Medical Devices and Related Methods

Abstract

The medical device includes a handle including an axis, a device shaft extending from the handle to a distal end, and a control device. The control device is coupled to the handle, the control device including a knob. The knob is rotatable relative to the handle. The control device also includes a control shaft extending from the knob, at least one spring clutch including two legs, and a spool. The spool is rotatable relative to the axis. The control device also includes one or more wires coupled to the spool. Rotation of the knob is configured to rotate the control shaft, loosening the at least one spring clutch, rotating the spool, and moving the one or more wires.

Description

[Technical field]

[0001] Various aspects of the present disclosure relate generally to medical devices and methods for accessing, viewing, manipulating, or otherwise treating tissue or other matter within the body. In particular, aspects of the present disclosure relate to medical devices and methods for controlling the locking and unlocking of deflection or other movement of a portion of a delivery shaft of a medical device. [Background technology]

[0002] In certain medical procedures, a physician, technician, or other user is required to control a duodenoscope (or other endoscope or medical device) and other medical accessory devices. Depending on the patient's position relative to the user's position, the user controlling the device may need to twist and / or turn the user's wrist and / or body so that the medical device is adjusted and positioned to face the intended target site. As a result, the user may be at increased risk of suffering ergonomic injuries to their hands, wrists, and back. Additionally, the distal end of the medical device may be deflectable in one or more directions. The deflection may be locked, for example, via a proximal locking element, while smaller or more controlled movements may require the locking element to be disengaged and then re-engaged. Alternatively, the user may attempt to deflect or otherwise manipulate the medical device with the locking element engaged. These movements may further increase the user's risk of suffering ergonomic injuries. These concerns may increase the duration, cost, and risk of the medical procedure. The devices and methods of the present disclosure may remedy some of the deficiencies noted above or address other aspects of the art. Summary of the Invention

[0003] Examples of the present disclosure relate, inter alia, to devices and methods for controlling the locking and unlocking of deflection or other movement of a portion of a shaft. Each of the examples disclosed herein may include one or more of the features described in association with any of the other disclosed examples.

[0004] In one embodiment, the medical device may include a handle including an axis, a device shaft extending from the handle to a distal end, and a control device. The control device may be coupled to the handle, and the control device may include a knob. The knob may be rotatable relative to the handle. The control device may also include a control shaft extending from the knob, at least one spring clutch including two legs, and a spool. The spool may be rotatable relative to the axis. The control device may also include one or more wires coupled to the spool. Rotation of the knob may be configured to rotate the control shaft, release the at least one spring clutch, rotate the spool, and move the one or more wires.

[0005] The medical device may include one or more of the following features: The shaft may include a radial extension, the shaft may include a first protrusion and a second protrusion extending from the radial extension. The spool may define a first gap and a second gap, the first protrusion and the second protrusion may be configured to be disposed within the first gap and the second gap. The at least one spring clutch may include a first spring clutch and a second spring clutch, the first spring clutch and the second spring clutch may include a first leg and a second leg, respectively. Rotation of the knob in a first direction may cause the first protrusion to contact a first leg of the first spring clutch to loosen the first spring clutch, and rotation of the knob in a first direction may cause the second protrusion to contact a first leg of the second spring clutch to loosen the second spring clutch. Further rotation of the knob in the first direction may (1) cause a first leg of the first spring clutch to contact a first stop surface of the spool adjacent the first gap, (2) cause a first leg of the second spring clutch to contact a second stop surface of the spool adjacent the second gap, and (3) rotate the spool in the first direction. Rotation of the knob in the second direction may cause the first protrusion to contact a second leg of the second spring clutch to release the second spring clutch, and rotation of the knob in the second direction may cause the second protrusion to contact a second leg of the first spring clutch to release the first spring clutch. Further rotation of the knob in the second direction may (1) cause the second leg of the second spring clutch to contact a third stop surface of the spool adjacent the second gap, (2) cause the second leg of the first spring clutch to contact a fourth stop surface of the spool adjacent the second gap, and (3) rotate the spool in the second direction.

[0006] The at least one spring clutch may include at least one spring formed of a coil with two radially outwardly extending legs. The at least one spring clutch may include at least one spring with a ring-like shape including a partially cylindrical portion and an interaction portion. The interaction portion may include a first end and a second end. The first end may include a first radially outwardly extending leg and the second end may include two radially outwardly extending legs. The spring clutch may include at least one spring with a partially ring-like shape including a partially cylindrical portion and an open portion. The partially cylindrical portion may include two radially outwardly extending legs on either side of the open portion. The spring clutch may include at least one spring formed of a coil with two radially inwardly extending legs.

[0007] The control device may be a first control device. The medical device may further include a second control device that is coaxial with the first control device. The second control device may include a second knob, which may be rotatable relative to the handle. The second control device may also include a second control shaft extending from the second knob, at least one second spring clutch including two legs, and a second spool. The second spool may be rotatable relative to the axis. The second control device may further include one or more second wires coupled to the second spool. Rotation of the second knob may be configured to rotate the second control shaft, release the at least one second spring clutch, rotate the second spool, and move the one or more second wires. A portion of the control shaft of the first control device may be nested within the second control shaft of the second control device. The medical device may further include a hollow shaft separating a portion of the control shaft from the second control shaft. The hollow shaft may be coupled to the handle, and the hollow shaft may include a radial extension separating the spool of the first control device from the second spool of the second control device. The distal end of the delivery shaft may be deflectable via the control device. The handle may include at least one port configured to receive a medical device. The port may be connected to a lumen extending through the handle and the delivery shaft. The control device may be configured to control an elevator disposed adjacent to the lumen at the distal end of the delivery shaft. The control device may be disposed on a proximal portion of the handle, and the medical device may not include a brake external to the body of the handle to lock the position of the knob.

[0008] In another aspect, the medical device may include a handle including an axis. The medical device may also include a device shaft extending from the handle to a distal end and a control device. The control device may be coupled to the handle and may include a first knob. The first knob may be rotatable relative to the handle. The control device may also include a first control shaft extending from the first knob, at least one first spring clutch including two legs, a first spool that may be rotatable relative to the axis, and one or more first wires coupled to the first spool. The control device may also include a second knob. The second knob may be rotatable relative to the handle. The control device may include a second control shaft extending from the second knob, at least one second spring clutch including two legs, a second spool that may be rotatable relative to the axis, and one or more second wires coupled to the second spool. Rotation of the first knob may be configured to rotate the first control shaft, loosen the at least one first spring clutch, rotate the first spool, move the one or more first wires, and deflect the distal end of the delivery shaft in a first plane, and rotation of the second knob may be configured to rotate the second control shaft, loosen the at least one second spring clutch, rotate the second spool, move the one or more second wires, and deflect the distal end of the delivery shaft in a second plane different from the first plane.

[0009] The medical device may include one or more of the following features: The first shaft may include at least one first protrusion and the second shaft may include at least one second protrusion. The first spool may define at least one first gap and the second spool may define at least one second gap. The at least one first protrusion may be disposed within the at least one first gap and the at least one second protrusion may be disposed within the at least one second gap. A plurality of legs of the at least one first spring clutch may be disposed between the at least one first protrusion and a plurality of edges of the at least one first gap. A plurality of legs of the at least one second spring clutch may be disposed between the at least one second protrusion and a plurality of edges of the at least one second gap. The first plane and the second plane may be perpendicular.

[0010] In yet another aspect, the medical device handle can include a shaft and a control device. The shaft can be fixed to the handle. The control device can include a first knob that can be rotatable relative to the handle, a first control shaft extending from the first knob, at least one first spring clutch including two legs, a first spool that can be rotatable relative to the shaft, and one or more first wires coupled to the first spool. The control device can also include a second knob that can be rotatable relative to the handle, a second control shaft extending from the second knob, at least one second spring clutch including two legs, a second spool that can be rotatable relative to the shaft, and one or more second wires coupled to the second spool. Rotation of the first knob can be configured to rotate the first control shaft, release the at least one first spring clutch, rotate the first spool, and move the one or more first wires. Rotation of the second knob may be configured to rotate the second control shaft, release the at least one second spring clutch, rotate the second spool, and move the one or more second wires.

[0011] The medical device handle may include one or more of the following features: A portion of the first control shaft may be nested within the second control shaft. The medical device handle may further include a hollow shaft separating a portion of the first control shaft from the second control shaft. The hollow shaft may be coupled to the handle and may include a radial extension separating the first spool from the second spool.

[0012] It is to be understood that both the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of the present disclosure, as claimed. [Brief description of the drawings]

[0013] The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate exemplary aspects of the present disclosure and, together with the description, serve to explain the principles of the disclosure. [Figure 1A] 1A-1D show different views of an exemplary medical device according to aspects of the present disclosure. [Figure 1B] 1A-1D show different views of an exemplary medical device according to aspects of the present disclosure. [Figure 1C] 1A-1D show different views of an exemplary medical device according to aspects of the present disclosure. [Figure 2A] 1A-1C depict different views of a control device of the medical device according to an embodiment of the present disclosure. [Figure 2B] 1A-1C depict different views of a control device of the medical device according to an embodiment of the present disclosure. [Figure 2C] 1A-1C depict different views of a control device of the medical device according to an embodiment of the present disclosure. [Diagram 3] 1 illustrates an exploded view of a control device according to an aspect of the present disclosure. [Figure 4A] 1A-1C, 2A-2C, and 3 show different exemplary spring clutches that may be incorporated into the control devices of FIG. [Figure 4B]1A-1C, 2A-2C, and 3 show different exemplary spring clutches that may be incorporated into the control devices of FIG. [Figure 4C] 1A-1C, 2A-2C, and 3 show different exemplary spring clutches that may be incorporated into the control devices of FIG. [Figure 4D] 1A-1C, 2A-2C, and 3 show different exemplary spring clutches that may be incorporated into the control devices of FIG. [Figure 5A] 1A-1D show different views of another exemplary medical device according to aspects of the present disclosure. [Figure 5B] 1A-1D show different views of another exemplary medical device according to aspects of the present disclosure. [Figure 5C] 1A-1D show different views of another exemplary medical device according to aspects of the present disclosure. [Figure 6A] 13A-13C show different views of another control device according to an aspect of the present disclosure. [Figure 6B] 13A-13C show different views of another control device according to an aspect of the present disclosure. [Figure 7] 1 illustrates an exploded view of another control device according to an aspect of the present disclosure. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0014] The terms "proximal" and "distal" are used herein to indicate relative locations of components of the exemplary medical system and exemplary medical device. As used herein, "proximal" indicates a location relatively closer to the outside of the body or closer to the medical professional using the medical system or medical device. In contrast, "distal" indicates a location relatively farther away from the medical professional using the medical system or medical device or closer to the inside of the body. As used herein, the terms "comprises," "comprising," "having," "including," or other variations thereof are intended to cover a non-exclusive inclusion, such that a system, device, or method comprising a list of elements does not include only those elements, but may include other elements not expressly listed or inherent thereto. Unless otherwise specified, the term "exemplary" is used in the sense of "example" rather than "ideal." As used herein, the terms "about," "substantially," and "approximately" indicate a range of values ​​within + / - 10% of the stated value.

[0015] Examples of the present disclosure include devices and methods for facilitating and / or improving the effectiveness, efficiency, and / or safety of medical procedures. Embodiments of the present disclosure may relate to devices and methods for performing various medical procedures and / or therapeutic portions of the large intestine (colon), small intestine, cecum, esophagus, stomach, any other portion of the gastrointestinal tract, kidneys or other portions of the urinary tract, heart, lungs, and / or any other suitable patient anatomical structure. Various embodiments described herein include single-use or disposable medical devices. Some aspects of the present disclosure may be used in performing endoscopes, arthroscopes, bronchoscopes, ureteroscopes, colonoscopes, or other types of procedures. For example, the disclosed aspects may be used with duodenoscopes, bronchoscopes, ureteroscopes, colonoscopes, catheters, diagnostic or therapeutic tools or devices, or other types of medical devices. One or more elements discussed herein may be metal, plastic, or may include any combination of shape memory metals (e.g., nitinol), shape memory polymers, polymers, or biocompatible materials.

[0016] Reference will now be made in detail to the examples of the present disclosure described above and illustrated in the accompanying drawings. Wherever possible, the same reference numbers will be used throughout the drawings to refer to the same or like parts. It should be noted that one or more aspects of the medical devices discussed herein may be combined and / or used in conjunction with one or more aspects of the other medical devices discussed herein.

[0017] 1A-1C show different views of an exemplary medical device 10. FIG. 1A is a front view of the medical device 10, and FIG. 1B is a perspective view of the medical device 10. FIG. 1C is a side view of a proximal portion of the medical device 10. The medical device 10 includes a handle 12 including a handle body and a device shaft or delivery shaft 14 extending from the handle 12 to a distal end 16. The medical device 10 may be a duodenoscope, endoscope, colonoscope, ureteroscope, bronchoscope, etc., or any other similar medical device having a handle and a shaft. In addition, the medical device 10 includes a control device 30. The control device 30 is movable (e.g., rotatable) relative to the handle 12 and may control the movement of a portion of the delivery shaft 14 (e.g., the distal end 16).

[0018] The handle 12 may include one or more openings 18A and 18B, for example, on a proximal portion of the handle 12. One or more of the openings 18A and 18B may be connectable to or receive one or more valves, for example, to control the delivery of air or water, or the application of suction through the handle 12 and delivery shaft 14.

[0019] In addition, the handle 12 may have one or more lumens (not shown), for example, extending to the distal end 16 and in communication with one or more lumens of the delivery shaft 14. In this embodiment, the handle 12 may include at least one port 20, for example, in an intermediate portion of the handle 12 (e.g., between a proximal portion and a distal portion). The port 20 may open into one or more working channels or lumens in the handle 12. The port 20 may receive one or more tools or end effectors that can be delivered through the handle 12 and the delivery shaft 14, for example, out of the distal end 16. In this embodiment, the port 20 may be sized and / or shaped to receive one or more medical devices (e.g., forceps, graspers, scissors, clips, staplers, needles, knives, electrodes, cautery loops, etc.) to deliver the one or more medical devices to a region proximate the distal end 16 of the delivery shaft 14. Additionally, the port 20 may be configured to help form a seal around a proximal portion of the medical device, for example, by including a valve, threads for screwing onto a cap, or the like.

[0020] The handle 12 may be coupled to a conduit 22. The conduit 22 may connect the handle 12 to an external power source, processing software, one or more displays, one or more memory or storage devices, and the like. In this embodiment, the medical device 10 may include one or more lighting devices and / or cameras at the distal end 16, which may be powered and / or connected to the processing software, one or more displays, memory, and the like via one or more communication wires (not shown) within the medical device 10 and via the conduit 22. Additionally, the conduit 22 may connect the handle 12 to one or more fluid sources (e.g., air source, water source, etc.). The conduit 22 may also connect the handle 12 to a suction source. In these embodiments, one or more valves coupled to or received within the openings 18A and 18B may control the delivery of air or water and / or the application of suction through the medical device 10 to a region proximate the distal end 16 of the delivery shaft 14.

[0021] The control device 30 is coupled to the handle 12, for example, at a proximal portion of the handle 12. As described above, the control device 30 is movable (e.g., rotatable) relative to the handle 12 and may control the movement (e.g., deflection) of the distal end 16 of the delivery shaft 14. Alternatively, the control device 30 may actuate or move an elevator in the delivery shaft 14 or otherwise actuate a cable drive function of the medical device 10.

[0022] The control device 30 may include a dial, wheel, lever, knob 32, or other rotary control element, which may be rotatable to deflect the distal end 16 of the delivery shaft 14 in a first direction or a second direction. As shown in FIG. 1C, the knob 32 may extend away from the handle 12 (e.g., perpendicular in a side view of the handle 12). Additionally, as discussed in detail below, the control device 30 may include one or more clutch devices, for example, to help lock and / or unlock the position of the knob 32, and thus the distal end 16 of the delivery shaft 14 or other features of the delivery shaft 14.

[0023] Additionally, the distal end 16 of the delivery shaft 14 may include at least one distal opening 24, for example, through which a medical device may be extended, fluids may be delivered, suction may be applied, or the medical device 10 may otherwise treat a treatment site. Although not shown, the distal end 16 may include one or more instruments for illumination (e.g., LEDs) and imaging (e.g., cameras), an elevator for directing an instrument or medical device out of the distal opening 24, and / or openings for irrigation and / or suction. Additionally, the medical device 10 may include one or more additional components (e.g., processors, memories, etc.) for controlling various functions at the distal end 16 and / or other portions of the medical device 10.

[0024] 2A-2C show various views of the control device 30. FIG. 2A is a front view of the control device 30. FIG. 2B is a cross-sectional view of the control device 30, for example, along section 2B-2B of FIG. 2A. FIG. 2C is a rear view of the control device 30, for example, from a position inside the handle 12 (not shown) when the control device 30 is coupled to the handle 12. As described above, the control device 30 includes a knob 32. The knob 32 may include, for example, one or more protrusions 34 extending radially away from a center of rotation 38 of the knob 32 and one or more recesses 36 extending radially toward the center of rotation 38 of the knob 32. The protrusions 34 and the recesses 36 may aid a user in gripping and / or rotating the knob 32. Additionally, the knob 32 may include one or more indicia, for example, a right-biased indicia 40A and a left-biased indicia 40B. In this aspect, rotation of knob 32 in the direction of right deflection indication 40A (e.g., clockwise) can deflect distal end 16 of delivery shaft 14 to the right, and rotation of knob 32 in the direction of left deflection indication 40B (e.g., counterclockwise) can deflect distal end 16 of delivery shaft 14 to the left. Alternatively, in other embodiments, rotating knob 32 in one direction can raise the elevator, and rotating knob 32 in the other direction can lower the elevator.

[0025] As shown in FIGS. 2A-2C, the control device 30 includes one or more indicator or control elements (e.g., linkages, chains, belts, wires, etc.), such as a first control wire 42A and a second control wire 42B. In at least one embodiment, the first control wire 42A and the second control wire 42B can extend from the knob 32, through the handle 12 and the delivery shaft 14, to a distal portion (e.g., the distal end 16) of the delivery shaft 14. In another embodiment, the first control wire 42A and the second control wire 42B can extend through the handle 12 and be coupled to one or more deflection wires or other control elements in the delivery shaft 14. In any of these embodiments, rotation of the knob 32 controls movement of the control wires 42A and 42B, which in turn may control deflection of the distal end 16 of the delivery shaft 14, actuation of an elevator, or otherwise actuate a cable drive function of the medical device 10.

[0026] As shown in FIGURE 2B, the control device 30 includes a control shaft 44. The shaft 44 may be integrally formed with the knob 32 or may otherwise be fixedly coupled to the knob 32. The shaft 44 may extend within a proximal portion of the handle 12. The proximal portions of the first and second control wires 42A, 42B may be indirectly coupled to the shaft 44, for example, tightly wound around and secured to an element that may be rotatably coupled to the shaft 44 (e.g., a spool 50, FIGURES 2B, 2C, and 3). For example, as shown in FIGS. 2C and 3, the spool 50 may include a coupling portion 51 (e.g., a slot, gap, opening, etc.) that receives a proximal portion of one or more of the first and second control wires 42A and 42B to secure the control wire(s) to the spool 50. Note that wire 42B is not shown in FIG. 2B because wire 42B is outside of cross section 2B-2B (FIG. 1). Nevertheless, both control wires 42A and 42B may be coupled to the spool 50 such that rotation of the spool 50 may control the movement of both control wires 42A and 42B. In this embodiment, rotating knob 32 rotates shaft 44, which in turn rotates spool 50. Rotation of the spool 50 may pull one of the first and second control wires 42A and 42B proximally to deflect a distal portion of the delivery shaft 14 in a direction. Alternatively, rotation of the knob 32 may rotate the shaft 44, which in turn may pull one of the first and second control wires 42A and 42B proximally via the spool 50 to actuate or move an elevator in the delivery shaft 14 or otherwise actuate a cable drive function of the medical device 10. Additionally, although not shown, the control device 30 may include one or more gears, sprockets, pulleys, cranks, etc. The control device 30 may also include one or more racks, chains, belts, linkages, etc.

[0027] 2B and 2C, the control device 30 includes at least one biasing device, such as at least one spring clutch 46. The spring clutch 46 may be at least partially circular and surround a rod or shaft 48. The shaft 48 may be fixed relative to the handle 12. Additionally, as shown in FIG. 2C, the spring clutch 46 may be disposed about the shaft 48, such as between the shaft 48 and the spool 50. When no force is acting on the control device 30, the spring clutch 46 is tightly disposed or pressed about the shaft 48, helping to secure the spool 50, and thus the first and second control wires 42A and 42B, relative to the shaft 48 and thus to the handle 12 and delivery shaft 14. In one or more embodiments, the spring clutch 46 may help to lock, hold, or otherwise restrict movement of the shaft 48, and thus the first and second control wires 42A and 42B, for example, via a frictional connection between the spring clutch 46 and the shaft 48.

[0028] The spring clutch 46 may include one or more legs 52. Rotating the knob 32 and shaft 44 may interact with one or more legs 52 of the spring clutch 46. For example, rotating the knob 32 and shaft 44 may cause a portion of the shaft 44 to contact one or more legs 52, thereby disengaging, expanding, or loosening the spring clutch 46 by pushing the one or more legs 52 in one direction. Loosening the spring clutch 46 may reduce the frictional connection between the spool 50 and the axle 48. Additionally, rotating the knob 32 and shaft 44 may also cause a portion of the shaft 44 or a portion of one or more legs 52 to contact a portion of the spool 50, thereby rotating the spool 50. Rotating the spool 50 may then retract one or more of the control wires 42A and 42B proximally to control a portion of the delivery shaft 14, for example, deflecting the distal end 16.

[0029] As described in more detail below, when force is no longer applied to the knob 32, the spring clutch 46 contracts and serves to secure the spool 50 relative to the shaft 48. Because the spring clutch 46 is in a relaxed position when the spool 50 is rotated, the spring clutch 46 does not provide a spring back force biasing the spool 50 toward its original position prior to rotation. Thus, the spring clutch 46 serves to lock the spool 50 in the rotated position. In this manner, the spring clutch 46 serves to secure the spool 50, and thus the first and second control wires 42A and 42B, in a position selected by a user acting on the knob 32. For example, securing the spool 50 in a selected position may serve to secure the distal end 16 in a deflected or articulated position. In this aspect, securing the spool 50 in a selected position can help lock or otherwise hold the distal end 16 in a selected configuration (e.g., an manipulated position), e.g., relative to other portions of the delivery shaft 14 and / or relative to a treatment site. As described below, the first control wire 42A or the second control wire 42B can thus impart force(s) to the spool 50 when the first control wire 42A or the second control wire 42B is pulled distally (e.g., due to an inherent force from a portion of the delivery shaft 14 bending or deflecting, by a portion of the delivery shaft 14 contacting tissue or other material, etc.). The force(s) may cause the spool 50 to interact with one or more legs 52 of the spring clutch 46 and may tighten the spring clutch 46, which in turn helps to more securely secure the spool 50 to the shaft 48 and prevents relative rotation.

[0030] 3 is an exploded view of control device 30, including knob 32, shaft 44, at least one spring clutch (i.e., two spring clutches 46A and 46B), axle 48, and spool 50. Although not shown, control wires 42A and 42B may be coupled to spool 50. In this embodiment, rotating knob 32 and shaft 44 can rotate spool 50, which can control the movement of control wires 42A and 42B (FIGS. 2A-2C) to deflect or otherwise control a distal portion of a delivery shaft (not shown).

[0031] As shown, a portion of the shaft 44 within the handle 12 includes at least one protrusion. As shown in FIG. 3, the shaft 44 may include two protrusions 54A and 54B, for example, each protrusion 54A, 54B on either side of the shaft 44, for example, on either side of the longitudinal axis of the shaft 44. The shaft 44 may also include, for example, a radial extension 56 extending radially outward from a longitudinal portion of the shaft 44 (e.g., the end of the shaft 44 opposite the knob 32). In this embodiment, the protrusions 54A, 54B may extend longitudinally from the radial extension 56. Additionally, spring clutches 46A and 46B are formed by wire coils with openings 58A and 58B, respectively, and spring clutches 46A and 46B include two legs 52A and 52B, and 52C and 52D, respectively, that project radially away from at least partially cylindrical spring clutches 46A and 46B, respectively. In this embodiment, spring clutch 46A includes two legs 52A and 52B, and spring clutch 46B includes two legs 52C and 52D.

[0032] The spool 50 may include a generally cylindrical outer portion 58. Additionally, the spool 50 may include a generally cylindrical inner opening 60 for receiving, for example, the shaft 48, the inner opening 60 may include two enlarged portions or gaps 62A and 62B. For example, the gap 62A may include a first stop surface 64A and a second stop surface 64B on opposite ends of the gap 62A. In this embodiment, the projections 54A, 54B may interact with the legs 52A-52D and the gaps 62A, 62B as the knob 32 and shaft 44 rotate, as discussed below. Additionally, although not shown, the control device 30 may include additional spring clutches, for example, to modify frictional forces generated between one or more of the spool 50 and the shaft 48. Additionally, the control device 30 may include additional projections from the shaft 44, gaps in the spool 50, etc., to accommodate and actuate the legs of the additional spring clutches.

[0033] 2B, 2C, and 3, when the control device 30 is assembled, the shaft 48 is fixedly coupled to a portion of the handle 12. The spring clutches 46A and 46B and the spool 50 may be disposed about a portion of the shaft 48. For example, the shaft 48 may include an enlarged portion 66. The openings 58A and 58B of the spring clutches 46A and 46B may be disposed on the enlarged portion 66, for example, spaced laterally along the enlarged portion 66. When the spring clutches 46A and 46B are disposed on the enlarged portion 66, the spring clutches 46A and 46B may be securely disposed about the enlarged portion 66. For example, the spring clutches 46A and 46B may be loosened (e.g., pinching or otherwise moving one or more of the legs 52A-52D of each spring clutch 46A and 46B toward one another) to be disposed about the enlarged portion 66. The spool 50 may be disposed over the spring clutches 46 A and 46 B and may be disposed about an enlarged portion 66 of the shaft 48 .

[0034] The shaft 44 can then be placed onto the axle 48. For example, as shown in FIG. 2B, the shaft 44 includes an inner lumen that receives the shaft 48. The shaft 48 can include a coupling portion 68, and the knob 32 can include an opening 70 that connects to a lumen within the shaft 44, for example. In this embodiment, a coupling element (e.g., a screw, bolt, etc.) can be used to couple the shaft 48 to the knob 32, while allowing relative rotation therebetween.

[0035] When shaft 44 is disposed on axle 48, radial extension 56 may abut or be adjacent to enlarged portion 66 of axle 48. Additionally, protrusions 54A and 54B may be disposed within gaps 62A and 62B between pairs of legs 52A-52D of spring clutches 46A and 46B. For example, protrusion 54A may be disposed within gap 62A between leg 52B of spring clutch 46A and leg 52D of spring clutch 46B. Additionally, protrusion 54B may be disposed within gap 62B between leg 54A of spring clutch 46A and leg 52C of spring clutch 46B.

[0036] When the control device 30 is assembled, rotating the knob 32, and thus the shaft 44, in a first direction, e.g., clockwise, can cause the protrusion 54A to contact the leg 52B of the spring clutch 46A and push the leg 52B clockwise. This contact can also rotate the entire spring clutch 46A, e.g., abutting the leg 52B of the spring clutch 46A with the stop surface 64B of the gap 62A. Further rotation of the knob 32 can loosen the spring clutch 46A such that the spool 50 is non-rotatably secured to the shaft 48 by the spring clutch 46A. In addition, rotating the knob 32 and the shaft 44 in the first direction can also cause the protrusion 54B to contact the leg 52C of the spring clutch 46B and push the leg 52C clockwise. This contact may also rotate the entire spring clutch 46B, for example, causing legs 52C of the spring clutch 46B to abut a stop surface in gap 62B. Further rotation of knob 32 may release spring clutch 46B such that spool 50 is non-rotatably secured to shaft 48 by spring clutch 46B.

[0037] Conversely, rotating the knob 32, and thus the shaft 44, in a second direction, e.g., counterclockwise, can cause the protrusion 54A to contact the leg 52D of the spring clutch 46B, pushing the leg 52D counterclockwise. This contact can also rotate the entire spring clutch 46B, e.g., causing the leg 52D of the spring clutch 46D to abut the stop surface 64A of the gap 62A. Further rotation of the knob 32 can loosen the spring clutch 46B, such that the spool 50 is non-rotatably secured to the shaft 48 by the spring clutch 46B. In addition, rotating the knob 32 and the shaft 44 in the second direction can also cause the protrusion 54B to contact the leg 52A of the spring clutch 46A, pushing the leg 52A counterclockwise. This contact may also rotate the entire spring clutch 46A, for example, causing legs 52A of the spring clutch 46A to abut a stop surface in gap 62B. Further rotation of knob 32 may release spring clutch 46A such that spool 50 is non-rotatably secured to shaft 48 by spring clutch 46A.

[0038] When both spring clutches 46A and 46B are released, rotation of knob 32 and shaft 44 may rotate spool 50, which in turn controls the movement of at least one of first control wire 42A and / or second control wire 42B (FIGS. 2A-2C). Additionally, as discussed above, an external force, e.g., a force applied to spool 50 by a control wire, may rotate spool 50 to contact one or more of clutch springs 46A, 46B to tighten one or more of clutch springs 46A, 46B. For example, if a force from one of the control wires acts on spool 50 to rotate spool 50 clockwise, stop surface 64A may contact leg 52D and push leg 52D clockwise, thereby tightening spring clutch 48B. Similarly, a clockwise force acting on the spool 50 can also cause the stop surface of the gap 62B to contact the leg 52A and push the leg 52A clockwise, thereby tightening the spring clutch 48A. Thus, the control device 30 can also help to hold a portion of the delivery shaft 14 in an operated position.

[0039] 4A-4D illustrate various spring clutches that may be incorporated into the control device 30 to selectively rotatably couple and decouple the spool 50 to the shaft 48 based on, for example, the rotation of the knob 32 and the shaft 44. As shown in FIG. 4A, the spring clutch 146 includes a coil of wire 168. Additionally, as discussed above, the spring clutch 146 includes two legs 152A and 152B that extend radially away from the coil 168. The legs 152A and 152B may be coupled to the coil 168 by bends 170A and 170B. As shown, the coil 168 may include approximately three wire loops. However, although not shown, the coil 168 may include fewer or more wire loops, which may affect the amount of force required to compress the spring clutch 146 and may affect the holding force applied by the spring clutch 146 to hold the spool against the shaft. As described above, a protrusion from the shaft may interact with legs 152A and 152B to release spring clutch 146.

[0040] 4B illustrates another exemplary spring clutch 246. As illustrated, the spring clutch 246 may include, for example, a ring-like shape including an at least partially cylindrical portion 272A and an interaction portion 272B. The interaction portion 272B may include a first end 274A and a second end 274B, which may, for example, overlap at least partially along a portion of the circumference of the spring clutch 246. The first end 274A may include a leg 252A extending radially outward. The second end 274B may include two legs 252C and 252D, which are spaced apart to form an opening that movably receives the first end 274A. Thus, the first end 274A and the second end 274B are movable relative to one another. For example, there may be a gap 276A between the leg 252A and one end of the cylindrical portion 272A. Additionally, there may be gaps 276B and 276C between the legs 252B and 252C and the other end of the cylindrical portion 272A. In this embodiment, the legs 252A may move within the gap 276A. Additionally, the legs 252B and 252C may move within the gaps 276B and 276C. As described above, a protrusion from the shaft may interact with one or more of the legs 252A, 252B, or 252C to loosen the spring clutch 246. The spring clutch 246 may be formed of sheet metal. Alternatively, the spring clutch 246 may be formed of a plastic material, for example, via an injection molding process.

[0041] 4C illustrates yet another exemplary spring clutch 346. As illustrated, the spring clutch 346 may include, for example, a partial ring-like shape including at least a partially cylindrical portion 372A and an open portion 372B. The open portion 372B may extend between the first leg 352A and the second leg 352B. As described above, a protrusion from the shaft may interact with one or more of the legs 352A or 352B to loosen the spring clutch 346. Similar to the spring clutch 246, the spring clutch 346 may be formed of sheet metal, or alternatively, the spring clutch 346 may be formed of a plastic material, for example, via an injection molding process.

[0042] 4D illustrates a further exemplary spring clutch 446. As shown, the spring 446 may also be formed with a coil 468 of windings. The spring clutch 446 also includes two legs 452A and 452B extending radially inward from the coil 468. The legs 452A and 452B may be coupled to the coil 468 by bends 470A and 470B. In this embodiment, although not shown, the spring 446 may be used for a control device that includes an outer cylinder (similar to the shaft 48) secured to a housing of the handle and a spool disposed within an opening of the outer cylinder. Rotation of the knob and shaft may interact with the legs 452A and 452B to selectively release the spring 346 and rotate the internal spool. Additionally, one or more of the spring clutches 46, 46A, 46B, 146, 246, and 346 may be modified to include respective legs extending radially inward.

[0043] In these embodiments, one or more of the spring clutches 46, 46A, 46B, 146, 246, 346, and 446 may be incorporated into the control device 30. For example, the desired compression force of the springs, manufacturing costs, and other factors may be considered in selecting one or more spring clutches for the control device 30. In addition, the compression force of the control device 30 may be changed by adding or removing one or more spring clutches (or modifying one or more spring clutches, e.g., by adding loops of coils) from the assembly connecting the spool 50 to the shaft 48. Furthermore, the compression force of the control device 30 may be changed by changing the diameter of the shaft 48 disposed within the spring clutch(es). The compression force of the control device 30 may also be changed by changing the material and / or friction characteristics of the control device 30. For example, the shaft 48 may be formed of a Teflon coated shaft. Alternatively or in addition, the spring clutch may be formed of a Teflon coated wire or a plastic that includes Teflon. Additionally, in one or more embodiments, one or more friction reducers (eg, greases) may be applied to one or more surfaces within control device 30.

[0044] Additionally, as discussed below, three or more control devices 30 may be used, for example, with a nested knob and a hollow tube or shaft. Additionally, while two control wires 42A and 42B are shown coupled to each spool 50, the disclosure is not so limited. For example, one control wire may be coupled to each spool 50, or three or more control wires may be coupled to each spool 50, for example, to provide additional proximal retraction force to one or more portions of the delivery shaft 14. Additionally, while two spring clutches 46 are shown coupling each spool 50 to the shaft 48, the disclosure is not so limited. For example, one spring clutch 46 may be used with each spool 50, or three or more spring clutches 46 may be used with each spool 50, for example, to control the frictional force selectively coupling the spool 50 to the shaft 48. The size, material, stiffness, elasticity, etc. of the spring clutches 46, along with the number of spring clutches 46, may be varied as desired to control the frictional coupling between the spool 50 and the shaft 48.

[0045] 5A-5C show different views of an alternative exemplary medical device 510 according to the present disclosure. FIGS. 5A-5C show similar elements to medical device 10, which are designated by the addition of the reference number 500. FIG. 5A is a front view of medical device 510 and FIG. 5B is a perspective view of medical device 510. FIG. 5C is a side view of a proximal portion of medical device 510. Medical device 510 includes a handle 512 including a handle body and a delivery shaft 514 extending from handle 512 to a distal end (not shown). Additionally, medical device 510 includes a control device 530.

[0046] The control device 530 includes a first knob 532 and a second knob 580. The second knob 580 may be disposed between the first knob 532 and the handle 512. In this embodiment, the first knob 532 may be rotatable relative to the handle 512 to actuate or control a distal portion of the delivery shaft 514 in a first embodiment, and the second knob 580 may be rotatable relative to the handle 512 to actuate or control a distal portion of the delivery shaft 514 in a second embodiment. The first knob 532, the second knob 580, and their respective couplings may be substantially coaxial. In one embodiment, the first knob 532 may control a first elevator in the delivery shaft 514, and the second knob 580 may control a second elevator in the delivery shaft 514. In another embodiment, the first knob 532 may be rotatable to deflect the distal end of the delivery shaft 514 in a first plane, and the second knob 580 may be rotatable to deflect the distal end of the delivery shaft 514 in a second plane. The second plane may be approximately perpendicular to the first plane. In this embodiment, the control device 530 including the first knob 532 and the second knob 580 may allow deflection of the distal end to any position or direction within a hemispherical range extending from the distal end of the delivery shaft 514. Furthermore, the control device 530 including the first knob 532 and the second knob 580 may allow deflection of the distal end to any position or direction within a range extending from the distal end of the delivery shaft 514 at a large deflection angle, the range being greater than the hemispherical range. In yet another embodiment, the first knob 532 may control the deflection of the distal end of the delivery shaft 514 and the second knob 580 may control the elevator, or vice versa. In these embodiments, the control device 530 includes an internal braking device and thus does not require an external braking device that a user can activate and / or release from outside the handle 512.

[0047] 6A and 6B show views of control device 530. FIG. 6A is a cross-sectional view of control device 530 along a section similar to section 2B-2B of FIG. 2A, for example. FIG. 6B is a rear view of control device 530 as viewed, for example, from a position within handle 512 (FIGS. 5A-5C) when control device 530 is coupled to handle 512. Control device 530 includes two or more indicator or control wires (e.g., 542A, 542B, 542C, and 542D), which may control one or more components of delivery shaft 514, as described above.

[0048] As mentioned above, the knob 532 may be coupled to or may be integrally formed with the control shaft 544. The shaft 544 may include an internal lumen for receiving a portion of the shaft 548 and may interact with a spool 550 to control the movement of one or more control wires, e.g., the first control wire 542A. Additionally, one or more spring clutches 546A may be disposed between the spool 550 and a portion of the shaft 548 to selectively rotate and secure or lock the spool 550 to the shaft 548.

[0049] Additionally, the knob 580 may be coupled to or integrally formed with the control shaft 582. The shaft 582 may include an internal lumen for receiving a portion of the shaft 544 and thus also the axle 548. In one embodiment, a hollow axle 578 may be disposed between the shaft 544 and the shaft 582. The shaft 582 may also interact with the spool 584 to control the movement of one or more control wires, for example, the second control wire 542B. Additionally, one or more spring clutches 546C may be disposed between the spool 584 and a portion of the hollow axle 578 to selectively rotate and secure or lock the spool 584 to the hollow axle 578. Furthermore, the hollow axle 578 may include an extension 586. The extension 586 may be disposed between the spool 550 and the spool 584 and may serve to allow the spool 550 and the spool 584 to be actuated and rotated separately from one another.

[0050] The shaft 544, spring clutch 546A, shaft 548, and spool 550 operate to selectively lock and unlock the rotation of the shaft 544 and spool 550 relative to the shaft 548, as discussed with respect to the corresponding structures in FIGS. 2A-2C and 3. As shown in FIG. 6B, the spring clutch 546A may be disposed about the shaft 548, for example, between the shaft 548 and the spool 550. When no force is acting on the control device 530, the spring clutch 546A is tightly disposed or pressed about the shaft 548, helping to secure the spool 550, and thus the first control wire 542A, relative to the shaft 548, and thus to the handle 512 and delivery shaft 514. The spring clutch 546A may include one or more legs 552. Rotating the knob 532 and shaft 544 may interact with one or more legs 552 of the spring clutch 546A. For example, rotating knob 532 and shaft 544 can cause a portion of shaft 544 to contact one or more legs 552, pushing one or more legs 552 in a direction, thereby disengaging or loosening spring clutch 546A. Loosening spring clutch 546A can reduce the frictional connection between spool 550 and axle 548. Additionally, rotating knob 532 and shaft 544 can also cause a portion of shaft 544, or a portion of one or more legs 552, to contact a portion of spool 550, which can rotate spool 550. Rotating spool 550 can then retract control wire 542A proximally to control a portion of delivery shaft 514.

[0051] Similarly, although not shown in Figures 6A and 6B, the shaft 582 may interact with one or more legs of the spring clutch 546C, for example, such that the rotating knob 580 loosens the spring clutch 546C, thus reducing the frictional connection between the spool 584 and the hollow shaft 578.

[0052] 7 is an exploded view of a control device 530 including knob 532, shaft 544, at least one spring clutch (i.e., two spring clutches 546A and 546B), shaft 548, and spool 550. Although not shown, one or more control wires (e.g., control wires 542A and 542B) may be coupled to spool 550. In this embodiment, similar to the interaction of knob 32, shaft 44, spring clutch 46, shaft 48, spool 50, and control wires 42A, 42B shown in FIGS. 2A-2C and 3, rotating knob 532 and shaft 544 can rotate spool 550, which can control the movement of one or more control wires to deflect or otherwise control a distal portion of a delivery shaft (not shown). As discussed above, rotating knob 530 and shaft 544 can release one or more of spring clutches 546A or 546B. For example, shaft 544 includes one or more protrusions, such as first protrusion 554A and second protrusion 554B coupled to shaft 544 via radial extension 556. Protrusions 554A and 554B can interact with legs of spring clutches 546A, 546B to loosen spring clutches 546A, 546B and loosen the connection between spool 550 and enlarged portion 566 of shaft 548, as described above. Additionally, as described above, the legs can interact with one or more stop surfaces (e.g., stop surfaces 564A and 564B) to rotate spool 550 to control one or more control wires (not shown).

[0053] 7, the control device 530 includes a knob 580, a shaft 582, at least one additional spring clutch (i.e., two spring clutches 546C and 546D), and a spool 584. Although not shown, one or more control wires (e.g., control wires 542C and 542D) may be coupled to the spool 584. This assembly operates in much the same manner as the interaction of the knob 32, shaft 44, spring clutch 46, axle 48, spool 50, and control wires 42A, 42B shown in FIGS. 2A, 2C, and 3. Specifically, rotating the knob 580 and shaft 582 can interact with and release the spring clutches 546C and 546D, as described above, and rotate the spool 584. Rotating the spool 584 can control the movement of one or more control wires to deflect or otherwise control a distal portion of the delivery shaft (not shown). Additionally, hollow shaft 578 may be secured to handle 512 and may serve to allow shafts 544 and 582 to rotate independently. Additionally, hollow shaft 578 may include an extension 586 that separates spool 550 and spool 584 and allows spool 550 and spool 584 to rotate independently.

[0054] Additionally, rotating the knob 580 and shaft 582 may loosen one or more of the spring clutches 546C or 546D. For example, the shaft 582 includes one or more protrusions, e.g., a first protrusion 588A and a second protrusion 588B, coupled to the shaft 582 via a radial extension 590. The protrusions 588A and 588B may interact with the legs of the spring clutches 546C, 546D to loosen the spring clutches 546C, 546D and loosen the connection between the spool 584 and the hollow shaft 578, as described above. Additionally, the legs may interact with one or more stop surfaces (e.g., stop surfaces 592A or 592B) to rotate the spool 584 to control one or more control wires (not shown).

[0055] Additionally, as discussed above, an external force, such as a force applied to the spool 550 or 584 by a control wire, can rotate the spool 550 or 584 and contact one or more of the clutch springs 546A, 546B, 546C, 546D to clamp one or more of the clutch springs 546A, 546B, 546C, 546D. For example, the control wires can impart forces from inherent forces on the delivery shaft 514, forces caused by the distal end of the delivery shaft 514 contacting tissue or other material at the treatment site, etc., to urge the delivery shaft 514 back to a non-bent or non-deflected position, which can cause the spool 550, 584 to contact and clamp one or more of the clutch springs 546A, 546B, 546C, 546D. Thus, the control device 530 can also help to hold a portion of the delivery shaft 514 in a manipulated position.

[0056] One or more, and any combination of spring clutches, can be incorporated into the control device 530. Additionally, more than two knobs, shafts, etc. can be included on the handle 512, for example, to control more than two aspects of the delivery shaft. For example, three knobs can be incorporated into the control device on the handle 512. A first knob and a second knob can be configured to deflect the delivery shaft 514 in two different planes, and a third knob can be configured to actuate an elevator disposed adjacent the distal opening 24 of FIGS. 1A and 1B, for example.

[0057] Various aspects discussed herein may help reduce the duration, cost, and / or risk of a medical procedure. For example, the control device allows a user to selectively manipulate one or more control wires. The control devices may also help lock the control wires in a selected position and prevent unintended movement of the control wires, for example, from forces acting on the delivery shaft. In this aspect, the control devices may help provide a brake with a small number of inexpensive components. Due to the spring force provided by the spring clutch(es), the brakes provided by the control devices are automatically disengaged when the knob and shaft are rotated by user manipulation, and the brakes provided by the control devices are automatically engaged after the user manipulation is terminated. For example, a user may rotate a knob to deflect a distal end of a delivery shaft. The user may release the knob in a rotated position, and the one or more spring clutches may automatically return to a retracted position and secure the spool to the shaft. In this embodiment, the force applied to the spool from the multiple control wires, or the back pressure from the multiple control wires, tightens one or more spring clutches, helping to prevent the force applied by the multiple control wires from rotating the spool.

[0058] In addition, the one or more spring clutches may be formed of commonly available spring or wire materials. Alternatively, the one or more spring clutches may be formed of stamped sheet metal, plastic materials, injection molded clips, and the like. The size, number, material, and the like of the one or more spring clutches may also be tailored to a particular medical device or a particular application of the medical device. The amount of friction that each spring clutch can withstand before slipping may vary based on the characteristics of each spring clutch. However, the amount of friction that each spring clutch can withstand before slipping also depends on the number of wraps or coils (or longitudinal width) that make up the one or more spring clutches, the material properties of the wire, the amount of preload friction (e.g., how "tight" the spring is on the shaft in the neutral or non-actuated position), due to interference between the inner diameter of the one or more spring clutches and the outer diameter of the shaft, and the like. The frictional force provided to the spool may also be controlled (e.g., increased or decreased) based on the number of spring clutches included around the shaft. The frictional force may then provide sufficient retention force to prevent the delivery shaft from naturally returning to a straight or unactuated position, while also minimizing the driving force required for the knob and shaft to release one or more spring clutches and rotate the spool to actuate a portion of the delivery shaft.

[0059] The control devices may be located anywhere on the handle, for example, wherever is convenient during a medical procedure. Furthermore, the control devices do not require an external braking system (braking components external to the handle body), which may help reduce the overall size and utility of the control devices and medical devices. Not requiring an external braking system may also help allow the knob(s) of the control devices to be located adjacent or close to the handles, which may improve the ergonomics and / or usability of the medical device, especially for users with smaller hands. Additionally, not requiring an external braking system may reduce the overall size of the handle, for example, reducing the risk that the handle may tip and / or fall off a table (e.g., during sterilization), reducing the size and / or amount of packaging required to package the medical device, reducing the space required to store the medical device, etc.

[0060] As described above, multiple control devices can automatically lock multiple control wires, and therefore the controlled portions of multiple delivery shafts, in a selected position, thus eliminating the need for a user to operate an external braking element, which can stress internal components, increase fatigue in the user's hand, and otherwise lock one or more components in place and then operate the components in a locked configuration for final or smaller operation. Additionally, multiple control devices may be incorporated onto one handle, as described above, to deflect the distal end of the delivery shaft in multiple directions, actuate or move one or more elevators within the delivery shaft, and / or otherwise perform cable drive functions of multiple medical devices.

[0061] Thus, various aspects discussed herein may help improve the effectiveness of treatment and / or recovery from a procedure, e.g., a procedure for treating a treatment site. Various aspects discussed herein may help reduce and / or minimize the duration of a procedure, may help reduce the risk of unintended manipulation by a user, and / or may help reduce the risk of unintended contact with tissue or other materials during delivery, repositioning, or use of a medical device in a procedure.

[0062] Although the principles of the present disclosure are discussed herein with reference to exemplary embodiments for various applications, it should be understood that the present disclosure is not limited thereto. Those skilled in the art and with access to the teachings provided herein will recognize that additional modifications, applications, embodiments, and equivalent substitutions are all within the scope of the embodiments described herein. Thus, the present disclosure should not be considered as limited by the foregoing description.

Claims

1. A handle including an axis; a device shaft extending from the handle to a distal end; A control device coupled to the handle, a knob rotatable relative to the handle; a control shaft extending from the knob; At least one spring clutch including two legs; a spool rotatable about the shaft; the control device including one or more wires coupled to the spool; A medical device comprising: The medical device configured such that rotation of the knob rotates the control shaft, releasing the at least one spring clutch, rotating the spool, and moving the one or more wires.

2. The medical device of claim 1 , wherein the shaft includes a radial extension and includes a first protrusion and a second protrusion extending from the radial extension.

3. 3. The medical device of claim 2, wherein the spool defines a first gap and a second gap, and the first protrusion and the second protrusion are configured to be disposed within the first gap and the second gap.

4. 4. The medical device of claim 3, wherein the at least one spring clutch includes a first spring clutch and a second spring clutch, the first spring clutch and the second spring clutch each including a first leg and a second leg.

5. Rotation of the knob in a first direction causes the first protrusion to contact a first leg of the first spring clutch, loosening the first spring clutch, and rotation of the knob in the first direction causes the second protrusion to contact a first leg of the second spring clutch, loosening the second spring clutch; 5. The medical device of claim 4, wherein further rotation of the knob in the first direction (1) causes the first leg of the first spring clutch to contact a first stop surface of the spool adjacent the first gap, (2) causes the first leg of the second spring clutch to contact a second stop surface of the spool adjacent the second gap, and (3) rotates the spool in the first direction.

6. Rotating the knob in a second direction causes the first protrusion to contact a second leg of the second spring clutch, releasing the second spring clutch; rotating the knob in the second direction causes the second protrusion to contact a second leg of the first spring clutch, releasing the first spring clutch; 5. The medical device of claim 4, wherein further rotation of the knob in the second direction (1) causes the second leg of the second spring clutch to contact a third stop surface of the spool adjacent the second gap, (2) causes the second leg of the first spring clutch to contact a fourth stop surface of the spool adjacent the second gap, and (3) rotates the spool in the second direction.

7. 7. The medical device of claim 1, wherein the at least one spring clutch includes at least one spring formed of a coil with two radially outwardly extending legs.

8. 7. The medical device of claim 1, wherein the at least one spring clutch includes at least one spring having a ring-like shape including a partially cylindrical portion and an interaction portion, the interaction portion including a first end and a second end, the first end including a first radially outwardly extending leg and the second end including two radially outwardly extending legs.

9. 7. The medical device of claim 1, wherein the spring clutch includes at least one spring having a partial ring-like shape including a partial cylindrical portion and an open portion, the partial cylindrical portion including two radially outwardly extending legs on either side of the open portion.

10. The medical device of any one of claims 1 to 6, wherein the spring clutch includes at least one spring formed of a coil with two radially inwardly extending legs.

11. The control device is a first control device, and the medical device further comprises a second control device coaxial with the first control device, the second control device comprising: a second knob rotatable relative to the handle; a second control shaft extending from the second knob; at least one second spring clutch including two legs; a second spool rotatable about the axis; one or more second wires coupled to the second spool; 7. The medical device of claim 1, wherein rotation of the second knob is configured to rotate the second control shaft, release the at least one second spring clutch, rotate the second spool, and move the one or more second wires.

12. a portion of the control shaft of the first control device is nested within the second control shaft of the second control device, the medical device further comprising:

12. The medical device of claim 11, comprising a hollow shaft separating a portion of the control shaft from the second control shaft, the hollow shaft being coupled to the handle and including a radial extension separating the spool of the first control device from the second spool of the second control device.

13. The medical device of any one of claims 1 to 6, wherein a distal end of a delivery shaft is deflectable via said control device.

14. 7. The medical device of any one of claims 1 to 6, wherein the handle includes at least one port configured to receive a medical device, the port connected to a lumen extending through the handle and a delivery shaft, and the control device configured to control an elevator positioned adjacent to the lumen at a distal end of the delivery shaft.

15. The medical device of any one of claims 1 to 6, wherein the control device is located on a proximal portion of the handle and the medical device does not include a brake external to the body of the handle to lock the position of the knob.

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