Resectoscope device, resection tool and resectoscope

Abstract

The present invention relates to a resectoscope device (10) comprising a shaft (18), an image acquisition device (36) arranged on a distal end piece (34) of the shaft (18) and defining an observation area (38), a resection tool (20) with a tool tip (28) and a support arm (26) and a joint (110) by means of which the support arm (26) can be articulated, wherein in at least one angular position of the support arm (26) a distance (130) between the tool tip (28) and a longitudinal axis (132) of the distal end piece (34) exceeds a radius (134) of a cross-sectional profile (136) of the distal end piece (34) by at least a factor of 2.

Description

The present invention relates to resectoscope devices, a resection tool and a resectoscope. A resection is the surgical removal of tissue from an organ or a tumor. Depending on the target and anatomical conditions, various types of resections can be performed. In the case of difficult-to-access tissue, surgical removal can be performed endoscopically using a resectoscope. Such a resectoscope is used, for example, in transurethral resection, in which diseased tissue is removed from the bladder or prostate. The operation is performed endoscopically through the patient's urethra, without the need for an incision. A conventional resectoscope for transurethral resection comprises a shaft with an observation optic, an irrigation device, and a resection instrument mounted at its distal end. The shaft provides access to the bladder via the urethra and offers stability during the procedure. The distal end of the shaft can therefore be positioned during the procedure by advancing and retracting the shaft along the urethra and by pivoting the shaft within the bladder. During such pivoting, a user moves a section of the shaft proximal to a pivot point within a large manipulation cone. This is necessary to allow the user to move a correspondingly distal section of the shaft within a sufficiently large application cone.A proximal section of the shaft is coupled to a control assembly that is held and moved by a user during the procedure. The control assembly also includes an actuating device by which the resection tool can be moved relative to the distal end section. A resection using a conventional resectoscope is typically performed as follows. The user grasps the resectoscope at the control unit. They then advance the shaft through the patient's urethra so that the distal end of the shaft protrudes into the bladder. The bladder is then filled using the irrigation device. An imaging device is activated, and the user obtains an overview of the bladder's interior through endoscopic observation. This allows them to identify the tissue to be removed. To remove this tissue, the user advances the shaft and pivots it as needed until the distal end is near the tissue in question. They then adjust the imaging device's viewing optics so that the tissue is clearly visible.To remove tissue, the user activates the actuating device, which moves the resection tool back and forth. In an iterative process, the tissue can thus be removed layer by layer by actuating the device. To reach a larger area of ​​tissue with the resection tool, which is often necessary, the user also pivots and shifts the shaft. In the manner described, transurethral resection can be used primarily for the treatment of superficial bladder cancer by resection within the bladder. The inventors of the present invention recognized that this procedure is difficult for the user and can lead to complications. During the resection, the user must, according to the prior art, swivel the resectoscope extensively and move it intensively along the urethra. This can compromise the precision of tissue removal. Furthermore, complications can arise for the patient, with the swiveling of the shaft in particular frequently leading to postoperative discomfort. For example, injuries to muscles and tissue, not immediately visible, or severe irritation of the mucous membranes can occur during the procedure. These complications can subsequently lead to urinary incontinence.As mentioned, using a conventional resectoscope always requires significant swiveling of the shaft during the resection. The resection is performed using a rowing motion, a combination of swiveling and pushing movements. This places considerable stress on the bladder neck in particular. Based on the prior art, the invention aims to provide a resectoscope by means of which a resection can be performed precisely and / or gently for a patient. The object is solved according to the invention by resectoscope devices, a resection tool and a resectoscope as described herein and defined in the claims. According to one aspect, the present invention provides for a resectoscope device, particularly for the transurethral resection of tissue. The resectoscope device comprises a shaft and an image acquisition device arranged at a distal end of the shaft, defining an observation area. Furthermore, the resectoscope device comprises a resection tool with a tool tip and a support arm, as well as a joint by means of which the support arm can be articulated. In at least one angular position of the support arm, the distance between the tool tip and a longitudinal axis of the distal end exceeds a radius of a cross-sectional profile of the distal end by at least a factor of 2. According to a further aspect, the present invention provides for a resectoscope device, in particular for the transurethral resection of tissue. The resectoscope device may, in particular, have the features mentioned above. It comprises a shaft and an image acquisition device arranged at a distal end of the shaft, defining an observation area. Furthermore, the resectoscope device comprises a resection tool with a tool tip and a support arm, as well as a joint by means of which the support arm can be articulated. The shaft defines a manipulation cone within which a section of the shaft proximal to a pivot point can be manipulated by a user.The tool tip can be moved on a surface section of an application cone located within the observation area by manipulating the proximal section of the shank within the manipulation cone and selecting at least one, and in particular exactly one, angular position of the support arm. An opening angle of the application cone is at least 1.5 times larger than an opening angle of the manipulation cone. According to a further aspect, the present invention provides for a resectoscope device, in particular for the transurethral resection of tissue. The resectoscope device may, in particular, have the features mentioned above. It comprises a shaft and an image acquisition device arranged at a distal end of the shaft, defining an observation area. Furthermore, the resectoscope device comprises a resection tool with a tool tip and a support arm, as well as a joint by means of which the support arm can be articulated. The image acquisition device comprises at least two image acquisition units directed in different directions, each defining a sub-region of the observation area. The tool tip is movable between the sub-regions by articulated movement of the support arm. Furthermore, the present invention provides for a resection tool, in particular for an inventive resectoscope device. It comprises a tool tip, a support arm, and a joint by means of which the support arm can be articulated. The resection tool defines an articulated section that can be articulated by means of the joint, wherein the length of the articulated section is between 15 mm and 50 mm, and in particular between 25 mm and 35 mm. Furthermore, the present invention provides for a resectoscope with an inventive resectoscope device. The features according to the invention allow for precise and patient-friendly transurethral resection. Patient comfort and safety are increased, and the risk of complications such as urinary incontinence is reduced. This, in turn, increases the acceptance of transurethral resections, thereby reducing the consequences of long-delayed resections. In particular, the strong pivoting movements required after conventional resection can be reduced by the features according to the invention. This enables a fundamentally different method of performing the resection, which is gentle on the patient and delivers high precision. For example, after inserting the distal end, the user can flex a section of the arm using the joint. This guides the instrument tip into a close-up position around the tissue to be removed, such as a tumor. The user no longer needs to move the entire resectoscope within a large manipulation cone or swivel the proximal section of the shaft far outside the bladder to reach the tissue. This results in less movement of the urethra. Specifically, this is possible because flexing the arm allows the instrument tip to be positioned at a relatively large distance from the radius of the distal end. The instrument tip then remains in this angular position, at least temporarily, during the tissue removal procedure.For this procedure, the user only needs to move the resection tool, and in some cases the resectoscope, back and forth, making small pivoting movements. With a conventional resectoscope, the user would have to pivot the shaft sharply and move it along a manipulation cone with a large opening angle, as described above. In other words, the conventional rowing motion during resection can be partially or even largely avoided by means of the inventive features. The application cone, within which tissue removal is possible, has a larger opening angle than the manipulation cone. Accordingly, tissue sections on the lower or upper bladder wall, for example, are easily accessible, even though the manipulation cone can be kept small. The large application cone can be achieved by angling the joint. Once the angle is selected, handling the inventive resectoscope is comparable to conventional resectoscopes, allowing users to draw on their experience with conventional resectoscopes when performing procedures. Tissue removal is carried out by sliding the resection tool and / or the shaft back and forth. The difference is that comparatively small pivoting movements of the shaft are now required. Another conceivable embodiment involves tissue removal through continuous angling of the jointed section of the support arm relative to the distal end. The angle of the support arm is continuously changed, resulting in a scooping motion. This guides the tool tip along the tissue to be removed, ablating it layer by layer. Consequently, the necessary back-and-forth movement of the resection tool and / or shaft can be reduced, as the angling of the support arm itself performs the removal motion. Furthermore, the use of at least two image acquisition units allows for a large observation area that can cover large portions of the bladder's inner wall (at least on one side). This area can extend to the bladder or its neck. The bladder orifice can therefore be viewed with minimal swiveling of the shaft within the manipulation cone. Since the tool tip is movable between the observation sections, it can be continuously observed by the image acquisition device while angling and moved into close proximity to the bladder orifice. Thus, a large section of the application cone can be covered by the image acquisition device, eliminating the need for the user to significantly swivel the distal end piece within the manipulation cone for endoscopic imaging.Even without strong swiveling, the resection, for example on the tissue sections at the lower or upper bladder wall, can be monitored using endoscopic imaging. A "resectoscope" is a medical instrument used for the endoscopic removal of tissue within a hollow organ, particularly the bladder and / or prostate. A resectoscope can enable minimally invasive procedures, especially through controlled resection movements and / or endoscopic imaging. The term "resectoscope device" refers in particular to a preferably functional component, especially a subassembly and / or a structural and / or functional component of a resectoscope. Preferably, the resectoscope device can constitute the resectoscope at least partially, preferably at least to a large extent, and most preferably completely. For example, the resectoscope device can be configured to be inserted at least partially, and preferably at least to a large extent, into a cavity, particularly an artificial and / or natural cavity, especially a body cavity, in particular for the purpose of examining it and modifying parts of it, especially removing parts of it. The resectoscope device can be a medical resectoscope device. Within the scope of this disclosure, "configured" can be understood to mean, in particular, specifically programmed, designed, and / or equipped. The fact that a component is configured for a specific function within the scope of this disclosure can be understood to mean, in particular, that the component fulfills and / or performs this specific function in at least one application and / or operating state. The term "distal" is understood to mean, particularly in the context of operation, facing towards a patient and / or away from an operator and / or user. In particular, "proximal" is the opposite of distal. The term "proximal" is understood to mean, particularly in the context of operation, facing away from a patient and / or towards an operator and / or user. The shaft can, for example, comprise an elongated, cylindrical, particularly hollow-cylindrical element that carries instruments, devices, and / or the like, by means of which a resection can be performed. It can facilitate the insertion of the instruments, devices, and / or the like into the cavity, particularly the bladder. In general, the shaft can thus provide access to the cavity. The shaft can be held and / or manipulated by a user at its proximal section to align the instruments, devices, and / or the like within the cavity. This manipulation also allows the user to perform the resection. The shaft can be designed to be rigid and / or flexurally stiff.The shaft can have an outer diameter of, for example, up to 15 mm, for example up to 10 mm, in particular up to 9 mm, preferably up to 8 mm, and a length of, for example, 10 cm to 50 cm, in particular from 15 cm to 40 cm, preferably from 20 cm to 30 cm. In particular, the shaft can be inserted into the patient's cavity in such a way that the distal end is positioned within the cavity. The distal end can carry functional units of the resectoscope device, by means of which the resection can be performed. The distal end can define a distal end section of the shaft and extend, for example, up to 5 cm, in particular up to 4 cm, preferably up to 3 cm, of the shaft. An "elongated part" shall be understood to mean, in particular, a component whose principal extent is greater by at least a factor of five, preferably at least a factor of ten, and most preferably at least a factor of twenty than a maximum extent of the component perpendicular to its principal extent, i.e., in particular, a diameter of the component. A "principal extent" of a component shall be understood to mean, in particular, its longest extent along its principal direction of extension. A "principal direction of extension" of a component shall be understood to mean, in particular, a direction that runs parallel to the longest edge of the smallest imaginary cuboid that just completely encloses the component and that preferably passes through a geometric center and / or a center of mass of the component. The image acquisition device enables endoscopic imaging. The device can be configured to image objects within the observation area, particularly the interior of the cavity, and / or to generate image data. An object might, for example, comprise tissue, especially a section of the bladder wall. Based on the image data, a display of the interior of the cavity can be generated on a screen. The user can thus observe the interior of the bladder and the progress of the resection or tissue removal via the screen. The image acquisition device can be positioned within the cavity, particularly by the user, and especially independently of the resection tool. The image acquisition device can comprise at least one image acquisition unit, which may be configured in particular by an input optic and / or an image sensor for image generation, especially a CCD chip or CMOS chip. The input optic can be arranged, for example, at a distal end face of the shaft. The image acquisition device, with at least two image acquisition units directed in different directions, allows for a large observation area for endoscopic imaging. Each image acquisition unit can be equipped with at least one input optic and / or an image sensor for image generation, in particular a CCD chip or CMOS chip. The at least two image acquisition units can, in particular, comprise a first image acquisition unit and a second image acquisition unit, wherein the first image acquisition unit is directed in a distal viewing direction, and wherein the second image acquisition unit is directed in a proximal viewing direction. The viewing direction from two different sides further improves the image available to the user by providing images from different perspectives, and in particular improves visibility when setting a starting point for tissue removal. In some embodiments, the image acquisition device comprises exactly two, exactly three, and / or more, or at least two, image acquisition units directed in different viewing directions, the image acquisition units jointly defining a continuous observation area. The observation sub-areas jointly define the observation area and may, in particular, overlap. The viewing direction can be directed proximally with respect to the shaft. The viewing direction can also be directed distally with respect to the shaft. The viewing direction can be defined by a viewing angle with respect to the longitudinal axis of the shaft. A viewing angle of 0° to less than 90° can be interpreted as directed distally, and a viewing angle of more than 90° to 180° can be interpreted as directed proximally. The image acquisition device can comprise at least three image acquisition units directed in three different viewing directions. The arrangement of multiple image acquisition units with different viewing directions improves the image of the tissue to be removed available to the user. The at least three image acquisition units can define three different observation sub-areas, and in particular, each can define an observation sub-area, whereby the different observation sub-areas can overlap at least partially. Thus, each observation sub-area can have a section that lies within an adjacent observation sub-area. With overlapping observation sub-areas viewed from different viewing directions, the image of the tissue to be removed available to the user is further improved. The overlapping observation sub-areas can jointly define the observation area. The multiple image acquisition units can be arranged offset in a longitudinal direction and / or with respect to a longitudinal axis of the shaft, in particular the distal end of the shaft, and especially arranged one behind the other. The one or more image acquisition units can each be formed by camera modules, in particular camera modules with short-profile lenses or so-called camera cubes with wafer-level optics. The one or more image acquisition units each have a single viewing angle. The single viewing angle can be, for example, 60°, 65°, 70°, 75°, 80°, 85°, 90°, 95°, 100°, 105°, or 110°. The viewing direction of an image acquisition unit can be its primary viewing direction. For example, the viewing direction can be the central axis of an input optic of the respective image acquisition unit. The individual viewing angle can be an angle spanned with respect to the viewing direction. In particular, the central axis can be a bisector of the individual viewing angle. Depending on the design of the image acquisition units, this can be defined by two individual viewing angles that are perpendicular to each other. These can, for example, define viewing angles with respect to a transverse axis and / or a viewing angle with respect to a vertical axis, each perpendicular to the central axis and / or the viewing direction.Particularly in cases where an image acquisition unit includes a rectangular image sensor, both viewing angles belonging to the image acquisition unit can be assigned to a short and a long side of the rectangular image sensor. The specification of a single viewing angle can also be understood as the largest viewing angle of the respective image acquisition unit and / or as a viewing angle corresponding to a diagonal of the respective image sensor. An image acquisition unit can also be described by a horizontal viewing angle, a vertical viewing angle, and a diagonal viewing angle. Specifications relating to a viewing angle can refer to any of these three dimensions and preferably refer to a diagonal viewing angle. To illuminate the interior of the cavity, the imaging areas, and / or the observation area, a lighting device can be arranged at a distal end of the shaft. This device is designed to provide illumination. Illuminating the imaging area(s) and / or the observation area facilitates the acquisition of an image by the image acquisition device and thus, in particular, improves the image quality of the image provided to the user. The lighting device can comprise several lighting units, which are directed in different directions. The individual lighting units can be formed by light-emitting diodes, laser diodes, and / or optical fibers. A compact resectoscope device can be provided if the image acquisition unit is integrally formed with the illumination unit. In particular, the distal end can be designed to be compact and utilize installation space efficiently. In some embodiments, the image acquisition unit and the illumination unit can be configured as pairs. This can mean that each illumination unit is integrally formed with each image acquisition unit. The resection tool may be configured to remove tissue by cutting and / or vaporization. The resection tool may incorporate an electrically conductive material, in particular a wire through which an electric current can flow. The resection tool may be designed as a high-frequency (HF) tool. The resection tool may include a resection loop. The resection tool may be loop-shaped, hook-shaped, or spherical. The resection tool may, in particular, include an RF loop (radio frequency loop). Alternatively or additionally, the resection tool may include a laser for cutting and / or vaporization. The laser may, in particular, be designed for holmium laser enucleation or KTP laser vaporization, or it may be a continuous-wave laser. These laser methods differ in the wavelength and energy of the laser light used, and thus, in particular, in their energy effect on the tissue and their penetration depth. Alternatively or additionally, the resection tool may include a monopolar or a bipolar RF tool (radio frequency tool). The monopolar RF tool may be designed as a hook electrode, ball electrode, or spatula electrode for cutting and / or vaporization. The bipolar RF tool may, in particular, be designed as bipolar forceps or pliers for cutting and / or vaporization.The resection tool can also be configured to perform contact coagulation on tissue. Depending on the application, one of the described configurations of the resection tool may be particularly suitable. The tool tip can define the part of the resection instrument that comes into contact with the tissue to be removed. Furthermore, the tool tip can, for example, include a lead-in section and / or the like, extending distally from at least one distal end of the support arm. In particular, the tool tip can be located distal to the support arm and / or connect distally to the support arm. A support arm can be configured to connect the tool tip to a proximal assembly, in particular an operating assembly. If the tool tip is electronically operated, an electrical supply line, for example a cable, can be routed within the support arm and / or the support arm can form such a supply line. In some embodiments, the support arm can be tubular in shape and accommodate at least one further functional unit and / or additional supply lines. Furthermore, a support arm can be rigid, stiff, and / or mechanically stable. If, for example, as described above, a resection is performed with a single selection of the support arm's angular position, the support arm can be designed to be so rigid, stiff, and / or mechanically stable that the user can apply a force suitable for tissue removal to the tissue to be removed without the support arm bending significantly. The joint allows, in particular, a distal section of the support arm to be articulated. This means that the angle of a section distal to the joint can be changed relative to a section proximal to the joint. The joint can be located on a longitudinal axis of the support arm and / or be integrated into the support arm. In some embodiments, the support arm at least partially forms the joint. By articulated the support arm, the tool tip can be positioned within the patient's cavity, particularly without manipulating the proximal section of the shank. The articulated section of the support arm can be part of an "articulated section." In other words, the resection tool can define the articulated section, which includes a section of the support arm and / or at least partially the tool tip. The articulated section is articulated by means of the joint. The articulated section can include the tool tip and a section, particularly a distal section, especially an end section. The term "articulated" can be understood to mean, in particular, that a part of the support arm can be mechanically adjusted or rotated relative to another part of the support arm. "Articulated articulated" can encompass a targeted movement and / or alignment. A component can be considered "articulated" if it is connected to another component via a mechanical joint, especially in such a way that relative movement of the two components is possible. This can include uniaxial mobility, for example, a tilting or pivoting movement around a pivot point. "Articulated articulated" can also encompass multi-axial and / or multidirectional mobility, which is enabled, for example, by means of a ball joint. Articulated articulated ...Additionally, in some embodiments a locking mechanism may be provided by means of which the articulated section of the support arm can be fixed in an angular position. The support arm can, in particular, define several angular positions. In some embodiments, the support arm can be continuously articulated by means of the joint. In other embodiments, the support arm can be articulated incrementally by means of the joint. An angle of the angular position can be defined with respect to a longitudinal axis of the shaft, in particular the distal end piece, and / or a section of the support arm located, in particular, immediately proximal to the joint. In a delivery configuration in which the resectoscope device can be delivered to the cavity, a delivery angular position can be defined, wherein the angular segment and the longitudinal axis of the distal end piece and / or the section of the support arm located, in particular, immediately proximal to the joint, enclose an angle of, for example, between 5° and -5° inclusive, in particular between 3° and -3° inclusive, preferably between 1° and -1° inclusive.In principle, the feed angle position can refer to a zero angle position in which the angled section is parallel to the longitudinal axis of the distal end piece. The angle is measured, for example, starting from the feed angle position or a coaxial arrangement of the angled section and one of the aforementioned longitudinal axes. The distance between the tool tip and the longitudinal axis of the distal end piece can refer, in particular, to the distance between the most distal point of the tool tip, especially in the feed angle position. The distance can also refer to the minimum distance between the point of the tool tip furthest from the longitudinal axis and the longitudinal axis itself, which can be adjusted, in particular, by angling the tool using the joint. This minimum distance can exceed the radius of the cross-sectional profile of the distal end piece by at least a factor of 2, in particular by at least a factor of 2.5, 3, 3.5, 4, 4.5, and / or greater than 4.5. In a distal view of the resectoscope device, the tool tip can therefore project beyond the cross-section of the distal end piece by at least this factor, especially if the longitudinal axis is located at a geometric center and / or a center of mass of the cross-section of the distal end piece. The radius of the cross-sectional profile can refer to the largest radius of the cross-sectional profile. In other words, the radius serving as a reference value can be determined at the point along the longitudinal axis of the distal end piece where the cross-sectional profile has its greatest spatial extent, particularly transversely to the longitudinal axis.In some embodiments, the distal end section may have a smaller radius of cross-sectional profile than a more proximal section of the shank. In such a case, for example, in at least one angular position of the support arm, the distance between the tool tip and the longitudinal axis of the distal end section may exceed the radius of a cross-sectional profile of the shank by at least a factor of 2. In particular, in one application configuration, the distance between the tool tip and the longitudinal axis of the distal end piece exceeds the radius of a cross-sectional profile of the distal end piece by at least a factor of 2 in at least one angular position of the support arm. Resection is feasible in this application configuration. Therefore, in the feeding configuration, the resection device can be fed into the cavity, and in the application configuration, resection or tissue removal is feasible. In a state where the shaft is inserted into the cavity, it can be rotated about a pivot point and / or linearly displaceable through this pivot point. This pivot point can be understood as a so-called trocar point. For example, when inserted, the shaft extends partly outside the cavity and partly inside it. In particular, the proximal section of the shaft is located outside the cavity, while at least the distal end is inside the cavity. The shaft, particularly its proximal section, can be moved by the user around the pivot point or trocar point within a conical area. The pivot point or trocar point is the apex of this cone. This movement or manipulation can include pivoting and sliding the shaft back and forth. For each opening angle selected by pivoting the proximal section of the shaft, the user can trace a surface of an imaginary, extracavitary cone. This can accordingly be defined as a manipulation cone. The imaginary, extracavitary cone can, in particular, have the shape of a right circular cone. A single manipulation cone therefore has a specific opening angle. The user can manipulate the proximal shaft section within the manipulation cone by pivoting and linearly moving it through the pivot point, without exceeding the opening angle. The distal end and the proximal section of the shank can both be positioned one behind the other along the shank's longitudinal axis. Accordingly, the distal end describes movement within a motion cone when the user manipulates the proximal section of the shank within the manipulation cone. The motion cone then has an opening angle that corresponds to the opening angle of the manipulation cone. Thus, the motion cone can be a mirror image of the manipulation cone. In the feeding configuration, the tool tip can therefore be moved essentially within the motion cone by manipulating the proximal section of the shank. Additionally, the user can angle the support arm using the joint. More precisely, they can angle the angular section. This allows them to select an angular position of the support arm. In this angular position, the tool tip can be at a distance from the longitudinal axis of the distal section. Particularly in the application configuration, the support arm is angled and / or can be at an angular position, especially one that differs from the angular position of the feed configuration. In the application configuration, the tool tip can be moved outside the movement cone by manipulating the proximal section of the shaft, particularly due to the distance of the tool tip to the longitudinal axis of the distal end piece. In the angled position and / or in the application configuration, the tool tip can be moved on the application cone by manipulating the proximal section of the shank within the manipulation cone. A specific manipulation cone allows movement of the tool tip on a specific application cone. Since the support arm can be angled, and in particular the tool tip can be at a distance from the longitudinal axis of the distal end piece, the application cone can have a larger opening angle than the movement cone and, consequently, the manipulation cone. If the proximal section of the shaft is moved within a specific manipulation cone, the tool tip can be moved on the surface of the application cone. The tool tip can then traverse a surface section of the application cone, which, for example, might correspond to the lateral surface of a truncated cone. The pivot point itself may be excluded from the surface of the application cone that can be traversed by the tool tip through manipulation of the proximal section of the shaft. To move the tool tip on the cylindrical surface of the truncated cone and / or the surface section of the application cone, the proximal section of the shank can be moved closer to the axis of the manipulation cone within the manipulation cone. The surface of the application cone can thus be traversed by a linear movement through the pivot point and a pivoting movement about the pivot point of the proximal section of the shank within the manipulation cone using the tool tip. Similarly, the tool tip can be moved within the application cone by manipulating the proximal section of the shank within the manipulation cone, where the application cone has a larger opening angle than the manipulation cone. The application cone can generally define the boundary of an area within which a resection can be performed while maintaining a specific manipulation cone. Due to the angulation of the support arm, the manipulation cone can have a comparatively small opening angle. This allows for a resection that is gentle on the patient. It can also be comfortable for the user, as they can easily and efficiently reach remote and / or distant tissue areas within the bladder. In other words, due to the choice of angular position, a larger area can be reached by the tool tip with the same degree of pivoting about the pivot point of the shaft, compared to a conventional resectoscope device that has no joint or no joint with the inventive features. In particular, the support arm can be articulated by means of the joint at least such that the opening angle of the application cone is at least 1.5 times, in particular 2.0 times, 2.5 times, 3.0 times, 3.5 times, 4.0 times, and / or 4.5 times as large as the opening angle of the manipulation cone. According to some embodiments, the opening angle of the manipulation cone need not exceed 15°, particularly 10°, to allow the resection tip to reach at least substantially the entire bladder wall. The necessary opening angle may depend on the patient's anatomy and the length of the angular segment. If the length of the angular segment is between 15 mm and 50 mm, and particularly between 25 mm and 35 mm, a small opening angle of the manipulation cone allows the tool tip to reach at least substantially the entire bladder wall for tissue removal. It is conceivable that the tool tip and / or the resection tool could be selected specifically for the patient to match the length of the angular segment to the patient's anatomy. In particular, the traversable area of ​​the tool tip can intersect with the observation area. The overlapping portion can be described as the surface section of the application cone on which the tool tip is movable. This section is therefore located within the observation area. Accordingly, the tool tip can be observed using endoscopic imaging as it traverses the surface section of the application cone. The surface section need not necessarily be limited exclusively by the observation area. A boundary, especially a boundary proximal to the pivot point, can be defined by the choice of angular position. A distal boundary can be limited by the observation area. According to some embodiments, the resection tool defines the angled section that can be articulated by means of the joint. The distance of the surface section of the application cone from the pivot point can be at least twice the length of the angled section, particularly when exactly one angular position is selected. This allows tissue sections of the cavity, especially the bladder, located far from the pivot point to be reached with the tool tip. The geometric relationships can, in principle, refer to a specific angular position. For example, tissue sections located at least 10 mm, particularly at least 20 mm, preferably at least 30 mm, and most preferably at least 40 mm from the bladder inlet can be reached.The distance can refer to a minimum distance, in particular a distance between a point of the bladder inlet closest to the tissue section and a point of the tissue section closest to the bladder inlet. In principle, the length of the angled section can include the length of the tool tip and the length of a section of the support arm that can be angled by means of the joint. The phrase "being movable between the observation areas" can also be understood to mean that the tool tip can be moved from one observation area to another by angling the support arm. Alternatively, it could be formulated, for example, that the tool tip can be moved from a first observation area of ​​a first image acquisition unit to a second observation area of ​​a second image acquisition unit by angling the support arm. Specifically, the tool tip can be moved back and forth between the observation areas. In particular, the tool tip can be moved out of one of the observation areas, especially the first observation area, by angling the support arm. Furthermore, the support arm can be articulated relative to the distal end of the shaft by means of the joint, whereby the distal end, in particular, remains immobile relative to a base body of the shaft. This enables gentle resection, during which the user only needs to pivot the shaft slightly. Since the image acquisition device is located at the distal end, it remains stationary when the support arm is articulated. Accordingly, the image acquisition device does not need to be moved when transferring from the delivery configuration to the application configuration. The support arm can be articulated independently of the image acquisition device and / or the distal end. The base body can be a section of the shaft that, when inserted into the bladder, is located within the ureter. Furthermore, the base body can, for example, comprise the proximal section of the shaft.It can, for example, form a structural base element of the shaft, providing in particular its basic shape and stability. The base body can thus represent the central supporting element to which at least the distal end piece is attached. The distal end piece can be rigidly, inflexibly, and / or immovably connected to the base body. Gentle resection can be performed if the shaft and the resection tool can be moved independently of each other along a longitudinal axis of the shaft. This eliminates the need to move the entire resectoscope device back and forth for tissue removal. For example, the resection tool can be coupled to a proximal control assembly which, when operated by the user, moves the resection tool independently of the shaft along its longitudinal axis. Furthermore, the resection tool can define the angled section that can be articulated by means of the joint, wherein the length of the angled section exceeds the radius of the cross-sectional profile of the distal end piece by at least a factor of 2, and in particular by at least a factor of 3. For an understanding of the advantages of these features, please refer to the explanations above. Furthermore, the length of the angled section can be between 15 mm and 50 mm, and in particular between 25 mm and 35 mm. For an understanding of these features and their advantages, please refer to the explanations above. According to some embodiments, the resectoscope device further comprises an irrigation device by means of which an area accessible to the resection tool can be irrigated. The irrigation device includes a supply line by means of which an irrigation fluid can be directed along the shaft, the supply line extending within the support arm. During tissue removal, the removed tissue can be flushed away, thus ensuring good visibility of the tissue being treated. The irrigation device may include a channel that is integrated into the support arm and / or extends along a longitudinal axis of the support arm. The channel may form the supply line. Alternatively, the supply line may comprise a tube that extends within a cavity of the support arm along the longitudinal axis from proximal to distal. This allows irrigation fluid to be introduced proximally into the supply line and directed along the support arm into the cavity.The bladder can also be filled with the irrigation fluid to tense the bladder wall. Particularly in a distal section of the support arm inserted into the bladder or cavity during a resection, the supply line can be located within the support arm. Furthermore, the rinsing device can include a spout located on a section of the support arm that can be angled by means of the joint. In other words, the angled section can encompass the spout and / or the spout can be located on a section of the angled section that encompasses the support arm. The spout can thus be angled by actuating the joint. When the support arm is angled, the spout and the tool tip can move together. The spout of the rinsing device can therefore have a fixed relative position with respect to the tool tip. This allows for efficient rinsing and / or the removal of abraded tissue remnants. The rinsing fluid can be precisely delivered regardless of the angular position. According to some embodiments, the resection tool comprises a further articulated support arm. The tool tip can be arranged between the support arm and the further support arm. In particular, the shaft extends, at least in one feed configuration, between the articulated sections of the support arms. This allows for a space-saving, compact resectoscope device. The tool tip can, in particular, comprise an RF resection loop. A feed line can be arranged in each of the support arms, with each feed line representing a pole. Tissue segments to be removed may also be located longitudinally along the shaft on the bladder wall or opposite the bladder inlet. To access these easily and with minimal rotation of the proximal section of the shaft, the instrument tip can incorporate a HS resection loop comprising a lead-in section and a working section. The working section is angled relative to a longitudinal axis of the lead-in section by a loop angle of no more than 90°. In particular, the working section extends partially distal to the lead-in section. Conventional resectoscopes with an HS resection loop typically have loop angles greater than 90°. These must be rotated accordingly to allow the working section to reach the tissue to be removed opposite the bladder inlet.The working section can be the portion of the tool tip that comes into contact with the tissue to be removed for tissue ablation. The supply section can include a supply line and / or a supply line can form at least part of the supply section. In some embodiments, the supply section has electrical insulation. A loop angle of 0° can mean that the working section is arranged coaxially with the supply section and / or extends distally from the supply section along the longitudinal axis of the supply section. For example, with a loop angle of 45°, the working section extends obliquely from the supply section, partly distally and partly perpendicular to the longitudinal axis of the supply section. Comprehensive endoscopic imaging of the bladder can be achieved if the distal end of the shaft can be positioned, at least partially, within the bladder to facilitate resection, ensuring that the bladder neck remains within the field of view of the image acquisition device. Even complex resections near the bladder neck can be performed with minimal rotation of the resectoscope, keeping the instrument tip within the field of view. As described above regarding the image acquisition device, to which reference is made, the device can comprise at least two image acquisition units oriented in different directions, each defining a sub-area of ​​the overall field of view.One of the viewing directions can be arranged such that the observation area of ​​the assigned image acquisition unit intersects the shaft. Tissue of the entire bladder wall can be easily reached with the tool tip if the resection instrument, together with the shaft, can be rotated around a longitudinal axis of the shaft. The image acquisition device can therefore be rotated together with the tool tip, allowing, for example, the bladder roof to be reached with the tool tip while still being observed using endoscopic imaging. The resectoscope device may further include an insertion sleeve that can be partially inserted into a patient's cavity and defines a longitudinal axis. The shaft can extend within the insertion sleeve, and the shaft and the resection tool can be moved independently of each other relative to the insertion sleeve along its longitudinal axis. In particular, the shaft and the resection tool can be inserted into the cavity together with the insertion sleeve. The insertion sleeve can reduce tissue damage and / or irritation caused by the linear movement of the shaft through the pivot point. The insertion sleeve can be designed as an elongated tube and / or comprise one, along whose longitudinal axis a guide channel can extend. In particular, it can be configured to provide access to a patient's bladder. For this purpose, it can be arranged in and / or inserted into the patient's urethra. When arranged in this way, the longitudinal axis and, in particular, the guide channel can extend along the urethra. In this case, the insertion sleeve extends from a proximal side to a distal side. The shaft and / or the resection tool can be guided, at least partially and / or section by section, in the guide channel and, in particular, can be advanced in a guided manner. In some embodiments, the shaft can be guided in the insertion sleeve and the resection tool can be guided on the shaft.The insertion sleeve can thus accommodate the shaft and the resection instrument, particularly at a section that can be positioned within the urethra. Other components can also be incorporated into the insertion sleeve, such as a suction channel for aspirating irrigation fluid from the bladder. The insertion sleeve can be securely attached to the shaft. In other words, the insertion sleeve can be movable relative to the shaft and fixed to it. Intuitive operation can be achieved, in particular, if the shaft has a linear degree of freedom and a rotational degree of freedom relative to the insertion sleeve, specifically axial mobility combined with rotation but fixed position with respect to a radial position. In some embodiments, a rotational position can be fixed and / or determinable. The resectoscope device can include a user-operated locking mechanism for this purpose.In the locked position, only axial movement is possible. Alternatively or additionally, an axial position can also be locked. A locking mechanism can also be provided for this purpose, in particular the aforementioned locking mechanism. In this case, only rotation is possible as a degree of freedom in the locked position. Particularly intuitive operation is achieved if the shaft is linearly movable and rotatable relative to the insertion sleeve. In other words, the insertion sleeve can function like a trocar, specifically a captive trocar known from minimally invasive surgery. It can therefore provide trocar-like access to the cavity, particularly the bladder. The longitudinal axis can run parallel to the main extension direction of the insertion sleeve. In a state where the insertion sleeve is at least partially inserted into the cavity, the longitudinal axis of the shaft can also run parallel to the main extension direction of the insertion sleeve and / or its longitudinal axis. The insertion sleeve can have a smaller longitudinal extent than the shaft. In some embodiments, the longitudinal extent of the insertion sleeve can be, for example, at most 95%, in particular at most 80%, preferably at most 70%, and most preferably at most 50% of the longitudinal extent of the shaft. Longitudinal extent refers to the extent along the longitudinal axis. The shaft can be, for example, between 20 cm and 40 cm long, in particular between 20 cm and 30 cm, and preferably between 20 cm and 25 cm long. The insertion sleeve can have an annular, particularly circular, cross-section, especially at its distal end. The wall thickness of the insertion sleeve can be, for example, 0.5 mm to 1.5 mm. The outer diameter can be, for example, up to 10 mm, particularly up to 9 mm, preferably up to 8 mm. Generally, a small diameter is desirable to minimize discomfort for the patient. The insertion sleeve can be made of stainless steel, a medical-grade plastic, titanium, polyetheretherketone, and / or similar materials. In some embodiments, the insertion sleeve is intended for single use or is a single-use product. Its inner surface may have a friction-reducing coating, for example, made of Teflon, silicone, and / or similar materials. The resectoscope device can also include a proximal control assembly that is accessible to the user and allows manipulation of the shaft. The user can thus align the tool tip within the bladder by manipulating the control assembly. Furthermore, the operating assembly as a whole can be movable relative to the insertion sleeve. Thus, the insertion sleeve can remain stationary and / or move only minimally when the proximal operating assembly is moved. If the insertion sleeve is guided to a urethra, this can reduce movement of the insertion sleeve relative to the urethra, while not restricting the longitudinal mobility of the shaft and / or the resection tool. The shaft and / or the resection tool can, for example, be coupled proximally to the operating assembly. By moving the operating assembly back and forth, the user can move the shaft and the resection tool, especially together, relative to the insertion sleeve and, in particular, perform a resection movement. The shaft and the resection tool can therefore be moved independently of each other, particularly by a single user, with the movement being relative to the insertion sleeve. For a resection, the user can insert the insertion sleeve, along with the shaft and the resection tool, into the urethra. This can also be done sequentially, for example, if the different components are of varying lengths. "Together" can be understood to mean that the insertion can be a single operation, and the user does not have to grasp the individual components one after the other and advance them individually through the urethra. Once partially inserted into the urethra or cavity, the user can optionally advance the resection tool and / or the shaft further, particularly to explore the bladder and / or to perform a resection. Referring to the above statements regarding the independent movement of the resection tool relative to the shank, the proximal operating assembly in some embodiments further comprises an actuating mechanism by means of which the resection tool can be moved along its longitudinal axis independently of the shank. By actuating the actuating mechanism, the user can move the resection tool back and forth, particularly independently of the shank and / or the insertion sleeve, especially to perform a removal movement. In other words, the shaft and resection instrument can be designed to move within the insertion sleeve after being placed into the cavity during tissue removal. Thus, unlike a conventional resection, the removal of tissue no longer involves moving a component in contact with the urethra. The insertion sleeve can be detachably coupled to the operating assembly. For example, the operating assembly and the insertion sleeve can form a coupling mechanism designed to detachably connect the insertion sleeve to the operating assembly. This allows the insertion sleeve to be released as needed, for example, after being inserted into the cavity together with the shank and the resection tool. Conversely, the insertion sleeve can also be mechanically coupled back to the operating assembly as needed to remove it from the cavity along with the shank and the resection tool. According to the above explanations, the resectoscope device can have different positions, which can be defined by a different longitudinal position of the resection tool to the shaft and to the insertion sleeve and / or a different longitudinal position of the shaft to the resection tool and to the insertion sleeve. As previously described, the introducer sleeve can be designed to remain atraumatically stationary during tissue resection. This increases patient comfort and reduces postoperative complications. It is understood that the introducer sleeve might move slightly relative to the ureter. However, this movement can be negligible, or significantly less than the relative movement between a shaft and the urethra during a conventional resection. In other words, the introducer sleeve can be designed to remain essentially stationary, at least in relation to the surrounding and, in particular, the contacting tissue, when the shaft is positioned within the cavity. Furthermore, the resectoscope device can include a return line for irrigation fluid, with the return line being formed between the insertion sleeve and the shaft. Tissue debris generated during resection can be flushed from the bladder to reduce turbidity of the fluid, particularly the irrigation fluid, within the bladder and to ensure good visibility of the tissue to be removed. In some embodiments, a gap may be provided between the insertion sleeve and the shaft, creating a space that can form the return line. The outer diameter of the shaft can be approximately up to 10%, particularly up to 7%, preferably up to 4% smaller than the inner diameter of the insertion sleeve. The resectoscope device can be connected proximally to a suction device by means of which suction pressure can be generated to draw the irrigation fluid out of the cavity, particularly the bladder. Precise angulation and positioning of the tool tip can be achieved if the joint is a mechanical swivel joint. This allows for improved controllability and greater stability of the resectoscope device. A mechanical swivel joint can be understood as a connecting device between two sections of the support arm, which connects them in such a way that they can rotate relative to each other around a fixed axis of rotation. The joint can also be actuated by a user, particularly by means of the operating assembly. This can mean that the user can angulate the articulated section by actuating it. For example, the resectoscope device could include an actuating mechanism for actuating the joint, such as a Bowden cable, a pull and / or push mechanism, a control cable, a push rod, and / or a pull wire. An actuating mechanism comprising a rack and pinion is also conceivable, with the pinion, for example, being located on the articulated section. The articulated section can be articulated by a linear movement of the rack along the longitudinal axis of the support arm. The actuating mechanism can extend at least partially within the support arm, for example, within the cavity of the support arm. Particularly precise positioning of the tool tip can be achieved if the joint has a single degree of freedom. The joint allows the angular segment to be rotated, for example, about an axis of rotation that is perpendicular to and / or through the longitudinal axis of the support arm. In other words, the axis of rotation of the joint can be transverse to the longitudinal direction of the distal end piece. In some embodiments, the resectoscope device comprises two support arms, with the axis of rotation in these embodiments being perpendicular to the respective longitudinal axis of each support arm. In particular, the axis of rotation is arranged such that the tool tip can be articulated within the observation range. The present invention is described below by way of example with reference to the accompanying figures. The drawing, the description, and the claims contain numerous features in combination. A person skilled in the art will expediently consider the features individually and use them meaningfully in combination within the scope of the claims. If more than one instance of a particular object exists, only one of them may be identified with a reference symbol in the figures and description. The description of this instance can then be applied to the other instances of the object. If objects are named using numerical terms, such as first, second, third object, etc., these serve to identify and / or classify objects. Thus, for example, a first object and a third object, but not a second object, may be included. However, numerical terms could also indicate a number and / or sequence of objects. Figure 1 shows a schematic representation of a resectoscope device in a side view; Figure 2 shows a schematic representation of the resectoscope device in a distal view; Figure 3 shows a perspective schematic representation of the resectoscope device in a first position; Figure 4 shows a perspective schematic representation of the resectoscope device in a second position; Figure 5 shows a schematic side view of a resectoscope device in a third position; Figure 6 shows a schematic representation of a resectoscope comprising the resectoscope device, a control unit, and a display device; Figure 7 shows a schematic representation of the resectoscope device in a side view; Figure 8 shows a schematic representation of a partial cross-section of the resectoscope device; Figure 9 shows another schematic representation of the resectoscope device; Figure 10 shows another schematic representation of the resectoscope device; Figure 13 shows...Fig. 11 is a schematic representation of a distal section of the resectoscope device in a side view; Fig. 12 is another schematic representation of the resectoscope device; Fig. 13 is another schematic representation of the resectoscope device; Fig. 14 is another schematic representation of the resectoscope device; Fig. 15 is another schematic representation of the resectoscope device; Fig. 16 is another schematic representation of the resectoscope device; Fig. 17 is another schematic representation of the resectoscope device; and Fig. 18 is another schematic representation of the resectoscope device. Fig. 1 shows a schematic side view of a resectoscope device 10. The resectoscope device 10 is configured for performing a resection and comprises an insertion sleeve 12, which has a longitudinal axis 16, a shaft 18, and a resection tool 20. The resectoscope device 10 is shown in one of many possible positions. The positions are defined by the relative positions of the insertion sleeve 12, the shaft 18, and the resection tool 20. These assemblies 12, 18, and 20 are movable independently of each other. The insertion sleeve 12 is shown in a state inserted into a urethra 13. A distal end 15 of the insertion sleeve 12 projects into a bladder 11. It is also conceivable that in other situations, for example depending on a patient's anatomy, the insertion sleeve 12 does not extend into the bladder 11. Since the insertion sleeve 12 is tubular and defines a guide channel 17, it provides trocar-like access to the bladder 11 for the shaft 18 and the resection instrument 20. The shaft 18 and the resection tool 20 extend along the longitudinal axis 16 of the insertion sleeve 12 through the guide channel 17 into the cavity 14, in this case the bladder 11. These assemblies 18, 20, together with the insertion sleeve 12, can be inserted into the urethra 13 by being mechanically coupled to one another. Once the insertion sleeve 12 is positioned as desired, the shaft 18 and the resection tool 20 can be advanced further distally. The shaft 18 has a distal end piece 34, which is immovably connected to a base body 19 of the shaft 18. At the distal end piece 34, the shaft 18 has an image acquisition device 36 for endoscopic imaging of the interior of the bladder 11 and an illumination device 46 for illuminating the interior of the bladder 11. The image acquisition device 36 and the illumination device 46 are integrally formed. The image acquisition device 36 comprises three image acquisition units 42, which define different viewing directions 44, 44', 44"". The image acquisition units 42 each also have a viewing angle 52. One image acquisition unit 42 has a viewing direction 44' distally, and another image acquisition unit 42 has a viewing direction 44" proximally. The image acquisition units 42 together define a continuous observation area 38.Each of the image acquisition units 42 has its own observation area 54 corresponding to the respective viewing angle 52. These areas each have at least one overlapping area 56 that partially overlaps an observation area 54 of an adjacent image acquisition unit. The image acquisition units 42 each comprise an input optic and an image sensor for image generation (both not shown in detail), which in particular includes a CCD chip or CMOS chip. The image acquisition units 42 are integrally formed with illumination units (not shown in detail) of the illumination device 46, which are designed as LEDs. The resection tool 20 comprises at least one support arm 26 and a tool tip 28, which is designed as a high-frequency resection loop. More precisely, the resection tool 20 comprises two support arms 26, as described below. A guide element 24 is formed on a surface of the shaft 18, which is designed as a guide groove for the support arm 26. The guide element 24 extends along a large part of the shaft 18 into the distal end piece 34. The end of the guide element 24 in the distal end piece 34 is designed as an open guide groove. The guide element 24, in particular the guide groove, partially accommodates the support arms 26 of the resection tool 20. As a result, the support arms 26 are guided linearly within the guide element 24 along a longitudinal axis 120 of the shaft 18. The longitudinal axis 120 is arranged coaxially with the longitudinal axis 16.The shaft 18 and the resection tool 20 are movable independently of each other along the longitudinal axis 120 of the shaft 18. The support arms 26 can therefore be moved linearly from proximal to distal and vice versa within the guide device 24. This movement allows the tool tip 28 to be moved linearly relative to the shaft 18 and independently of it. In particular, the tool tip 28 can be moved beyond a distal end 58 of the shaft 18 (see Fig. 4). Furthermore, the resection tool 20, in particular the support arm 26, comprises a joint 110 by means of which the support arm 26 can be articulated. The support arm 26 forms at least part of the joint 110. More precisely, by means of the joint 110, an articulated section 112 can be articulated relative to a section 114 of the support arm 26 that is proximal to the joint 110. The articulated section 112 comprises an articulated section 113 of the support arm 26 and the tool tip 28. Accordingly, the support arm 26, in particular the articulated section 112, can be articulated relative to the distal end piece 34 of the shaft 18 by means of the joint 110. This allows the tool tip 28 to be moved within the observation area 38. Reference is also made to the following figures regarding the joint 110 and its function. Furthermore, the resectoscope device 20 includes a flushing device 32. This comprises an inlet 33 and an outlet 40. The inlet 33 extends along a longitudinal axis of the support arm 18 and within the support arm 26 from proximal to distal, across the joint 110, to the outlet 40. The outlet 40 is located on the support arm 26, specifically at a distal end of the support arm 26, particularly at the articulated section 113 of the support arm 26. A flushing fluid can be guided through the inlet 33 and exits at the outlet 40. The flushing fluid can be used to fill the bladder 11 for resection and also to flush away tissue residue generated during the resection. The supply line 33 can be configured section by section as a channel formed within the support arm 26. Section by section, the supply line 33 can also be configured as a flexible line, such as a hose (not shown in detail). The flushing fluid can be conveyed via the joint 110 by means of the flexible line. In some embodiments, the flexible line is guided within the cavity (not shown) of the support arm 26 over at least a large part of its longitudinal extent. Furthermore, the resectoscope device 10 includes a proximal operating assembly (see Fig. 6) which, as a whole, is movable relative to the insertion sleeve 12. A user can hold the resectoscope device 10 by the operating assembly and operate a resectoscope comprising the resectoscope device 10 (see Fig. 6). The proximal operating assembly is accessible to the user, and the shaft 18 can be manipulated through it. Using the resectoscope device 10, the user can perform a resection as follows. First, the user inserts the shaft 18 and the resection instrument 20, together with the insertion sleeve 12, into the cavity 14, in this case the urethra 13 and partially the bladder 11. The insertion sleeve 12 is then positioned as desired within the urethra 13. The user then fills the bladder 11 using the irrigation device 32 to expand it. Next, the user positions the distal end 34 of the shaft 18, encompassing the image acquisition device 36, within the bladder 11. To do this, the user advances the shaft 18 distally relative to the insertion sleeve 12. The insertion sleeve 12 remains in its original position. This reduces the total distance traveled by the relative movement between the resectoscope device and the urethra compared to the prior art. During advancement, the resection tool 20 is coupled to the shaft 18. This means that both assemblies 18 and 20 are advanced together. By pivoting the shaft 18 and advancing it as needed, the user can gain an overview of the interior of the bladder 11 and examine the tissue 22 on an inner wall of the bladder 11. This allows the user to identify tissue to be removed that shows, for example, a pathological change. Cancerous tissue is one example of such tissue. This identified tissue can then be removed using the tool tip 28. To do this, the user brings the tool tip 28 into close proximity to the tissue by angling the angled section 112, pivoting the shaft 18, and longitudinally positioning the shaft 18. The distal end piece 34 is positioned so that the tissue to be removed is located within the observation area 38 and can be clearly visualized. During longitudinal positioning, the insertion sleeve 12 remains stationary relative to the urethra 13 or the cavity 14, as previously described. In other words, the insertion sleeve 12 rests atraumatically. After positioning the distal end piece 34 and selecting an angular position for the angled section 112 (see the following figures), the user moves the resection tool 20 relative to the shaft 18 according to one embodiment, with the insertion sleeve 12 also remaining stationary and atraumatic, and brings the tool tip 28 into contact with the tissue. After activating the tool tip 28, for example, if it is configured as a high-frequency resection loop, the tissue can be removed layer by layer. For this purpose, the tool tip 28 is iteratively stroked over the tissue, superficially processing and removing the tissue to be removed. To stroke over the tissue, the resection tool 20 can be moved relative to the shaft 18. Alternatively, the shaft 18 can be moved together with the resection tool 20, while the insertion sleeve 12 remains stationary in the urethra 13. The angular position is maintained during the movement. According to another embodiment, the tissue removal movement is carried out by angling the angled section 112. The shaft 18 can be held almost stationary. For further details of both embodiments, reference is made to the following figures. During the removal of the tissue, the rinsing device 32 is used continuously, and rinsing fluid is removed from the bladder 11 by means of a return flow 48 (see Fig. 2). After resection, the shaft 18 can be pulled out of the cavity 14 together with the resection tool 20 and the insertion sleeve 12. The shaft 18 and the resection tool 20 are thus designed to be moved within the insertion sleeve 12 after being inserted into the cavity 14 during the removal of tissue 22. The insertion sleeve 12 is designed to remain atraumatically stationary during the removal of tissue 22. Fig. 2 shows a schematic representation of the resectoscope device 10 in a distal view of a distal end 58 of the shaft 18, or a distal end face of the resectoscope device 10. A distal end face 59 of the shaft 18 is visible, on which an illumination unit 47 of the illumination device 56, designed as an LED, is arranged. An input optic 43 of one of the image acquisition units 42 is also arranged on the distal end face 59. Furthermore, the guide device 24 is visible, the distal end of which is laterally embedded in the distal end surface 59. The support arms 26 are guided in the guide device 24. The resection tool 20 comprises two support arms 26. The tool tip 28, in particular the HF resection loop 30, is arranged between the support arms 26. The shaft 18 is arranged between the support arms 26. The outlet 40 of the irrigation device 32 of the support arm 26 is also visible. Both support arms 26 are identical in design and each accordingly has an outlet 40. The shaft 18 has play in the insertion sleeve 12. Therefore, a gap 49 is visible between the insertion sleeve 12 and the shaft 18. This gap 49 forms the return channel 48. The flushing fluid can thus be drawn out through the gap 49. In the illustrated embodiment, the insertion sleeve 12 has an outer diameter of 9 mm and an inner diameter of 7.5 mm. The shaft 18 has an outer diameter of 6.5 mm and a length of 30 cm. The insertion sleeve 12 has a length of 25 cm. Significantly shorter insertion sleeves 12 are also conceivable, for example, half the length of the shaft 18. Even shorter insertion sleeves 12 are also possible. The dimensions mentioned are merely examples. Figures 3 and 4 each show a perspective schematic representation of the resectoscope device 10 in different positions. These are defined by a different relative position of the resection tool 20 with respect to the shaft 18. Figure 3 shows the resection device 10 with the image acquisition device 36 in the distal end 34 of the shaft 18. Also shown is the resection instrument 20 with the tool tip 28 and one of the support arms 26, as well as the joint 110. The insertion sleeve 12, which is guided into the urethra 13, is also visible. The shaft 18 and the resection instrument 20 extend through the insertion sleeve 12 and into the bladder 11. The shaft 18 and the resection instrument 20 can be moved together relative to the insertion sleeve 12, which remains stationary in the urethra 13. In the position shown in Figure 3, the tool tip 28 is flush with the distal end 58 of the shaft 18. As shown in Fig. 4, the resection tool 20 can be moved independently of the shaft 18 relative to it and to the insertion sleeve 12. In the position shown in Fig. 4, the tool tip 28 is positioned distally beyond the distal end 58 of the shaft 18. The insertion sleeve 12 remains in the same position as shown in Fig. 3. The resection tool 20 was thus moved independently of the shaft 18. A further support arm 27 is also visible. This is identical in construction to the support arm 26, as described above. It is also articulated. Furthermore, a joint 110 is visible for each support arm 26 and 27. The tool tip 28 is positioned between the support arm 26 and the further support arm 27. Referring to the previous figures, the shaft 118 extends in the angular position shown between the articulated sections 113 of the support arms 26, 27.This configuration is referred to as the delivery configuration. Since the support arms 26, 27 are not angled, the resection tool 20 can be introduced into the body cavity via the insertion sleeve 12. Accordingly, the angular position shown is a delivery angle position. In this position, the angled section 112 extends parallel to the longitudinal axes 16, 120. Fig. 5 shows a schematic side view of the resectoscope device 10 in another position. In the position shown, the distal end 34 of the shaft 18 is completely enclosed by the insertion sleeve 12. The resection instrument 20 also does not project distally beyond the insertion sleeve 12. In the position shown, the resectoscope device 10 could, for example, be inserted into the cavity 14. However, other positions are also conceivable in which at least one of the assemblies 18, 20 projects distally beyond the insertion sleeve 12. Fig. 6 shows a schematic representation of the resectoscope 60, which includes the resectoscope device 10. The proximal operating assembly 50, which is movable as a whole relative to the insertion sleeve 12, is also shown. The proximal operating assembly 50 further includes an actuating device 51 by means of which the resection tool 20 can be operated, in particular moved forwards and backwards. The operating assembly 50 also forms, at least partially, an actuating device 122 for actuating the joint 110. The actuating device is not shown in detail. For example, a rack could be used, extending approximately along line 123 within the support arm 26 to the joint 110. A pinion could be formed on the angled section 112, which engages with the rack. The user can thus angle the angled section 112 by actuating the rack. The resectoscope 60 is connected to a control unit 62, which can, for example, process image data and control a function of the resectoscope 60. In particular, the image acquisition device can be controlled by means of the control unit 62. The control unit 62 is connected to a display unit 64, which can generate a representation of an endoscopic image. The user can view the interior of the bladder 11 via this display and thus also monitor the resection procedure. The following figures illustrate the function and features of the resectoscope device 10 in more detail. Figures 7 and 8 show various schematic representations of the resectoscope device 10. Figure 7 shows a side view, and Figure 8 shows a partial cross-section of the resectoscope device 10. The resectoscope device 10 comprises the shaft 18, the image acquisition device 36 (see Figures 1, 2, 3, 4, 5 to 6), which is arranged on the distal end 34 of the shaft 18, and the resection tool 20. The resection tool has the tool tip 28, the support arm 26, and the joint 110. The resection tool 20 can be articulated section by section by means of the joint 110. Specifically, the articulated section 112 can be articulated with respect to the section of the support arm 26 located proximal to the joint 110 and can be moved into an angular position by articulated movement. As already explained, the angled section 112 comprises the articulated section 113 of the support arm 26 and the tool tip 28. As shown in Fig.As can be seen in Figure 8, the resectoscope device comprises two support arms 26, 27, between which the tool tip 28 extends. In Figures 7 and 8, the resection tool 20 is shown in an angular position. In this position, the angled section 112 is angled with respect to the longitudinal axis 132 of the distal end piece 34. The support arm 26, in particular the articulated section 113 of the support arm 26, is therefore articulated relative to the distal end piece 34 of the shaft 18. In the angular position of the support arm 26 shown in Fig. 7, the tool tip 28 is at a distance 130 from the longitudinal axis 132 of the distal end piece 34. The distance 130 describes the distance between the point of the angled section 112 furthest from the longitudinal axis 132 and the longitudinal axis 132. This distance 130 is approximately a factor of 4 larger than a radius 134 of a cross-sectional profile 136 of the distal end piece 34 (see also Fig. 8). In the illustrated case, the radius 134 is a maximum radius of the distal end piece 34, where a [missing information] occurs during resection within the body cavity or [missing information].The distal end piece 34 is defined by the section of the shaft 18 that can be arranged in relation to the bladder. Figure 8 shows an angular position in which the distance 130 is twice the radius 134. Furthermore, Fig. 7 shows a length 152 of the angled section 112. This is measured as the distance between the joint 110 and the point on the angled section 112 furthest from the joint 110, with the distance being measured parallel to the main extension direction of the articulated section 113. The length 152 of the angled section 112 exceeds the radius 134 of the cross-sectional profile 136 of the distal end piece 34 by a factor of approximately 3.5. More precisely, the length 152 of the angled section 112 is 25 mm. The joint 110 is a mechanical pivot joint and has a single degree of freedom. This is a rotational degree of freedom. An axis of rotation 111 of the joint 110 runs orthogonally to the longitudinal axis 132 of the distal end piece 34 (see Fig. 7 and Fig. 8). As can be seen in Fig. 8, the axis of rotation 111 runs along an imaginary connecting line between the respective joints 110 of the support arms 26, 27. The support arms 26, 27 thus each have a joint 110, which each defines an axis of rotation 111. The axes of rotation 111 of the joints 110 are arranged coaxially. By means of the joint 110, the articulated section 113 can be moved into an angular position in which a principal extension axis of the articulated section 113 and the longitudinal axis 132 enclose an arm angle 118 of at least 45°. In some embodiments, the joint allows an arm angle 118 of at least 90°, in particular at least 135°, and / or an arm angle 118 of up to, for example, 170°, in particular 175°. As will be explained in more detail below, the angular positions of the support arm 26 shown in Fig. 7 and Fig. 8 each define an application configuration in which a resection is performed. Figure 9 shows a further schematic representation of the resectoscope device 10. The angular position of the support arm 26 corresponds to the angular position shown in Figure 7. This was set by selecting the angular position. The angled section 112 was thus angled relative to the distal end piece 34. In this angular position, the tool tip 28 is movable on the surface of an application cone 148. To move the tool on the surface of the application cone 148, the user can move a proximal section 144 of the shaft 18 within a manipulation cone 140. This is achieved by pivoting about a pivot point 142 and linearly displacing the shaft 18 through the pivot point 142. If the user moves, for example, the tool tip 28 closer to the pivot point 142, he pivots the shaft 18 in such a way that an angle 147 between the longitudinal axis 120 of the shaft 18 and a central axis 143 of the manipulation cone 140 becomes smaller.In the opposite direction, it increases the angle 147 accordingly. A maximum distance of the tool tip 28 to the pivot point 142 on the surface of the application cone 148 is accordingly limited by an opening angle 141 of the manipulation cone 140 when selecting the angular position of the support arm 26. Since the resection tool 20, together with the shank 18, is rotatable about the longitudinal axis 120 of the shank 18, the application cone 148 and the manipulation cone 140 have the shape of a circular cone. Accordingly, the opening angle 141 is twice the angle 147. Furthermore, the image acquisition device 36 in the distal end piece 34, as described above, defines the observation area 38. This area partially intersects the application cone 148. Within this area, a surface section 146 of the application cone 148, the tool tip is movable. More precisely, the tool tip 28 can be moved by manipulating the proximal section 144 of the shaft 18 within the manipulation cone 140 and selecting the angular position of the support arm 26 on the surface section 146 of the application cone 148 located within the observation area 38. In the illustrated case, the surface section 146 is defined by the observation area 38. This means that the tool tip 28 could also be movable outside the observation area 38. Due to the angular position of the support arm 26, the opening angle 149 of the application cone 148 is larger than the opening angle 141 of the manipulation cone 140. Since the tool tip 28 has been angled beyond the cross-section of the shaft 18, tissue further away can be reached with a smaller pivoting of the shaft 18 compared to a non-angleable support arm (not shown). The opening angle 149 of the application cone 148 is at least 1.5 times larger than the opening angle 141 of the manipulation cone 140, and in the illustrated case, at least twice as large. Figure 10 shows a schematic representation of the resectoscope device 10, which is arranged in a different position than shown in Figure 8. The insertion sleeve 12, through which the shaft 18 and the resection tool 20 extend, is also visible. The manipulation cone 140, the application cone 148, and the opening angles 141, 149 correspond to those shown in Figure 9. The angular position is also the same. It can be seen that the pivot point 142 is located within the insertion sleeve 12. Due to the angular position of the support arm 26, the resection tool 20 cannot be withdrawn further proximally. Accordingly, the accessible surface section 146 is limited by the insertion sleeve 12 and the choice of angular position. In the embodiment shown, the distance 150 of the surface section 146 of the application cone 148 to the pivot point 142 is at least 2 times as large as the length 152 of the angled section 112 (see Fig.7). The observation area 38 therefore extends proximally beyond the surface section 146. Fig. 11 shows a schematic side view of a distal section of the resectoscope device 10. The support arm 26 is in the feed configuration. The tool tip 28 is designed as an HS resection loop 30, as can be seen in more detail, for example, in Fig. 8. The HF resection loop 30 comprises a feed section 160 and a working section 162. During resection, the working section 162 is brought into contact with the tissue for tissue removal. The feed section 160 connects the working section 162 to the support arm 26. The working section 162, in particular a longitudinal axis 163 of the working section 162, is angled relative to a longitudinal axis 164 of the feed section 160 by a loop angle 166 of at most 90°. In the embodiment shown, the loop angle 166 is 45°. The working section 162 therefore extends partially distal to the supply section 160.This allows easy access to a tissue area of ​​the bladder opposite the bladder neck in the illustrated delivery configuration. Since the support arm 26 is articulated, other tissue areas can also be easily reached, and the tool tip 28 can be positioned according to the application by selecting the appropriate angle. Fig. 12 shows a further schematic representation of the resectoscope device 10. It is shown in a state partially inserted into the cavity 14, in this case the bladder 11. The shaft 18 and the resection tool 20 extend through the insertion sleeve 12, which is located in the urethra 13, and the distal end piece 34 with the image acquisition device 36 projects into the bladder 11. The resection tool 20 is shown in two different angular positions. Both define an application configuration. In the two different angular positions, the tool tip 28 is positioned in different observation areas 54, 54'. The observation areas 54, 54' are each assigned to different image acquisition units 42 of the image acquisition device 36, with the image acquisition units 42 defining different viewing directions 44, 44' (see also Fig. 1).In the first angular position (solid lines), the tool tip 28 is positioned in an observation area 54 that is partially directed distally. In the second angular position (dashed lines), the tool tip 28 is positioned in an observation area 54' that is associated with an image acquisition unit 42 with a viewing direction 44' perpendicular to the longitudinal axis 120 of the shaft 18. The tool tip 28 can be moved from the first observation area 54 to the second observation area 54' by angling the support arm 26 or by selecting an angular position. Thus, the tool tip 28 can be moved between the observation areas 54 and 54' by angling the support arm 26. The user can position the tool tip 28 in the direction of arrow 170 by angling the support arm 26. Furthermore, the user can position the tool tip 28 in the direction of arrow 172 by pivoting the shaft 18 and in the direction of arrow 176 by advancing the resection instrument 20. The shaft 18 can be positioned in the direction of arrow 174, for example, to align the image acquisition device 36. The shaft 18 can also be rotated together with the resection instrument 20 about the longitudinal axis 120 (not shown). With reference to Figures 13, 14, 15, 16, 17 to 18, the following explains how the user can perform a resection using the resection instrument 20 with an articulated support arm 26. Basically, two tissue removal movements are conceivable (this list is not exhaustive). On the one hand, the tissue could be removed primarily by longitudinal displacement of the resection instrument 20, either together with the shaft 18 or independently of it (Figure 13). In this tissue removal movement, an angular position of the support arm 26 is selected once before the movement is performed and then maintained. The tissue removal movement thus corresponds approximately to that performed in a conventional resection. In contrast, however, the shaft 18 does not need to be rotated as much, since the choice of angular position allows access to remote tissue areas with minimal rotation of the shaft 18. On the other hand, the tissue could be removed by a looping motion of the angled section 112 (Figs. 14 and 16). During the looping motion, the support arm 26 is continuously angled. In this case, the tissue removal movement is therefore a rotational movement of the support arm 26 and not a linear movement of the resection tool 20. A combination of both tissue removal movements is also conceivable. For example, a first tissue area could be treated using the linear movement, and then a second tissue area could be treated using the loop movement. Figure 13 shows a further schematic representation of the resectoscope device 10, illustrating two different linear positions of the resection tool 20. These linear positions are achieved by a relative displacement of the resection tool 20 relative to the shaft 18. The angular position of the support arm 26 remains constant in both linear positions. Moving between the two linear positions results in a movement of the tool tip 28 along the direction of arrow 178. In this way, the tool tip 28 can be iteratively moved over the tissue 180 to be removed, and this tissue can be removed layer by layer. Figure 14 shows a further schematic representation of the resectoscope device 10. The looping motion is performed by continuously changing the angular position of the support arm 26. During this motion, the resection tool 20 proximal to the joint 110 and the shaft 18 remain stationary relative to each other. The continuous angling thus iteratively moves the tool tip 28 over the tissue 180 to be removed along the direction of arrow 182. Layer-by-layer tissue removal is therefore enabled by the looping motion. Figure 15 shows another schematic representation of the resectoscope device 10, with the tissue 180 removed as shown in Figure 14. Since the image acquisition device 36 defines the several observation areas 54, a large part of the bladder interior can be monitored without having to reposition the image acquisition device 36. As shown, further tissue 184 to be removed may be located in observation area 54'. This can be identified by the user after the removal of tissue 180 (see Figure 14) without moving the image acquisition device 36. As explained, for example, in Figure 12, the tool tip 28 can then be moved into observation area 54'. The tissue 184 can then be removed either by linear or looping motion. Figure 16 shows a further schematic representation of the resectoscope device 10. The image acquisition unit 36 ​​comprises an image acquisition unit 42 with a viewing direction 44 that is partially directed proximally. This allows the distal end 34 of the shaft 18 to be positioned for resection within a bladder 11 such that the bladder neck 186 is located within the observation area 38 of the image acquisition unit 36. Accordingly, resection can also be performed in the immediate vicinity of the bladder neck 186 or the urethra 13. This represents a particularly challenging resection. Nevertheless, it can be performed gently for the patient by using the looping motion of the support arm 26 for tissue removal. Extensive swiveling of the shaft 18 is not necessary. After tissue removal, further tissue 184 to be removed can be identified in the observation area 54, as shown in Fig. 17, which shows a further schematic representation of the resectoscope device 10. By rotating the shaft 18 together with the resection tool 20, the tool tip 28 can be realigned to reach the further tissue 184 to be removed. Fig. 18 shows a further schematic representation of the resectoscope device 10. The resection tool 20 is shown in the feed configuration. Due to the loop angle 166 of a maximum of 90° (see Fig. 11 and associated description), tissue 180 to be removed, which is opposite the bladder neck 186, can be reached in the feed configuration. For this purpose, the shaft 18 does not need to be swivelled sharply because of the loop angle 166. Reference symbol list 10 Resectoscope device 11 Bladder 12 Insertion sleeve 13 Urethra 14 Cavity 15 Distal end piece 16 Longitudinal axis 17 Guide channel 18 Shaft 19 Base body 20 Resection tool 22 Tissue 24 Guide device 26 Support arm 27 Additional support arm 28 Tool tip 30 RF resection loop 32 Irrigation device 33 Lead wire 34 Distal end piece 36 Image acquisition device 38 Observation area 40 Outlet 42 Image acquisition unit 43 Entrance optics 44 Viewing direction 46 Illumination device 47 Illumination unit 48 Return 49 Gap 50 Proximal operating assembly 51 Actuating device 52 Viewing angle 54 Observation area 56 Overlap area 58 Distal end 59 Distal end face 60 Resectoscope 62 Control unit 64 Display device 110 Joint 111 Axis of rotation 112 Angle section 113 Angled section 114 Proximal section 116 Main extension axis 118 Arm angle 120 Longitudinal axis 122 Actuating mechanism 123 Line 130 Distance 132 Longitudinal axis 134 Radius 136 Cross-sectional profile140 Manipulation cone 141 Opening angle 142 Pivot point 143 Central axis 144 Proximal section 146 Surface section 148 Application cone 149 Opening angle 150 Distance 152 Length 160 Supply section 162 Working section 163 Longitudinal axis 164 Longitudinal axis 166 Loop angle 170 Arrow 172 Arrow 174 Arrow 176 Arrow 178 Arrow 180 Tissue to be removed 182 Arrow 184 Further tissue to be removed 186 Bladder neck

Claims

Resectoscope device (10) comprising: a shaft (18); an image acquisition device (36) arranged at a distal end piece (34) of the shaft (18) and defining an observation area (38); a resection tool (20) with a tool tip (28) and a support arm (26); and a joint (110) by means of which the support arm (26) can be articulated; wherein, in at least one angular position of the support arm (26), a distance (130) between the tool tip (28) and a longitudinal axis (132) of the distal end piece (34) exceeds a radius (134) of a cross-sectional profile (136) of the distal end piece (34) by at least a factor of 2. Resectoscope device (10), in particular according to claim 1, comprising: a shaft (18); an image acquisition device (36) arranged on a distal end piece (34) of the shaft (18) and defining an observation area (38); a resection tool (20) with a tool tip (28) and a support arm (26); and a joint (110) by means of which the support arm (26) can be articulated;wherein the shaft (18) defines a manipulation cone (140) within which a section (144) of the shaft (18) proximal with respect to a pivot point (142) can be manipulated by a user, wherein the tool tip (28) can be moved on a surface section (146) of an application cone (148) located within the observation area (38) by manipulating the proximal section (144) of the shaft (18) within the manipulation cone (140) and selecting at least one angular position of the support arm (26), and wherein an opening angle (149) of the application cone (148) is at least 1.5 times larger than an opening angle (141) of the manipulation cone (140). Resectoscope device (10) according to claim 2, wherein the resection tool (20) defines an angled section (112) which can be angled by means of the joint (110), and wherein a distance (150) of the surface section (146) of the application cone (148) to the pivot point (142) is at least 2 times as large as the length (152) of the angled section (112). Resectoscope device (10), in particular according to one of the preceding claims, comprising: a shaft (18); an image acquisition device (36) arranged on a distal end piece (34) of the shaft (18) and defining an observation area (38); a resection tool (20) with a tool tip (28) and a support arm (26); and a joint (110) by means of which the support arm (26) can be articulated; wherein the image acquisition device (36) comprises at least two image acquisition units (42) directed in different viewing directions (44), wherein the image acquisition units (42) each define an observation part area (54) of the observation area (38), and wherein the tool tip (28) can be moved between the observation part areas (54) by articulated articulation of the support arm (26). Resectoscope device (10) according to one of the preceding claims, wherein the support arm (26) is articulated relative to the distal end piece (34) of the shaft (18) by means of the joint (110), and wherein the distal end piece (34) is immovable relative to a base body (19) of the shaft (18). Resectoscope device (10) according to one of the preceding claims, wherein the shaft (18) and the resection tool (20) are movable independently of each other along a longitudinal axis (120) of the shaft (18). Resectoscope device (10) according to one of the preceding claims, wherein the resection tool (20) defines an angled section (112) which can be angled by means of the joint (110), and wherein a length (152) of the angled section (112) exceeds a radius (134) of a cross-sectional profile (136) of the distal end piece (34) by at least a factor of 2, in particular by at least a factor of 3. Resectoscope device (10) according to claim 7, wherein the length (152) of the angled section (112) is between 15 mm and 50 mm and in particular between 25 mm and 35 mm. Resectoscope device (10) according to one of the preceding claims, further comprising: a rinsing device (32) by means of which an area that can be processed by the resection tool (20) can be rinsed, comprising a supply line (33) by means of which a rinsing fluid can be directed along the shaft (18), wherein the supply line (33) extends within the support arm (26). Resectoscope device (10) according to claim 9, wherein the rinsing device (32) comprises an outlet (40) which is arranged on a section (113) of the support arm (26) which can be angled by means of the joint (110). Resectoscope device (10) according to one of the preceding claims, wherein the resection tool (20) comprises a further articulated support arm (26), wherein the tool tip (28) is arranged between the support arm (26) and the further support arm (27), and wherein in particular the shaft (18) extends at least in a feed configuration between the articulated sections (113) of the support arms (26, 27). Resectoscope device (10) according to one of the preceding claims, wherein the tool tip (28) comprises an HS resection loop (30) comprising a lead section (160) and a working section (162), wherein the working section (162) is angled relative to a longitudinal axis (164) of the lead section (160) by a loop angle (166) of at most 90°, and wherein in particular the working section (162) extends partially distal to the lead section (160). Resectoscope device (10) according to one of the preceding claims, wherein the distal end piece (34) of the shaft (18) can be arranged for the performance of a resection at least partially within a bladder (11) such that the bladder neck is located within the observation area (38) of the image acquisition device (36). Resectoscope device (10) according to one of the preceding claims, wherein the resection tool (20) together with the shaft (18) is rotatable about a longitudinal axis (120) of the shaft (18). Resectoscope device (10) according to one of the preceding claims, further comprising: an insertion sleeve (12) which is partially feedable into a cavity (14) of a patient and defines a longitudinal axis (16), wherein the shaft (18) extends within the insertion sleeve (12), wherein the shaft (18) and the resection tool (20) are movable independently of each other relative to the insertion sleeve (12) along the longitudinal axis (16) of the insertion sleeve (12), and wherein in particular the shaft (18) and the resection tool (20) are feedable into the cavity (14) together with the insertion sleeve (12). Resectoscope device (10) according to one of the preceding claims, further comprising a proximal operating assembly (50) which is accessible to a user and by means of which the shaft (18) can be manipulated. Resectoscope device (10) according to one of the preceding claims, wherein the joint (110) is a mechanical swivel joint. Resectoscope device (10) according to one of the preceding claims, wherein the joint (110) has a single degree of freedom. Resection tool (20), in particular for a resectoscope device (10) according to one of the preceding claims, comprising: a tool tip (28) and a support arm (26); and a joint (110) by means of which the support arm (26) can be articulated, wherein the resection tool (20) defines an articulated section (112) which can be articulated by means of the joint (110), and wherein the length (152) of the articulated section (112) is between 15 mm and 50 mm and in particular between 25 mm and 35 mm. Resectoscope (60) with a resectoscope device (10) according to any one of claims 1 to 18.

Images