Handle for medical endoscopes, and endoscope system

Abstract

The invention relates to a handle for medical endoscopes, wherein the handle has a proximal contact surface for the endoscope and a distal contact surface for the endoscope. The direction of extent of the proximal contact surface is oriented at an angle greater than 0° with respect to the direction of extent of the distal contact surface. The invention also relates to an endoscope system comprising a medical endoscope and a handle according to the invention, wherein the handle is connected to the endoscope.

Description

[0001] Handle for medical endoscopes and endoscope systems

[0002] The use of endoscopes during surgical procedures allows a surgeon to visually inspect surgical sites that are not visible to the naked eye. Furthermore, endoscopes enable the visual inspection of desired, otherwise invisible body areas as part of a wide range of diagnostic procedures. Minimally invasive surgical procedures would be inconceivable without the use of endoscopes for visual inspection of the surgical process and outcome due to the small openings in the skin required to access the surgical site.

[0003] Typically, the endoscope is held by the surgeon or an assistant during a procedure and adjusted as necessary to give the surgeon the opportunity to visually inspect the surgical site throughout the entire procedure. However, particularly in more complex procedures, this inevitably leads to fatigue when holding and adjusting the endoscope, which can disrupt the course of the operation. For example, during orthopedic procedures on the spine, where access is created to an intervertebral region between two adjacent vertebrae, great care must be taken to ensure that under no circumstances are nerves located near the spine damaged. This risk increases with the duration of the procedure, also due to the aforementioned fatigue when holding and adjusting the endoscope.

[0004] To support the endoscopist, freely movable holding arms are known from the state of the art. These holding arms can rigidly hold endoscopes and can therefore be fixed in any position. This means that the surgeon no longer has to hold the endoscope with his hand. The disadvantage of this, however, is that in order to readjust the endoscope, the surgeon has to realign it together with the holding device during the procedure. This is not only mechanically complex. Especially during the aforementioned procedures on the spine, the surgeon has to turn towards the holding arm and away from the surgical instrument currently in use to readjust the endoscope. This realignment therefore represents an additional step in the procedure and prolongs its duration.In addition, the known holding arms often restrict the freedom and flexibility of the surgeon, so that the known holding arms for endoscopes are perceived by surgeons as more of a nuisance than as helpful.

[0005] It is therefore the object of the invention to eliminate the above-mentioned disadvantages of the prior art and in particular to develop a device with which it is possible to use an endoscope for a longer period of time without having to forego the flexibility in adjusting the endoscope required for the procedure.

[0006] The object of the invention is achieved with a handle for medical endoscopes with a proximal support surface for the endoscope and with a distal support surface for the endoscope, wherein the extension direction of the proximal support surface is aligned at an angle greater than 0 ° with respect to the extension direction of the distal support surface.

[0007] The object of the invention is further achieved by an endoscope system with a medical endoscope and with a handle according to the invention, wherein the handle is connected to the endoscope in particular in a detachable manner.

[0008] The invention is based on the fundamental finding that a significant cause of the fatigue symptoms mentioned when using the endoscope for extended periods is that the endoscope does not lie ideally in the surgeon's hand due to its geometric shape, center of gravity and weight. Endoscopes typically have an endoscope shaft that is aligned axially, i.e. from proximal to distal, which, in addition to a lumen for a working channel through which surgical instruments can be inserted and moved to the surgical site, has further lumens, for example lumens for light and / or irrigation channels. With modern endoscopes, the visual inspection of the surgical site is no longer carried out directly by the human eye; rather, the image information of the surgical site is digitally recorded by modern endoscopes and shown to the surgeon on a display unit.For this purpose, a fiber optic connector is usually designed in the form of an endoscope attachment, through which image information from the surgical site can be transmitted to the display unit via a camera cable. The fiber optic connector typically extends from the endoscope shaft at an angle other than 0°.

[0009] Endoscopes designed in this way are not ergonomically optimal to grip, move and hold. This leads to fatigue, particularly during longer procedures. In addition, due to the endoscopes' additional irrigation connections, the center of gravity of the endoscope is not ideally located in the surgeon's hand. This also leads to accelerated fatigue. These problems are further exacerbated by the fact that surgeons have different hand sizes and shapes, so that no endoscope is optimally designed for all hand sizes. The handle according to the invention does not mean that the flexibility guaranteed when endoscopes are used manually has to be sacrificed. At the same time, the handle according to the invention enables the endoscope to be held, guided and adjusted more comfortably and ergonomically.Since the handle according to the invention can be individually manufactured for different hand sizes and shapes without great effort, it is in a certain sense also suitable as an adapter for endoscopes. The design of the proximal support surface and the distal support surface ensures that not only the endoscope shaft, but also the fiber optic connection rests comfortably on the surgeon's hand. The handle according to the invention therefore enables the surgeon to handle the endoscope ergonomically and prevents signs of fatigue, even during longer use. In the sense of the invention, proximal refers to a direction directed towards the surgeon and distal to a direction directed towards the patient. In this respect, the direction of extension of a support surface refers to its axial component. In the sense of the invention, a proximal direction points forwards, while a distal direction points backwards.

[0010] The handle according to the invention can be grasped by the surgeon in two different gripping positions. In a first gripping position, the pollex and index of the surgeon enclose the endoscope shaft, i.e. are aligned parallel to the direction of extension of the distal contact surface of the handle, while the surgeon's hand can rest on the proximal contact surface in the area of ​​the os metacarpale pollicis, the metacarpal bone of the thumb. The digitus annularis and the digitus minimus of the surgeon enclose the handle in the area of ​​the proximal contact surface. If necessary, the digitus medius of the surgeon can also be placed on the endoscope shaft, so that a trigital grip of the endoscope shaft is formed, which is also referred to as a tridigital fingertip grip.In a second grip position, the handle according to the invention is enclosed by the surgeon's index in the area of ​​the distal contact surface, whereby the digitus medius, the digitus annularis and the digitus minimus are not in contact with the handle. The pollex rests on the proximal contact surface of the handle. Alternatively, the digitus medius can also enclose the handle and the index also rests on the proximal contact surface of the handle. In a standing hand position, the proximal contact surface of the handle extends away from the surgeon's hand, whereby the endoscope shaft extends away from the hand - distally - downwards. For interventions on the spine, the second grip position is therefore particularly suitable when the patient is in a prone position and the surgeon wants to guide the endoscope perpendicular to the spine.

[0011] The handle can be formed in one piece, making it particularly easy to manufacture. The handle can also be designed so that it can be operated with a left-handed and / or right-handed user. For example, the handle is designed symmetrically to a plane of symmetry that is spanned by the axial direction and the vertical and runs centrally through the handle.

[0012] Preferably, the angle between the direction of extension of the proximal support surface and the direction of extension of the distal support surface is between 10° and 90°, in particular between 10° and 80°, more preferably between 15° and 75°, in particular between 30° and 60°, most preferably 45°.

[0013] In an advantageous development of the invention, at least one central support surface for the endoscope can be arranged between the proximal support surface and the distal support surface, wherein the central support surface can be in direct contact with the proximal support surface and / or with the distal support surface. The direction of extension of the central support surface can enclose an angle of between 10° and 90° relative to the direction of extension of the distal support surface, in particular between 10° and 80°, more preferably between 15° and 75°, in particular between 30° and 60°, most preferably The proximal support surface preferably has a recess in order to create a defined support position for the endoscope, in particular for its light guide connection. At the same time, this prevents the endoscope from slipping.The recess can have at least one directional component that is axially aligned and / or can be designed as a groove and / or a bore. To further secure the endoscope against slipping, the recess of the proximal support surface can have a cross-section that is variable, in particular along the axial direction. In particular, this makes it possible for the endoscope to be inserted into the recess, at least in sections, with a tight fit.

[0014] The proximal support surface can have at least one lateral projection to optimize the center of gravity of the handle and improve ergonomics. The projection can have an outer contour, in particular in the shape of a circular arc, wherein the outer contour can be ergonomically shaped. The outer contour can be adapted to a finger and / or a hand of the surgeon and serve as a support surface for this. In a particularly advantageous embodiment, the proximal support surface has a projection on each side to enable right- and left-handed operation of the handle.

[0015] The proximal support surface preferably has at least one undercut, which is arranged in particular in a proximal region of the proximal support surface. The undercut is particularly preferably arranged in a proximal end region of the proximal support surface. The undercut serves as an abutment for the endoscope and, in particular, prevents the endoscope from slipping proximally, in particular from slipping out of the handle.

[0016] The distal support surface preferably has at least one recess, in particular with a directional component in the axial direction. The recess is preferably aligned parallel to the axial direction. The recess of the distal support surface can have a cross-section that is at least partially circular and / or can be designed to prevent lateral slipping of the endoscope in the region of the distal support surface. It can be provided that the recess has a constant cross-section over its entire length. In a further embodiment of the invention, the width of the recess, in particular its cross-section, can be tapered from proximal to distal.

[0017] The distal support surface can have at least one elevation in a distal region which serves as an abutment for the endoscope, so that slipping of the endoscope distally relative to the handle is prevented. In particular in combination with the undercut of the proximal support surface, the elevation of the distal support surface serves to ensure that the handle can be connected to the endoscope in a form-fitting manner, at least in the axial direction. The elevation can extend axially over at least part of the axial length of the distal support surface in order to reduce the risk of breakage of the elevation when the handle is subjected to mechanical stress. For example, the elevation extends over an axial length of approximately 10 mm to 20 mm, in particular from 13 mm to 15 mm. The elevation is particularly preferably designed as a partially annular extension and / or in one piece with the handle.The elevation of the distal support surface can extend circumferentially over at least 180° in order to obtain a positive connection between the endoscope and the handle.

[0018] Most preferably, the elevation is designed as an annular extension. It is preferably provided that the inner diameter of the extension corresponds to the diameter of the recess in the distal support surface, so that the endoscope can be arranged in a space defined by the distal support surface and the extension. In combination with the annular extension, the endoscope, particularly in the area of ​​the endoscope shaft, can be surrounded by the extension of the handle over its entire circumference, so that the endoscope cannot fall out of the handle. The handle can therefore be connected to the endoscope in a form-fitting manner.

[0019] Further developments of the invention provide that the elevation has at least one, in particular two depressions, wherein the at least one depression can be axially aligned in order to improve the reception of the endoscope in the handle. In particular when the endoscope has lateral flushing connections, which are designed for example as Luer-Lock connections, these flushing connections can engage in the depressions of the elevation, in particular in the depressions of the annular attachment. The depressions, which can be designed as openings, are formed for example as cutouts and serve to improve the reception of the endoscope in the handle. In addition, the depressions enable a rotation-proof mounting of the endoscope, in particular with regard to an axially aligned axis of rotation.

[0020] The distal support surface can have at least one projection, in particular a lateral projection, in a proximal region, preferably in a transition region to the central support surface. The projection is preferably aligned perpendicular to the axial direction and serves in particular as an abutment for the endoscope in order to prevent the endoscope from slipping proximally. In particular, the at least one projection serves as an abutment for the rinsing connections which, in some embodiments of the endoscopes, are arranged laterally on the endoscope and at an angle other than 0° to the axial direction. Preferably, a projection is arranged as an abutment on each side of the recess in the distal support surface.

[0021] The proximal support surface can be designed to support and / or accommodate a fiber optic connection and / or a camera connection of an endoscope.

[0022] The at least one central support surface has, in particular, at least one recess for the endoscope, wherein the at least one recess of the at least one central support surface can have a smaller diameter than the diameter of the recess of the distal support surface. The at least one central support surface can be designed to support and / or receive a fiber optic connection and / or a camera connection of an endoscope. The distal support surface is preferably designed to support and / or receive an endoscope, in particular an endoscope shaft. The handle can have a projection on its distal end region, in particular on its distal end face, the direction of extension of which has a directional component that is aligned perpendicular to the axial direction.The projection on the distal end side can therefore serve as an abutment for a finger of the surgeon, for example the index finger, and improves the ergonomics of the handle. In a further embodiment of the invention, it can be provided that the projection is oriented obliquely backwards-proximally. To improve the ergonomics of the handle, its rear side can have a parabolic outer contour, at least in some areas, wherein it is provided in particular that the apex of the outer contour is arranged at the axial height of the distal support surface. In the region of the apex, the handle can accommodate a recess directed towards the distal support surface, which recess is in particular provided with an arcuate cross-section and / or is arranged in a ring shape.

[0023] To avoid damage to the endoscope, the material of the handle can be selected such that its hardness is lower than the hardness of the endoscope. The material is preferably sterilizable, in particular autoclavable. In addition, the material of the handle can be biocompatible and have at least one component made of a thermoplastic and / or a homopolymer. The handle preferably comprises or consists of polyamide 12, which is also referred to as PA12 or polylaurylactam. Furthermore, it can be provided that the roughness of the handle is less than 12 μm, wherein the roughness corresponds to the mean roughness value R a , the quadratic roughness R q or the average roughness depth R zIn addition, it can be provided that the weight of the handle is less than 500 g, in particular less than 200 g, preferably less than 150 g, most preferably less than 100 g. The handle can be designed as a disposable instrument or can be recycled. Preferably, the handle is designed symmetrically to an axis of symmetry that encompasses the axial direction.

[0024] The endoscope of the endoscope system can be connected to the handle in a form-fitting and / or force-fitting manner, in particular can be clamped and / or latched thereto. The endoscope preferably has at least one optical output and / or at least one irrigation connection, which creates additional locking options for the endoscope within the meaning of the invention. The endoscope can be designed as an orthopedic endoscope, in particular for performing transforaminal and / or interlaminar and / or intradiscal and / or cervical interventions on the spine. The endoscope is preferably designed as a foraminoscope and / or as a laminoscope and / or as a nucleoscope.

[0025] In a further development of the endoscope system, the endoscope can be in direct contact with the proximal support surface and with the distal support surface of the handle. It can be provided that a fiber optic connection and / or a camera connection of the endoscope rest on the proximal support surface of the handle and / or are received thereby. Furthermore, it can be provided that the fiber optic connection and / or the camera connection of the endoscope rest on the at least one central support surface of the handle and / or are received thereby. Furthermore, it can be provided that the endoscope, in particular its endoscope shaft, rests on the distal support surface of the handle and / or is received thereby.

[0026] Further advantages and features of the invention emerge from the claims and the following description, in which an embodiment of the invention is explained in detail with reference to the drawings. In the drawings:

[0027] Fig. 1 shows a handle according to the invention in a perspective side view,

[0028] Fig. 2 the handle according to Fig. 1 in a side view rotated by 180°,

[0029] Fig. 3 the handle according to Fig. 1 in a front view,

[0030] Fig. 4 the handle according to Fig. 1 in a side view,

[0031] Fig. 5 shows the handle according to Fig. 4 in a view rotated by 180°,

[0032] Fig. 6 is an enlarged view of a distal portion of the handle according to Fig. 1,

[0033] Fig. 7 the handle according to Fig. 1 in a view from below,

[0034] Fig. 8 shows the handle according to Fig. 7 in a view rotated by 180°, Fig. 9 shows an endoscope system with the handle according to Fig. 2 and an endoscope connected thereto,

[0035] Fig. 10 the endoscope system of Fig. 9 in a frontal view,

[0036] Fig. 11 the endoscope system of Fig. 9 in a view from behind,

[0037] Fig. 12 the endoscope system of Fig. 9 in a side view and

[0038] Fig. 13 shows the endoscope system of Fig. 13 in a reduced view.

[0039] Fig. 1 shows a perspective side view of a handle 10 according to the invention for a medical endoscope 39 not shown in Fig. 1, wherein the handle 10 has a proximal support surface 11, a middle support surface 12 and a distal support surface 13. In the sense of the invention, a proximal direction corresponds to a direction pointing towards the user and a distal direction corresponds to a direction facing the patient. The extension direction from proximal to distal corresponds to an axial direction. The middle support surface 12 is arranged between the proximal support surface 11 and the distal support surface 13.

[0040] The direction of extension of the distal support surface 13 of the handle 10 according to Fig. 1 is aligned parallel to the axial direction, so that an endoscope shaft 40 (not shown in Fig. 1) can be arranged in axial alignment on the distal support surface 13. To stabilize the endoscope shaft 40 on the distal support surface 13, the latter has a recess 14 with a part-circular cross-section over its entire length, which is constant over the entire length of the distal support surface 13. The recess 14 is designed as a groove in the illustrated embodiment. This is also shown in the perspective view in Fig. 2 and in the front view according to Fig. 3. The design of the handle 10 is symmetrical to a plane of symmetry (not shown), which encompasses the axial direction, which is aligned parallel to the direction of extension of the handle 10. Therefore, the representation corresponds to Fig.2 essentially corresponds to the representation in Fig. 1.

[0041] In a distal region 15, the distal support surface has an annular projection 16 with an axial length of approximately 10 mm to 20 mm to prevent the endoscope shaft 40 from falling out of the handle 10. The projection 16 is hollow-cylindrical and axially aligned. In the illustrated embodiment, the inner diameter of the projection corresponds to the diameter of the recess 14 of the distal support surface 13.

[0042] 1 and 2, in a proximal region 17 of the attachment 16, two oppositely disposed elongated hole-shaped recesses 18 are designed as depressions which serve to receive Luer-Lock connectors arranged to the side of the endoscope, for example flushing connectors 42, and which can ensure additional fixation of the endoscope 39 in the sense of an anti-rotation device. From the side views of FIGS. 4 and 5 and in particular from the enlarged side view of the recesses 18 of the attachment according to FIG. 6, it can be seen that the outer contours 19 of the recesses 18 are each parabolic and that there is a smooth transition from the recesses to the distal support surface 13 (not shown) on the left side in FIG. 6.

[0043] In a distal end region 20, the distal support surface 13 has a projection 21 which extends downward in the proximal direction and forms the distal end face of the handle 10. According to the side views of Fig. 4 and Fig. 5, the distal surface of the projection 21 extends obliquely backward-proximally in order to serve as a support for a finger of the surgeon. Due to the already mentioned axially symmetrical design of the handle 10, the representation in Fig. 5 corresponds to the representation in Fig. 4.

[0044] The distal support surface 13 has, in a proximal region, two lateral projections 22 lying opposite one another, which serve as abutments for the endoscope 39 and prevent it from falling out proximally.

[0045] The central support surface 12 directly adjoins the distal support surface 13 in the proximal direction, the direction of extension of the central support surface 12 being arranged at an angle of 35° relative to the direction of extension of the distal support surface 13. The central support surface 12 also has a partially circular recess 24 which is designed as a groove in such a way as to accommodate a fiber optic connection 41 or camera connection (not shown) of the endoscope 39. The diameter of the recess 24 of the central support surface 12 is therefore smaller than the diameter of the recess 14 of the distal support surface 13. In a proximal region 25, the central support surface 12 is provided with an undercut 26 in the region of its recess 24 in order to prevent the endoscope 39 from accidentally falling out.

[0046] On both sides of the recess 24 of the central support surface 12, thus perpendicular to the axial direction, a projection 27 is formed on the central support surface 12, which serves as a finger rest when the handle 10 is used.

[0047] The middle support surface 12 merges proximally into the proximal support surface 11. The direction of extension of the proximal support surface 11 is arranged at an angle of 25° relative to the direction of extension of the middle support surface 12, and thus at an angle of 60° relative to the direction of extension of the distal support surface 13. The proximal support surface 11 has a recess

[0048] 28, wherein in particular according to Fig. 1 to 3 between the recess 24 of the central support surface 12 and the recess 28 of the proximal support surface 11 a raised portion

[0049] 29 which serves as an abutment for the endoscope 39 .

[0050] The diameter of the recess 28 of the proximal support surface 11 is variable over its length in order to accommodate the endoscope 39 with a tight fit. In a proximal region 30 of the proximal support surface 11, the recess 28 of the proximal support surface 11 has an undercut 31 which serves as an axial abutment for the endoscope 39 and prevents the endoscope 39 from falling out proximally. On both sides of the recess 28 of the proximal support surface 11, projections 32 extending perpendicular to the axial direction are formed on the proximal support surface 11 and serve as finger rests for the user. For ergonomic reasons, the projections 32 each have a circular arc-shaped upper outer contour 33.

[0051] 4 and 5, the rear side 34 of the handle 10 has an approximately parabolic outer contour 35, the apex 36 of which is arranged at the axial height of the distal support surface 13, so that the endoscope 39 can be held ergonomically by the surgeon. In the area of ​​the apex 36, the handle 10 has an annular recess 37 with an arcuate cross-section, aligned with the distal support surface 13, in order to improve the ergonomics of the handle 10. This is also evident from the view of the handle 10 from the proximal rear according to Fig. 7 and from the view rotated by 180° according to Fig. 8.

[0052] In particular, two grip positions of the handle 10 are possible and are explained with reference to the illustration in Fig. 4, wherein the endoscope shaft 40 (not shown in Fig. 4) is arranged vertically and extends through the annular extension 16 of the distal support surface 13. The light guide connection 41 of the endoscope 39 rests on the central support surface 12 and on the proximal support surface 11 and extends upwards to the right as shown in Fig. 4. In the first grip position, for example, the right hand of the surgeon approaches the handle 10 as shown in Fig. 4 from above, i.e. proximally, with the index and the pollex in contact with the endoscope shaft 40 (not shown in Fig. 4), i.e. are axially aligned. The surgeon's hand rests in the area of ​​the metacarpal bone on the lateral attachment 32 of the proximal support surface 11 .If necessary, the index can detach from the endoscope shaft 40 and engage the distal end region 20 of the handle 10, the distal projection 21 of the distal support surface 13, as an abutment. The arrangement of the endoscope 39 on the handle 10 connected thereto in the first grip position is shown in Fig. 12.

[0053] In the second grip position, for example, the surgeon's left hand encloses the handle 10, coming from the left, as shown in Fig. 4. The surgeon's index finger encloses the apex 36 of the outer contour 35 of the rear side 34 of the handle 10, while the pollex rests on the endoscope shaft (not shown in Fig. 4). The arrangement of the endoscope 39 on the handle 10 connected to it in the second grip position is shown in Fig. 13.

[0054] The handle 10 according to the invention is designed symmetrically to a plane of symmetry spanned by the axial direction and the vertical and extending centrally through the handle 10. As a result, the handle 10 according to the invention can be operated both left-handed and right-handed, particularly with regard to the grip positions described above.

[0055] Fig. 9 shows an endoscope system 38 according to the invention with the handle 10 according to the invention and the endoscope 39 detachably connected thereto, such that the endoscope 39 is in contact with the proximal support surface 11, the central support surface 12 and the distal support surface 13 of the handle 10. The fiber optic connection 41 or camera connection of the endoscope 39 engages in the recess 28 of the proximal support surface 11 and is aligned at an angle of approximately 60° relative to the axially aligned extension direction of the endoscope shaft 40. The endoscope 39 engages in the recess 14 of the distal support surface 13 of the handle 10 and passes through the annular extension 16.The endoscope 39 is provided with rinsing connections 42, each of which is arranged at an angle of greater than 0° relative to the direction of extension of the endoscope 39, and thus also relative to the endoscope shaft 40, and each of which is designed as a Luer-Lock connection, which is also evident from the frontal view of the endoscope system 38 in Fig. 10.

[0056] The flushing connections 42 are each located in contact with the projections 23 of the distal support surface 13, so that movement of the endoscope 39 relative to the handle 10 in the proximal direction is prevented. Movement of the endoscope 39 relative to the handle 10 in the distal direction is prevented by the flushing connections 42 of the endoscope 39 passing through the recesses 18 of the annular attachment 16. Fig. 11 shows the endoscope system 38 in a rear view.

[0057] Fig. 12 shows the endoscope system 38 according to Fig. 9 in a side view, wherein the handle 10 is in the already described first handle position, in which the light guide connection 41 of the endoscope 39 is in contact with the proximal support surface 11 of the handle 10. Fig. 13 shows the endoscope system 38 according to Fig. 9 in the also already described second handle position, in which the light guide connection 41 is not in contact with the proximal support surface 11 of the handle 10. In the second handle position, the endoscope 39 is rotated by 180° about its direction of extension compared to the first handle position. In both grip positions, the endoscope shaft 40 penetrates the annular extension 16 and the rinsing connections 42 are in contact with the projections 23 on the one hand and penetrate the recesses 18 on the other hand, so that a reliable, positive connection of the endoscope 39 with the handle 10 is ensured.

Claims

Patent claims 1. Handle (10) for medical endoscopes (39) with a proximal support surface (11) for the endoscope (39) , with a distal support surface (13) for the endoscope (39) , wherein the extension direction of the proximal support surface (11) is aligned with the extension direction of the distal support surface (13) at an angle greater than 0°.

2. Handle according to claim 1, characterized in that the angle between the extension direction of the proximal support surface (11) and the extension direction of the distal support surface (13) is between 10° and 90°, in particular 45°.

3. Handle according to one of claims 1 or 2, characterized in that at least one central support surface (12) for the endoscope (39) is arranged between the proximal support surface (11) and the distal support surface (13).

4. Handle according to one of claims 1 to 3, characterized in that the proximal contact surface (11) has a recess (28).

5. Handle according to claim 4, characterized in that the recess (28) of the proximal support surface (11) has a variable cross-section.

6. Handle according to one of claims 1 to 5, characterized in that the proximal contact surface (11) has at least one lateral projection (32), wherein the projection (32) has a particularly arc-shaped outer contour (33).

7. Handle according to one of claims 1 to 6, characterized in that the proximal contact surface (11) has an undercut (31) in a proximal area (30).

8. Handle according to one of claims 1 to 7, characterized in that the distal contact surface (13) has a recess (24) with, in particular, at least a partially circular cross-section.

9. Handle according to one of claims 1 to 8, characterized in that the distal contact surface (13) has a protrusion (16) in a distal area (15), wherein in particular the protrusion (16) is designed to be at least partially ring-shaped.

10. Handle according to claim 9, characterized in that the projection (16) extends circumferentially over at least 180°.

11. Handle according to one of claims 9 or 10, characterized in that the projection (16) is designed as an annular extension (16), wherein in particular it is provided that the inner diameter of the extension (16) corresponds to the diameter of the recess (14) of the distal bearing surface (13).

12. Handle according to one of claims 9 to 11, characterized in that the projection (16) has at least one, in particular two, recesses (18), wherein in particular the at least one recess (18) is axially oriented.

13. Handle according to one of claims 1 to 12, characterized in that the distal contact surface (13) has at least one, in particular lateral, projection (23) in a proximal area (22).

14. Handle according to one of claims 1 to 13, characterized in that the handle (10) has a projection (21) at its distal end region (20) whose direction of extension has a directional component that is oriented perpendicular to the axial direction.

15. Endoscope system (38) comprising a medical endoscope (39) and a handle (10) according to one of claims 1 to 14, wherein the handle (10) is in particular detachably connected to the endoscope (39).

16. Endoscope system according to claim 15, characterized in that the endoscope (39) is in contact with the proxi- paint the bearing surface (11) and with the distal bearing surface (13) of the handle (10).

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