MEDICAL INTERVENTIONAL DEVICE WITH VERSATILE HANDLE

Abstract

Medical intervention device, including: a distal end (102) comprising a pair of jaws (108); a handle (404) functionally connected to the distal end comprising: a pair of pivotable finger arms (412) which are each connected to the handle at a pivot point and extend proximally to at least one finger loop (418), wherein the pivoting finger arms are arranged for opening and closing the pair of jaws at the distal end; and at least one actuator interface comprising an interface for actuating a cutting blade (436B) located on the handle and in a position distal to the respective pivot points of the pair of pivotable finger arms, and comprising a lever (426B); and a locking mechanism that prevents the lever from being actuated unless the jaws are substantially closed.

Description

PRIORITY CLAIM

[0001] The present application claims priority over the preliminary US patent application No. 63 / 270,158 filed on October 21, 2021, the contents of which are incorporated herein in full by reference. TECHNICAL AREA

[0002] The present application relates to a medical intervention device. In particular, the present application relates to a medical intervention device with a handle configured for standard and reverse grip orientations. More specifically, the present application relates to a medical device with a rotating and / or articulated distal tip, jaws arranged at the distal tip and configured for grasping and / or cutting tissue, and / or an exciter arranged at a distal tip, wherein a handle is provided and configured to control the various distal end devices and to provide standard and reverse grip orientations. BACKGROUND

[0003] The background description given here serves to present the general context of the disclosure. Works of the inventor currently named, insofar as they are described in this background section, as well as aspects of the description that may not have been part of the prior art at the time of filing, are neither expressly nor implicitly recognized as prior art with respect to the present disclosure.

[0004] Medical interventional devices can be used to perform medical procedures on patients. In many cases, the interventional device can be configured to access the patient's abdomen, chest, or other body parts via a trocar or other port that allows insertion of the device. The interventional device sometimes has a distal end that can be actuated by a handle. For access to the patient through the port, the distal end and a medial portion of the device can be relatively long and slender, and the handle can be designed to remain outside the patient for operation by a surgeon to control the distal end. Pistol handles are one example. Handles resembling those of conventional scissors are also available.German patent DE 603 ​​12 873 T2 describes an electrosurgical forceps instrument with movable finger arms and a lever for actuating a cutting mechanism. US patent 2016 / 0038168 A1 describes an electrosurgical forceps instrument whose finger arms are connected to the main body via film joints.

[0005] In thoracic surgery, access to the patient may be through the thoracic cavity and / or between one or more of the patient's ribs. In these circumstances, the extended portion and distal end of the device may be positioned in a generally vertical orientation to allow access through the opening, which is typically oriented upwards. A pistol grip or scissor grip may be cumbersome in these situations, forcing the surgeon to position their forearm vertically with the elbow over the port. BRIEF DESCRIPTION OF THE DRAWINGS

[0006] Although the description concludes with claims in which the subject matter, which is considered to be the various embodiments of the present disclosure, is particularly highlighted and claimed, it is assumed that the invention will be better understood from the following description in conjunction with the accompanying figures, in which: Fig. 1A is a perspective view of a medical intervention device according to one or more examples. Fig. 1B a side view of a distal part of the device Fig. 1A with a removed cheek is, according to one or more examples. Fig. 1C is a side view of it. Fig. 1D a side view of a distal part of the device of Fig. 1A is wherein one jaw is removed and the blade is partially advanced, according to one or more embodiments. Fig. 1E is a side view of it. Fig. 1F is a side view where the blade is pushed further forward. Fig. 1G is a close-up side view where one jaw has been removed to expose the blade. Fig. 1H is a diagram showing the rotation of the distal part. Fig. 1I is a diagram showing the mobility of the distal part. Fig. 2A is a perspective view of a handle part of a medical intervention device, which is generally used horizontally according to one or more examples. Fig. 2B a perspective view of the handle part of Fig. 2A is the one that is generally used vertically, according to one or more examples. Fig. 3 is a cross-sectional view of a handle part of a medical intervention device according to one or more examples. Fig. 4 is a schematic view showing the relative movement of actuators on a handle of a medical intervention device, according to one or more examples. Fig. 5 is a schematic view showing the relative movement of actuators on a handle of a medical intervention device, according to one or more examples. Fig. 6 is a side view of a handle part of a medical intervention device according to one or more examples. Fig. 7 is a side view of a handle part of a medical intervention device according to one or more examples. Fig. 8A is a side view of a handle part of a medical intervention device, according to one or more examples. Fig. 8B an additional side view of the handle part of Fig. 8A is, according to one or more examples. Fig. 9A is a side view of a handle part of a medical intervention device, according to one or more examples. Fig. 9B an additional side view of the handle part of Fig. 9A is, according to one or more examples. Fig. 10 is a perspective view of a handle of a medical intervention device according to one or more examples. Fig. 11A is a perspective view of a handle of a medical intervention device, according to one or more examples. Fig. 11B, Fig. 11C and Fig. 11D perspective views of a distal end of the medical intervention device of Fig. 11A are, according to one or more examples. Fig. 11E a perspective view of a distal end jaw of the medical intervention device of Fig. 11A is, according to one or more examples. Fig. 11F is a transparent view of a handle of the medical intervention device according to one or more examples. Fig. Figure 11G shows a side view of a drive interface and a jaw drive interface, each arranged on an inner housing, according to one or more examples. Fig. 11H is an additional view of the jaw drive interface. Fig. 11I is a side view of various mechanisms for actuating jaws, corresponding to one or more examples. Fig. Figure 11J shows a side view of various shovel actuation mechanisms according to one or more examples. Fig. Figure 11K is a close-up of the jaw drive mechanism showing the locking sleeve, according to one or more examples. Fig. 11L, Fig. 11M and Fig. 11N progressive schematic views of a locking system are shown that prevents the blade from being actuated when the jaws are not substantially closed, and that prevents the jaws from being opened when the blade is not substantially retracted, according to a further example. Fig. 11O is a diagram that illustrates the mechanical advantage of the mechanism for actuating the jaws according to one or more examples. Fig. 11P is a diagram that illustrates the mechanical advantage of the blade actuation mechanism according to one or more examples. Fig. 11Q is an additional transparent view of the handle, according to one or more examples. Fig. 11R is an additional transparent view of the handle, according to one or more examples. Fig. 12A is a side view of a handle part of a medical intervention device, according to one or more examples. Fig. 12B an additional side view of the handle part of Fig. 12A is, according to one or more examples. Fig. Figure 12C is a perspective view of it. Fig. 12D is a side view of a handle part of a medical intervention device, according to one or more examples. Fig. 12E an additional side view of the handle part of Fig. 12A is, according to one or more examples. Fig. 12F is a perspective view of it.

[0007] In the drawings, which are not necessarily to scale, the same numbers may describe similar components in different views. The same numbers with different letter suffixes may represent different versions of similar components. The drawings illustrate, generally and exemplarily, but not exclusively, various examples discussed in this document. DETAILED DESCRIPTION

[0008] The present application relates, in one or more examples, to a medical intervention device with a versatile handle design. In particular, in one or more examples, the handle may comprise a scissor-like handle with associated actuation interfaces arranged such that the handle can be used in a generally horizontal or a generally vertical position, while providing access to the actuation interfaces in both positions and avoiding relatively twisted positions of the user. The medical intervention device can therefore be used for a variety of medical procedures. For example, the device can be used by insertion into the side of a patient, generally in a horizontal orientation, with the user's hand in a handshake position.Alternatively, the device can be inserted through a patient's chest, generally in a vertical orientation, with the user's hand in an arm-wrestling position. In both orientations, the user's forearm can generally be positioned horizontally or slightly tilted upwards or downwards. However, an inverted forearm position, where the user's elbow is above their hand, can be avoided.

[0009] Fig. Figure 1 is a perspective view of a medical intervention device 100 according to one or more examples. The device 100 may be configured to provide access to a surgical site in a patient. In particular, the device may be configured to be inserted into the patient through a trocar or other surgical access opening. As such, the device may comprise a distal section 102 configured to be inserted through the access opening, a handle section 104 configured to remain outside the patient and be operated by the user (e.g., the surgeon), and a medial section 106 extending between the handle 104 and the distal section 102.

[0010] The distal part 102 can be configured to manipulate, modify, grasp, cut, cauterize, or otherwise interact with tissues, vessels, organs, or other aspects of a patient's anatomy. In particular, the distal part 102 may include one or more end effectors for interaction with the patient. For example, in Fig. As shown in Figures 1B-1G, the distal part 102 can comprise a pair of jaws 108 and a cutting blade 110. The end effectors can be actuated by the handle 104 via mechanical, electrical, or electromechanical mechanisms located in, on, or through the central part 106. That is, the mechanisms can extend from the handle 104 through the central part 106 and to the distal end 102, where they function to control the functions of the end effectors. In one or more embodiments, wireless communication between the handle 104 and the end effectors can be provided if the physical elements do not extend through the central part 106. In other examples, electrical power can extend through the central part 106 to supply electromechanical devices at the distal end 102, which can be configured for wireless communication and control by the handle 104.Other approaches to providing the operability of the end effectors via handle 104 may be provided.

[0011] With continued reference to Fig. In embodiments 1B-1G, the pair of jaws 108 can be configured to grasp and / or cauterize tissue, vessels, or other aspects of a patient's anatomy. As shown, the jaws 108 can be hinged jaws configured to open and close relative to each other in order to clamp, grasp, or otherwise collect and / or retain material between them when closed. In one or more embodiments, the jaws 108 can be selectively excited to cause them to cauterize vessels or tissue grasped by the jaws 108. For example, a clamping surface of the jaws can include electrodes that allow current to flow from one jaw through the tissue to the other jaw.The jaws 108 may have a slot or other articulation space that allows the cutting blade 110 to pass between the jaws and cut tissue or other aspects of the patient's anatomy. As shown, for example, a slot may generally be located centrally on each of the jaws and have a depth equal to or slightly greater than the blade width. The blade 110 may be oriented vertically so that it moves longitudinally in a distal / proximal direction between the jaws 108. In addition, the end effectors may have one or more degrees of freedom beyond the opening / closing of the jaws and the longitudinal movement of the blade. For example, in one or more embodiments, as shown in . Fig. As shown in Figure 1H, the jaws and / or the cutting blade may be arranged to rotate about a generally longitudinal axis and relative to the other parts of the device. Furthermore, the jaws may, as shown in Fig. As shown in Figure 1I, they can also be arranged to move (e.g., pivot together about an axis extending transversely to the device) so that the centerline of the opening / closing movement is inclined relative to the medial part 106 of the device. Other types of movement may also be provided.

[0012] In the Fig. Various handles with one or more actuation interfaces are described, corresponding to the different functions of the distal end 102 of the device. It should be understood that, while several different examples may be provided, many of the features are not mutually exclusive and can be selected, exchanged, and / or combined to correspond to the functions of the distal end 102 of the device 100. Even though certain combinations of actuator interfaces are described, this should not be interpreted as restricting the combination of an actuator interface or a particular type of actuator interface shown in one example with one or more of the other examples shown.

[0013] As in Fig. 2A and Fig. As shown in Figure 2B, the handle 204 can comprise a body part 214 and a pair of opposing and pivotable arms 212. The arms 212 can have finger loops in the form of single finger loops, double finger loops, or loops otherwise configured for this purpose. As shown, the present example can comprise a finger arm 212 having a generally elongated rod section 216, a double finger loop 218 arranged outside the rod section 216, an extension section 220 at which the rod extends beyond the double finger loop 218, and a loop end 222. The present example can also comprise a thumb arm having a generally elongated rod section 216 and a single finger loop 218 arranged outside the rod section 216. As can be seen from the comparison of the Fig. As can be seen, the handle can be used in a generally horizontal orientation, with the user's hand / forearm in a handshake position, as shown in Fig. As shown. In this position, the user can insert one or more fingers (e.g., index finger, middle finger, ring finger) through the double finger loop and place another finger (e.g., index finger) along the bar section distal to the double finger loop. The remaining fingers (e.g., ring finger and / or little finger) can be placed on the end of the loop 222 or on the extension section 220. In this position, the user can insert their thumb through the single finger loop 218 on the thumb arm. Alternatively, the grip can be used in a generally vertical orientation with the user's hand in an arm-wrestling position, as shown. Fig. 2B shown. In this position, the user can insert one or more fingers (e.g., middle finger, ring finger, little finger) through the double finger loop 218 and place another finger (e.g., the little finger) along the rod section 216 distal to the double finger loop 218. The remaining fingers (e.g., middle finger, index finger) can be placed on the end of the loop 222 or on the extension section 220. The user can also insert their thumb through the single finger loop 218 on the thumb arm 216.

[0014] As can be seen, the pivot arms 212 can be used to open and close the jaws 108. That is, when the arms 212 are pivoted away from each other, the jaws 108 can open, and when the arms 212 are pivoted towards each other, the jaws 108 can close. Thus, the user experience can be comparable to using scissors. However, the jaws 108 can be located at a distance from the arms 212 and not, as with scissors, directly next to and / or as part of the arms. In one or more embodiments, a mechanism for converting the arm movement into the movement of the jaws can include an arm linkage system 224, as described below in relation to Fig. 3 explained in more detail. In other embodiments, a gear system similar to a rack and pinion system may be provided. Other mechanisms for transmitting the arm movement to the jaw movement may also be provided. In one or more embodiments, the movement of one arm 212 may induce the movement of the opposite arm 212. That is, the movement of the arms 212 may be linked so that neither arm is movable without the movement of the other. This may be helpful for maintaining control over the distal end of the device, with the device's centerline remaining centered between the two arms, regardless of the arms' position. An example of this type of control is shown in Fig. 3 is shown and will be explained in more detail below.

[0015] In Fig. Figure 3 shows the mechanism for converting the arm movement into the jaw movement. As shown, the mechanism can include a system for connecting the arms 224. Each arm 212 can be pivotally attached to the body 214 at adjacent but spaced-apart pivot points. Each arm 212 can also have a laterally extending pin or a pin extending orthogonally to the plane of pivoting movement of the arms 212. The arm connection system 224 can include a motion conversion slide 226. The motion conversion slide 226 can have a pair of spaced-apart and diagonally extending slots 228, which are configured to receive the pins extending laterally from the arms. The slots 228 can be arranged such that, as they extend distally, they converge towards each other and, as such, form a distally pointing V-shape.The slots can be slightly spaced apart at the conversion point to prevent them from interlocking. The motion conversion slider 226 can be fixed in the body 214 of the handle to restrict its movement to a longitudinal motion. That is, the motion conversion slider 226 can be arranged, for example, in a longitudinally extending shaft, rail, or slot. When the arms 212 are pivoted outward away from the body 214 of the handle 204, the motion conversion slider 226 can be advanced in a distal direction as the pins move outward (see figure). When the arms 212 are pivoted toward the body 214 of the handle, the motion conversion slider 226 can be pulled in a proximal direction. Thus, the motion conversion slider can convert the reciprocating pivoting motion of the arms 212 into a reciprocating longitudinal motion.Since the movement of one arm displaces the motion-converting slide 226, this movement causes the other arm 212 to move together by the same or a similar amount (e.g., rotate about a pivot point). For example, physically actuating one arm 212 by fifteen degrees of rotation away from the body 214 can cause the other arm 212 to rotate by fifteen degrees away from the body 214 in the opposite direction. It has been shown that such embodiments, in which the arms 212 are mechanically linked to move together, significantly improve the stability of the device 100 during surgical procedures. While a motion-converting slide 226 has been described, other systems, such as a gear system similar to a rack and pinion system, can also be provided.Other mechanisms for converting arm movement into cheek movement can also be provided, as described in the . Fig. 11A-11R are described.

[0016] In one or more examples, as in Fig. 4 and Fig. As shown in Figure 5, certain movement ranges of the arms 212 can influence certain actuators of the jaws 108 and / or the cutting blade 110. As shown in Fig. As shown in Figure 4, the arms 212 can, for example, be brought into a fully open position, which in turn can bring the jaws 108 at the distal end into a fully open position. The arms 212 may have a first range of motion 232 extending inward from the fully open position to a fully closed position, in which the jaws 108 can be fully closed, but the arms 212 may also have a further ability to pivot over a second range of motion 234. For example, the further pivoting ability of the arms 212, or the second range of motion 234, may comprise 3% to 30%, or 5% to 15%, or about 10% of the full range of motion (e.g., first and second ranges of motion combined 232 / 234) of the jaws 108. As shown in Fig. As shown in Figure 5, the further range of motion 234 of the arms 212 can, for example, actuate the cutting blade 110. Mechanically, this can be achieved, for example, by the engagement of the motion conversion slide 226 to actuate the cutting blade. Alternatively, laterally extending actuators can also be used, which are actuated directly by the inward movement of the arms 212. In both cases, when the arms 212 approach the sides of the body 214 to a certain selected distance, an actuator can be triggered that moves the cutting blade 110 forward. In one or more embodiments, the arm can be provided with a safety device that prevents actuation of the blade without deactivating the safety device. For example, a lock or other mechanism can be arranged on the arms 212 such that further inward movement of the arms is prevented as long as the safety device is not deactivated.This could be a laterally extending tab that can be pressed or inserted into the arm 212 so that the arm 212 fits next to the body, or another mechanism could be provided for this purpose.

[0017] As from the Fig. As can be seen, the handle 204 can also have one or more interfaces for actuation. For example, as shown, a rotary control knob 228 and a pivot control knob 230 can be provided. The rotary control knob 228 can, for example, be arranged distal to the pair of opposing and pivotable arms 212. In one or more embodiments, the rotary control knob 228 can be non-rotatably connected to the central part in order to rotate the central part relative to the handle 204 and thus rotate the jaws at the distal end of the device. In other embodiments, the rotary control knob 228 can be non-rotatably connected to a shaft, a coil, or another element that extends through the central part and is coupled to the end effector, so that the rotation of the rotary control knob 228 rotates the one or more end effectors relative to the central part and the handle 204.The rotary control knob 228 can enclose a distal end of the handle 204 and be rotatable relative to the handle via a bearing raceway, a low-friction connection or another circumferential connection that allows relative rotation between the handle and the rotary control knob 228.

[0018] The articulated control knob 230 can, for example, be arranged distal to the pair of opposing and pivotable arms 212 and distal or proximal to the rotary control knob 228. In one or more embodiments, the articulated control knob 230 can be functionally coupled to the end effector to move the end effector about a laterally extending axis (e.g., an axis that is substantially orthogonal to a longitudinally extending axis of the central part). For example, the articulated control knob 230 can be rotatably attached to a shaft, coil, or other element extending along the central part 106. The shaft, coil, or other element can terminate in a gear, and an orthogonally arranged gear can be present on the end effector so that the rotary motion of the shaft, coil, or other element about the longitudinal axis can be converted into a rotary motion about a laterally extending axis.There are other ways to convert the rotary movement of the joint control knob 230 into a movable movement of the end effector.

[0019] The present embodiment can be advantageous in that it allows the device to be used horizontally or vertically, with different types of hand engagement by the user, while also placing the actuation interfaces in a position accessible to the user in both orientations. For example, as shown in Fig. As shown in Figure 2A, both the rotary control knob 228 and the hinged control knob 230 are accessible via the user's index finger. Fig. 2B Both the rotation control knob and the joint control knob are accessible via the user's little finger. This allows the user to flexibly employ the device in a wider range of procedures, depending on the orientation of the entry port. That is, the user can use the device for a procedure with a lateral entry port on a patient, generally in a horizontal position. Alternatively, the user can also use the device for a procedure with a superior entry port (e.g., through the chest) on a patient, generally in a vertical orientation.

[0020] In Fig. Figure 6 shows another example of a handle 304 for the medical intervention device 100. As shown, the handle 304 can be attached to the one described in the Fig. 2A and Fig. The handle shown in Figure 2B may be very similar, but the handle may have a slightly different arm configuration and may also include an actuator device 336 for the cutting blade, an actuator device 338 for the energy, and a finger rest 340. Even if a different arm configuration is shown, an arm configuration like the one in Figure 2B may also be used. Fig. 2A & 2B can be set up for this purpose. Furthermore, the internal work elements, as described in the Fig. 3-5 are described, are the same or similar.

[0021] As shown, the handle 304 can comprise a body section 314 and a pair of opposing and pivotable arms 312. The arms 312 can have finger loops in the form of single finger loops. As shown, the present example can comprise a finger arm with a generally elongated rod section 316 and a single finger loop 318 located at a relatively proximal position on the handle. The present example can also comprise a thumb arm, which has a generally elongated rod section 316 and a single finger loop 318 located at a relatively proximal position on the handle and opposite the finger loop of the other finger arm. The handle can be used in a generally horizontal orientation, with the user's hand / forearm in a handshake position. In this position, the user can insert a finger (e.g.,Insert one finger (e.g., the middle finger) through the finger loop and place another finger (e.g., the index finger) along the bar section distal to the finger loop. The remaining fingers (e.g., ring finger and / or little finger) can be positioned from the proximal end of the handle or along an actuating interface element, such as an actuator for the cutting device. In this position, the user can insert their thumb through the single finger loop on the thumb arm. Alternatively, the handle can be used in a generally vertical orientation with the user's hand in an arm-wrestling position. In this position, the user can insert one finger (e.g., index, middle, or ring finger) through the finger loop and place one or more additional fingers (e.g., ring or little finger) along the bar section distal to the finger loop. The remaining fingers (e.g.,The middle finger and index finger can be placed at the proximal end of the handle or along the actuator of the cutting device.

[0022] With further reference to Fig. 6. The device may include a rotary control knob 328 and a joint control knob 330, which are identical or similar elements on the device. Fig. 2A and Fig. 2B. In addition, the handle 304 can also include an actuator 336 for the cutting blade. In this embodiment, the actuating device 336 can comprise a proximal button or plunger. The button or plunger can, for example, be located at a proximal end of the handle 304 and be depressible in a distal direction. A user can, for example, press the button with their thumb when the device is used in a generally vertical orientation. When the device is used in a generally horizontal orientation, the button can be pressed, for example, with the palm of the hand. The button can be coupled directly or proportionally to the cutting blade 110, such that a movement of the button in a distal direction moves the cutting blade 110 distally by a distance equal to or proportional to the movement of the button.It is to be understood that the device for actuating the cutting blade 336 is additional to or alternative to the one above in relation to the . Fig. 4 and Fig. The actuation of the cutting blade can be discussed in section 5. For example, if the device 100 is used in a generally vertical orientation, the cutting blade actuation device 336 may be relatively easily accessible to a user's thumb. However, if the cutting blade actuation device is used in a generally horizontal orientation, actuation of the cutting blade actuation device may be more easily accomplished with the range of motion of the arm than with the palm of the hand to actuate the button / piston. This may also be a matter of personal user preference, as one method may not be easier for some users than the other.

[0023] Furthermore, the handle 304 may also include an energy release feature 338. The energy release feature 338 may comprise an actuating button or a finger sensor located on the body 314 of the handle 304. As shown, the button or finger sensor may be located distal to the finger loops on the arms 312 and immediately proximal to the pivot points of the arms 312. Alternatively, the button or finger sensor may be located on a surface of the body 314 that extends circumferentially between the arms. As with the rotary control knob 328 and the joint control knob 330, the energy release feature 338 may be located distal to the finger loops and, as such, be accessible to the index finger when the device is used in a generally horizontal orientation, and to the ring or little finger when the device is used in a generally vertical orientation.

[0024] Furthermore, the present example can include a finger rest 340. As shown, the finger rest 340 can comprise a recessed, convex, and / or concave area on the surface of the body part 314, which is designed for the nested placement of a fingertip. As shown, the finger rest 340 can generally be positioned on the body part 314 between the pivot points of the arms and distal to the energy actuation device 338. When the device is used horizontally, the user can place their index finger in the finger rest 340 so that they are ready to actuate the energy actuation device 338. When the device is used generally vertically, the user can place their ring or little finger in the finger rest 340 so that they are ready to actuate the energy actuation device 338.

[0025] Fig. Figure 7 shows another example of a handle 404 for a medical intervention device 100 such as that of Fig. 1. This embodiment may incorporate features of the example of Fig. 2A and Fig. 2B and the example of Fig. 6 and may also have the same or similar internal working elements as those described in relation to Fig. 3-5 are described. Furthermore, although certain elements are shown and described, similar elements from the previously described examples can be used instead of the elements shown.

[0026] The in Fig. The 7 arms shown (412) can be the same or similar to the arms of the Fig. 2A and Fig. 2B. That is, the present example can comprise a finger arm 412 having a generally elongated rod section 416, a double finger loop 418 arranged outside the rod section 416, and an extension section 420 at which the rod extends beyond the double finger loop 418. In contrast to Fig. 2A and Fig. 2B The present example may not have a loop end. However, a loop end can be provided if desired. The present example may also include a thumb arm comprising a generally elongated rod section 416 and a single finger loop 418 located outside the rod section. In contrast to the examples in the Fig. 2A, Fig. 2B and Fig. 6. The arms 412 and the corresponding loops 418 can, for example, extend proximally beyond the proximal end of the body 414. An actuator 436A for the cutting blade can be attached to a proximal end of the body 414 of the handle 404 as shown in Fig. 6 and, given the arm configuration, can generally be arranged between the finger loops 418 on the arms 412. As in Fig. As mentioned in Figure 6, the actuator device 436A can be used alternatively or additionally to the actuation of the cutting blade effected by the range of motion of the arms 412. As shown, the finger loop 418 on the double finger loop on the finger arm can have a pressable button 442 on its outer side. This button can contain a cutting blade lock for controlling the range of motion of the arms 412 for actuating the cutting blade device, or this button can contain an energy actuation function. That is, instead of having the energy actuation function on the body 414 of the handle 404, as in Figure 6, the button can be used on the arm 418. Fig. As shown in Figure 6, the energy actuation function can be arranged on the loop of the arm as shown.

[0027] The example of Fig. 7 may include a further actuator device 436B in the form of a lever, which is arranged distal to the arms 412. That is, as shown, a rotary lever, knob, or other actuating device may be arranged on a surface of the body 414 of the handle 404 at or near the pivot point of the arms on the body 414 of the handle 404. As shown, the lever may have a central pivot point and a lever arm with a knob or stud at one end thereof. The user can rotate the lever to actuate the cutting blade 110. In contrast to the coordinated arm movement, the actuation of one or more of the actuators 436A / B while actuating the cutting blade 110 may not actuate the other actuators 436A / B. For example, pressing down the plunger 436A at the proximal end of the handle 404 cannot cause the lever 436B near the distal end of the handle 404 to rotate, and vice versa.In one or more embodiments, for example, a longitudinally extending shaft, extending from the handle 404 through the central part 106 of the device 100 and to the distal end 102, can be engaged by the multiple actuators 436A / B for the cutting blade to actuate the cutting blade 110. However, the actuating devices 436A / B for the cutting blade can engage with the shaft in only one direction, so that the movement of the shaft does not actuate the other actuators 436A / B. To enable the actuators 436A / B to engage with the shaft or other drive device in one direction, ridges, pawls, or other locking mechanisms can be used to allow unilateral engagement.

[0028] As in Fig. As shown in Figure 7, the example can contain a rotary control knob 430 or a joint control knob 428. Alternatively, both can be present.

[0029] Fig. 8A and Fig. Figure 8B shows another example of a handle 504 for a medical intervention device 100, such as that of Fig. 1. This embodiment may incorporate features of the example of Fig. 2A and Fig. 2B and the example of Fig. 6 and Fig. 7 exhibit and may also have the same or similar internal working elements as those described in relation to Fig. 3-5 are described. Furthermore, the elements shown can be replaced by similar elements from the previously described examples, although certain elements are shown and described.

[0030] In the present example, finger arms 512 can be provided which are the same or similar to those in Fig. 6 are described. As in Fig. However, 7, the proximal end of the finger arms, and in particular the finger loops 518 of the finger arms 512, can project, for example, beyond the proximal end of the housing 514. An energy actuation device 538 can be provided on the housing 514. The feature can be located at or near the pivot point of the finger arms. However, instead of as in the example of Fig. 6. To be located centrally between the finger arms 512, the feature can be laterally offset so that it is somewhat more accessible compared to the paddle described below. Furthermore, an additional actuator can also be provided on the opposite side of the housing, which is not shown. This additional energy actuation device can be in the same position as the energy actuation device shown, or a different position can be chosen. In addition, a rotary control knob 528, a hinged control knob 530, or both can be provided.

[0031] The present example can include an actuator device 536 in the form of a paddle. The paddle can be a relatively large paddle mechanism pivotally connected at a proximal end to the handle 504 and extending distally along and spaced from the body 514 of the handle. A pivoting movement of the paddle toward the body 514 of the handle 504 can actuate or drive the cutting blade 110 at the distal end 102 of the device 100. For example, the paddle can have a lever arm extending into the body 514 of the handle 504 (e.g., generally orthogonal to the paddle). An internal lever can be arranged within the body of the handle and held at its center by a pivot point or axis of rotation. The lever arm of the paddle can extend into the body, along the internal lever, past the pivot point, and be attached at one end of the internal lever.The drive rod or other drive mechanism for the blade can be attached to one end of the inner lever opposite the paddle lever connection. This allows the reverse motion at the point where the paddle lever connects to the inner lever to be converted into a forward motion at the opposite end, which can move the drive rod or other drive mechanism forward. Other approaches exist for converting the paddle motion into a propulsive motion of the blade.

[0032] Fig. 9A and Fig. Figure 9B shows another example of a 604 handle for a medical intervention device such as that of Fig. 1. This embodiment may incorporate features of the example of Fig. 2A and Fig. 2B and the example of Fig. 6, Fig. 7, Fig. 8A and Fig. 8B and may also have the same or similar internal working elements as those found in the Fig. 3-5 are described. Furthermore, while certain elements are shown and described, similar elements from the previously described examples can be used instead of the elements shown.

[0033] In the present example, finger arms 612 can be provided which are the same or similar to those provided in Fig. 7 are described. An energy actuation device 638 can be provided on the housing 614, which is described in Fig. The energy actuation device shown in Figure 6 corresponds to or is similar to it. In addition, a rotary control knob 628, a hinged control knob 630, or both may be provided.

[0034] The present example can comprise an actuator device 636 in the form of a pair of lever arms. The lever arms can generally be arranged in the same plane as the finger arms 612. The lever arms can be somewhat shorter than the finger arms 612 and can perform a movement dependent on or independent of the finger arms 612. That is, in one or more embodiments, the lever arms can be pivotally attached to the finger arms 612, such that the movement of the finger arms 612 moves the pivot point of the lever arms and thus moves the lever arms. Alternatively, the lever arms can be pivotally attached to the body 614 at the same position as the finger arms 612 or at a different position than the finger arms 612. In both cases, the movement of the finger arms 612 cannot cause movement of the lever arms.In one or more embodiments, a preload mechanism can be provided between the lever arms and the finger arms 612, such that the movement of the finger arms 612 causes a movement of the lever arms, and a relative movement between the finger arms 612 and the lever arms can occur when the preload force is overcome. The lever arms can be actuated by compressing them towards the handle body. In one or more embodiments, the movement of the lever arms relative to the body can actuate the cutting blade 110. In other embodiments, the movement of the lever arms relative to the finger arms 612 can actuate the cutting blade. In one or more embodiments, a safety mechanism can be provided that prevents actuation of the cutting blade 110 as long as the jaws 108 of the device 100 are not closed or are about to be closed.In this embodiment, for example, actuation of the lever arms relative to the body 614 or relative to the finger arms 612 (as applicable) can be prevented until the finger arms 612 close within a selected range of movement, which is considered closed. In one or more embodiments, this safety can be achieved in the form of a preload mechanism between the lever arms and the finger arms 612. That is, the preload mechanism can be so rigid that the lever arms are held in an unactuated position unless the finger arms 612 close completely and a force can develop to overcome the preload. Thus, if the lever arms are pressed when the finger arms 612 are open, this can cause the finger arms 612 to close instead of causing any relative movement between the lever arms and the finger arms 612.Relative movement between the lever arms and the finger arms 612 can only occur when the finger arms 612 are fully closed and have reached a stop point. This safety mechanism can, for example, help ensure that the tissue to be cut is firmly gripped by the jaws 108 before the cutting blade 110 is advanced, and can prevent the cutting blade 110 from being advanced in an unprotected or unguided state. That is, as described above, the jaws 108 can have grooves or slots that guide the cutting blade 110, and when the jaws 108 are open, advancing the blade 110 can cause the blade 110 to be subjected to lateral bending forces due to the lack of support from the grooves or slots, and the blade 110 could otherwise, for example, unintentionally cut tissue, vessels, or other aspects of a patient's anatomy.There are other ways to provide a safety mechanism for the operation of the cutting blade 110.

[0035] In the Fig. 10 and 11A-11R are another example of a medical intervention device 700 shown. That is to say, Fig. Figure 10 shows a prototype of a handle, and Fig. Figures 11A-11R show several details of an intervention device 700, which incorporates a handle design similar to that described in Fig. The design shown in Figure 10 is identical or similar. Although these figures show a complete intervention device (e.g., not just the handle), nothing in this document should be construed as excluding any of the devices or features described above from Device 700. That is to say, one or more devices, systems, mechanisms, or features of Device 100 and the various handle designs 200-600, alone or in combination, may be incorporated into Device 700.

[0036] As can be seen from the consideration of Fig. As shown in 11A-11E, the medical intervention device 700 can comprise a handle 704, a medial part 706, and a distal part 702. As above in relation to Fig. As explained in section 1, the distal section 702 can form a pair of jaws 708 (see Fig. 11E) comprising jaws that are held at a distal end 702 of the device 700 and are configured to open and close in order to grasp tissues, vessels, etc. The jaws 708 may have a contoured gripping surface 744, and the contoured gripping surface of each jaw 708 may complement the contoured shape of the other jaw 708 to establish complete contact between the gripping surfaces when the jaws 708 are closed. In addition, as shown, each jaw may have a slot 746 extending longitudinally along the jaw 708 to receive a cutting blade 710 that can be advanced from the central part 706 and through the closed jaws 708. For the purpose of opening and closing, the jaws 708 may also have proximally extending tabs 748 with a fixed pin 750 and arcuate slots 752.The tabs 748, including the fixed pin 750 and the arcuate slots 752, can interact with the distal end 702 of the device to cause the jaws 708 to open and close, as will be explained in more detail below.

[0037] As in Fig. As shown in Figures 11B-11D, the central part 706 can comprise an outer housing 754, an inner housing 756, and a drive rod 758. The outer housing 754 can include two distally extending arms, each having a pin hole and a slot located proximal to the pin hole. The inner housing 756 can have a slightly smaller diameter and be configured to slide within the outer housing 754 and move longitudinally during use. This means that actuation of the finger arms 712 between an open and a closed position can advance and retract the inner housing 756 relative to the outer housing 754. The inner housing 756 can also have two distally extending arms, arranged and configured to be aligned with the arms of the outer housing 754. The arms of the inner housing 756 can have a pin hole at one of their ends.

[0038] As can be seen from the consideration of Fig. 11E in conjunction with Fig. 11B and Fig. As can be seen in Figure 11C, the jaws 708 can be arranged in the distal end 702 of the device 700. The fixed pins on the tabs of the jaws 708 can be arranged in the pin hole at the distal end of the outer housing 754. An additional pin can be arranged in the pin holes at the distal end of the inner housing 756 and can extend through the arcuate slots 752 of the tabs 748 on the jaws 708. When the inner housing 756 moves back and forth longitudinally within the outer housing 754, the pin at its distal end can slide along the arcuate slots 752 of the tabs 748 of the jaws 708, causing the jaws 708 to open and close depending on the direction of movement of the inner housing 756. This means that if the inner housing 756 is pulled in a proximal direction (e.g. towards the handle 704), the jaws 708 can close, and if the inner housing 756 is pulled in a distal direction (e.g.When the handle is pressed away from the handle, the jaws 708 can open. While a pin and slot configuration for actuating the jaws at the distal end has been described, other approaches for generating jaw movements are also conceivable.

[0039] With regard to Fig. Figure 11F and the following figures describe the handle 704 of the present example in more detail. As shown, the handle 704 can comprise a body part 714, a pair of finger arms 712, an interface for actuating the cutting blade 736, a rotary and / or joint control knob 728 / 730, and an energy actuation function 738.

[0040] The pair of finger arms may be the same or similar to those in Fig. 7 described above. That is, the finger arms 712 can be the same as or similar to the finger arms of Fig. 2A and Fig. 2B without the loop end. However, a loop end can be provided upon request. The energy actuation feature 738 can be the same as or similar to the one in Fig. The energy actuation feature described in section 6 may be located, however, the energy actuation feature 738 may be located further distally than the one described in section 6. Fig. 6 shown location. That is, the energy release feature 738 can be located in the immediate vicinity of the rotary or joint control knob 728 / 730. The rotary and / or joint control knob 728 / 730 can be located at the distal end of the handle 704 and can comprise a circumferentially extending knob 728 / 730, as shown in relation to the Fig. 2A and Fig. 2B discussed.

[0041] The interface 736 for actuating the cutting blade of the present example can take the form of a single lever instead of the one in Fig. 9A and Fig. The double lever shown in Figure 9B. However, as shown, the lever can generally be arranged in one plane with the finger arm 712 containing the double finger loop (e.g., the finger arm configured for engagement by the user's fingers rather than the thumb). The lever can be arranged distal to the finger arm 712 and have a first distal end located on the body 714 at a pivot point distal to the pivot point of the finger arm 712. The lever can extend radially outward and proximal to the pivot point when in a non-actuated position, as shown in Figure 9B. Fig. Figure 11F shows an actuating strut 760 extending radially inward from a pin along the lever. In one or more examples, the pin may be spaced from the pivot point of the lever and extend along the lever for a distance of approximately 2 / 3 of the total length of the lever. The strut 760 may penetrate into the housing of the body 714 and engage with an internal branching mechanism 762 configured to advance the cutting blade 710.

[0042] As shown, the folding mechanism 762 can comprise a first leg 764 and a second leg 766, which is pivotally attached to the first leg. The strut 760 of the actuating lever can engage in the bifold mechanism at or near the pivot point of the two legs. The first leg 764 can have an anchoring end opposite the pivot point of the two legs, where the first leg 764 is pivotally attached to the housing or body 714 and to a distal end of the bifold mechanism 762. The second leg 766 can have an actuator end opposite the pivot point of the two legs, with the second leg 766 being pivotally attached to the drive rod or other drive mechanism of the cutting blade 710 and to a proximal end of the bifold mechanism 766. As shown in Fig. As shown in Figure 11G, the inner housing 756 can, for example, extend into the handle 704 and have an elongated hole 768 that allows access to the drive rod 758, which can also extend into the handle 704. The inner housing 756 can have a drive interface 770 that is slidably arranged on the inner housing 756, wherein a pin or other connecting element extends through the elongated hole 768 on the inner housing 756 and is connected to the drive rod 758, or extends through a hole on the drive rod 758. As can be seen from the consideration of the Fig. As can be seen in Figures 11L-11M, when the lever is depressed, the strut 760 can press inwards against the bifold mechanism 762, causing the bifold mechanism to fold inwards, with the first leg 764 and the second leg 766 pivoting relative to each other about the pivot joint of the two legs. Since the distal end of the bifold mechanism 762 is attached to the housing, the folding action of the bifold mechanism 762 can pull the proximal end of the bifold mechanism 762 in a distal direction. This movement can pull the drive interface 770 in a distal direction relative to the inner housing 756, and the pin or other binding element arranged in the slot 768 of the inner housing 756 can cause the drive rod 758 to move in a distal direction, thereby advancing the cutting blade 710 at the distal end 702 of the device 700. As shown in Fig. 11F and Fig. As shown in Figure 11N, the second leg 766 of the bifold mechanism 762 can have an outer curved cam surface which may be configured to create clearance during actuation of the mechanism and to avoid contact with the central rod and inner housing. A locking system may also be provided to prevent actuation of the lever until the finger arms are substantially closed. This will be discussed in more detail below, following the description of the finger-arm mechanism.

[0043] The mechanism for opening and closing the jaws 708 can be described with reference to the Fig. 11F and Fig. 11I described. For example, as shown, the finger arms 712 can be pivotally attached to the housing or body 714 at a distal end, and the arms 712 can thus be configured to open and close by pivoting about their respective pivot attachments. A pull rod 772 can extend proximal from a point located relatively distal to each of the finger arms 712. The pull rods 772 can extend to a proximal end of the inner housing 756 and, for example, be pivotally attached to a jaw drive interface 774 at the proximal end of the inner housing 756. In one or more embodiments, as shown in Fig. As shown in Figure 11F, the pull rods 772 can have a kink or bend that allows them to avoid interaction with other components within the handle 704 when the finger arms 712 are in a closed position. As shown in the Fig. As can be seen, the pull rods 772 can be pulled forward when the finger arms 712 are open. Their connection with the proximal end of the inner housing 756 can push the inner housing 756 in a distal direction. As above with regard to the Fig. 11B and Fig. As explained in Figure 11C, the jaws 708 can open when the inner housing 756 is pushed distally. When the finger arms 712 are compressed, the proximal end of the pull rods 772 can be driven in a proximal direction, thereby pulling the inner housing 756 in a proximal direction and closing the jaws 708.

[0044] As in the Fig. As shown in Figure 11K-11N, a locking system can be provided that prevents or stops the actuation of the cutting blade under certain circumstances. As shown, the locking mechanism can comprise a sleeve 776 located above the drive interface 770 of the cutting blade. As shown in Fig. As shown in Figure 11K, the sleeve 776 can be part of the jaw drive interface 774 or otherwise attached to the inner housing 756, which can be actuated by the finger arms 712. The sleeve 776 can include an internal raceway for receiving a bearing, roller, or pin 778, as shown in the Fig. Figures 11L-11N show that the raceway may have a relief notch at a distal end. Furthermore, the drive interface 770 may have an outer surface with a distal ramp 780. When the finger arms 712 are open, and thus the inner housing 756 and the sleeve 776 are positioned distally, the bearing or roller 778 may be held relatively tightly against the drive interface 770 in a position distal to the distal ramp 780. That is, the bearing or roller 778 may be positioned in the raceway in a position not aligned with the relief notch, as shown in Figure 11L-11N. Fig. 11L shown. However, when the fingers 712 are closed, the inner housing 756 and the sleeve 776 can move in a proximal direction, thereby aligning the relief notch of the sleeve 776 with the bearing or roller 778, and the bearing or roller 778 can move radially outward under the force or pressure of a distally advancing ramp 780 at the drive interface 770, as shown in Fig. Figure 11M shows that since the bearing or roller 778 can move radially outward, the drive interface 770 can push the bearing or roller 778 radially outward, thereby overcoming the ramp 780 of the drive interface 770 and allowing the drive interface 770, the drive rod 758, and the blade 710 to advance under the force of the actuating lever. It is understood that this outward movement of the bearing or roller 778 can also block the sleeve 776 and thus the inner housing 756 against movement, as shown in Figure 11M. Fig. 11N shown. That is, if the bearing roller 778 moves radially outwards, it can create an engagement between the sleeve 776 and the housing or body 714, which prevents the movement of the sleeve 776, which in turn prevents the movement of the inner housing 756 and the finger arms 712.

[0045] Fig. Figure 11O is a diagram of the mechanical advantage provided by the finger-arm mechanism. That is, the connection of the pull rod 772 to the finger arm 712 at a point relatively far from the finger arm 712 and closer to the pivot point of the finger arm 712 than the finger ring provides a mechanical advantage that increases the user's pressing force to a much higher force acting on the pull rod 772. Furthermore, the force exerted on the finger ring produces a much higher compression in the pull rod because the force component within the pull rod is at such a shallow angle relative to the finger arm. As shown in Fig. As shown in Figure 11O, the mechanical advantage of the finger arms 712 when the jaws 708 approach a clamping position can be, for example, approximately 15:1. That is, for every unit of force applied to the finger arms 712, the jaws 708 can experience 15 units of force.

[0046] Fig. Figure 11P is a diagram of the mechanical advantage provided by the cutting lever. Here, the mechanical advantage can decrease as the cutting stroke is completed, potentially resulting in a strong cutting action at the beginning of a cut and a weaker cutting action at the end. The lever is engaged by a strut 760, which is attached closer to the end of the pressing stroke than to the pivot point on the lever. Nevertheless, the force of the strut can exceed the user's pressing force, providing some initial mechanical advantage (though not as much as the advantage of the finger arm). Because the strut 760 transfers the pressing force to the bifold mechanism 762, the bifold mechanism 762 can be in a relatively flat orientation.The compressive force in the strut 760 is balanced by the tension in the legs 766 of the bifold mechanism 762, but the tension acts at a very shallow angle relative to the strut force, which is laterally directed. Thus, a relatively small compression of the strut 760 causes a high tension in the legs 766 of the bifold mechanism, which generates a high cutting force. However, as the cutting motion continues, the legs 766 of the bifold mechanism 762 begin to align with the strut 760, or at least approach a more closely aligned state, so that the compression in the strut 760 begins to induce less tension in the legs 766 and a lower driving force for the cutting blade. As shown, the diminishing driving force can have a mechanical advantage of, for example, almost 1:1.

[0047] Fig. 11Q and Fig. Figure 11R shows additional details of the handle. In particular, it shows Fig. 11R describes the routing of the power supply wire 782, which can supply power to the handle, so that the energy actuation interface can supply power to the electrodes on the jaws when the button is pressed. This means that, for example, the clamping surfaces of the jaws can contain electrodes, and supplying the electrodes with electrical power can make it possible to provide or perform cauterizing or other heat-based treatments.

[0048] Fig. Figures 12A-12C show another example of an 804 handle for a medical intervention device such as that of Fig. 1. This embodiment may incorporate features of the example of Fig. 2A and Fig. 2B and the example of Fig. 6, 7, 8A, 8B, 9A, 9B, 10 and 11A-11R and may also have the same or similar internal working elements as those described in relation to the Fig. 3-5 are described. Furthermore, although certain elements are shown and described, similar elements from the previously described examples can be used instead of the elements shown.

[0049] In the present example, finger arms 812 can be provided which are the same or similar to those in Fig. 11A. However, the finger loop 818 may be somewhat smaller (e.g., a single finger loop) than the finger loop in Fig. 11A, so that more space is available along the handle for the interface for actuating the cutting blade 836. That is, the interface for actuating the cutting blade 836 of the present example can be in the form of a lever, similar to the interface 736, and can generally be arranged in a plane with the finger arm 812, which has the finger loop with the extension section (e.g., the finger arm that is set up for engagement by the user's fingers rather than the thumb). The lever can be arranged distal to the finger arm 812 and have a first distal end that is located on the body 814 at a pivot point that is distal to the pivot point of the finger arm 812. The lever can extend radially outward and proximal to the pivot point when the lever is in a non-actuated position, as in Fig. shown in Figure 12A. The interface 836 may include a loop on the lever, which may be designed to accommodate multiple fingers, such as the little finger and ring finger. Furthermore, the lever may have a body-facing plug or pin, which may be configured to engage with a notch or other recess on the body when the interface 836 is actuated and / or pulled / pivoted inward toward the body 814. Other internal mechanisms and actuation features may be the same as or similar to the handle in the Fig. 11A-11R.

[0050] Fig. Figures 12D-12F show another example of a 904 handle for a medical intervention device such as that of Fig. 1. This embodiment may incorporate features of the example of Fig. 2A and Fig. 2B and the example of Fig. 6, 7, 8A, 8B, 9A, 9B, 10, 11A-11R and 12A-12C and may also have the same or similar internal working elements as those described in relation to Fig. 3-5 are described. Furthermore, while certain elements are shown and described, similar elements from the previously described examples can be used instead of the elements shown.

[0051] In the present example, finger arms 912 can be provided which are the same or similar to those provided in Fig. Figures 10 and 11A-11R are shown. In addition, a single-lever interface 936 can also be provided for actuating the cutting blade, as shown in the Fig. 11A-11R and Fig. 12A-12C. However, the interface 936 may have flanking sides extending from a pressure surface of the lever and returning toward the body part 914 of the handle 904. The flanking sides can assist in aligning the lever as it moves about its pivot point. That is, the flanking sides may be dimensioned and positioned to run along the outer surface of the handle and maintain the alignment of the interface 936. Other internal mechanisms and actuators may be the same as or similar to the handle in Fig. 11A-11R.

[0052] The directional terms described here are used in their normal and customary usage in technical contexts. For example, the terms proximal, distal, lateral, top, bottom, and upper and lower can be used to describe the device whose longitudinal axis is parallel to the floor and which is in an upright position. The proximal direction refers to the direction toward the user end of the device, and the distal direction refers to the direction toward the patient end of the device.

[0053] The relative terms described here, such as "approximately" or "essentially", can be used to indicate a possible deviation of ± 10% from a specified numerical value or a manufacturing deviation.

[0054] As described in this revelation, components and assemblies can be functionally connected and interact in a way that enables improved operation, a more compact and simpler design, lower costs, and higher user satisfaction than conventional medical devices.

[0055] The detailed description above contains references to the accompanying drawings, which form part of the detailed description. The drawings illustrate specific embodiments in which the invention can be carried out. These embodiments are also referred to herein as "examples." Such examples may include additional elements beyond those shown or described. However, the inventor also considers examples in which only the elements shown or described are provided. Furthermore, the inventor also considers examples in which any combination or permutation of the elements shown or described (or one or more aspects thereof) is used, either in relation to a particular example (or one or more aspects thereof) or in relation to other examples shown or described herein (or one or more aspects thereof).

[0056] In this document, the terms "a" or "an" are used, as is customary in patent documents, to include one or more than one, irrespective of other instances or uses of "at least one" or "one or more". In this document, the term "or" is used to refer to a non-exclusive "or", so that "A or B" includes "A but not B", "B but not A", and "A and B" unless otherwise indicated. In this document, the expressions "including" and "in which" are used as simple equivalents of the respective terms "comprising" and "whereby". Likewise, in the following claims, the terms "including" and "comprising" are open, i.e.,A system, device, article, composition, formulation, or method comprising elements in addition to those listed after such a term in a claim is still considered to fall within the scope of that claim. Furthermore, in the following claims, the terms "first," "second," "third," etc., are used merely as designations and are not intended to establish numerical requirements for their subject matter.

[0057] In case of conflicting uses between this document and the documents incorporated by reference, the use in this document shall prevail. In this document, the terms "including" and "in which" are used as simple equivalents of the respective terms "comprising" and "whereby." Likewise, in the following claims, the terms "including" and "comprising" are open, meaning that a system, device, article, composition, formulation, or method comprising elements in addition to those listed after such a term in a claim shall still be considered to be included in the endoscope of that claim.

[0058] The above description serves for illustration and is not restrictive. For example, the examples described above (or one or more aspects thereof) may be used in combination with one another. Other embodiments may be used, for example, by a person skilled in the art who has read the above description. The summary is intended to enable the reader to quickly gain an understanding of the nature of the technical disclosure. It is presented with the understanding that it is not to be used for the interpretation or limitation of the endoscope or the meaning of the claims. In the above detailed description, various features may be summarized to simplify the disclosure. This is not to be understood as meaning that an unclaimed disclosed feature is essential for a claim. Rather, the subject matter of the invention may consist of fewer than all features of a particular disclosed embodiment.Therefore, the following claims are hereby included in the detailed description as examples or embodiments, each claim representing a separate embodiment, and it is considered that such embodiments may be combined with one another in various combinations or permutations. The scope of the invention should be determined with reference to the appended claims, together with the full scope of the equivalents to which these claims entitle.

Claims

[1] Medical intervention device comprising: a distal end (102) comprising a pair of jaws (108); a handle (404) functionally connected to the distal end comprising: a pair of pivotable finger arms (412) which are each connected to the handle at a pivot point and extend proximally to at least one finger loop (418), wherein the pivoting finger arms are arranged for opening and closing the pair of jaws at the distal end; and at least one actuator interface comprising an interface for actuating a cutting blade (436B) located on the handle and in a position distal to the respective pivot points of the pair of pivotable finger arms, and comprising a lever (426B); and a locking mechanism that prevents the lever from being actuated unless the jaws are substantially closed. [2] Medical intervention device according to claim 1, wherein the device is configured for use in a generally horizontal orientation and a generally vertical orientation depending on the type of procedure to be carried out. [3] Medical intervention device according to claim 1, wherein the lever comprises a pair of levers (436A, 436B). [4] Medical intervention device according to claim 3, wherein the interface for actuating the cutting blade comprises two interfaces for actuating the cutting blade. [5] Medical intervention device according to claim 1, wherein the at least one actuation interface includes an energy actuation feature (338). [6] Medical intervention device according to claim 1, wherein the at least one actuation interface includes a rotary control knob (430). [7] Medical intervention device according to claim 1, wherein the at least one actuation interface includes a joint control knob (428). [8] Medical intervention device according to claim 1, wherein the movement of a first finger arm of the pair of finger arms is dependent on the movement of a second finger arm of the pair of finger arms. [9] Handle for controlling a distal end of a medical intervention device, the handle comprising: a body (414); a pair of pivotable finger arms (412), each pivotally attached to the body at a pivot point and each having at least one finger loop, the pivotable finger arms being configured to open and close a pair of jaws at the distal end; and at least one actuator interface comprising an interface (436B) for actuating a cutting blade, which is located on the handle (404) and in a position distal to the respective pivot points of the pair of pivotable finger arms and includes a lever (436B); and a locking mechanism that prevents the lever from being actuated unless the jaws are substantially closed.

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