Actuator for an endoscope, and endoscope with actuator

Abstract

The present disclosure relates to an actuator (2) for applying a tensile force to a cable pull (46), for an endoscope (38), having a fastening portion (4) for fastening to the endoscope (38), and a manually actuatable handwheel (6) which can be coupled to the cable pull (46) and has a handwheel axis of rotation, wherein the handwheel (6) is rotatable about the handwheel axis of rotation relative to the fastening portion (4), wherein the fastening portion (4) has a fastening frame (14) with at least one web (16) for bearing flat on the endoscope (38) and at least one preferably extensible loop (20) for engaging around the endoscope (38). The present disclosure further relates to an endoscope (38) having such an actuator (2).

Description

[0001] Actuating device for an endoscope and endoscope with actuating device

[0002] Description

[0003] Technical area

[0004] The present disclosure relates to an actuating device for an endoscope. The actuating device serves to apply a tensile force to a cable pull. The actuating device serves, in particular, to wind a thread in order to pull the thread in a proximal direction and thereby strip a tissue clip coupled to the thread from the endoscope. Furthermore, the present disclosure relates to an endoscope with such an actuating device.

[0005] Background of the Revelation

[0006] When inserting medical devices into a body orifice, particularly into a patient's hollow organ, endoscopic implantation procedures can be performed in a known manner, which pose little risk to the patient. For example, it is known to attach medical devices to the hollow organ starting from the interior of the hollow organ. In this case, tissue clips / tissue staples are inserted into the hollow organ, preferably with the aid of an endoscope or a similar advancement device, and positioned at predetermined points / positions on the inside of the organ. For this purpose, the respective tissue clip is brought towards the organ tissue, and elastic hinges of the tissue clip are used to snap the clip into place and thus attach it to the organ tissue.This tissue clip then holds or clamps a fold of tissue between its gripping sections ( / (gripping) teeth / spikes), causing the gripping sections to cut ( / pierce) and / or penetrate the tissue.

[0007] The prior art includes approaches for surgical tissue clips that are attached to a patient's organ tissue wall via an endoscopic procedure. For example, EP 2 449 983 B1 describes a clip that is placed on an endoscope head in a spread-open position and inserted into the patient. Once correctly positioned, the endoscope head then pushes the clip forward / distalward, causing the tissue clip to snap shut and clamp the organ tissue between its gripping sections.

[0008] Furthermore, there are approaches in the prior art to implement or simplify the application of the tissue clip, in particular the removal of the tissue clip. For example, EP 3 638 092 B1 shows a tissue clip application set comprising a tissue clip, a cap that can be attached to the distal end of an endoscope, and a removal ring mounted on the cap for axial sliding. The removal ring can be pulled forward by means of a removal device to push the tissue clip forward beyond the cap, so that it is removed from the cap.

[0009] Typically, the pull-off ring is operated via a pull-off device, particularly in the form of a cable pull. The pull-off device comprises a thread, which is preferably guided within an endoscope working channel to the distal, i.e., the patient-side end of the endoscope. There, it is preferably coupled to the pull-off ring in such a way that the pull-off ring (and thus also the tissue clip) can be (axially) displaced distally by pulling / applying a tensile force on the thread until the tissue clip is pushed distally off the cap for application.

[0010] To apply the pulling force, the thread is coupled or can be coupled to an actuating device at a proximal end of the endoscope, i.e., at the end facing the operator. The actuating device comprises, in particular, a manually rotatable handwheel, to which the thread can be firmly connected, for example, clamped, so that the thread is wound upon rotation of the handwheel and thus pulled in a proximal direction, which in turn causes the tissue clip to be displaced in a distal direction. The actuating device is mounted on the endoscope, in particular on the endoscope handle or a rigid part of an endoscope shaft, such that a handwheel axis is transverse, preferably substantially perpendicular, to an endoscope axis.

[0011] Known actuating devices have a preferably hollow pin for attachment to the endoscope, which can be inserted into a working channel connection, as well as a Velcro fastener that can be guided around the endoscope, threaded onto the actuating device, tightened and closed.

[0012] The problem, however, is that the actuating device can rotate freely around a longitudinal axis after the pin is inserted until the hook-and-loop fastener is closed. This can cause the actuating device to twist, which in turn complicates threading and closing the hook-and-loop fastener. This can also lead to the actuating device being inadvertently attached to the endoscope in a rotational position that impairs the guidance of the cable or thread, which in turn can lead to further problems when applying the tissue clip.

[0013] Summary of the present disclosure

[0014] Therefore, the present disclosure is based on the object of avoiding or at least mitigating the disadvantages described above. In particular, an actuating device is to be provided that can be attached to an endoscope particularly easily and securely and with which effective thread guidance can be ensured.

[0015] The object of the present disclosure is achieved by an actuating device having the features of patent claim 1. In addition, the object is achieved by an endoscope having such an actuating device according to the independent patent claim 19. Furthermore, the object is achieved by an actuating device having the features of patent claim 20. Advantageous developments are the subject of the dependent claims and / or are explained below. Accordingly, the present disclosure relates to an actuating device for an endoscope. The actuating device serves to apply a tensile force to a cable pull. The actuating device serves in particular to wind up a thread in order to pull the thread in a proximal direction and thereby, for example, to strip a tissue clip coupled to the thread from the endoscope.

[0016] The actuating device has a fastening section for (stationary) attachment to the endoscope. In particular, the fastening section can be used for attachment to a proximal / operator-side end of the endoscope, such as an endoscope handle.

[0017] The actuating device has a manually operable handwheel. The handwheel has a handwheel rotation axis. The handwheel rotation axis can preferably correspond to a longitudinal axis / central axis of the handwheel. The handwheel is rotatable about the handwheel rotation axis relative to the fastening section. When the actuating device is mounted on the endoscope, the handwheel rotation axis can be aligned transversely to an endoscope axis. Preferably, the handwheel rotation axis can be aligned perpendicular to the endoscope axis. The handwheel can be coupled to the cable, in particular the thread. In particular, the handwheel is rigidly connectable to the cable. The handwheel can preferably have a receiving slot extending radially to the handwheel rotation axis as a through-hole, into which the thread can be clamped. According to the disclosure, a handwheel is to be understood as a rotatable or rotatable part which can be turned or rotated by a user with one hand about an axis.can be rotated, for example a wheel or a (rotatable) lever.

[0018] According to one aspect of the present disclosure, the fastening section comprises a fastening frame with at least one web for surface contact with the endoscope and at least one preferably stretchable loop for gripping the endoscope. The provision of the web ensures a positive and surface contact with the endoscope. Due to the surface contact, the actuating device, in the contact state, can only be displaced within the contact plane and rotated about an axis perpendicular to the contact plane. Thus, the contact web precisely precludes rotation or pivoting about any axis that is transverse or inclined to the handwheel rotation axis. This significantly facilitates attachment of the loop. The loop is preferably designed in the form of an elastic belt. The loop is in particular long enough to be guided around the endoscope (in the circumferential direction).In this context, "surrounding" means that the loop encloses or encompasses the endoscope circumferentially over at least an angle of 120°, for example, at least an angle of 180°, for example, at least an angle of 270°. Preferably, the fastening section, i.e., the fastening frame and the loop, can completely enclose the endoscope circumferentially when mounted on the endoscope. The loop is preferably made of an elastomer, for example, in the form of a rubber band.

[0019] According to a preferred embodiment, a contact surface of the web can extend in a contact plane that is substantially perpendicular to the handwheel rotation axis. This means that the contact surface is aligned parallel to a transverse plane of the handwheel. In other words, the contact surface of the web prevents the actuating device from being displaced along the handwheel rotation axis when mounted on the endoscope. This means that the web is preferably designed to bear against a side surface or a vertically lateral surface of the endoscope. In this way, the actuating device can be suitably applied to the endoscope and then fixed to the endoscope by means of the loop.

[0020] According to a preferred embodiment, the mounting frame can have a support section for resting on the endoscope. This means that the mounting frame is designed to rest on or against a surface or a vertically upper surface of the endoscope. Thus, the actuating device can be suitably placed on the endoscope and then secured to the endoscope by means of the loop.

[0021] According to the preferred embodiment, a support surface of the support section can extend in a support plane. The support surface can be oriented transversely / inclined to the contact surface. Preferably, the support surface can be oriented substantially perpendicular to the contact surface. This means that the support plane is substantially parallel to a longitudinal plane of the handwheel (containing the handwheel rotation axis). This means that the two surfaces designed transversely / inclined to one another for resting on or contacting the endoscope are preferably perpendicular to one another. Alternatively, the contact surface can also be inclined, i.e. not parallel, to the longitudinal plane. For example, the contact surface can not be arranged in the same plane as the contact surface, and can preferably be oriented transversely / inclined to the contact surface.As a result, a position of the actuating device is fixed in a form-fitting manner in several directions when it is in contact with the endoscope.

[0022] According to a preferred embodiment, the handwheel can have a winding area, wherein the cable can be wound onto the winding area, i.e., wherein the cable can be looped around the winding area by rotating the handwheel in the circumferential direction. The winding area can preferably be arranged in the region of the support section, as viewed along the handwheel's rotation axis. This means that the cable is wound, in particular, vertically directly above the endoscope. This ensures suitable cable or thread guidance.

[0023] According to a preferred embodiment, the loop can have a first end that can be or is firmly connected to the mounting frame, and a second end that can be or is firmly connected to the mounting frame. The first end is preferably connected to the mounting frame in the region of the web. When connected at both ends, the loop preferably extends in a substantially U-shaped manner. This allows the endoscope to be suitably clamped between the loop and the mounting frame.

[0024] According to the preferred embodiment, a fastening point of the first end and a fastening point of the second end can be offset from one another in a direction along the handwheel rotation axis. This ensures that the loop does not completely encompass the endoscope on its own, but rather together with the fastening frame.

[0025] According to a preferred embodiment, the loop can be guided in sections so that it rests against the web. This means that the loop preferably rests against the web on a side of the web opposite the contact surface. In other words, the loop extends in its longitudinal direction in the same direction from the handwheel as the web.

[0026] According to a preferred embodiment, the fastening frame can have a preferably hook-shaped, mushroom-shaped, or button-shaped fastening projection, and the loop can have at least one fastening hole. The fastening hole can be smaller than the fastening projection. The loop can be stretchable for attachment to the fastening frame so that the fastening projection can be passed through the fastening hole. This allows an elastically releasable positive connection between the fastening frame and the loop to be realized.

[0027] According to a preferred embodiment, the loop can have a plurality of fastening holes. The fastening holes can be arranged offset along a loop's longitudinal direction. The fastening projection can be guided through the fastening holes, i.e., through each of the fastening holes. This has the advantage that—depending on the selection of a corresponding fastening hole—a different encompassing length of the loop can be realized. In particular, the actuating device can be clamped to the endoscope, or the endoscope can be clamped in the loop.

[0028] According to a preferred embodiment, the mounting frame can have a pin insertable into a working channel connection or working channel inlet of the endoscope, in particular into an adapter tube or a biopsy valve attached thereto. According to the preferred embodiment, the pin can extend transversely, for example, substantially perpendicular to the support surface. A cavity connectable to the working channel connection or a working channel of the endoscope can be formed in the pin, or the pin can be designed as a hollow pin, wherein the cavity is accessible, for example, via a valve or a seal from the handwheel side. This allows the cable to be inserted into the working channel connection or the working channel in order to guide the cable to a distal end of the endoscope. The presence of the pin and the web makes it particularly easy to firmly position the actuating device on the endoscope.The inserted pin allows the actuating device to rotate relative to the endoscope only around a pin's longitudinal axis (and to be pulled off (upward) along the pin's longitudinal axis). In combination with the web adjacent to the endoscope, this rotation is prevented. Thus, the actuating device is positioned in a predetermined position on the endoscope (apart from being pulled out upwards, which ensures assembly and disassembly). In other words, the actuating device can be fixed to the endoscope by the pin and the web, either rigidly or rotationally fixed, or translationally fixed in a horizontal plane.

[0029] According to an alternative embodiment, the mounting frame can have an adapter / connector that can be connected, preferably directly, to a working channel connection or working channel inlet of the endoscope. For example, the adapter / connector of the mounting frame can be designed in the form of a Luer connector and, for example, can be screwed directly onto the working channel inlet. This allows for an alternative, suitable attachment to the working channel connection of the endoscope.

[0030] According to a preferred embodiment, the web can have two preferably hook-shaped, mushroom-shaped, or button-shaped fastening projections, and the loop can have two fastening holes. In particular, the fastening projections and the fastening holes are designed as already described. One of the two fastening projections can each pass through one of the two fastening holes. This means that the first end of the loop is fastened to the fastening frame or the web at two fastening points. This has the advantage that, in contrast to fastening to only one fastening point, twisting about the fastening point axis is not possible because twisting about the two fastening point axes is mutually prevented.

[0031] According to the preferred embodiment, the two fastening holes can be offset in a direction along a loop's longitudinal axis. This allows the loop to be positioned accordingly.

[0032] According to a preferred embodiment, the mounting frame can have two webs, each with a contact surface for contact with the endoscope. This means that, in addition to the already described (first) web with the (first) contact surface, the mounting frame has a further (second) web for surface contact with the endoscope. For this purpose, a (second) contact surface of the (second) web can extend in a contact plane that is (likewise) aligned parallel to a transverse plane of the handwheel. This means that the (second) web is preferably designed to contact a (second) side surface or a (second) lateral surface of the endoscope in the vertical direction. The two webs can be arranged substantially parallel to one another. This means that the webs lie in different transverse planes of the handwheel. In particular, the two contact surfaces of the two webs can be arranged facing one another.This has the advantage that the webs are designed to rest against opposite side surfaces of the endoscope, so that the position of the actuating device is fixed in multiple directions. Thus, the actuating device is positioned in a predetermined position on the endoscope (apart from an upward pinning, which ensures assembly and disassembly). In other words, the actuating device can have the second web, in particular instead of the pin. The presence of the two webs allows the actuating device to be fixed to the endoscope in a fixed or rotationally fixed manner, as well as translationally displaceable only along the endoscope axis. Because the pin can be omitted in this design with two webs, the endoscope working channel connection is freely accessible and thus usable for the insertion of medical instruments or the like.At the same time, the thread can be inserted or threaded directly from the handwheel into the endoscope working channel connection. According to this preferred embodiment, the contact surfaces of the two webs can be offset from each other in a direction along the handwheel's rotation axis.

[0033] In particular, the (first) web can be arranged on one side of the support section in a direction along the handwheel rotation axis, and the (second) web can be arranged on the other side of the support section in a direction along the handwheel rotation axis. This means that the two webs and the support section, for example, viewed in cross-section, essentially form an LI shape. In other words, the two webs and the support section are designed to encompass the endoscope at least by an angle of 120°, for example, at least by an angle of 180°, for example, at least by an angle of 270°.

[0034] In this preferred embodiment, the fastening frame preferably does not have a pin insertable into a working channel connection of the endoscope. In particular, this preferred embodiment allows the endoscope, in particular the endoscope handle, to be suitably encompassed by the two webs in a form-fitting manner. If the fastening frame, in particular the webs, are adapted to the endoscope handle of an endoscope intended for use with the actuating device according to the disclosure, and if additional fastening or fixation is achieved via one or more stretchable loops, relative movement between the actuating device according to the disclosure and the endoscope is preferably no longer possible.Thus, according to this preferred embodiment, the working channel connection of the endoscope remains pin-free and can thus be used in an improved manner for its generic purpose, in particular the introduction of surgical tools or instruments into the working channel.

[0035] According to a preferred embodiment, the fastening section can have at least two preferably stretchable loops. This means that, in addition to the already described (first) loop, the fastening section has at least one further (second) loop for gripping the endoscope. The (second) loop preferably has the features described in connection with the (first) loop. According to the preferred embodiment, the two loops can be offset from one another in a direction perpendicular to the handwheel rotation axis. This has the advantage that pivoting of the actuating device about the handwheel rotation axis is prevented.

[0036] According to a further aspect, which can be present in combination with or optionally independently of the aspect described above relating to the presence of at least one expandable loop for gripping the endoscope, the fastening frame can have the (described) two webs, each with a contact surface for contact with the endoscope, wherein at least one of the two webs is flexible or non-rigid or elastic or bendable. The two webs can preferably be flexible. Preferably, the web or webs can be laterally flexible (relative to the endoscope), i.e., can be bent in particular in a direction away from the other web. The flexibility can be material-related and / or design-related. For example, the flexibility can be achieved by providing recesses or slots in the respective web.In addition, the two webs can be spaced far enough apart that, when attached to the endoscope, they clamp the endoscope between them. This has the advantage that a secure connection to the endoscope is easily possible, especially without an expandable loop, and the flexibility allows for easy installation. This means that at least one expandable loop can be optional, but is not required.

[0037] The present disclosure therefore also relates to an actuating device for applying a tensile force to a cable pull for an endoscope, comprising a fastening section for fastening to the endoscope, and a manually operable handwheel that can be coupled to the cable pull and has a handwheel rotation axis, wherein the handwheel is rotatable about the handwheel rotation axis relative to the fastening section, wherein the fastening section has a fastening frame with two webs, each with a contact surface for contact with the endoscope, wherein at least one of the two webs is designed to be flexible, preferably the two webs are designed to be flexible. In other words, in another embodiment, the fastening section can also be designed without an expandable loop. Advantageously, the other aspects described above with regard to a fastening frame with two webs are also applicable to this further aspect.

[0038] The present disclosure also relates to an endoscope with a described actuating device. When the actuating device is mounted on the endoscope, the web of the mounting frame rests flat against the endoscope, in particular a proximal / operator-side endoscope handle of the endoscope. Furthermore, the loop encompasses the endoscope, in particular the endoscope handle.

[0039] Short description of the characters

[0040] The disclosure is explained in more detail below using advantageous embodiments and with reference to the accompanying figures. They show:

[0041] Fig. 1 is a perspective view of an actuating device according to a first embodiment of the present disclosure,

[0042] Figs. 2 and 3 are perspective views of the actuating device according to a second embodiment of the present disclosure,

[0043] Fig. 4 is a perspective view of the actuating device according to a third embodiment of the present disclosure,

[0044] Fig. 5 is a schematic representation of an endoscope according to the present disclosure, and

[0045] Fig. 6 is an illustration of a tissue clip application set and a puller.

[0046] Detailed Description of Preferred Embodiments Fig. 1 shows an actuating device 2 according to a first embodiment for an endoscope 38 (see Fig. 5). The actuating device 2 serves to apply a tensile force to a pull-off device in the form of a cable or thread 46.

[0047] The application of the tensile force serves to apply a tissue clip 50 of a tissue clip application set 48 (see Fig. 6). In particular, the actuating device 2 serves to wind the thread 46 in order to pull the thread 46 in a proximal direction and, for example, thereby strip the tissue clip 50 from the endoscope 38. The thread 46 is preferably coupled to the tissue clip 50 via a pull-off ring 52 of the tissue clip application set 48.

[0048] The actuating device 2 has a fastening section 4 for fastening to the endoscope 38. In particular, the fastening section 4 can serve for stationary, i.e., fixed or immovable, attachment to a proximal / operator-side end of the endoscope 38, such as an endoscope handle 40.

[0049] The actuating device 2 has a handwheel 6. The handwheel 6 is, in particular, manually operable. The handwheel 6 has a handwheel rotation axis H. The handwheel 6 is rotatable about the handwheel rotation axis H relative to the fastening section 4. The handwheel rotation axis H can preferably correspond to a longitudinal axis / center axis of the handwheel 6. When the actuating device 2 is mounted on the endoscope 38, the handwheel rotation axis H can be oriented transversely to an endoscope axis (cf. Fig. 5). Preferably, the handwheel rotation axis H can be oriented perpendicular to the endoscope axis.

[0050] The handwheel 6 can be coupled to the cable or thread 46. In particular, the handwheel 6 can be fixedly connected to the cable or thread 46. The handwheel 6 can have an actuating section 8 and a winding section 10 or winding region. The actuating section 8 and the winding section 10 are preferably offset along the handwheel rotation axis H and are connected to one another in a rotationally fixed manner. The winding section 10 has an outer circumferential surface that is preferably circular in cross-section. The cable can be wound onto the outer circumferential surface of the winding section 10. In particular, the cable can be looped around the winding section 10 by rotating the actuating section 8 around the handwheel rotation axis H in the circumferential direction. Preferably, the handwheel 6 can have a receiving slot 12 for coupling to the cable or the thread 46, into which the cable or the thread 46 or a proximal end of the thread 46 can be clamped.The receiving slot 12 can extend radially to the handwheel rotation axis H as a through hole. The receiving slot 12 can be arranged in the region of the winding section 10.

[0051] According to one aspect of the present disclosure, the fastening section 4 has a fastening frame 14. The fastening frame 14 can, in particular, be designed to be substantially rigid or stiff. The fastening frame 14 has at least one web 16 for flat contact with the endoscope 38. In particular, the web 16 is designed to bear against a side surface or a lateral surface in the vertical direction of the endoscope 38. For this purpose, the web 16 preferably has a contact surface 18. The contact surface 18 extends in a contact plane that is preferably substantially perpendicular to the handwheel rotation axis H. This means that the contact surface 18 preferably lies in a transverse plane of the handwheel 6 or is aligned parallel to a transverse plane of the handwheel 6. Alternatively, the contact surface 18 can extend in a plane that is slightly inclined, i.e., by up to 20°, to a transverse plane of the handwheel 6.

[0052] According to one aspect of the present disclosure, the fastening section 14 has at least one loop 20 for gripping around the endoscope 38. The loop 20 is, in particular, designed to be stretchable. The loop 20 is preferably in the form of an elastic belt. The loop 20 is, in particular, long enough to be guided around the endoscope 38 or the endoscope handle 40 in the circumferential direction. In this case, the term "guided around" means that the loop 20 (alone) encloses or grips the endoscope 38 or the endoscope handle 40 at least over an angle of 120°, for example at least over an angle of 180°, for example at least over an angle of 270°. The fastening section 4, i.e. the fastening frame 14 and the loop 20 together, enclose or grip the endoscope 38 or the endoscope handle 40 circumferentially, preferably completely.

[0053] In addition, the fastening frame 14 can preferably have a support section 22 for resting on the endoscope 38. This means that the fastening frame 14 is designed to rest on or against a surface or a vertically upper surface of the endoscope 38. For this purpose, the support section 22 preferably has a support surface 24. The support surface 24 extends in a support plane which is preferably substantially parallel to a longitudinal plane of the handwheel 6 (containing the handwheel rotation axis H). Alternatively, the support surface can also be inclined, i.e. not parallel, to the longitudinal plane of the handwheel 6. The support surface 24 can preferably be aligned transversely / inclined to the support surface 18 and preferably aligned perpendicular to the support surface 18.

[0054] Preferably, the winding area 10 can be arranged in the region of the support section 22, as viewed along the handwheel rotation axis H. This means that the cable pull is wound, in particular in the vertical direction, directly above the endoscope 38 or the endoscope handle 40.

[0055] The loop 20 can have a first end that is permanently connectable or connected to the fastening frame 14, particularly in the region of the web 16, and a second end that is permanently connectable or connected to the fastening frame 14. Preferably, the loop 20 extends substantially in a U-shape when connected at both ends.

[0056] Preferably, a fastening point of the first end and a fastening point of the second end can be offset from one another in a direction along the handwheel rotation axis H. In particular, the fastening point of the first end can be arranged on one side of the support section 22 in a direction along the handwheel rotation axis H. In particular, the fastening point of the second end can be arranged on the other side of the support section 22 in a direction along the handwheel rotation axis H. In particular, the loop 20 can be guided in sections so that it bears against the web 16. This means that the loop 20 preferably bears against the web 16 on a side of the web 16 opposite the contact surface 18. In other words, the loop 20 extends in its longitudinal direction in the same direction from the handwheel 6 as the web 16.

[0057] The loop 20 is attached to the fastening frame 14. In the illustrated embodiment, the fastening frame 14 has a fastening projection 26 for this purpose. The fastening projection 26 is preferably button-shaped, mushroom-shaped, or hook-shaped. In the illustrated embodiment, the loop 20 has at least one fastening hole 28. The fastening hole 28 can be smaller than the fastening projection 26. The loop 20 can be stretchable for attachment to the fastening frame 14 such that the fastening projection 26 can be passed through the fastening hole 28 or the loop 20 with its fastening hole 28 can be slipped over the fastening projection 26. In the attached state, the fastening projection 26 engages behind a material of the loop 20 that surrounds the fastening hole 28. Due to the elastic design of the loop 20, this positive fastening between the fastening frame 14 and the loop 20 can be released.

[0058] Preferably, the loop 20 can have a plurality of fastening holes 28. The fastening holes 28 can be arranged offset along a loop's longitudinal direction. The fastening projection 26 can be guided through the fastening holes 28, ie, through each of the fastening holes 28.

[0059] According to the first embodiment shown in Fig. 1, the mounting frame 14 can have a pin 30 insertable into a working channel connection 44 of the endoscope 38. The pin 30 can extend transversely, for example, substantially perpendicular to the support section 22 or the support surface 24. A cavity connectable to the working channel connection 44 or a working channel of the endoscope 38 can be formed in the pin 30, which is accessible, for example, via a valve 32 or a seal from the side of the handwheel 6. This allows the cable pull to be inserted into the working channel connection 44.

[0060] Preferably, the web 16 can have two preferably hook-shaped, mushroom-shaped, or button-shaped fastening projections 26, and the loop 20 can have two fastening holes 28. In particular, the fastening projections 26 and the fastening holes 28 are designed as already described. Each of the two fastening projections 26 can be passed through each of the two fastening holes 28. This means that the first end of the loop 20 is fastened at two fastening points to the fastening frame 14 or the web 16. In particular, the two fastening holes 28 can be arranged offset in a direction along a loop longitudinal axis.

[0061] Figs. 2 and 3 show the actuating device 2 according to a second embodiment. The actuating device 2 has the fastening section 4 for attachment to the endoscope 38. Furthermore, the actuating device 2 has the manually operable handwheel 6 that can be coupled to the cable pull. The design of the handwheel 6 according to the second embodiment corresponds to the design of the handwheel 6 according to the first embodiment.

[0062] The fastening section 4 according to the second embodiment has the fastening frame 14 with the described web 16 forming the contact surface 18 for flat contact with the endoscope 38. Furthermore, the fastening section 4 according to the second embodiment has the described loop 20 for gripping the endoscope 38.

[0063] The mounting frame 14 according to the second embodiment can have the described support section 22 for resting on the endoscope 38.

[0064] Preferably, the loop 20 can be fastened or secured at its first end via the described fastening hole 28 or the two described fastening holes 28 to the described fastening projection 26 or the two described fastening projections 26. In particular, the loop 20 can be attached or secured at its second end selectively via one of the plurality of fastening holes 28 to the fastening projection 26.

[0065] According to the second embodiment shown in Figs. 2 and 3, the mounting frame 14 can have two webs 16, 34, each with a contact surface 18, 36 for contact with the endoscope 38. This means that, in addition to the already described (first) web 16 with the (first) contact surface 18, the mounting frame has a further (second) web 34 for surface contact with the endoscope. For this purpose, a (second) contact surface 36 of the (second) web 34 can extend in a contact plane that is (likewise) aligned parallel to a transverse plane of the handwheel 6. This means that the (second) web 34 is preferably designed to contact a (second) side surface or a (second) lateral surface of the endoscope in the vertical direction. In particular, the webs 16, 34 are designed to contact opposite side surfaces of the endoscope 38. The two webs 16, 34 can be arranged substantially parallel to each other.This means that the webs 16, 34 lie in different transverse planes of the handwheel 6. In particular, the two contact surfaces 18, 36 of the two webs 16, 34 can be arranged facing each other.

[0066] Preferably, the contact surfaces 18, 36 of the two webs 16, 34 can be offset from one another in a direction along the handwheel rotation axis H. In particular, the (first) web 16 can be arranged on one side of the support section 22 in a direction along the handwheel rotation axis H, and the (second) web 34 can be arranged on the other side of the support section 22 in a direction along the handwheel rotation axis H. This means that the two webs 16, 34 and the support section 22, for example viewed in cross-section, essentially form a U-shape. In other words, the two webs 16, 34 and the support section 22 are preferably designed to encompass the endoscope at least by an angle of 120°, for example at least by an angle of 180°, for example at least by an angle of 270°. The fastening section 4 can preferably have two preferably stretchable loops 20.This means that, in addition to the already described (first) loop 20, the fastening section has a further (second) loop 20 for gripping the endoscope 38. The (second) loop 20 preferably has the features described in connection with the (first) loop 20. In particular, the two loops 20 can be offset from one another in a direction perpendicular to the handwheel rotation axis.

[0067] Fig. 4 shows a third embodiment of the actuating device 2 according to the present disclosure.

[0068] The actuating device 2 has the fastening section 4 for attachment to the endoscope 38. Furthermore, the actuating device 2 has the manually operable handwheel 6 that can be coupled to the cable pull. The design of the handwheel 6 according to the third embodiment corresponds to the design of the handwheel 6 according to the first and second embodiments.

[0069] The fastening section 4 according to the third embodiment has the fastening frame 14 with the described web 16 forming the contact surface 18 for flat contact with the endoscope 38.

[0070] The mounting frame 14 according to the third embodiment can have the described support section 22 for resting on the endoscope 38.

[0071] According to the third embodiment shown in Fig. 6, the mounting frame 14 has two webs 16, 34, each with a contact surface 18, 36 for engagement with the endoscope 38. This means that the mounting frame (analogous to the second embodiment) has, in addition to the already described (first) web 16 with the (first) contact surface 18, a further (second) web 34 for surface engagement with the endoscope.

[0072] Preferably, a (second) contact surface 36 of the (second) web 34 can be in a

[0073] extend into a contact plane which is (likewise) aligned parallel to a transverse plane of the handwheel 6. This means that the (second) web 34 is preferably designed to bear against a (second) side surface or a (second) lateral surface of the endoscope in the vertical direction. In particular, the webs 16, 34 are designed to bear against opposite side surfaces of the endoscope 38. The two webs 16, 34 can be arranged substantially offset parallel to one another. This means that the webs 16, 34 lie in different transverse planes of the handwheel 6. In particular, the two contact surfaces 18, 36 of the two webs 16, 34 can be arranged facing one another.

[0074] Preferably, the contact surfaces 18, 36 of the two webs 16, 34 can be offset from one another in a direction along the handwheel rotation axis H. In particular, the (first) web 16 can be arranged on one side of the support section 22 in a direction along the handwheel rotation axis H, and the (second) web 34 can be arranged on the other side of the support section 22 in a direction along the handwheel rotation axis H. This means that the two webs 16, 34 and the support section 22, for example viewed in cross-section, essentially form a U-shape. In other words, the two webs 16, 34 and the support section 22 are preferably designed to encompass the endoscope at least by an angle of 120°, for example at least by an angle of 180°, for example at least by an angle of 270°.

[0075] In the actuating device 2 according to the third embodiment, at least one of the two webs 16, 34 is flexible or non-rigid or elastic or bendable. The two webs 16, 34 can preferably be flexible. Preferably, the web 16, 34 or the webs 16, 34 can be laterally flexible (relative to the endoscope 38), i.e., can be bent in particular in a direction away from the other web 16, 34. The flexibility can be material-related and / or design-related. For example, the flexibility can be achieved by providing recesses or slots in the respective web 16, 34. In addition, the two webs 16, 34 can be arranged so far apart that, when plugged onto the endoscope 38, they clamp the endoscope 38 between them. In particular, the actuating device 2 according to the third embodiment has the at least one stretchable loop 20 only optionally. Fig.5 shows the endoscope 38 according to the present disclosure. The endoscope 38 includes the proximal / operator-side endoscope handle 40. In addition, the endoscope 38 may include a rigid or flexible endoscope shaft 42. The endoscope shaft 42 extends distally from the endoscope handle 40 and is connected to the endoscope handle 40. The endoscope 38 may include the working channel connector 44, which is connected to a working channel of the endoscope 38 extending within the endoscope shaft 42 to a distal tip of the endoscope 38. Furthermore, the endoscope 38 may include an optical device, which is preferably arranged in a distal end portion 45 of the endoscope 38.

[0076] When the actuating device 2 is mounted on the endoscope 38, the web 16 of the mounting frame 14 rests flat against the endoscope 38, in particular against the endoscope handle 40. Furthermore, the loop 20 surrounds the endoscope 38, in particular in the area of ​​the endoscope handle 40.

[0077] For fastening the actuating device 2 according to the first embodiment to the endoscope 38,

[0078] - the contact surface 18 of the web 16 rests against a side surface of the endoscope 38 or the endoscope handle 40, and / or

[0079] - the support surface 24 of the support section 22 rests on an upper surface of the endoscope 38 or the endoscope handle 40 or on an end face of the working channel connection 44, and / or

[0080] - the pin 30 is inserted or inserted into the working channel connection 44, and / or

[0081] - the loop 20 is looped or stretched around the endoscope 38 or the endoscope handle 40.

[0082] For fastening the actuating device 2 according to the second embodiment to the endoscope 38,

[0083] - the contact surface 18 of the web 16 rests on a first side surface of the endoscope 38 or the endoscope handle 40, and / or - the support surface 24 of the support section 22 rests on an upper surface of the endoscope 38 or the endoscope handle 40, and / or

[0084] - the contact surface 36 of the web 34 rests against a second side surface of the endoscope 38 or the endoscope handle 40, wherein the second side surface is preferably opposite the first side surface (in the direction of an endoscope transverse axis), and / or

[0085] - the two loops 20 are looped or stretched around the endoscope 38 or the endoscope handle 40.

[0086] For fastening the actuating device 2 according to the third embodiment to the endoscope 38,

[0087] - the contact surface 18 of the web 16 rests against a first side surface of the endoscope 38 or the endoscope handle 40, and / or

[0088] - the support surface 24 of the support section 22 rests on an upper surface of the endoscope 38 or the endoscope handle 40, and / or

[0089] - the contact surface 36 of the web 34 rests against a second side surface of the endoscope 38 or the endoscope handle 40, wherein the second side surface is preferably opposite the first side surface (in the direction of an endoscope transverse axis),

[0090] - wherein the web 16 and / or the web 34 are / is designed to be flexible and clamp the endoscope 38 or the endoscope handle 40 between them.

[0091] As described above, the thread 46 or the proximal end of the thread 46 is preferably firmly connected to the handwheel 6 or the receiving slot 12. From the handwheel 6, the thread 46 can preferably be inserted into the working channel connection 44. In the actuating device 2 according to the first embodiment, the thread 46 can be inserted into the working channel connection 44 via the pin 30. In the actuating device 2 according to the second embodiment, the thread 46 can be inserted directly into the working channel connection 44. From there, the thread 46 extends, preferably within the endoscope working channel, to the distal, i.e., the patient-side end or distal tip of the endoscope 38. As described above, the actuating device 2 according to the present disclosure serves to apply the tensile force to the puller in the form of the cable or thread 46, in order to thereby apply the tissue clip 50 of the tissue clip application set 48.

[0092] Fig. 6 shows the tissue clip application set 48 and the removal device in the form of the cable or thread 46. The tissue clip application set 48 has the tissue clip 50 and the removal ring 52. The removal ring 52 is (externally) attached to a cap 54, which can be attached to the distal end of the endoscope 38, or directly to the distal end section 45 of the endoscope 38.

[0093] The tissue clip 50 has circumferentially alternating and interconnected gripping sections 56, each having a plurality of (gripping) teeth, and hinge sections 58. The hinge sections 58 are designed such that the gripping sections 56 can be spread apart, allowing the tissue clip 50 to be placed externally onto the cap 54 or the distal end section 45. The tissue clip 50 is positioned distally of the pull-off ring 52, so that when the pull-off ring 52 is advanced axially, the tissue clip 50 is pushed forward and thereby removed from the endoscope 38.

[0094] The pull-off ring 52 is mounted for axial sliding on the cap 54 or the distal end section 45. The pull-off ring 52 is actuated via the cable pull or thread 46. The thread 46 is guided to the distal tip of the endoscope 38 and is preferably coupled there to the pull-off ring 52 such that the pull-off ring 52 (and thus also the tissue clip 50) is displaced (axially) in the distal direction by pulling on the thread 46 until the tissue clip 50 is pushed down distally from the endoscope 38 for its application.

[0095] In particular, the thread 46 may not be permanently attached to the pull-off ring 52, but may be movable relative to the pull-off ring 52, in particular longitudinally displaceable. At the tip of the endoscope 38, the thread 46 may be guided outward distal to the pull-off ring 52, coupled there to the pull-off ring 52, in particular guided (twice) through the pull-off ring 8, guided inward again distal to the pull-off ring 52, and there firmly connected, for example, to the cap 54 or to the endoscope 38.

[0096] List of reference symbols

[0097] 2 Actuating device

[0098] 4 Fastening section

[0099] 6 Handwheel

[0100] 8 Operating section

[0101] 10 winding section

[0102] 12 Recording slot

[0103] 14 Mounting frame

[0104] 16 jetty

[0105] 18 contact surface

[0106] 20 loops

[0107] 22 support section

[0108] 24 support surface

[0109] 26 Mounting projection

[0110] 28 mounting hole

[0111] 30 cones

[0112] 32 valve

[0113] 34 second bridge

[0114] 36 second contact surface

[0115] 38 Endoscope

[0116] 40 Endoscope handle

[0117] 42 Endoscope shaft

[0118] 44 Working channel connection

[0119] 45 distal end section

[0120] 46 threads

[0121] 48 Tissue clip application set

[0122] 50 tissue clips

[0123] 52 Puller ring

[0124] 54 Cap 56 Gripping section

[0125] 58 Hinge section

Claims

Claims 1. Actuating device (2) for applying a tensile force to a cable pull (46), for an endoscope (38), with a fastening section (4) for fastening to the endoscope (38), and a manually operable handwheel (6) which can be coupled to the cable pull (46) and has a handwheel rotation axis, wherein the handwheel (6) is rotatable about the handwheel rotation axis relative to the fastening section (4), characterized in that the fastening section (4) has a fastening frame (14) with at least one web (16) for flat contact with the endoscope (38) and at least one preferably stretchable loop (20) for gripping around the endoscope (38).

2. Actuating device (2) according to claim 1, characterized in that a contact surface (18) of the web (16) extends in a contact plane which is substantially parallel to a transverse plane of the handwheel (6).

3. Actuating device (2) according to claim 1 or 2, characterized in that the fastening frame (14) has a support section (22) for resting on the endoscope.

4. Actuating device (2) according to claim 3, characterized in that a support surface (24) of the support section (22) extends in a support plane which is substantially parallel to a longitudinal plane of the handwheel (6).

5. Actuating device (2) according to one of claims 1 to 4, characterized in that the loop (20) has a first end which is firmly connected to the fastening frame (14) and a second end which is or can be firmly connected to the fastening frame (14).

6. Actuating device (2) according to claim 5, characterized in that a fastening point of the first end and a fastening point of the second end are offset from one another in a direction along the handwheel rotation axis.

7. Actuating device (2) according to one of claims 1 to 6, characterized in that the loop (20) is guided in sections adjacent to the web (16).

8. Actuating device (2) according to one of claims 1 to 7, characterized in that the fastening frame (14) has a preferably hook-shaped or mushroom-shaped or button-shaped fastening projection (26) and the loop (20) has at least one fastening hole (28), wherein the fastening hole (28) is smaller than the fastening projection (26) and the loop (20) is stretchable for fastening to the fastening frame (14) such that the fastening projection (26) can be passed through the fastening hole (28).

9. Actuating device (2) according to claim 8, characterized in that the loop (20) has a plurality of fastening holes (28) which are arranged offset along a loop longitudinal direction and through which the fastening projection (26) can be passed.

10. Actuating device (2) according to one of claims 1 to 9, characterized in that the fastening frame (14) has a pin (30) insertable into a working channel connection (44) of the endoscope (38).

11. Actuating device (2) according to claim 3 and 10, characterized in that the pin (30) extends perpendicular to the support section (22).

12. Actuating device (2) according to one of claims 1 to 11, characterized in that the web (16) has two preferably hook-shaped or mushroom-shaped or button-shaped fastening projections (26) and the loop (20) has two fastening holes (28) through which one of the two fastening projections (26) is passed.

13. Actuating device (2) according to claim 12, characterized in that the two fastening holes (26) are arranged offset in a direction along a loop longitudinal axis.

14. Actuating device (2) according to one of claims 1 to 9, characterized in that the fastening frame (14) has two webs (16, 34), each with a contact surface (18, 36) for contact with the endoscope (38).

15. Actuating device (2) according to claim 14, characterized in that the contact surfaces (18, 36) of the two webs (16, 34) are offset from one another in a direction along the handwheel rotation axis.

16. Actuating device (2) according to one of claims 1 to 9, 14 or 15, characterized in that the fastening section (4) has two preferably stretchable loops (20).

17. Actuating device (2) according to claim 16, characterized in that the two loops (20) are offset from one another in a direction perpendicular to the handwheel rotation axis.

18. Actuating device (2) according to one of claims 1 to 9 or 14 to 17, characterized in that the fastening frame (14) does not have a pin (30) insertable into a working channel connection (44) of the endoscope (38) 19. Endoscope (38) with an actuating device (2) according to one of claims 1 to 18, wherein in a state of the actuating device (2) mounted on the endoscope (38), the web (16) of the fastening frame (14) lies flat against the endoscope (38) and wherein the loop (20) engages around the endoscope (38).

20. Actuating device (2) for applying a tensile force to a cable (46), for an endoscope (38), with a fastening section (4) for fastening to the endoscope (38), and a manually operable handwheel (6) which can be coupled to the cable pull (46) and has a handwheel rotation axis, wherein the handwheel (6) is rotatable about the handwheel rotation axis relative to the fastening section (4), characterized in that the fastening section (4) has a fastening frame (14) with two webs (16, 34), each with a contact surface (18, 36) for contact with the endoscope (38), wherein at least one of the two webs (16, 34) is designed to be flexible, preferably the two webs (16, 34) are designed to be flexible.

Images