Device and method for extending working channel

Abstract

To provide a medical device having compatibility with a plurality of auxiliary devices.SOLUTION: A medical delivery device system includes a first medical device provided with a delivery catheter and an extension device. The extension device includes: a tubular inner member having a projection; a tubular outer member having an opening; a proximal connector configured to be at the proximal end of the tubular outer member and removably connected to the distal end of the first medical device; and a distal connector configured to be at the distal end of the tubular inner member and removably connected to a proximal end of an endoscope. The lumen of the tubular outer member is configured to receive the tubular inner member. Both the tubular outer member and the tubular inner member are relatively slidable to each other in a nesting manner. The projection is configured to engage to an opening so as to fix the tubular outer member to the tubular inner member at a desired position.SELECTED DRAWING: Figure 2

Description

[Technical field]

[0001] The present invention relates to the field of medical devices. In particular, the present invention relates to devices, systems and methods for expanding the working channel of an endoscope, such as for the delivery of a stent. [Background technology]

[0002] Medical devices may have components (e.g., the shaft of a delivery catheter) of a predetermined length to reach a particular treatment site on a patient and / or to be compatible with a particular ancillary medical device (e.g., an endoscope). In manufacturing these medical devices with a predetermined shaft length, they may not work well with other patient treatment sites or with other ancillary medical devices that they are not designed to be compatible with (e.g., other types of endoscopes or other patient body cavities). For example, a medical device may be attached to an endoscope for which it is not designed to fit, resulting in the length of the shaft of the medical device (e.g., a delivery catheter) extending much further distally than the working channel of the endoscope, such that the device or system may not operate as intended or may not be fully integrated. For example, the distal tip of a catheter shaft that extends far beyond the end of an ultrasound endoscope may not be imageable by ultrasound. Designing and manufacturing a variety of alternative medical devices with appropriate design features compatible with a variety of ancillary medical devices may require excessive additional development and inventory costs. Furthermore, having to purchase different versions of the same medical device simply to be compatible with multiple auxiliary devices may be unattractive in marketing. Summary of the Invention [Problem to be solved by the invention]

[0003] Therefore, it may be desirable to have a device and / or system that allows a medical device to be compatible with multiple auxiliary devices. It is also desirable to improve the ergonomics of the medical device and / or system for a user who operates the medical device and / or auxiliary device. In view of these considerations, the improvements made by the present invention are advantageous. [Means for solving the problem]

[0004] The invention in various embodiments may include a device designed to couple to and work with an ultrasound endoscope or other endoscope. The shaft of the device may extend a predetermined distance into the patient beyond the distal end of the working channel of the ultrasound endoscope. This predetermined distance is within the range of operation of the ultrasound endoscope to display the treatment site to the user via ultrasound. A distal end length of the device that extends longer than this may exceed the functional range of the ultrasound endoscope for this procedure, while a distal end length that extends shorter than this may not allow for proper insertion, placement, and delivery of the stent.

[0005] The invention in various embodiments includes devices, systems, and methods for extending a working channel of an endoscope. According to one embodiment, the extension device may have a tubular inner member having a lumen extending therethrough. The tubular outer member may have a lumen extending therethrough. The lumen of the outer member may be configured to receive the inner member, and the outer and inner members may be telescopically slidable relative to one another to a desired position corresponding to an adjustable length of the device. A locking assembly fixes the relative positions of the outer and inner members relative to one another at the desired position. The proximal connector may be at a proximal end of the outer member and configured to connect to a distal end of a first medical device. The distal connector may be at a distal end of the inner member and configured to connect to a proximal end of a second medical device. The lumens of the inner and outer members may be coaxially disposed. At least one of the proximal and distal connectors may be a luer lock connector. The plurality of desired positions may include three predetermined fixed positions. The fixed position may include a visual indicator on the inner member or the outer member, or both. The visual indicator may include markings. The fixed position may include a fastener on one or both of the inner and outer members. The fastener may include a first element on the inner member and a second element on the outer member. The first and second elements may be configured to mate with one another. The joint may be pivotable such that the first longitudinal axis is at an angle between 90 degrees and 180 degrees from the second axis. The locking assembly may be a detent. The locking assembly may be a screw. The screw may engage with the inner member to lock the outer member in a desired position relative to the inner member.

[0006] In another aspect, the extension system may include an endoscope having a working channel. The system may include a delivery device. The shaft may extend distally from the delivery device and be receivable within the working channel. The system may include an extension device. The extension device may include a tubular inner member having a lumen extending therethrough. The device may include a tubular outer member having a lumen extending therethrough. The lumen of the outer member may be configured to receive the inner member, and the outer and inner members may be telescopically slidable relative to one another to a desired position corresponding to an adjustable length of the extension device. The device may include a locking assembly configured to secure the relative position of the outer and inner members relative to one another at a desired position. The device may have a proximal connector at a proximal end of the outer member and configured to connect to a distal end of the delivery device. The device may have a distal connector at a distal end of the inner member and configured to connect to a proximal end of the endoscope. The predetermined distance may be about 8 centimeters. The adjustable length may be a minimum of about 0 centimeters and a maximum of about 8 centimeters. The lumens of the inner and outer members may be coaxial. The proximal connector may be a male luer connector and the distal connector may be a female luer connector. The desired position may include a plurality of predefined fixed positions. The desired position may include three predefined fixed positions. The joint may be pivoted such that the first longitudinal axis is at an angle of 90 degrees to 180 degrees from the second axis. The joint may include a sphere at a distal portion of the inner member. The sphere may have a first lumen extending therethrough in fluid communication with the inner lumen. The cup-shaped body may be at a distal portion of the inner member and disposed about the sphere. The cup-shaped body may have a second lumen extending therethrough in fluid communication with the first lumen. The sphere may be pivotable within the cup-shaped body. The first and second lumens may be configured to receive a device. The locking assembly may be a protrusion on the inner member that corresponds to a predefined opening on the outer member. The locking assembly can include a plurality of pre-set openings that can correspond to a plurality of desired positions, which can define a predetermined plurality of adjustable lengths.The protrusions may include a compressible button such that the button can be compressed to disengage the inner member from the outer member. The locking assembly may be a screw that can engage the inner member to lock the outer member in a desired position relative to the inner member.

[0007] In another aspect, a method of extending a length of a working channel may include inserting an endoscope having a working channel extending therethrough into a patient. A catheter is inserted into the patient through the working channel. An extension device may be disposed about a shaft of the catheter with a lumen extending therethrough. The extension device may be attached to a proximal end of the working channel. The catheter may be attached to a proximal end of the extension device. The extension device may be adjusted to a desired position corresponding to an adjustable length of the extension device. The extension device may be locked at the desired position. The tip of the catheter may be visualized using the endoscope. Placing the extension device about the shaft may be prior to inserting the catheter into the patient. The desired position may include at least one predetermined fixation position of a locking assembly of the extension device configured to fix the adjustable length. The desired position may include a plurality of predetermined fixation positions. A plurality of channels of the extension device may be aligned with one another such that the extension device may be positioned and removed about the shaft. The extension device may be rotatable between an open configuration in which the channels are substantially aligned and a closed configuration in which the channels are substantially unaligned.

[0008] Non-limiting embodiments of the present disclosure are described by way of example with reference to the accompanying drawings, which are schematic and are not intended to be drawn to scale, in which each identical or nearly identical component shown is typically represented with a single reference number, and for purposes of clarity, not every component is labeled in every figure, nor are every component of every embodiment shown whose illustration is not necessary to enable a person skilled in the art to understand the disclosure. [Brief description of the drawings]

[0009] [Figure 1] 1 is a perspective view showing an example of a user operating a medical device connected at a fixed length to an endoscope. [Diagram 2] 1 is a perspective view illustrating a condition during delivery of a stent through a medical device, an extension device, and an endoscope connected in series, in accordance with an embodiment of the present invention. [Diagram 3] 1 is a perspective view showing an extension device according to an embodiment of the present invention. [Figure 4] 1 is a perspective view of an extension device having a predetermined locking position, according to an embodiment of the present invention. [Figure 5A] 1 is an exploded perspective view showing an extension device having inner and outer channels in an open configuration, according to an embodiment of the present invention. [Figure 5B] 1 is an exploded perspective view showing an extension device having inner and outer channels in an open configuration, according to an embodiment of the present invention. [Figure 5C] 1 is an exploded perspective view showing an extension device having inner and outer channels in an open configuration, according to an embodiment of the present invention. [Figure 5D] FIG. 5D is a perspective view of the extension device of FIGS. 5A-5C in a closed configuration. [Figure 5E] FIG. 5D is a perspective view of the extension device of FIGS. 5A-5C in a closed configuration. [Figure 5F] FIG. 5D is a perspective view of the extension device of FIGS. 5A-5C in a closed configuration. [Figure 6A] 1 is a perspective view showing an extension device having a pivotable joint according to an embodiment of the present invention. [Figure 6B] FIG. 6B shows a portion of the device of FIG. 6A. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0010] The present invention is not limited to the specific embodiments described. The terms used herein are for the purpose of describing specific embodiments only and are not intended to be limiting. Unless otherwise defined, all technical terms used herein have the same meaning as commonly understood by those skilled in the art to which the present invention belongs.

[0011] As used herein, the singular forms "a," "an," and "the" are intended to include the plural forms unless the context clearly indicates otherwise. As used herein, the terms "comprises" and / or "comprising" or "includes" and / or "including" specify the presence of stated features, regions, step elements and / or components, but do not exclude one or more other features, regions, integers, steps, operations, elements, components, and / or combinations or additions thereof.

[0012] As used herein, "and" includes each of the structures, components, features, etc. so combined, unless the context clearly dictates otherwise, and "or" includes one or the other of the structures, components, features, etc., alone or combined in any combination and number, unless the context clearly dictates otherwise.

[0013] As used herein, the term "distal" refers to the end of the device that is furthest from the medical professional when introducing the device into a patient, and the term "proximal" refers to the end of the device that is closest to the medical professional when introducing the device into a patient.

[0014] In this specification, all numerical values, whether explicitly stated or not, are assumed to be modified by the term "about". The term "about", in the context of numerical values, generally refers to a range of numerical values ​​that one of ordinary skill in the art would consider equivalent to the recited value (i.e., having the same function or result). In many cases, the term "about" may include numerical values ​​that are rounded to the nearest significant figure. Other uses of the term "about" (i.e., in contexts other than numerical values) are deemed to have the ordinary and customary definition as understood and consistent with the context of the specification, unless otherwise indicated.

[0015] Enumerating numerical ranges by endpoints includes all numbers within that range, including the endpoints (e.g. 1 to 5 includes 1, 1.5, 2, 2.75, 3, 3.80, 4, and 5). References herein to "embodiments," "some embodiments," "other embodiments," and the like indicate that the described embodiment may include a particular feature, structure, or characteristic, but not all embodiments include the particular feature, structure, or characteristic. Moreover, such phrases do not necessarily refer to the same embodiment. Moreover, when a particular feature, structure, or characteristic is described in connection with an embodiment, it is understood that it is within the knowledge of one of ordinary skill in the art to provide such feature, structure, or characteristic in connection with other embodiments, unless expressly stated to the contrary, whether expressly or not. In other words, even if not expressly shown in a particular combination, it is believed that various individual elements described below can be combined or arranged with each other to form other additional embodiments or to complement and / or enhance the described embodiments, as will be understood by one of ordinary skill in the art.

[0016] Embodiments of the present invention include devices and systems and methods used to extend the working channel. Medical devices (e.g., catheters) that can be designed to extend to a particular treatment site on a patient and / or be compatible with a particular ancillary medical device (e.g., endoscope) can be used with the extension devices of the present invention to reach other treatment sites and / or provide compatibility with other ancillary medical devices.

[0017] As an example, a delivery catheter can be used to deliver a self-expanding drainage stent using an ultrasound endoscope. The stent delivery device can be designed to connect to and function with the ultrasound endoscope. Placement of the drainage stent in the body can be performed by inserting a catheter carrying the stent under ultrasound guidance. The catheter is passed through the wall of a first body lumen (e.g., gastrointestinal tract) into an adjacent lumen (e.g., pseudocyst) and a distal retention member of the stent is deployed. The catheter can then be retracted and a proximal retention member can be positioned in the GI tract (e.g., stomach). Such ultrasound-based procedures can be performed using an ultrasound endoscope, where the shaft of the delivery device is inserted through the ultrasound endoscope. The working channel of the ultrasound endoscope is typically a certain length, e.g., about 125 cm to about 130 cm, and the delivery catheter or device typically extends the entire length of the working channel with a shaft length of about 137 cm to about 138 cm, so that about 8 cm of the distal end of the catheter extends out a predetermined distance within the patient from the distal end of the working channel. This predetermined distance may be within the working range of the ultrasound endoscope to display the treatment site, including the catheter tip and stent, to the user via ultrasound, and while a catheter distal end length that extends longer than this may exceed the working range of the ultrasound endoscope for this procedure, a shorter extended distal end length may not allow for proper insertion, placement, and delivery of the stent.

[0018] Referring to FIG. 1, an example of a device and an ultrasonic endoscope according to the above description for delivery of a drainage stent is shown. The device 140 is connected to the ultrasonic endoscope 130 for manipulation by a user 150. The device 140 is connected to the ultrasonic endoscope 130 via a connector 142, which is a luer lock fitting, providing the device 140 in a locked position relative to the ultrasonic endoscope 130. The user 150 can manipulate the ultrasonic endoscope 130 with one hand while manipulating the device 140 with the other hand. The shaft of the device 140 extends through the working channel of the ultrasonic endoscope 130 and extends a predetermined distance from the distal end of the ultrasonic endoscope 130. The device 140 is in a locked position with the ultrasonic endoscope 130 and has a shaft length that is a predetermined distance so that it does not change in the proximal or distal direction through movement of the device 140 relative to the ultrasonic endoscope by the user. The handle 146 of the device 140 can be sequentially actuated during the procedure to deliver the stent while the distal tip of the shaft of the device is visualized with the ultrasonic endoscope.

[0019] A medical professional may wish to use a medical device designed for a particular auxiliary medical device (e.g., an ultrasound endoscope) having a predetermined working channel length with another auxiliary medical device (e.g., a direct imaging endoscope or an endoscope of a different brand or configuration) having a different working channel length. If a professional user connects the device to another auxiliary device, the portion required for the device's function (e.g., the length of the catheter shaft) may not match the needs of the procedure. For example, the distance that the medical device extends from the distal end of the working channel of different auxiliary devices may vary with the different lengths of the various auxiliary devices. For example, it may be necessary or desirable for the medical device to be locked to the endoscope, for example, to allow manipulation with the endoscope with one hand of the user, or to prevent the medical device from being partially or inadvertently pulled out or extended from the endoscope, and to maintain a predetermined extension distance beyond the working channel by a desired amount.

[0020] Referring to FIG. 2, an embodiment of a system for extending a working channel in accordance with the present invention is shown, including an endoscope 230 inserted into a patient having a working channel therethrough for passage of the device therethrough. An exemplary stent delivery device 240, shown here for illustrative purposes as an AXIOS™ device manufactured by Boston Scientific Corporation, includes a distal end with a shaft 244 extending distally therefrom. The shaft 244 is receivable within the working channel. The shaft 244 is depicted to deliver a stent 246 to a target tissue 260 of the patient. The extension device extending between the delivery device and the endoscope enables the delivery device 240 to maintain the shaft 244 at a predetermined distance from the distal end of the endoscope 230. The extension device 200 is attached between the delivery device 240 and the endoscope 230. The extension device 200 has a tubular inner member 202 having a lumen extending therethrough. The extension device 200 also includes a tubular outer member 204 having a lumen extending therethrough. The lumen of the outer member 204 is configured to receive the inner member 202. The outer member 204 and the inner member 202 are telescopically slidable relative to one another to a desired position corresponding to the adjustable length of the extension device 200. A proximal connector at a proximal end of the outer member 204 is configured to connect to a connector 210 at a distal end of a handle of a delivery device 240. A distal connector 208 at a distal end of the inner member is configured to connect to a proximal end of an endoscope 230. The adjustable length of the device 200 allows the shaft 244 to extend a predetermined distance through the lumens of the outer member 204 and inner member 202 of the extension device 200, through a working channel from the proximal end to the distal end of the endoscope 230, and beyond the distal end of the endoscope 230.

[0021] In various embodiments described herein or within the scope of the present invention, the predetermined distance of the shaft from the distal end of the endoscope can range from, for example, about 7.5 cm to about 8.5 cm. The extension device can be releasable around the shaft of the endoscope and ancillary medical device, such as a delivery device, without withdrawing the shaft proximally through the lumens of the inner and outer members of the extension device. The adjustable length of the extension device can be, for example, a minimum of about 0 centimeters, a maximum of about 3 centimeters, or a minimum of about 0 centimeters and a maximum of about 8 centimeters. The lumens of the inner and outer members can be coaxial. The lumen of the inner member can have a diameter that substantially matches the diameter of the working channel of the endoscope. The lumen of the outer member can have a diameter that substantially matches the outer diameter of the inner member. The extension device can include a locking assembly, such as a set screw shown in FIG. 2, to secure the outer member 204 and the inner member 202 relative to one another in a desired position corresponding to the adjustable length of the extension member 200. The locking assembly of the extension device can have a predetermined fixed position between the proximal end of the endoscope and the distal end of the medical device (e.g., a delivery device) that corresponds to the length of the shaft of the medical device (e.g., a catheter).

[0022] Referring to FIG. 3, an embodiment of an extension device for extending a working channel according to the present invention is shown. The extension device 300 includes a tubular inner member 302 having a lumen extending therethrough. The device 300 also includes a tubular outer member 304 having a lumen extending therethrough configured to receive the inner member 302. The lumen of the outer member 304 may have a diameter that substantially matches the outer diameter of the inner member 302. The outer member 304 and the inner member 302 are telescopically slidable relative to one another to a desired position corresponding to the adjustable length of the device 300. A locking assembly 306 (e.g., a screw, etc.) is configured to fix the relative position of the outer member 304 and the inner member 302 relative to one another at a desired position. The locking assembly 306 locks the outer member 304 in the desired position relative to the inner member 302 by engaging the inner member 302. The locking assembly 306 shown in FIGS. 2-3 includes a knob screw that is disposed through an opening in the outer member 304. A user can tighten the knob screw to engage and lock the inner member 302 relative to the outer member 304. A proximal connector 310 (e.g., a luer lock connector) at the proximal end of the outer member 304 is configured to connect to a distal end of a first medical device (e.g., a stent delivery device). A distal connector 308 (e.g., a female luer lock connector) at the distal end of the inner member 302 is configured to connect to a proximal end of a second medical device (e.g., an endoscope).

[0023] 4, an embodiment of a device for extending a working channel according to the present invention is illustrated, which includes an extension device 400 with a locking assembly. The locking assembly includes a protrusion 406 (e.g., a compressible button, detent) on the inner member 402 that corresponds to a preset opening 412 in the outer member 404. The protrusion 406 can be radially compressed to fully enter and pass through the inner surface of the lumen of the outer member 404, disengaging the inner member 402 from the opening 412 in the outer member 404. This allows the inner member 402 and protrusion 406 to slide relative to the outer member 404, thereby adjusting the overall length of the device 400. In some embodiments, the locking assembly 406 can include multiple preset openings 412 corresponding to multiple desired positions. Multiple positions of the locking assembly 406 can define a predetermined adjustable length of the device 400. For example, the openings 412 and desired positions can correspond to known lengths required for use with various auxiliary devices, such as endoscopes having working channels of different lengths. Each opening 412 may correspond to a certain type of auxiliary device. The protrusion 406 may engage with the opening 412 corresponding to the auxiliary device being used to achieve the appropriate adjustable length of the device 400. The appropriate adjustable length of the device 400 may be such that the shaft extends through the device 400 and only a predetermined length of the shaft extends from the distal end of the auxiliary device. For example, FIG. 4 shows three openings 412 corresponding to three predetermined fixed positions of the inner member 402 relative to the outer member 404 of the device. Thus, in this embodiment, the three example fixed positions correspond to three predetermined adjustable lengths of the extension device that shorten the effective length of the shaft by the amount of the adjustable length of the extension device. Visual indicators, such as markings, may be provided on the inner and / or outer members corresponding to the desired positions. As an alternative to protrusions and openings, in other embodiments, one or both of the inner and outer members may have a fastener comprising a first element on the inner member and a second element on the outer member configured to mate with each other.

[0024] 5A-5F, an embodiment of a device for extending a working channel according to the present invention is shown, including a channel 514 that extends along the inner member 502, along the distal connector 508, and into the lumen of the inner member 502. A channel 516 extends along the outer member 504, along the proximal connector 510, and into the lumen of the outer member 504. The channels 514 and 516 of the inner member 502 and outer member 504 are configured to align with one another. When the channels 514 and 516 are aligned, the device 500 can be placed and removed about a shaft of a medical device that extends through the lumens of the inner member 502 and outer member 504 of the extension, including without the need to withdraw the shaft of the medical device proximally from the extension device. One or both of the outer member 504 and inner member 502 are rotatable relative to one another. The device may be varied between an open configuration in which the channels 514 and 516 are substantially aligned (e.g., as shown in FIGS. 5A-5C) and a closed configuration in which the channels 514 and 516 are substantially not aligned (e.g., as shown in FIGS. 5D-5F). When the device 500 is in the closed position and the shaft extends through the inner and outer members 502 and 504, the device 500 and the shaft are secured such that they cannot be separated from one another and cannot be separated except by removing the shaft proximally through the inner and outer members 502 and 504. When the device 500 is in the open position and the shaft is disposed through the inner and outer members 502 and 504, the device 500 may be removed from about the shaft in a substantially radial direction relative to a longitudinal axis extending through the channels 514, 516 along the length of the shaft. In various embodiments described herein or elsewhere in this specification, one or more channels 514 and / or 516 extending along the distal connector 508 and / or the proximal connector 510 may alternatively be comprised of a porous material, a weakened material, and / or a material that is thinner than the remainder of the connectors 508 and / or 510.Alternatively, the connectors 508 and / or 510 may be made entirely of a material that is breakable by intentional force by a user pulling or peeling the extension device 500 off the shaft. Such an embodiment may allow the device 500 to be removed from the shaft of an endoscope and / or medical device without first removing other parts of the system. Such an embodiment may also allow the device 500 to be removed more quickly compared to removing other auxiliary devices of the system or other medical devices before removing the extension device 500.

[0025] In other embodiments described herein or within the scope of the present invention, the inner and outer members can be made of a variety of polymeric and / or metallic materials, including but not limited to stainless steel, aluminum, polytetrafluoroethylene (PTFE), ethylene tetrafluoroethylene (ETFE), fluorinated ethylene propylene (FEP), polyoxymethylene (POM, e.g., DELRIN® available from DuPont), polyether block esters, polyurethanes (e.g., Polyurethane 85A), polypropylene (PP), polyvinyl chloride (PVC), polyether esters (e.g., ARNITEL® available from DSM Engineering Plastics), ether or ester based copolymers (e.g., butylene / poly(alkylene ether) phthalates, and / or ethylene glycol). polyester elastomers, such as HYTREL® available from DuPont; polyamides (e.g. DURETHAN® available from Bayer or CRISTAMID® available from Elf Atochem); elastomeric polyamides; block polyamide / ethers; polyether block amides (PEBA, such as those available under the trade name PEBAX®); ethylene vinyl acetate copolymers (EVA); silicones; polyethylene (PE); Marlex® high density polyethylene; Marlex® low density polyethylene; linear low density polyethylene (e.g. REXELL®); , polyester, polybutylene terephthalate (PBT), polyethylene terephthalate (PET), polytrimethylene terephthalate, polyethylene naphthalate (PEN), polyether ether ketone (PEEK), polyimide (PI), polyetherimide (PEI), polyphenylene sulfide (PPS), polyphenylene oxide (PPO), polyparaphenylene terephthalamide (such as KEVLAR®), polysulfone, nylon, nylon-12 (such as GRILAMID® available from EMS American Grillon), perfluoro(propyl vinyl ether) (PFA), ethylene vinyl alcohol, polyolefin, polystyrene, epoxy, and / or polyvinylidene chloride (PVdC).Materials can be selected to withstand the forces associated with advancing and retracting medical devices and endoscopes within a patient.

[0026] 6A and 6B, an embodiment of a device for extending a working channel according to the present invention is illustrated and includes a pivotable joint 620 disposed at a distal portion of an inner member 602 of the device 600. The device 600 extends the working channel of an endoscope 630 to accommodate a shaft of a medical device 640 such that the shaft can extend a predetermined distance beyond the distal end of the endoscope. The pivot joint 620 is proximal to a distal connector 608 that connects the device 600 to the endoscope 630. The joint 620 has a first longitudinal axis 627 that is alignable with the longitudinal axis of the endoscope 630 and a portion of the inner member 602 distal to the pivot joint. The joint 620 also has a second longitudinal axis 621 that is alignable with the longitudinal axis of the remaining portion of the inner member 602. The joint 620 includes a sphere 622 at a distal portion of the inner member 602 near the distal connector 608. The sphere 620 has a lumen 624 extending therethrough that is in fluid communication with the lumen of the inner member 602. The joint 620 also includes a cup-shaped body 626 at a distal portion of the inner member 602 proximal to the distal connector 608. The cup-shaped body 626 is disposed about the spherical body 620. The cup-shaped body 626 has a lumen 628 extending therethrough that is in fluid communication with the lumen 624 of the sphere 622. The sphere 620 is rotatable within the cup-shaped body 626 while maintaining the lumens of the inner member 602, the sphere 622, and the cup-shaped body 626 in fluid communication. A shaft 642 of a medical device 640 is extendable through the lumens 624, 628 of the joint 620. The joint 620 can be pivoted such that the first longitudinal axis 627 is at an angle of about 90 degrees to about 180 degrees from the second axis 621. The user can benefit from the pivotable joint 620 because it can allow the medical device 640 and the device 600 to move freely at an angle relative to the cup-shaped body 626 and the endoscope 630. The second axis 621 has the freedom to move 360 ​​degrees in any plane from 90 degrees (perpendicular to the first axis 627) to 180 degrees (parallel to the first axis 627). This can ergonomically assist the user during the procedure.There may be more freedom and comfort for a user operating the medical device 640 and endoscope 630 than in other embodiments in which the medical device, extension device, and endoscope are locked together in one position and cannot pivot relative to one another.

[0027] In various embodiments described herein or within the scope of the present invention, the proximal and / or distal connectors may be male or female luer fittings. One or more of the connectors may include a rotating luer nut and / or a wrapped luer fitting. The connectors may be releasably connected and fastened to various endoscopes and medical devices.

[0028] In other embodiments described herein or within the scope of the present invention, the locking assembly can include a quick release locking nut, a torsional friction fit lock, a slotted fit lock, a button fit lock, a detent lock, or the like.

[0029] In various embodiments described herein or within the scope of the invention, the extension device can be a tubular member of a length corresponding to the endoscope such that the shaft of the catheter extends a predetermined distance distally from the endoscope. The tubular member can have a proximal connector at a proximal end of the member configured to connect to a distal end of a medical device. The tubular member can have a distal connector at a distal end of the member configured to connect to a proximal end of an endoscope.

[0030] In various embodiments, a method of extending a length of a working channel may include inserting an endoscope having a working channel into a patient. A catheter is inserted into the patient through the working channel. An extension device may have a lumen extending through and around the shaft of the catheter. The extension device may be attached to a proximal end of the working channel. The catheter may be attached to a proximal end of the extension device. The extension device may be adjusted to a desired position corresponding to an adjustable length of the extension device. The extension device may be locked at the desired position. The extension device may be adjusted to a desired position such that a distal tip of the catheter extends a maximum of about 8 cm from a distal end of the endoscope. The tip of the catheter may be visualized using the endoscope. The extension device may be removed from around the endoscope and the shaft of the catheter while the catheter remains within the working channel of the endoscope. The positioning step may include positioning the extension device around the shaft after the catheter is inserted into the patient. The positioning step may include positioning the extension device around the shaft before the catheter is inserted into the patient. The desired position may include at least one predetermined locking position of a locking assembly of the extension device configured to lock the adjustable length. The desired position can include a plurality of predetermined fixed positions. The plurality of channels of the extension device can be aligned with one another such that the extension device can be placed and removed about the shaft of the catheter. The extension device can transition between an open configuration in which the channels are substantially aligned and a closed configuration in which the channels are substantially misaligned.

[0031] (Additional Note) The technical ideas that can be understood from the above-described embodiments will be described below. [Item 1] a tubular inner member having a lumen extending therethrough; a tubular outer member having a lumen therethrough, the lumen of the outer member being configured to receive the inner member, the outer member and the inner member being telescopically slidable relative to one another to a desired position corresponding to an adjustable length of the extension device; a locking assembly configured to secure the outer and inner members relative to one another in a desired position; a proximal connector configured to releasably connect to a distal end of a first medical device and at a proximal end of the outer member; a distal connector configured to releasably connect to a proximal end of a second medical device and at a distal end of the inner member; the first medical device extends through and beyond the distal end of the second medical device to deliver a stent from the distal end of the first medical device; the distal end of the first medical device further comprises a shaft extending distally therefrom, the adjustable length of the extension device being such that the shaft extends through lumens of the outer and inner members of the extension device and from the proximal end to the distal end of the second medical device a predetermined distance beyond the distal end of the second medical device; The extension device is removable from about the shaft of the first medical device without withdrawing the shaft proximally through the lumens of the inner and outer members. [Item 2] Item 2. The extension device of item 1, wherein the predetermined distance is 8 centimeters. [Item 3] 3. The extension device of item 1 or 2, wherein the first medical device is a delivery catheter and the second medical device is an endoscope. [Item 4] 2. The extension device according to item 1, wherein the adjustable length is a minimum of 0 centimeters and a maximum of 8 centimeters. [Item 5] Item 2. The extension device of item 1, wherein the desired position comprises at least one predetermined fixed position of the locking assembly. [Item 6] Item 2. The extension device of item 1, wherein the desired position comprises a plurality of predetermined fixed positions of the locking assembly. [Item 7] a tubular inner member having a lumen extending therethrough; a tubular outer member having a lumen therethrough, the lumen of the outer member being configured to receive the inner member, the outer member and the inner member being telescopically slidable relative to one another to a desired position corresponding to an adjustable length of the extension device; a locking assembly configured to secure the outer and inner members relative to one another in a desired position; a proximal connector configured to releasably connect to a distal end of a first medical device and at a proximal end of the outer member; a distal connector configured to releasably connect to a proximal end of a second medical device and at a distal end of the inner member; a channel extending along the inner tubular member, along the distal connector, and into a lumen of the inner tubular member; a channel extending along the tubular outer member, along the proximal connector, and to a lumen of the tubular outer member; the channels of the inner tubular member and the outer tubular member are aligned with one another such that the extension device is placed and removed about a shaft of the first medical device; An extension device, wherein the first medical device extends through and beyond the distal end of the second medical device to deliver a stent from the distal end of the first medical device. [Item 8] 8. The extension device of claim 7, wherein at least one of the outer member and the inner member is rotatable relative to one another such that the extension device can be transitioned between an open configuration in which the channels of the inner member are aligned with the channels of the outer member and a closed configuration in which the channels of the inner member are not aligned with the channels of the outer member. [Item 9] a tubular inner member having a lumen extending therethrough; a tubular outer member having a lumen therethrough, the lumen of the outer member being configured to receive the inner member, the outer member and the inner member being telescopically slidable relative to one another to a desired position corresponding to an adjustable length of the extension device; a locking assembly configured to secure the outer and inner members relative to one another in a desired position; a proximal connector at a proximal end of the outer member, the proximal connector being configured to connect to a distal end of a first medical device; a distal connector configured to connect to a proximal end of a second medical device and at a distal end of the inner member; a pivotable joint disposed on a distal portion of the inner member proximal to the distal connector, the joint having a first longitudinal axis alignable with a longitudinal axis of the second medical device and a portion of the inner member distal to the pivotable joint, the joint having a second longitudinal axis alignable with a longitudinal axis of a remainder of the inner member; An extension device, wherein the first medical device penetrates and extends beyond the distal end of the second medical device to deliver a stent from the distal end of the first medical device. [Item 10] The pivotable joint is a sphere at a distal portion of the inner member, the sphere having a lumen extending therethrough and in fluid communication with a lumen of the inner member; a cup-shaped body disposed about the sphere and at a distal portion of the inner member, the cup-shaped body having a lumen extending therethrough and in fluid communication with a lumen of the sphere; 10. The extension device of claim 9, wherein the sphere is capable of pivoting within the cup-shaped body while maintaining the lumens of the inner member, the sphere, and the cup-shaped body in fluid communication. [Item 11] Item 11. The extension device of item 10, wherein the locking assembly is a protrusion on the inner member that corresponds to a pre-set opening in the outer member. [Item 12] Item 12. The extension device of item 11, wherein the locking assembly has a plurality of pre-set openings corresponding to a plurality of desired positions, thereby defining a plurality of predetermined adjustable lengths. [Item 13] Item 13. The extension device of item 11 or 12, wherein the protrusion comprises a compressible button to release the inner member from the outer member. [Item 14] 9. The extension device of any one of items 1 to 8, wherein the locking assembly is a protrusion on the inner member that corresponds to a preset opening in the outer member. [Item 15] Item 15. The extension device of item 14, wherein the locking assembly includes a plurality of preset openings corresponding to a plurality of desired positions, the plurality of preset openings defining a plurality of predetermined adjustable lengths. [Item 16] 16. The extension device of claim 14 or 15, wherein the protrusion comprises a button compressible to disengage the inner member from the outer member. All of the devices and / or methods disclosed and claimed herein can be made and executed in light of the present invention without undue experimentation. Although the devices and methods of the present invention have been described with reference to specific embodiments, it will be apparent to those skilled in the art that variations may be applied to the devices and / or methods, and to the steps or sequence of steps of the methods described herein, without departing from the concept, spirit and scope of the invention. All such similar substitutes and modifications apparent to those skilled in the art are deemed to be within the scope of the present invention.

Claims

1. a first medical device comprising a delivery catheter; Extension device and wherein the extension device comprises: a tubular inner member including a lumen extending therethrough and having a protrusion; a tubular outer member including a lumen extending therethrough and having an opening; a proximal connector at a proximal end of the tubular outer member and configured to be removably connected to a distal end of the first medical device; a distal connector at a distal end of the inner tubular member and configured to be removably connected to a proximal end of an endoscope; Equipped with the lumen of the tubular outer member is configured to receive the tubular inner member; the outer tubular member and the inner tubular member are telescopically slidable relative to one another; the projections are configured to engage the openings to secure the outer tubular member relative to the inner tubular member in a desired position. A medical delivery device system.

2. 2. The medical delivery device system of claim 1, wherein the opening is a first opening of a plurality of openings, the desired location is a first desired location of a plurality of desired locations, and the protrusion is configured to engage any one of the plurality of openings to secure the tubular outer member relative to the tubular inner member for each one of the plurality of desired locations.

3. The medical delivery device system of claim 2 , wherein the protrusion comprises a compressible button to disengage the inner tubular member from one of the plurality of openings to disengage the outer tubular member from the inner tubular member.

4. The medical delivery device system of claim 1 , wherein the protrusion comprises a compressible button to disengage the inner tubular member from the opening and disengage the outer tubular member from the inner tubular member.

5. 5. The medical delivery device system of claim 1, wherein the length of the extension device when fixed in the desired position allows the delivery catheter to be extended a predetermined distance through the lumens of the tubular outer member and the tubular inner member beyond the distal end of the tubular inner member.

6. 5. The medical delivery device system of claim 1, wherein the delivery catheter is configured to extend a predetermined distance through the distal end of the endoscope and beyond the distal end of the working channel of the endoscope to deliver a stent from the distal end of the delivery catheter.

7. The medical delivery device system of claim 6 , wherein the predetermined distance is 8 cm.

8. 5. The medical delivery device system of claim 1, wherein the extension device is configured to be removable from around the delivery catheter of the first medical device without withdrawing the delivery catheter proximally through the lumen of the tubular inner member and the lumen of the tubular outer member.

9. 5. The medical delivery device system of claim 1, further comprising a joint disposed on a distal portion of the tubular inner member proximal to the distal connector, the joint having a first longitudinal axis alignable with a longitudinal axis of the endoscope and a portion of the tubular inner member distal to the joint, the joint having a second longitudinal axis alignable with a longitudinal axis of a remaining portion of the tubular inner member.

10. a tubular inner member including a lumen extending therethrough and having a protrusion; a tubular outer member including a lumen extending therethrough and having an opening; a proximal connector at a proximal end of the tubular outer member and configured to be removably connected to a distal end of a first medical device; a distal connector at a distal end of the inner tubular member and configured to be removably connected to a proximal end of a second medical device; Equipped with the lumen of the tubular outer member is configured to receive the tubular inner member; the outer tubular member and the inner tubular member are telescopically slidable relative to one another; the projections are configured to engage the openings to secure the outer tubular member relative to the inner tubular member in a desired position. Extension device.

11. 11. The extension device of claim 10, wherein the opening is a first opening of a plurality of openings, the desired location is a first desired location of a plurality of desired locations, and the protrusion is configured to engage any one of the plurality of openings to secure the tubular outer member relative to the tubular inner member to each one of the plurality of desired locations.

12. The extension device of claim 11 , wherein the protrusion comprises a compressible button to disengage the inner tubular member from one of the plurality of openings to disengage the outer tubular member from the inner tubular member.

13. The extension device of claim 10 , wherein the protrusion comprises a compressible button to disengage the inner tubular member from the opening and disengage the outer tubular member from the inner tubular member.

14. 14. The extension device of any one of claims 10 to 13, wherein the distal end of the first medical device further comprises a shaft extending distally from the first medical device, and the length of the extension device when secured in the desired position is such that the shaft is extendable a predetermined distance through the lumens of the tubular outer member and the tubular inner member beyond the distal end of the tubular inner member.

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