Handpiece for a flexible endoscope or a flexible endoscopic instrument, and flexible endoscope or flexible endoscopic instrument

Abstract

The invention relates to a handpiece for a flexible endoscope or a flexible endoscopic instrument having a shaft section which can be angled, wherein the handpiece has a housing, a holding frame, a control element and an operating element, and the handpiece can be assigned at least one Bowden cable with a pulling element for angling the shaft section which can be angled, and the handpiece has a guide device, wherein the guide device has a guide element having at least two mutually opposing guide cut-outs for feeding through the pulling element, and a clamping device having at least one clamping element, wherein the guide element is detachably arranged at a distal end of the holding frame, the clamping device is detachably arranged distally of the guide element and is connected force-fittingly to the holding frame by means of the at least one clamping element so that the guide element is fixed between the clamping device and the distal end of the holding frame, and the pulling element can be fed through the at least two mutually opposing guide cut-outs in a proximal direction to the control element. The invention also relates to a flexible endoscope or a flexible endoscopic instrument.

Description

Handpiece for a flexible endoscope or a flexible endoscopic instrument and flexible endoscope or flexible endoscopic instrument

[0001] The invention relates to a handpiece for a flexible endoscope or a flexible endoscopic instrument with an articulated shaft section, wherein the handpiece comprises a housing with a distal end and a proximal end, a retaining frame, a control element and an actuating element, wherein the retaining frame is internally connected to the housing, the handpiece is associated with at least one Bowden cable with a pull element for angling the articulated shaft section of the flexible endoscope or the flexible endoscopic instrument, the retaining frame holds the control element for actuating the pull element of the at least one Bowden cable and the control element can be actuated by means of the actuating element, and the handpiece comprises a guide device for guiding the at least one Bowden cable and / or the pull element.Furthermore, the invention relates to a flexible endoscope or a flexible endoscopic instrument with a shaft and an articulated shaft section.

[0002] In medical and non-medical applications, angled instruments and endoscopes are frequently used, which can be operated manually and / or robotically. Reusable endoscopes or instruments often require a large number of guide wires. These components are arranged around pivot links of a distal-sided joint mechanism and attached proximally to a driven swashplate. Such a complex design and assembly is not feasible for single-use endoscopes and instruments. For disposable endoscopes and instruments, it is known to use one or more Bowden cables for the distal-sided and proximal-sided joint mechanisms.

[0003] From US Patent 2020 / 0229684, a handpiece for an endoscope is known in which the Bowden cable sheaths are glued into through-holes of an anchor block, the anchor block being located inside the handpiece. However, the necessary gluing process results in increased assembly time due to the adhesive's curing time. Furthermore, incomplete curing and / or cross-linking of the adhesive can lead to the subsequent release of undesirable substances, and an unfavorable position of the Bowden cable sheath poses a risk of the pull wire becoming glued to the sheath. Most importantly, the through-holes in the anchor block restrict the spatial orientation of the Bowden cable and the pull wire.

[0004] The purpose of the invention is to improve the state of the art.

[0005] The problem is solved by a handpiece for a flexible endoscope or a flexible endoscopic instrument with an articulated shaft section, wherein The handpiece comprises a housing with a distal end and a proximal end, a retaining frame, a control element, and an actuating element, wherein the retaining frame is internally connected to the housing; the handpiece is associated with at least one Bowden cable with a pull element for angling the articulated shaft section of the flexible endoscope or flexible endoscopic instrument; the control element for actuating the pull element of the at least one Bowden cable is held by the retaining frame, and the control element can be actuated by means of the actuating element; the handpiece comprises a guide device for guiding the at least one Bowden cable and / or the pull element; and the guide device comprises a guide element with at least two opposing guide recesses for guiding the pull element and a clamping device with at least one clamping element.wherein the guide element is detachably arranged at a distal end of the holding frame, the clamping device is detachably arranged distal to the guide element and is forcefully connected to the holding frame by means of the at least one clamping element, so that the guide element is held between the clamping device and the distal end of the holding frame and the pulling element can be guided in a proximal direction to the control element through the at least two opposing guide recesses.

[0006] Thus, a handpiece with simple and cost-effective guidance of the pulling element and / or the Bowden cable is provided by means of the guide device. It is particularly advantageous that the guide element, with its at least two opposing guide recesses, is securely fixed to the mounting frame by means of the clamping device, thus eliminating the need for a material-fit connection such as welding or gluing. By clamping the guide element, these two components can be easily and quickly mounted to the mounting frame. Likewise, quick disassembly is possible, and the individual guide element and clamping device can be disposed of or recycled separately. This makes the handpiece suitable for single use, for example, as a disposable endoscope or a disposable instrument.

[0007] Above all, the handpiece is quickly and easily adaptable to different flexible endoscopes or instruments, for example, those with different shaft diameters, since, depending on the respective shaft diameter, one or more Bowden cables with appropriately adapted cross-sections are typically used. To adapt to the characteristics of the respective endoscope or instrument and / or the Bowden cables, only the guide element and / or the clamping device needs to be replaced. Thus, different guide element designs, for example, with guide recesses of different sizes and / or at different heights, and / or different The specially designed clamping devices, for example with differently shaped clamping elements and / or different clamping forces, allow for easy adaptation to the requirements of the respective endoscope or instrument. Thus, apart from the detachable and replaceable guide element and / or the detachable and replaceable clamping device, the handpiece can always be configured identically for different endoscopes and / or instruments.

[0008] A key aspect of the invention is that an identical handpiece is provided for various flexible endoscopes and instruments, in which the guide device for guiding the at least one Bowden cable and / or the pull element is forcefully connected to the holding frame by means of the at least one clamping element and thus free from a material-fit connection, so that simple assembly and configuration of the handpiece is possible using differently designed guide elements, clamping devices and / or clamping elements in order to quickly and easily adapt the guide device to the requirements of the respective endoscope or instrument.Due to the simple installation and assembly of the guide element and the clamping device, the spatial course of the at least one Bowden cable and / or the pull element coming from the distal joint mechanism can be spatially aligned by means of the guide device and guided towards the control element.

[0009] The following terms will be explained:

[0010] A "handpiece" is, in particular, a hand and / or holding part for an endoscope or instrument. The handpiece can be a handle for manual and / or automated operation. The handpiece has, in particular, a housing. For example, the housing can be formed from two lateral, interconnected grip shells. At the distal end of the handpiece, it can be connected, for example by means of an adapter, to the proximal end of a shaft of the endoscope or instrument.

[0011] An "endoscope" is, in particular, a medical or industrial device for the endoscopic examination and viewing of a human or animal body cavity and / or an industrial cavity, such as a pipe. The endoscope specifically comprises a handpiece, a shaft, a light source, an optical fiber, and a camera. The endoscope is, in particular, a video endoscope, which features digital image acquisition and transmission. A video endoscope is, in particular, a chip-on-the-tip (COTT) endoscope, in which the image sensor is designed as a chip, for example, a CMOS chip, and is located at the distal end of the shaft of the video endoscope.The image data captured by the image sensor can be transmitted electronically through the shaft in a proximal direction to the handpiece and then to a display system and / or an image processing unit to present the endoscopic image to the user. Besides human and veterinary medical applications, an endoscope and / or... Video endoscopes can also be used for industrial purposes, for example for visual inspection in hard-to-reach cavities. In industrial applications, an endoscope is often referred to as a borescope.

[0012] An "endoscopic instrument" is, in particular, any mechanical or mechano-electrical working unit that is suitable for manipulating human or animal tissue. The endoscopic instrument includes, in particular, a handpiece, a flexible shaft, and a tool and / or an optical system for viewing a field of view. A flexible endoscopic instrument typically does not have its own optics for capturing an endoscopic image, but is particularly suitable for use in conjunction with a flexible endoscope. The endoscopic instrument may include, in particular, a grasping tool, a cutting tool, a needle holder, a clip setter, and / or other types of tools.

[0013] A "flexible endoscope" or "flexible endoscopic element" is understood to mean, in particular, an endoscope or endoscopic instrument with a flexible shaft. A "flexible shaft" is, in particular, a partially or fully flexible, elongated tube. The flexible shaft is specifically designed to be inserted into a cavity to be examined endoscopically, for example, a body cavity or a technical opening in industrial applications. The shaft typically has an outer diameter in the range of 4 mm to 10 mm. The flexible shaft has, in particular on its internal side, at least one working channel for rinsing or for passing working instruments through it. The flexible shaft has at least one articulated shaft section. The "articulated shaft section" is, in particular, an articulated distal end section of the shaft. To achieve angulation of the shaft section, the flexible shaft has, in particular on its internal side, a distal-sided joint mechanism with longitudinally arranged articulating elements and at least one circumferential Bowden cable that runs externally around both sides of the articulating elements. The outer sheath of the Bowden cable can be attached distally in front of the first articulating element or in the distal end section in front of the camera head, for example, by gluing.

[0014] The terms "distal" and "distal" refer to an arrangement close to the body and therefore farther from the user, and / or a corresponding end or section. Similarly, "proximal" and "proximal" refer to an arrangement close to the user and therefore farther from the body, and a corresponding end or section. Thus, the "proximal direction" is a direction directed towards the proximal end of the handpiece and / or endoscope or endoscopic instrument.

[0015] A "retaining frame" (also called a "bearing block") is, in particular, a load-bearing structure inside the housing. The retaining frame is connected, in particular, internally to the housing and / or a handle recess. The retaining frame is, in particular, connected to two opposing Retaining arms are formed, between which the control element is arranged. The control element is connected to the two retaining arms of the retaining frame, in particular by means of a shaft.

[0016] A "control element" is, in particular, an element that causes a movement of the pull element of the at least one Bowden cable and thus an angular movement of the articulated shaft section. A control element can be, for example, a pulley or a steering wheel.

[0017] An "actuating element" is, in particular, an element whose movement actuates the control element. An actuating element could, for example, be an articulating lever with a terminal handle, the lever itself being guided through the housing of the handpiece and connected to the control element.

[0018] A "Bowden cable" is, in particular, a movable machine element for transmitting mechanical motion. A Bowden cable has, in particular, a flexible outer sheath (also called the outer cable) that is resistant to compression in the direction of pull, and a pull element (also called the inner cable, pull rope, or pull wire) arranged inside the outer sheath. The pull element is, in particular, movable along the longitudinal direction of the Bowden cable within the outer sheath. The pull element is, in particular, a steel wire or wire rope. By moving the pull element by means of the control element, a displacement of the pull element occurs along the longitudinal direction of the Bowden cable relative to the outer sheath. The Bowden cable is mounted on a flexible shaft, allowing the articulated shaft section to be angled by a predetermined amount in a predetermined direction by means of the distal joint mechanism. The outer sheath of the Bowden cable is at least partially essentially cylindrical. The Bowden cable can, for example, have an outer diameter in the range of 0.10 mm to 3.00 mm, in particular from 0.30 mm to 1.00 mm, preferably from 0.40 mm to 0.75 mm.

[0019] A "guiding device" is, in particular, a device that guides the at least one Bowden cable and / or the pull element in the handpiece in a proximal direction to the control element. The guiding device specifically comprises a guide element with at least two opposing guide recesses and a clamping device with at least one clamping element.

[0020] A "guide element" can be, in particular, any component that has guide recesses on two opposite sides for the passage of the tension element. A guide element can, in particular, be a three-dimensional rectangular component. Preferably, the guide element is a plate with a thin wall. The guide element is, in particular, made of a metal and / or an alloy, such as stainless steel.

[0021] A "guide recess" is, in particular, a breakthrough defined by the dimensions of the guide element in proximal direction. A guide recess can be a hole, a groove, or a slot. In cross-section transverse to the proximal direction, a guide recess is preferably formed directly in the left and right side walls of the guide element. For example, a guide opening can be provided there, which extends slot-shaped further into the interior of the guide element transversely to the proximal direction and continuously in the proximal direction.

[0022] A "clamping device" is, in particular, a three-dimensionally shaped component that can be clamped to the mounting frame by means of at least one clamping element and thus detachably connected to the mounting frame in a force-fit connection. In the assembled state of the guide device, the guide element is clamped, in particular over a surface area, between the proximal side of the clamping device and the distal side of the mounting frame and thus spatially fixed. The guide element is preferably oriented such that its two opposing larger surfaces lie flush against both the proximal side of the clamping device and the distal side of the mounting frame. The clamping device is made, in particular, of plastic, such as polypropylene.

[0023] A "clamping element" is, in particular, an elastic element that can be directly and forcefully connected to the mounting frame. A clamping element can, for example, be a locking hook with a locking lug or a spring clamp.

[0024] A "force-fit connection" is, in particular, a connection in which a normal force is exerted on the surfaces to be joined. This prevents the surfaces from sliding against each other due to static friction. In a force-fit connection, the holding force of the clamping element is used to fix the clamping device and the guide element to the mounting frame by means of self-locking. A force-fit connection is, in particular, a clamping connection. A force-fit connection is, in particular, reversible and detachable by releasing the clamping element.

[0025] A "cohesive bond" is, in particular, a bond in which the components are held together by atomic or molecular forces. A cohesive bond is, in particular, a permanent bond that can only be separated by destroying the bonding agents. Examples of cohesive bonds include welding and gluing.

[0026] In another version, the handpiece has at least one Bowden cable, a second Bowden cable and / or further Bowden cables, each with a pull element.

[0027] Thus, instead of one Bowden cable running all the way around, two or more Bowden cables can be guided inside the handpiece by means of the guide device.

[0028] In the case of two Bowden cables, two opposing cable elements can be located on opposite sides of the The control element must be guided. These two tension elements can also be connected proximally and thus be designed as a continuous tension element.

[0029] A “second Bowden cable” and “additional Bowden cables” correspond in their design and function to the Bowden cable defined above, but they can be guided differently and at different distances from each other in the handpiece and / or through the flexible shaft to the articulated shaft section.

[0030] In order to ensure a stable and secure force-fit connection of the at least one clamping element to the holding frame, the holding frame has at least one recess, an undercut and / or at least one protruding element for gripping and / or grasping by means of the at least one clamping element.

[0031] Thus, a defined point or area of ​​the holding frame is provided where the at least one clamping element or the clamping elements can apply their clamping force by gripping and / or grasping.

[0032] A "recess" is, in particular, a cut and / or an opening. The recess can be, for example, a notch, a groove, and / or some other type of incision in the surface of the mounting frame.

[0033] An "undercut" is, in particular, a design element that protrudes freely from the mounting frame.

[0034] A "projecting element" refers in particular to a The term "projecting element" refers to a protruding element that extends beyond the surface of the mounting frame. This protruding element can, in particular, widen conically and / or in a stepped manner towards the clamping area. Preferably, the protruding element has one or more corners for gripping by means of one or more clamping elements.

[0035] In another embodiment, the retaining frame has on both sides a corresponding opening in the proximal direction for the passage of the pulling element or elements, or has a narrower width than the guiding element.

[0036] This allows the guide element or guide elements to be guided freely or guided on both sides from the two opposing guide recesses of the guide element through the openings on both sides of the retaining frame in the proximal direction to the control element.

[0037] A "corresponding opening" is understood to be a right- and left-sided opening through a distal wall of the retaining frame, which is aligned with the guide element. The openings in the distal wall of the retaining frame are arranged in such a way that the tension elements guided proximally by the guide recesses of the guide element, or the two-sided sections of the tension element, pass through the openings of the The mounting frame can be guided. Preferably, the openings in the mounting frame have a larger free opening diameter than the guide recesses, so that the guide element(s), guided on both sides, can be spatially flexible and thus laterally and / or vertically displaceable relative to the control element. This also allows for different diameters of the control element.

[0038] A "breakthrough" is, in particular, a continuous opening through the distal wall of the mounting frame. A breakthrough can be a hole in the surface of the distal wall or a recess in the right and left sides of the distal wall of the mounting frame in the proximal direction. Thus, the wall thickness of the distal side wall can have a groove or a notch on both sides from the outside. Preferably, the breakthrough is at least partially round or circular in shape so that friction of the inserted tensioning element within the breakthrough is avoided.

[0039] In principle, the retaining frame can also have a narrower width than the guide element, so that the pulling element or elements passing through the guide recesses in the proximal direction are guided freely around the distal wall of the retaining frame to the control element.

[0040] In order to clamp a protruding element on two opposite sides and / or to at least partially grip it on both sides, the clamping device has at least two Opposing, cooperating locking hooks, each with a locking lug, which at least partially engage a first protruding element on an upper side of the retaining frame.

[0041] Thus, a clip closure is provided by the two opposing cooperating locking lugs and the locking hooks.

[0042] A "latching lug" is an element projecting from the latching hook. A latching lug can be designed, in particular, as a pin, projection, and / or offset. The latching lug is, in particular, arranged at the free end of a latching hook. The latching hook is, in particular, elastically deformable so that the two latching hooks can be slid around the projecting element on both sides before the latching lugs on both sides, for example, each engage a corner of the projecting element.

[0043] In another embodiment, the clamping device has two further opposing, cooperating locking hooks, each with a locking lug, which at least partially encompass a second projecting element on an underside of the retaining frame.

[0044] Thus, the clamping device can be forcefully connected by means of one or two pairs of locking hooks with locking lugs on the top and / or bottom of the mounting frame. With a force-fit connection on the top and bottom of the mounting frame, the clamping device clamps the mounting frame at its distal end largely from the outside.

[0045] In order to also use the clamping device for guiding the at least one Bowden cable or Bowden cables, the clamping device has at least one lateral guide projection on each side with a groove extending in the proximal direction for guiding the at least one Bowden cable or Bowden cables to the guide recesses of the guide element.

[0046] Consequently, the Bowden cable or Bowden cables can be specifically aligned from the shaft towards the guide recesses of the guide element by means of the guide projections on both sides.

[0047] A "guide projection" is understood to be a part of the clamping device that projects laterally and thus transversely to the proximal direction, and which has a continuous groove in the proximal direction. The respective lateral guide projection can therefore be designed, for example, in the form of a projecting wing. This limits the width of the clamping device transversely to the proximal direction, and the clamping device does not need to be solid in this transverse direction, thus saving weight and space. The handpiece is saved.

[0048] In another embodiment, the clamping device has two lateral guide projections on each side, each with a groove extending proximally, wherein the two guide projections on each side extend proximally. arranged one after the other and / or the respective two grooves are arranged in opposite directions to each other.

[0049] The Bowden cable guide is precisely adjustable in the proximal direction thanks to the two guide projections arranged one after the other on each side. Because the two consecutive grooves are arranged in opposite directions to each other—for example, the groove of the distal guide projection opens upwards and the groove of the subsequent proximal guide projection opens downwards—a passage area for the Bowden cable(s) is defined in the cross-section. This allows Bowden cables with different diameters and / or tolerance deviations to be guided through this opening area, and the arrangement of the two consecutive grooves can be used to achieve precise alignment of the Bowden cable in the proximal direction.

[0050] In order to guide the two sections of the Bowden cable or the two Bowden cables and thus the respective cable elements at a greater lateral distance from each other in a proximal direction, the proximally arranged lateral guide projection has a larger lateral dimension than the distally arranged lateral guide projection, so that the at least one Bowden cable or the Bowden cables widen laterally outwards along the proximal direction through the two successively arranged grooves on both sides.

[0051] Thus, the Bowden cable(s) can be guided by the two guide projections located proximally to each other, both in their proximal and transverse orientations, and therefore at a predetermined lateral distance to the control element. This allows the Bowden cable(s) to be guided more easily on the outside and their orientation towards the control element to be extended in a V-shape. Consequently, even with a double-ended Bowden cable, an extension of the distance in the proximal direction can be achieved.

[0052] In another embodiment of the handpiece, a proximal end of a respective outer sheath of the at least one Bowden cable or of the respective Bowden cable lies against a distal side of the guide element around the respective guide recess and / or is materially connected.

[0053] Thus, the proximal end of the Bowden cable's outer sheath abuts the distal side of the guide element around the corresponding guide recess, and only the pull element is guided further proximally through the guide recess towards the control element. This allows the pull element to move along the longitudinal and thus axial direction of the Bowden cable within the outer sheath, thereby enabling the angular movement of the articulated shaft section of an endoscope or endoscopic instrument. The end face of the proximal end of the outer sheath can be located on the distal side. The guide element must be securely connected to the material, for example by gluing. Additionally or alternatively, the outer sleeve can also be glued into the groove of a guide projection of the clamping device.

[0054] In order to easily insert the tension element or elements laterally from the outside into the opposing guide recesses, the at least two opposing guide recesses each have a guide opening, wherein the guide openings are arranged on both sides in opposite side walls of the guide element in a cross-section transverse to the proximal direction.

[0055] Because the guide openings are inserted laterally into the side walls from the outside and do not pass through them within the distal surface, it is possible to easily thread the pulling element and / or pulling elements from the outside.

[0056] In another embodiment, the at least two opposing guide recesses, starting from the respective guide opening, have a constant recess height, a stepped recess height and / or a tapered recess height along a recess width.

[0057] This allows tension elements with different diameters to be guided in a positionally stable manner without lateral displacement through the respective guide recess in the proximal direction.

[0058] The term "recess width" refers specifically to the dimension of the recess in a direction perpendicular to the proximal direction. The term "recess height" refers to a dimension of the recess in a vertical direction, thus perpendicular to both the recess width and the proximal direction. Starting from the guide openings on both sides of the opposing guide recesses, the guide recesses narrow in cross-section towards the center of the guide element.

[0059] In order to provide a high clamping force and a large clamping area by means of the clamping device, the guide element is designed as a guide plate, with a wall thickness of the guide plate arranged in the proximal direction.

[0060] Thus, the opposing plate surfaces lie flat against the clamping device on their distal sides and flat against the distal side of the holding frame.

[0061] A "guide plate" is, in particular, a flat element with a uniform thickness (wall thickness) throughout, which is bounded on two opposite sides by a flat surface that is very extensive in relation to its thickness.

[0062] In another embodiment, the guide plate has an upper recess and a lower recess in a cross-section transverse to the proximal direction, and the retaining frame has an upper retaining projection corresponding to the upper recess and a lower one. Holding projection corresponding to the lower recess on .

[0063] This allows the guide plate to be easily positioned on the distal side of the holding device before being clamped to the holding frame using the clamping mechanism. Due to the projecting upper and lower retaining projections on the distal side of the holding frame, the guide plate can be positioned against the distal side of the holding frame without slipping downwards. Of course, the holding frame can also have only a lower retaining projection on its distal side, and the guide plate only a lower recess. The upper and lower recesses of the guide plate can each have any shape; for example, they can be triangular or rectangular. The respective retaining projections of the holding frame are correspondingly opposite in shape.

[0064] In a further aspect of the invention, the problem is solved by a flexible endoscope or a flexible endoscopic instrument with a shaft and an articulated shaft section, wherein the articulated shaft section can be articulated by means of at least one Bowden cable, and with a handpiece arranged at a proximal end of the shaft, wherein the handpiece is a handpiece as previously described.

[0065] Thus, a flexible endoscope or a flexible endoscopic instrument is used in a cost-effective manner. A single-use handpiece is provided that is easy to manufacture and assemble, thus eliminating the need for reuse and the otherwise necessary autoclaving. Above all, a largely identical handpiece, where only the guide element and clamping device can be designed differently, provides the user with an easy-to-use endoscope or endoscopic instrument, meaning that the user does not have to readjust the handpiece operation when switching between different types of endoscopes or instruments.

[0066] The invention will now be explained in more detail using an exemplary embodiment. The figures shown are... Figure 1 is a three-dimensional representation of a Endoscopes with a handpiece and a flexible shaft, Figure 2 shows a three-dimensional representation of the opened handpiece. Figure 3 is a three-dimensional representation of a Guide device in the unassembled state and a bearing block of the handpiece, and Figure 4 shows the guide device mounted on the Bearing block.

[0067] An endoscope 101 has a shaft 103 with a flexible shaft section 105 and a distal The articulated shaft section 107 is located on a articulated shaft section 107. A camera head 109 is arranged in a distal end section of the articulated shaft section 107. A proximal end of the shaft 103 is connected to a distal end 111 of a handpiece 121 by means of an adapter 117. The handpiece 121 has a housing 123, which is formed by a left-side and a right-side grip cup 125. In a proximal section in front of a proximal end 113 of the handpiece 121, the handpiece 121 has an articulating lever 141, which is guided inwards into the housing 123. In a distal section in front of the distal end 111, the handpiece 121 has two valve bodies 147 and a power cable 145 (Figure 1).

[0068] Inside the handpiece 121 (Figure 2 shows a view into the interior of the handpiece 121 with the left grip shell 125 removed), a circuit board 149 and a bearing block 127 are located on the proximal side. The bearing block 127 has an upper bearing arm 128 and a lower bearing arm 130, which are connected distally to a wall 132. A drive shaft 139 passes through the proximal end of the upper bearing arm 128 and the lower bearing arm 130, so that the bearing block 127 supports the drive shaft 139, to which a control wheel 137 is attached. The control wheel 137 is secured proximally with a retaining clip 143. The articulating lever 141 is connected to the control wheel 137.

[0069] On the distal side, in a mounted state, a guide device 151 with a guide clip 171 and a guide plate 153 is attached to the bearing block 127 for a A Bowden cable 191 with an outer sheath 193 and a pull cord 195 is arranged (see Figures 2, 3, and 4). A clip projection 131 is arranged on the upper side of the upper bearing arm 128. The clip projection 131 on the upper side of the upper bearing arm 128 transitions into an upper retaining projection 133 on the distal wall 132 of the bearing block 127. Furthermore, the lower bearing arm 130 also has a clip projection 131 on its underside, which transitions into a lower retaining projection 135 on the distal wall 132. In the distal wall 132, a through-opening 129 is provided on both the right and left sides, extending through a side wall of the distal wall 132 in a proximal direction 115 (see Figure 3).

[0070] The guide plate 153 has a right guide slot 155, a left guide slot 157, and a stop side 165. Furthermore, the guide plate 153 has an upper recess 161, which corresponds to the upper retaining projection 133 of the bearing block 127, and a lower recess 163, which corresponds to the lower retaining projection 135 of the bearing block 127. Thus, the guide plate 153 has an H-shape in cross-section. The guide clip 171 has a vertical wall 172 and a base 174. On the upper side of the vertical wall 172, two locking hooks 173 with inwardly directed locking lugs 175 are arranged on both sides at an angle of 90°. Likewise, two locking hooks 173, not fully visible in Figure 3, with inwardly directed locking lugs 175 are arranged opposite each other on the underside of the guide clip 171. These are located laterally on both sides of the base. 174 The guide clip 171 has a distal guide wing 179 with a distal, upwardly open groove 183 and, spaced apart in the proximal direction 115, a proximal guide wing 177 on each side, each with a proximal groove 181, which is open downwards. The proximal and distal grooves 181 and 183 are continuous in the proximal direction 115.

[0071] The following steps are carried out to mount the guide plate 153 and the guide clip 171 to the bearing block 127:

[0072] The guide plate 153 is placed against the distal wall 132 of the bearing block 127, so that the upper retaining projection 133 and the lower retaining projection 135 of the bearing block 127 each project into the upper recess 161 and the lower recess 163, thereby holding the guide plate 153 against the distal wall 132. The guide clip 171 is then slid in the proximal direction 115 onto the held guide plate 153 and the distal end of the bearing block 127. In this process, the two opposing upper locking hooks 173 and the lower locking hooks 173 (not fully visible in Figure 3) laterally engage the upper clip projection 131 and the lower clip projection 131, respectively.Due to the spring-like elastic design of the locking hooks 173 and the proximal-direction 115 conically expanding shape of the respective clip projection 131, the two opposing locking hooks 173 are widened when pushed on, until their locking lugs 175 engage the proximal corners of the two sides. The guide plate 153 is gripped and locked into place by the respective clip projection 131. Due to this force-fit connection, the guide plate 153 is clamped and spatially fixed between the inside of the vertical wall 172 of the guide clip 171 and the distal wall 132 of the bearing block 127.

[0073] The Bowden cable 193 is now threaded through the distal groove 183 of the distal guide wing 179, which extends upwards, and the proximal groove 181 of the proximal guide wing 179, which extends downwards. The outer sheath 193 abuts the stop side 165 of the guide plate 153 around the right-hand guide slot 155 with its proximal end and is glued in place. Alternatively, the proximal end of the outer sheath 193 can be butt-fitted to the guide plate 153 before being clamped by means of the guide clip 171. The internal pull rope 195 is guided through the right guide slot 155 of the guide plate 153 and through the subsequent breakthrough opening 129 of the distal wall 132 of the bearing block 127 and is guided back around the outside of the steering wheel 137 in the opposite direction 115 to the proximal direction.In Figure 4, the Bowden cable 193 and the pull rope 195 are shown guided only on the right side of the guide device 151 and the bearing block 127, with the Bowden cable 193 and the pull rope 195 being guided analogously to the right side on the left side.

[0074] To angulate the articulated shaft section 107 of the endoscope 101, a user operates the articulation lever 141. Due to the rotationally fixed arrangement of the control wheel 137 on the rotatable drive shaft 139, which is connected to the articulation lever 141, pivoting the articulation lever 141 rotates the control wheel 137 and moves the pull cable 195 within the outer sheath 193 of the Bowden cable 191. This allows the user of the endoscope 101 to manually control the angulation of the articulated shaft section 107.

[0075] Thus, a handpiece 121 with a guide device 151 is provided, in which the The guide clip 171 and the guide plate 152 of the guide device 151 can be detachably and forcefully fixed to the distal wall 132 of the bearing block 127, thus ensuring optimal guidance of the Bowden cable 191 and the pull rope 195 with a lateral extension of the pull element guide in the proximal direction 115 to the steering wheel 137. Reference character list 101 Endoscope 103 shaft 105 flexible shaft section 107 articulated shaft section 109 Camera head 111 distal end 113 proximal end 115 proximal direction 117 adapters 121 Handpiece 123 cases 125 Grip bowl 127 Bearing block 128 upper bearing arm 129 breakthrough opening 130 lower bearing arm 131 Clip protrusion 132 distal wall 133 upper holding projection 135 lower holding projection 137 Steering wheel 139 Drive shaft 141 Articulation levers 143 Safety clip 145 power cables 147 Valve bodies 149 printed circuit board 151 Guide system Guide plate, right guide slot, left guide slot, upper recess, lower recess, stop side, guide clip, vertical wall, locking hook, base, locking lug, proximal guide wing, distal guide wing, proximal groove, distal groove, Bowden cable, outer sheath, pull cable

Claims

Patent claims:

1. Handpiece (121) for a flexible endoscope (101) or a flexible endoscopic instrument with an articulated shaft section (107), wherein the handpiece (121) comprises a housing (123) with a distal end (111) and a proximal end (11139), a retaining frame (127), a control element (137) and an actuating element (141), wherein the retaining frame (127) is internally connected to the housing (123), the handpiece (121) is associated with at least one Bowden cable (191) with a pull element (195) for angling the articulated shaft section (107) of the flexible endoscope (101) or the flexible endoscopic instrument, and the retaining frame (127) is connected to the control element (137) for actuating the pull element (195) of the at least one Bowden cable. (191) is held and the control element (137) can be actuated by means of the actuating element (141),wherein the handpiece (121) has a guide device for guiding the at least one Bowden cable (191) and / or the pull element (195), characterized in that the guide device (151) has a guide element (153) with at least two opposing, Guide recesses (155, 157) for carrying out the a pulling element (195) and a clamping device (171) with at least one clamping element (173, 175), wherein the guide element (153) is detachably arranged at a distal end of the retaining frame (127), the clamping device (171) is detachably arranged distal to the guide element (153) and is forcefully engaged with the at least one clamping element (173, 175) by means of the The retaining frame (127) is connected so that the guide element (153) is held firmly (127) between the clamping device (171) and the distal end of the retaining frame, and the pulling element (195) is guided by the at least two opposing Guide recesses (155, 157) in a proximal direction (115) to the control element (137). Handpiece (121) according to claim 1, characterized in that the handpiece (121) has at least one Bowden cable (191), a second Bowden cable and / or further Bowden cables, each with a pull element. Handpiece (121) according to claim 1 or 2, characterized in that the retaining frame (127) has at least one recess, an undercut and / or at least one projecting element (131) for engaging and / or gripping by means of the at least one clamping element (173, 175). Handpiece (121) according to one of the preceding claims, characterized in that the retaining frame (127) has on both sides a corresponding guide recess (155, 157). The opening (129) in the proximal direction (115) for guiding the pulling element (195) or pulling elements, or having a narrower width than the guide element (153), is a handpiece (121) according to one of the preceding claims, characterized in that the clamping device (171) has at least two opposing, cooperating locking hooks (173), each with a locking lug (175), which at least partially engage a first projecting element (131) on an upper surface of the holding frame (127). The handpiece (121) according to one of the preceding claims, characterized in that the clamping device (171) has two further opposing, cooperating locking hooks (173), each with a locking lug (175), which engage a second projecting element (131) on a The underside of the retaining frame (127) at least partially encompasses the handpiece (121) according to one of the preceding claims, characterized in that the clamping device (171) has at least one lateral guide projection (177, 179) on each side, with a groove (181, 183) extending in the proximal direction (115) for guiding the at least one Bowden cable (191) or Bowden cables to the guide recesses (155, 157) of the guide element (153). Handpiece (121) according to claim 7, characterized in that the clamping device (171) has two lateral guide projections (177, 179) on each side, each with a groove (181, 183) extending in the proximal direction (115), wherein the two guide projections (177, 179) on each side are arranged one after the other in the proximal direction (115) and / or the two grooves (181, 183) are arranged in opposite directions to each other.Handpiece (121) according to claim 8, characterized in that the proximally arranged lateral guide projection (177) has a larger lateral dimension than the distally arranged lateral guide projection (179), such that the at least one Bowden cable (191) or the Bowden cables extend laterally outwards along the proximal direction (115) on both sides through the two successively arranged grooves (181, 183). Handpiece (121) according to any of the preceding claims, characterized in that a proximal end of a respective outer sheath (193) of the at least one Bowden cable (191) or of the respective Bowden cable extends on a distal side (165) of the guide element (153) by the respective guide recess (155, 157) abuts and / or is materially bonded. Handpiece (121) according to one of the preceding claims, characterized in that the at least two opposing guide recesses (155, 157) each have a guide opening, wherein the guide openings are arranged on both sides in opposite side walls of the guide element (153) in a cross-section transverse to the proximal direction (115). Handpiece (121) according to claim 11, characterized in that the at least two opposing guide recesses (155, 157) have, starting from the respective guide opening, a constant recess height, a stepped recess height and / or a tapered recess height along a have a recess width. Handpiece (121) according to one of the preceding claims, characterized in that the guide element is designed as a guide plate (153), wherein a wall thickness of the guide plate (153) is arranged in the proximal direction (115). Handpiece (121) according to claim 13, characterized in that the guide plate (153) has an upper recess (161) and a lower recess (163) in a cross-section transverse to the proximal direction (115), and the retaining frame (127) has an upper retaining projection (133) corresponding to the upper recess (161) and a lower retaining projection (135) corresponding to the lower recess (163). Flexible endoscope (101) or flexible endoscopic Instrument with a shaft (103) and an articulated shaft section 07), wherein the articulated shaft section (107) can be angled by means of at least one Bowden cable (191), and with a handpiece arranged at a proximal end of the shaft (103), characterized in that the handpiece is a handpiece (121) according to one of claims 1 to 14.

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