HANDLE WITH A MECHANISM FOR CONTROLLING THE BEND OF THE HEAD OF A MEDICAL ENDOSCOP

Description

Technical Field

[0001] The present invention relates to the technical field of medical endoscopes in the general sense allowing access to the interior of a hollow organ, a cavity or a natural or artificial conduit of the human body in order to carry out various operations for therapeutic, surgical or diagnostic purposes.

[0002] The present invention relates more specifically to the control handle of such endoscopes, adapted to remain outside the hollow organ, cavity or duct to be inspected and equipped in particular with a mechanism for controlling the flexion of the head of a medical endoscope.

[0003] The endoscope according to the invention is used for diagnostic, therapeutic or surgical purposes for the inspection of all internal parts of the human body accessible by natural or artificial means. For example, the endoscope according to the invention can be used in the field of the urinary tract, the gastrointestinal tract, the respiratory system, the cardiovascular system, the trachea, the sinus cavity, the female reproductive system, the abdominal cavity or any other part of the human body to be explored by a natural or artificial means. Prior art

[0004] Generally speaking, an endoscope comprises a control handle in the form of a housing adapted to be held by a user of the endoscope and to which is attached a tubular structure designed to be inserted into a body cavity of a patient to be examined. This tubular insertion structure comprises a distal head equipped with a vision system for illuminating and examining the organ, cavity or duct of the human body. Upstream of the distal head, the tubular insertion structure comprises a deflecting portion controlled by a mechanism of the control handle to orient the distal head inside the insertion path.

[0005] The state of the art has proposed numerous solutions for producing the mechanism for controlling the flexion of the distal head of the tubular insertion structure. For example, US patent 6,017,322 describes a control mechanism comprising a rotating wheel acting on a pulley on which are fixed the ends of two cables, the other ends of which are fixed to the distal head of the tubular insertion structure.

[0006] Another example of a simple mechanism is described in patent EP 1 804 639 comprising a pair of control wires connected to a transmission structure comprising a plurality of bodies connected to each other by links so as to slide between them. This mechanism is controlled by a rotating wheel extending outside the handle.

[0007] In WO 2010 / 066789, the handle comprises a lever movable along a curved path and connected to a lever which can pivot around a pivot axis and acts on two control wires to ensure the flexion of the distal head.

[0008] US patent application 2013 / 324973 describes a handle for a catheter comprising a housing formed of two half-shells defining a housing for an annular actuation mechanism for cables causing the flexion of the distal head. The annular actuation mechanism comprises a base element and a cover assembled together and internally defining a retaining and sliding channel for the terminal parts of the cables. The inner face of one half-shell is provided with a tubular shaft around which the actuation mechanism rotates. This actuation mechanism is provided with two diametrically opposed knobs, projecting from the housing to be accessible by the operator. A tensioning system is supported on one half-shell while a screw is engaged through the other half-shell and into the tubular shaft to cooperate with the tensioning system.Tightening the tension system allows the compression force applied by the half-shells to the annular actuating mechanism to be adjusted and, consequently, the rotation capacity of this actuating mechanism to be adjusted.

[0009] Patent application WO 2011 / 089349 describes an endoscope comprising a system for actuating the distal head of the insertion tube comprising pulleys mounted coaxially in the housing of the control handle. These pulleys are rotated by rotary control levers extending laterally and on the rear of the handle.

[0010] Regardless of the embodiment of the control mechanism, it must be considered that actuating the control button is a delicate operation to be carried out by the operator given that the operator must firmly hold the control handle during the inspection operation. In many solutions, the user has difficulty exerting on the control button an effort suitable for ensuring the flexion of the distal head while holding the handle. An additional difficulty arises when the user must also act on the closure device of a fluid circulation circuit to bring fluids or to suck fluids at the distal head. Statement of the invention

[0011] The present invention therefore aims to remedy the drawbacks of the state of the art by proposing a new control handle for a medical endoscope, designed to facilitate control operations aimed at ensuring the flexion of the distal head.

[0012] To achieve such an objective, the handle for a medical endoscope comprises the characteristics of claim 1, namely a housing having two opposite main faces and provided with a mechanism for controlling the flexion of a distal head of the medical endoscope, this control mechanism comprising at least one member for actuating a pivoting part produced in the form of an actuating ring having an axial ferrule having a cylindrical external surface cooperating with an annular bearing to be guided in rotation by this annular bearing, about a transverse axis of rotation and the rotation of which causes the flexion of the distal head, the axial ferrule having an internal bore partially delimiting a cylindrical opening configured for the insertion of a finger and which passes right through the housing, opening out via internal bores on the two opposite main faces of the housing,the pivoting part and the annular bearing being arranged to be located outside the cylindrical opening.,

[0013] According to one embodiment characteristic, the cylindrical opening has a passage section of between 8 x 8 mm and 30 x 30 mm and preferably between 8 x 8 mm and 25 x 25 mm.

[0014] Typically, the pivoting part is guided in movement by a pivot connection around a transverse axis of rotation coinciding with the transverse axis of the cylindrical opening, the pivoting part being blocked in translation on one side, by the annular bearing mounted integrally with a first half-shell of the housing and on the other side, by a second half-shell of the housing.

[0015] Advantageously, the axial ferrule of the actuating ring has at its free end a bearing edge cooperating with a stop edge of a neck of the annular bearing to together form an empty cylinder internally delimiting the cylindrical opening.

[0016] According to an exemplary embodiment, the actuating member is part of an annular collar fixed to the pivoting part and having an internal bore of section identical to the internal bore of the axial ferrule to form with the axial ferrule and the neck of the bearing, an empty cylinder internally delimiting the cylindrical opening

[0017] For example, the first half-shell and the second half-shell of the case are fixed together.

[0018] Furthermore, the pivoting part is blocked transversely in one direction, by a stop edge of the annular bearing arranged or fixed on the first half-shell and in the other direction, by being in abutment on the second half-shell of the housing.

[0019] According to an alternative embodiment, the actuating member is a lever mounted integral with the pivoting part guided in rotation so as to move the pivoting part in rotation by a rotational movement of the lever.

[0020] Advantageously, the lever comprises an actuating arm extending parallel to the transverse axis of rotation and external to the housing, between the two main faces of the housing.

[0021] Preferably, the actuating member is part of an annular collar delimited by a bore mounted integral with the pivoting part while abutting the second half-shell of the housing.

[0022] According to another embodiment, the actuating member is guided in linear movement and acts on the pivoting part using a system for transforming the linear movement of the control member into a rotational movement of the pivoting part.

[0023] Conventionally, at least one control cable for flexion of the distal head is mounted inside the control handle, the pivoting part acting directly or by a movement transformation system, on at least said control cable for flexion of the distal head.

[0024] According to an advantageous embodiment characteristic, the housing comprises a first housing for a fluid circulation circuit and a second housing for an electric cable, a part of these housings passing on either side of the cylindrical opening, these housings opening out at a proximal part of the housing.

[0025] Another object of the invention is to provide a medical endoscope comprising a tubular insertion structure supported by a handle according to the invention.

[0026] Various other characteristics emerge from the description given below with reference to the appended drawings which show, by way of non-limiting examples, embodiments of the subject of the invention. Brief description of the drawings

[0027] [ Fig. 1 ]There Figure 1 is a perspective view of a medical endoscope according to the invention. Fig. 2 ]There Figure 2 is a perspective view of an exemplary embodiment of a control handle according to the invention from which part of the housing is removed. Fig. 3 ]There Figure 3 is a perspective view of the control handle shown in Fig. 2 a part of which is removed to show a feature of the subject matter of the invention. Fig. 4 ]There Figure 4 is a cross-sectional view showing characteristic details of the handle according to the invention. Fig. 5 ]There Figure 5 is an exploded perspective view illustrating the control handle according to the invention. Fig. 6 ]There Figure 6 is a diagram showing another example of the embodiment of the mechanism for controlling the flexion of the distal head of the endoscope. Fig. 7 ]There Figure 7 is a diagram showing another example of the embodiment of the mechanism for controlling the flexion of the distal head of the endoscope, using a linear actuator. Description of the embodiments

[0028] As more precisely shown in the Fig. 1 à 5 , the subject of the invention relates to a medical endoscope 1 comprising an actuation support 2 such as a control handle equipped with a consumable medical instrument 3. This consumable medical instrument 3 which is in contact with human tissues or organs is essentially for single or multiple use by a patient or even for reusable use after decontamination, disinfection and even sterilization.

[0029] The consumable medical instrument 3 is assembled to the handle 2 permanently or temporarily using an assembly system 4. For example, the assembly system 4 ensures a complete connection between the handle 2 and the consumable medical instrument 3 or is of the snap-in type to quickly ensure at least a temporary mechanical connection while offering the advantage of allowing easy separation of the consumable medical instrument 3 from the handle 2.

[0030] Conventionally, the consumable medical instrument 3 comprises an external insertion tube 5 having a greater or lesser length and flexibility and intended to be introduced into a natural or artificial access route in order to carry out various operations or functions for therapeutic, surgical or diagnostic purposes. For example, the insertion tube 5 has a distal portion 7 forming the head of the endoscope 1. The insertion tube 5 also comprises a proximal portion 8 opposite the distal portion 7 and extending projecting from the distal end 9i of a housing 9 forming the main body of the handle 2.

[0031] This housing 9 is in the form of an elongated body designed to provide easy gripping of the endoscope. In the illustrated embodiment, the housing 9 comprises a first half-shell 9 1 and a second half-shell 9 2 of a shape complementary to the first half-shell 9 1 so as to be able to be assembled or fixed together by any fixing system such as by snap-fastening for example ( Fig. 5 ). The first half-shell 9 1 and the second half-shell 9 2 have C-shaped cross-sections. This housing 9 thus has, on one side of a median longitudinal plane P, a first main face 9a and on the opposite side of this plane, a second main face 9b. These two opposite main faces 9a, 9b are connected by a peripheral area 9p.

[0032] The handle 2 comprises a mechanism 11 for controlling the flexion of the distal head 7 of the insertion tube 5 making it possible to orient the distal head 7 relative to the longitudinal axis of the insertion tube 5. For this purpose, the insertion tube 5 comprises, upstream of the distal head 7, a flexion, folding or bending part 5a allowing the orientation of the distal head 7 relative to the longitudinal axis of the insertion tube 5. This flexion, folding or bending part 5a can be produced in any suitable manner to ensure the flexion of the distal head 7 relative to the longitudinal axis of the insertion tube 5. For example, this flexion, folding or bending part 6 can be produced by a spring or by tubular vertebrae articulated together.

[0033] According to the invention, the control mechanism 11 comprises at least one actuating member 12 which, following the application of a manual force, causes the distal head 7 to flex. According to the exemplary embodiment illustrated in Fig. 1 à 5 , the actuating member 12 is a lever guided in rotation over a limited angular range, along a transverse axis of rotation T. According to the example illustrated in Fig. 7 , the actuating member 12 is a pusher guided in linear movement and subjected to elastic return.

[0034] The actuating member 12 acts on a pivoting part 13 so as to directly or indirectly cause it to rotate around the transverse axis of rotation T. This pivoting part 13 is connected to the distal head 7 so that a rotation of the pivoting part 13 causes the distal head 7 to bend. This pivoting part 13 is guided in rotation by an annular-shaped bearing 14.

[0035] According to a characteristic of the invention, the pivoting part 13 and the annular bearing 14 are arranged to be located outside a cylindrical opening or hole 15 which passes right through the housing 9 to open onto the two opposite main faces 9a, 9b of the housing. As is clearly evident from the Figures, the cylindrical opening 15 passes completely through the housing 9, opening onto the two opposite main faces 9a, 9b of the housing and corresponding to an empty space. The cylindrical opening 15 thus passes through the annular bearing 14, the pivoting part 13, the first half-shell 9 1 and the second half-shell 9 2 . As will be explained in the remainder of the description, the operator can thus insert a finger therein to facilitate the operations of gripping and / or maneuvering the endoscope.Typically, the cylindrical opening 15 has a circular section with a diameter of between 10 and 40 mm and preferably between 10 mm and 25 mm to allow in particular the insertion of an operator's finger or a hook for suspending the medical endoscope 1. In the case where the cylindrical opening 15 is not of circular section, the cylindrical opening 15 has a passage section of between 8 mm x 8 mm and 30 mm x 30 mm and preferably between 8 mm x 8 mm and 25 mm x 25 mm.

[0036] The cylindrical opening 15 has a transverse axis which is advantageously coincident with the transverse axis of rotation T of the pivoting part 13. In the example illustrated, the cylindrical opening 15 has a circular section but it is clear that the section of the cylindrical opening 15 can be of a different shape.

[0037] According to an example of realization illustrated on the Fig. 1 à 5 , the lever 12 directly drives the pivoting part 13 in rotation around the transverse axis of rotation T. According to this example, the lever 12 is part of an annular collar 12a delimited by an internal bore 12i, intended to be fixed by any suitable means on the pivoting part 13. For example, the annular collar 12a comprises lugs 12b adapted to engage in holes 13t provided in the pivoting part 13. Of course, the lever 12 can be an integral part of the pivoting part 13, as in the variant embodiment illustrated in Fig. 6 in which the pivoting part 13 is a ring provided radially with an arm forming a lever 12 for rotational actuation.

[0038] According to another example of embodiment illustrated in the Fig. 7 , the actuating member 12 can indirectly drive the rotation of the pivoting part 13 around the transverse axis of rotation T. According to this example, the actuating member 12 which is a pusher movable in translation and returned to position by a spring 12r, acts on the pivoting part 13 by means of a system for transforming the linear movement of the pusher into a rotational movement of the pivoting part 13. This transformation system comprises a pinion 13p and a rack 12c fixed respectively to the pivoting part 13 and to the actuating member 12. It must be considered that for example the actuating member 12 is part of an annular collar 12a mounted around the pivoting part 13 and delimited by an internal bore 12i partially delimiting the cylindrical opening 15 which passes right through the housing.

[0039] According to an advantageous embodiment characteristic, the pivoting part 13 is guided by a pivot connection so as to present only a rotational movement around the transverse axis of rotation T. The pivoting part 13 can be produced in different ways, considering that the rotational movement of the pivoting part is generally limited to an angular amplitude of less than one turn and in particular, less than a third of a turn. According to the embodiment example illustrated in Fig. 1 à 5 , the pivoting part 13 is produced in the form of a ring comprising a complete or closed ring 13a. Of course, the pivoting part 13 can be produced in a different manner, such as in the form of a semi-ring or a portion of a ring in particular, as illustrated according to the variant embodiment of the Fig. 7 For example.

[0040] This ring 13 is guided in rotation by an axial ferrule 13b cooperating with the annular bearing 14. This axial ferrule 13b projects axially relative to the ring 13a of the ring while being centered along the transverse axis of rotation T. The axial ferrule 13b has a cylindrical outer surface 13e cooperating with the annular bearing 14 to ensure the rotational guidance of the ring.

[0041] For this purpose, the annular bearing 14 has an annular guide formed by a series of axial ribs 14a each having an axial inner edge 14b. These radial inner edges 14b are distributed on a circle centered along the transverse axis of rotation T in order to cooperate with the cylindrical outer surface 13e of the axial shell.

[0042] The ring 13a of the ring 13 is delimited at its periphery by an outer edge 13 1 and in its central part, by an inner bore 13 2 . It should be noted that the inner bore 13 2 delimits the inner surface of the axial ferrule 13b, which is coaxial with the cylindrical outer surface 13e. It follows that the ring 13 has an inner bore 13 2 forming a part of the cylindrical opening 15 which passes right through the housing. The pivoting part 13 is thus guided externally by the interior of the annular bearing 14 making it possible to delimit an inner bore 13 2 with a large diameter and corresponding to an empty space.

[0043] According to an advantageous embodiment characteristic, the axial ferrule 13b of the ring 13 has at its free end, a bearing edge 13c cooperating with a stop edge 14c of the annular bearing 14. As is more precisely shown in the Fig. 4 , the annular bearing 14 thus comprises a cylindrical neck 14d extending axially while being centered along the transverse axis of rotation T and ending at its free end, by the stop edge 14c. It should be noted that the ribs 4a are carried by the cylindrical outer surface of the neck 14d. This neck 14d has an internal bore 14i. Thus, the annular bearing 14 thus delimits by its internal bore 14i, a part of the cylindrical opening 15 which passes right through the housing 9.

[0044] Advantageously, the ring 13 has an internal bore 13 2 of section identical to the internal bore 14 1 of the annular bearing 14. It follows that the ring 13 and the annular bearing 14 which are juxtaposed in the extension of one another, together delimit the cylindrical opening 15 which opens into the first half-shell 9 1 and into the second half-shell 9 2 . Thus, the axial ferrule 13b of the actuating ring cooperates by its bearing edge 13c, with the stop edge 14c of the cylindrical neck 14d of the annular bearing to together form an empty cylinder internally delimiting the cylindrical opening 15.

[0045] In the illustrated embodiment, the lever 12 is attached by an annular collar 12a fixed to the ring 13. As shown in Fig. 4 , the inner bore 12i of the annular collar 12a has a section identical to the inner bore 13 2 of the ring 13 so that the ring 13, the annular bearing 14 and the annular collar 12a together delimit the cylindrical opening 15 which passes right through the housing. The annular collar 12a comes by its inner part delimiting the inner bore 12i, in support or in the extension of the axial ferrule 13b, on the side opposite the support edge 13c. It follows that the annular collar 12a delimits by the inner bore 12i with the axial ferrule 13b of the ring 13 and the neck 14d of the bearing, an empty cylinder internally delimiting the cylindrical opening 15.

[0046] According to the embodiment illustrated in the drawings, the annular bearing 14 is fixed to a main face of the housing and more precisely to the first half-shell 9 1 of the housing. For this purpose, the annular bearing 14 is in the form of an attached annular trim and fixed by any suitable means to a half-shell of the housing, for example the first half-shell 9 1 . For example, the first half-shell 9 1 has a mounting hole 9' 1 for the trim 14 which comprises, for example, at its periphery, radial lugs 14r axially blocked by tabs 9j arranged on the internal face of the first half-shell 9 1 at the periphery of the mounting hole 9' 1 . For example, the first half-shell 9 1 is arranged to have a handle or a circular collar 9d forming a projection or a boss and extending axially while being centered on the transverse axis of rotation T and delimiting the mounting hole 9' 1 of circular section.The annular bearing 14 is therefore mounted inside the mounting hole 9' 1 of the first half-shell 9 1 and delimited by the handle or the circular collar 9d.

[0047] According to an exemplary embodiment not illustrated in the drawings, the annular bearing 14 can be arranged directly on the first half-shell 9 1 . According to this example, the first half-shell has on its internal face all the characteristics of the annular bearing 14 described above.

[0048] It should be noted that the ring 13 is locked in translation, by the stop edge 14c of the annular bearing 14 which is integral with the first half-shell 9 1 , in one direction of the transverse axis of rotation T, namely that directed towards the first half-shell 9 1 in the example considered. The ring 13 is also locked in translation in the other direction of the transverse axis of rotation T, namely that directed towards the second half-shell 9 2 in the example considered. Thus, the ring 13 is in abutment on the second main face 9b of the housing while retaining its freedom of rotation relative to the housing.

[0049] In the illustrated embodiment, the ring 13 abuts on the second main face of the housing and more precisely on the second half-shell 9 2 , by means of the annular collar 12a of the actuating member, fixed to the ring 13. According to this example, the annular collar 12a comprises lugs 12e distributed around its periphery to come into abutment against a rim 9c of a hole 9' 2 made in the second half-shell 9 2 . For example, the second half-shell 9 2 is arranged to have a handle or a circular collar 9e forming a projection or a boss and extending axially while being centered on the transverse axis of rotation T and delimiting the mounting hole 9' 2 of circular section. The annular collar 12a is therefore mounted inside the mounting hole 9' 2 provided in the second half-shell 9 2 and delimited by the handle or the circular collar 9e.

[0050] It is clear from the drawings that the circular handle or collar 9d arranged in the first half-shell 9 1 and the circular handle or collar 9e arranged in the second half-shell 9 2 together form a tubular transverse shaft 9d, 9e crossed by the cylindrical opening 15. The housing 9 thus has at its proximal part, the transverse shaft 9d, 9e which extends in the direction of the distal end 9d of the housing 9, by an elongated body. The transverse shaft 9d, 9e of the housing 9 is extended in the opposite direction of the distal end 9i, by a proximal nose 9n delimiting the proximal end 9k of the housing.

[0051] According to an advantageous embodiment variant, the actuating member 12 and in particular the support arm 12p has a non-slip surface, produced for example by the material constituting the support arm 12p (rubber for example) or by a textured surface (by knurling for example). This non-slip surface guarantees good grip with the thumb during the crutch phase during the examination despite the practitioner's gloves or fluids which may make the support arm slippery.

[0052] According to another advantageous embodiment characteristic, the actuating lever 12 comprises a support arm 12p extending parallel to the transverse axis of rotation T and externally to the housing, between the two main faces of the housing. For this purpose, the annular collar 12a of the actuating member is provided with a radial segment 12s at the end of which extends perpendicularly the support arm 12p which is positioned close to the peripheral area 9p of the housing. As can be seen in the drawings, the support arm 12p which has a displacement along an arc of a circle, is able to move opposite a part of the circular handles or collars 9e, 9d of the housing.

[0053] Advantageously, the handle or the circular collar 9e of the second half-shell 92 is provided with a notch 9f delimited on either side by shoulders 9g and in which the radial segment 12s of the actuating lever 12 is placed. The shoulders 9g thus constitute end-of-travel stops for the actuating lever 12. This notch 9f is arranged on a limited portion of the handle or the circular collar 9e, for example of the order of 45°, being located in the lower part of the housing when the handle is in the use position.

[0054] The pivoting part 13 acts directly or by a transformation mechanism, on at least one and in the example illustrated two control cables 20 to ensure the flexion of the distal head 7. In the embodiment illustrated in Fig. 2 à 5, the ends of the cables 20 are fixed to the pivoting part 13 in any suitable manner so that a rotation of the pivoting part 13 causes the flexion of the distal head 7. Advantageously, each cable 20 passes through a groove 13g provided in the outer edge 13 1 of the ring 13. The pivoting part 13 thus forms a pivoting annular pulley ensuring, for example, the left-right or down-up movement of the head 7. Of course, the cables 20 are made in any suitable manner to ensure this flexion function. Thus, these cables 20 can be mounted in a sheath and be made of rods, wires or chains, made of a metallic or polymer material for example.

[0055] The actuating cables 20 are mounted inside the control handle 2, exiting therefrom through the distal end 9i to enter the insertion tube 5 and being fixed by their distal ends to the distal portion 7 of the insertion tube. The proximal ends of the actuating cables 20 are fixed to the pivoting part 13 in any suitable manner. In the example illustrated, the pivoting part 13 is made of two parts assembled together, namely a male annular flange 13' provided with assembly pins and a female annular flange 13" provided with housings for receiving the pins of the male annular flange. At least one of the annular flanges 13', 13" is arranged to comprise two housings 13x adapted to each receive a sleeve crimped onto the end of a cable 20. These housings 13x, which are closed during the assembly of the two annular flanges 13', 13" ensure the anchoring of the cables 20 to the pivoting part 13.

[0056] It is clear from the above description that the handle according to the invention has optimized handling ergonomics thanks to the cylindrical opening 15 which corresponds to an empty space passing right through the housing of the handle. This cylindrical opening 15 allows in particular a good grip on the handle while offering ease for maneuvering the actuating member 12 which is located close to the cylindrical opening 15. This cylindrical opening 15 also offers a possibility of hanging the handle on a hook of any type known per se.

[0057] It should also be noted that this handle 2 has a longitudinal symmetry allowing an ambidextrous grip. Similarly, the actuation of the actuating member 12 can be carried out as easily with the left hand as with the right hand.

[0058] Furthermore, this handle 1 offers good resistance to crushing through cooperation with the tubular transverse shaft 9d, 9e of the half-shells, the pivoting part 13 and the annular bearing 14. However, it should be noted that this handle has a reduced weight given the presence of the cylindrical opening 15 making it possible to reduce the mass of the material constituting the half-shells of the housing.

[0059] Furthermore, it should be noted that the actuating lever 12 is easily mounted on the pivoting part 13 which is guided in rotation over a large angular range making it possible to obtain precision for the rotation of the pivoting part 13.

[0060] In the above description, the handle 1 comprises a control mechanism 11 for bending the distal head 7 in one direction, but it is clear that the handle can comprise two control mechanisms 11 for bending the distal head 7 in two perpendicular directions.

[0061] According to another characteristic of the invention, the handle 1 comprises a fluid circulation circuit 22 adapted to bring fluid to the distal head 7 or to suck fluids from the distal head 7. This fluid circulation circuit 22 is mounted inside the housing, between the proximal end 9k and the distal end 9i to extend inside the insertion tube 5 to the distal head 7. Similarly, the handle 2 is capable of illuminating and bringing back an image of the distal part 7 of the insertion tube 5. For this purpose, an electric cable 24 is mounted inside the housing, between the proximal end and the distal end to extend inside the insertion tube 5 to the distal head 7.

[0062] According to another characteristic of the invention, the housing 9 is arranged to allow the positioning of the fluid circulation circuit 22 on one side of the cylindrical opening 15 and the positioning of the electric cable 24, on the other side of the cylindrical opening 15. For this purpose, the housing 9 and in particular, the first half-shell 9 1 at the level of the handle or the circular collar 9e, is arranged so as to delimit on one side of the mounting hole 9' 1 , a first housing 25 for the passage of the fluid circulation circuit 20 and on the other side of the mounting hole 9' 1 , a second housing 26 for the electric cable 24. These housings 25, 26 which each have the shape of a half-crown meet in the elongated part of the housing in which the fluid circulation circuit 20 and the electric cable 24 are mounted.The fluid circulation circuit 20 and the electrical cable 24 pass through the distal end 9i of the housing to be inserted into the insertion tube 5. These housings 25, 26 also meet on the opposite side, to open into the proximal nose 9n of the housing and allow the mounting outside the housing of a connector 24r on the electrical cable 24 and of a connector 20r on the fluid circulation circuit 20 for its connection to a source of suction or supply of a fluid.

[0063] The preceding description shows a good balance of the masses inside the handle 2 insofar as in particular the outlets of the fluid circulation circuit 20 and the electric cable 24 are located at the proximal end 9k of the housing, that is to say opposite the distal end 9i of the housing through which the fluid circulation circuit 20 and the electric cable 24 exit. The fluid circulation circuit 20 and the electric cable 24 are thus mounted inside the housing 9 from one end 9k to the other end 9i, passing on either side of the cylindrical opening 15. The positioning of these outlets at the proximal end 9k of the housing provides good gripping quality for the handle.

[0064] Conventionally, the fluid circulation circuit 20 is provided with a shutter 30 controlling the opening and closing of the circuit 20 using a control button 31 movable in translation and projecting from the housing. Advantageously, the housing 9 is arranged to have an orifice 9t bordering the tubular transverse shaft 9d, 9e of the half-shells so that the control button 31 extends tangent to this tubular transverse shaft 9d, 9e of the half-shells, in the upper part of the housing when the handle is in the use position. Thus, this control button 31 can be easily actuated by the hand also moving the lever 12 for the flexion of the distal head 7.

[0065] The invention is not limited to the examples described and shown, the invention is limited only by the appended claims.

Claims

1. A handle for a medical endoscope including a casing (9) having two opposite main faces (9a, 9b) and provided with a mechanism for controlling (11) the bending of a distal head (7) of the medical endoscope, this control mechanism (11) including at least one member for actuating (12) a pivoting part (13) made in the form of an actuation ring (13a) having an axial ferrule (13b) having a cylindrical outer surface (13e) cooperating with an annular bearing (14) to be guided in rotation by this annular bearing (14), along a transverse axis of rotation (T) and whose rotation causes the bending of the distal head, the axial ferrule (13b) having an internal bore (132) partly delimiting a cylindrical opening (15) which passes right through the casing (9) by opening out through internal bores (12i, 14i) on the two opposite main faces (91, 92) of the casing, the pivoting part (13) and the annular bearing (14) being arranged to be located outside the cylindrical opening (15).

2. The handle according to claim 1, according to which the cylindrical opening (15) has a passage section comprised between 8 x 8 mm and 30 x 30 mm and preferably between 8 x 8 mm and 25 x 25 mm.

3. The handle according to any of the preceding claims, according to which the pivoting part (13) is guided by a pivot connection about a transverse axis of rotation (T) coincident with the transverse axis of the cylindrical opening (15), the pivoting part (13) being blocked in translation on one side, by the annular bearing (14) mounted secured to a first half-shell (91) of the casing and on the other side, by a second half- shell (92) of the casing.

4. The handle according to the preceding claim, according to which the axial ferrule (13b) of the actuation ring has at its free end, a bearing edge (13c) cooperating with an abutment edge (14c) of a neck (14d) of the annular bearing to form together an empty cylinder internally delimiting the cylindrical opening (15).

5. The handle according to the preceding claim, according to which the actuation member (12) forms part of an annular collar (12a) fixed on the pivoting part (13) and having an internal bore (12i) of section identical to the internal bore (132) of the axial ferrule (13b) to form, with the axial ferrule (13b) and the neck (14d) of the bearing, an empty cylinder internally delimiting the cylindrical opening (15).

6. The handle according to any of the preceding claims, according to which the first half-shell (91) and the second half-shell (92) of the casing are fixed together.

7. The handle according to the preceding claim, according to which the pivoting part (13) is blocked transversely in one direction by an abutment edge (14c) of the annular bearing (14) arranged or fixed on the first half-shell (91) and in the other direction by abutting on the second half-shell (92) of the casing.

8. The handle according to any of the preceding claims, according to which the actuation member (12) is a lever mounted secured to the pivoting part (13) guided in rotation so as to move in rotation the pivoting part (13) by a rotational movement of the lever.

9. The handle according to the preceding claim, according to which the lever (12) includes an actuation arm (12p) extending parallel to the transverse axis of rotation (T) and externally to the casing, between the two main faces of the casing.

10. The handle according to any of the preceding claims, according to which the actuation member (12) forms part of an annular collar (12a) mounted secured to the pivoting part (13) by abutting on the second half-shell (92) of the casing.

11. The handle according to any of claims 1 to 8, according to which the actuation member (12) is guided in linear displacement and acts on the pivoting part by means of a system for transforming (12c, 13p) the linear movement of the control member into a rotational movement of the pivoting part.

12. The handle according to any of the preceding claims, according to which at least one control cable (20) for the bending of the distal head is mounted inside the control handle, the pivoting part (13) acting directly or by a movement transformation system, on at least said control cable (20) for the bending of the distal head.

13. The handle according to any of the preceding claims, according to which the casing includes a first housing (25) for a fluid circulation circuit (20) and a second housing (26) for an electric cable (24), part of these housings passing on either side of the cylindrical opening (15), these housings (25, 26) opening out at a proximal part (9n) of the casing.

14. A medical endoscope including a handle (2) according to any of the preceding claims and a tubular insertion structure (3) supported by said handle (2).