 6, a spring or the like could be used to adjust the instrument position. This spring would be penetrated by the instrument 4 and could be deflected / folded by means of the tensioning elements 12 or the like.

[0066] In principle, it is also possible to use shear elements instead of the comparatively flexible traction elements. Hydraulic adjustment is also conceivable.

[0067] Disclosed are a working channel device and an endoscope system equipped with such an external working channel device, wherein an instrument inserted into the external working channel device can be controlled via a pivotable control head of the working channel device. The adjustment of the control head is preferably effected via a handle designed in the manner of a joystick, which is operatively connected to the control head via traction elements. Reference symbol: 1 Working channel device / AWC 2 working channel 4 Instrument 6 Steering head 8 clips 10 Endoscope shaft 12 traction elements 14 Traction element guidance arrangement 15 lumens 16. Handling 18 adjusting levers 20 control housings 22 shaft 24 clamping ring 26 cuff 28 operating levers 30 clamping legs 32 clamping legs 34 Endoscope handle 36 Endoscope 38 Actuator 40 Steering head muzzle 42 heads 44 Mouth cone 46 Exclusion 48 Steering head housing 50 Implementation 52 fixing slots 54 fixing nipples 56 bearing shell 58 Extension 60 ball bearings 62 ball bearings 64 Storage section 66 ring lids 68 Guide hole 70 Actuating ball bore 72 Spherical pole 74 shaft bore 76 Tension spring 78 Control lever section 80 Axial bore 82 fixing screw 84 Ring groove 86 adjusting cam 88 Tax backdrop 90° spreader groove 92 bags 94 Device for limiting the swivel range 96 bearing balls 98 storage bag 100 storage bags 101 bags 102 Bulge 104 Nut 106 extended area 108 guide pin 110 Clutch 112 Clamping screw QUOTES INCLUDED IN THE DESCRIPTION

[0000] This list of documents cited by the applicant was automatically generated and is included solely for the reader's convenience. The list is not part of the German patent or utility model application. The DPMA accepts no liability for any errors or omissions. Cited patent literature

[0000] WO 2018 / 185 293 A1 [0002, 0031]

Claims

[1] Working channel device for optional mounting on an endoscope (36), with a working channel (2) that is at least partially designed in a tubular or hose-like manner, which has a distal tip and a proximal end section and on which fastening means for positioning it on the endoscope (36) are provided, characterized by , that the tip is equipped with a control head (6) which is controllable, preferably by means of a handle (16) arranged on the proximal end section, and into which the working channel (2) opens. [2] Working channel device according to claim 1, wherein the control head (6) and the handle (16) are mechanically connected, in particular via traction means (12) or electronically via a signal or data connection. [3] Working channel device according to claim 2, wherein the traction means (12) are flexible control filaments, in particular multi-stranded rope, thread strands or wire strands, via which an actuating movement of the handle (16) can be transmitted to the control head (6). [4] Working channel device according to one of the preceding claims, wherein the control head (6) is designed with a spring which can be deflected via the tension means (12) or with a sectionally approximately spherical head (42) which is mounted in a complementarily designed bearing shell (56) and is preferably acted upon in the bearing shell (56) in the bearing direction via the tension means (12). [5] Working channel device according to one of the preceding claims, wherein the handle (16) is designed in the manner of a joystick with an actuating lever (18) which substantially forms the proximal end section of the working channel (2) and which is mounted by means of a bearing arrangement. [6] Working channel device according to claim 5, wherein the bearing arrangement has an actuating ball (60) which is slidably or ball-bearing mounted in a control housing (20) of the working channel device (1) and into which an actuating lever section (78) of the actuating lever (18) is inserted. [7] Working channel device according to claims 3 and 6, wherein the traction means (12), in particular the control filaments, are attached to the actuating ball (60) in such a way that an actuating movement of the actuating lever (18) can be transmitted to the control head (6). [8] Working channel device according to one of claims 2 to 7, wherein the actuating ball (60) and the control head (6) are operatively connected via at least three traction elements (12) arranged at equal angular distances from each other. [9] Working channel device according to one of claims 2 to 8, wherein the traction means (12) are guided in a traction means guide arrangement (14) with one lumen (15) for each traction means (12). [10] Working channel device according to one of claims 4 to 9, wherein the head (42) is designed with an outlet cone (44) adjoining the spherical section. [11] Working channel device according to claim 8, wherein head-side end sections of the traction means (12) are guided section by section along the outer circumference of the spherical section of the head (42) and are fixed in position in the transition area to the mouth cone (44). [12] Working channel device according to one of claims 6 to 11, wherein the end sections of the traction means (12) facing the handle (16) are guided section by section along the outer circumference of the actuating ball (60) and through each actuating ball bore (70) to an actuating lever-side ball pole (72), in the area of ​​which clamping means for fixing the traction means (12) with a preload are provided. [13] Working channel device according to one of the preceding claims, with a position fixing device for fixing the handle (16) in a pivot position. [14] Working channel device according to claim 13 and one of claims 5 to 12, wherein the actuating lever (18) is rotatably mounted in the actuating ball (60) about a predetermined angle of rotation about its longitudinal axis and has at least one actuating cam (86) which, when rotated via a control cam (88), applies a clamping force to the actuating ball (60). [15] Working channel device according to one of the preceding claims, wherein the fastening means comprise a distal fastening device for positioning the control head (6) on an endoscope head and a proximal fastening device for positioning the end section with the handle (16) on the endoscope (36), in particular on an endoscope handle (34), wherein this positioning can be variable depending on the type of endoscope (36). [16] Working channel device according to one of the preceding claims, comprising a device (94) for limiting the pivoting range of the handle (16). [17] Endoscope system comprising an endoscope (36) to which an external working channel device (1) according to one of the preceding claims is attached.

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