Device tip

Abstract

To provide an endoscope tip for positioning an endoscope device.SOLUTION: In one aspect of the present disclosure, a device includes a shaft having a distal end, and a tip at the distal end of the shaft. The tip includes an opening defined by a surface of the tip. An instrument inserted through the shaft extends distally out of the opening. The device also includes an elevator for engaging the instrument. The elevator includes a proximal end fixed relative to the surface of the tip, a proximal portion extending distally from the proximal end, and a distal portion extending distally from the proximal portion. A force exerted on the elevator bends the proximal portion to deflect the distal portion without bending the distal portion.SELECTED DRAWING: Figure 2

Description

[Technical Field]

[0001] The present invention relates to a tip for an instrument, and more particularly to an endoscope tip for positioning an endoscopic instrument. [Background technology]

[0002] Endoscopic retrograde cholangiopancreatography (ERCP) is a technique for treating patients with pancreatic and biliary tract diseases. In some cases, ERCP is performed using a side-viewing endoscope. The distal end of the side-viewing endoscope includes a side-viewing optical system, an optical lens cleaning system, a side-viewing light source, a side-exiting working channel, and an elevator assembly for elevating instruments extending outside the side-exiting working channel. These features can assist a user in cannulating the patient's papilla with diagnostic or therapeutic instruments to access target sites in the patient's pancreas. However, the elevator assembly has a complex structure containing multiple components, making it expensive to manufacture and maintain (e.g., clean and repair). Improving the complex structure of the elevator assembly may reduce the overall cost associated with endoscope use. Furthermore, if the overall cost is kept within a certain amount, disposable endoscopes may be possible. Using an endoscope only once before discarding it may reduce the cost and time associated with maintaining an endoscope and potentially improve outcomes by eliminating the risk of exposing patients to infection due to improper endoscope cleaning. Summary of the Invention

[0003] The present invention relates particularly to tips for devices. Each embodiment described herein can include one or more of the elements described in connection with any other embodiment disclosed. In one aspect of the invention, a device includes a shaft having a distal end and a tip portion at the distal end of the shaft. The tip portion includes an opening formed in a surface of the tip portion. An instrument inserted through the shaft extends distally out of the opening. The device also includes an elevator portion that engages the instrument. The elevator portion includes a proximal end fixed to a surface of the tip portion, a proximal portion extending distally from the proximal end, and a distal portion extending distally from the proximal portion. A force applied to the elevator portion bends the proximal portion, biasing the distal portion without bending the distal portion.

[0004] In another aspect of the invention, the device comprises one or more of the following elements: The distal portion has a larger cross-sectional area than the proximal portion; The distal portion has a thickness greater than the proximal portion in the anterior-posterior direction, the anterior-posterior direction being perpendicular to the proximal-distal direction; The tip portion may be constructed from a single material; The elevator portion may be constructed from a single material; The outer surface of the elevator portion and the surface of the tip portion are part of a continuous surface; The outer surface of the distal portion of the elevator portion is continuous with the outer surface of the proximal portion of the elevator portion; The proximal portion has a substantially straight rest configuration and a curved configuration; When the proximal portion transitions from the rest configuration to the curved configuration, the proximal portion moves the distal portion along an arcuate path in the anterior and proximal directions.

[0005] In another aspect of the invention, a device includes a shaft having a distal end. The device includes a tip at the distal end of the shaft. The tip includes an instrument opening. An instrument inserted through the shaft extends distally out of the instrument opening. The tip includes an elevator portion that engages the instrument when the instrument extends distally out of the instrument opening. The elevator portion includes a passage extending therethrough. The device includes a control wire coupled to the elevator portion. A proximal pulling force applied to the control wire biases the elevator portion. The device includes a first control wire opening and a second control wire opening. A first portion of the control wire extends from the first control wire opening to the passage. A second portion of the control wire extends from the second control wire opening to the passage. A third portion of the control wire extends through the passage and connects the first portion of the control wire to the second portion of the control wire.

[0006] In another aspect of the invention, the device comprises one or more of the following features: a handle at the proximal end of the shaft; the handle comprising a drive mechanism for applying a proximal pulling force to the control wire; the drive mechanism operably connected to a first portion of the control wire and a second portion of the control wire to simultaneously apply a proximal pulling force to the first portion and the second portion of the control wire; the elevator portion comprising opposing sides; at least one of the sides comprising a channel for receiving at least a portion of the control wire; the opening in the passageway being within the channel; the tip portion comprising sidewalls on opposing sides of the elevator portion; at least one of the sidewalls comprising a channel for receiving at least a portion of the control wire; the tip portion being a one-piece, unitary polymeric component.

[0007] In another aspect of the invention, a device includes a shaft having a distal end. The device also includes a tip portion at the distal end of the shaft. The tip portion includes an elevator portion. An instrument inserted through the shaft extends distally to engage the elevator portion. The device may include a drive to bias the elevator portion. The elevator portion includes a proximal portion having a proximal end fixed relative to the shaft. The elevator portion also includes a distal portion extending distally from the proximal portion. The proximal portion has a smaller cross-sectional area than the distal portion, so that a force applied to the elevator portion can bend the proximal portion and bias the distal portion. The elevator portion is formed from a single, continuous piece of material.

[0008] In another aspect of the invention, the device comprises one or more of the following elements: the single, continuous member is a continuous member made of injection-molded polymer; the proximal portion comprises one or more recesses so that the proximal portion has one or more thinned portions and one or more thickened portions, facilitating bending of the proximal portion along the one or more thinned portions; the distal portion comprises at least one portion connected to the single, continuous member; and the at least one portion may be formed of a material that is more rigid than the single, continuous member; and the drive unit comprises a control wire connected to the lift portion.

[0009] It is to be understood that the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of the invention as claimed. The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate aspects of the invention and, together with the detailed description, serve to explain the principles of the invention. [Brief explanation of the drawings]

[0010] [Figure 1] 1 is a diagram illustrating an endoscope according to an embodiment of the present invention. [Figure 2] 2 is a perspective view showing the distal end portion of the endoscope of FIG. 1 according to an embodiment of the present invention. [Figure 3] FIG. 2 is a front view showing the distal end portion of the endoscope of FIG. 1 according to an embodiment of the present invention. [Figure 4] 2 is a side view showing the distal end portion of the endoscope of FIG. 1 according to an embodiment of the present invention in a first configuration. [Figure 5] 2 is a side view showing the distal end portion of the endoscope of FIG. 1 in a second configuration according to an embodiment of the present invention. [Figure 6] FIG. 1 is a front view of a distal end portion of an alternative endoscope according to an aspect of the present invention. [Figure 7A] 1 is a front view showing a living hinge at the distal end of an endoscope according to an embodiment of the present invention; [Figure 7B] FIG. 1 is a side view showing a living hinge at the distal end of an endoscope according to an embodiment of the present invention. [Figure 8A] FIG. 2 is a top view showing a lifting unit according to an embodiment of the present invention. [Figure 8B] FIG. 2 is a front view showing a lifting unit according to an embodiment of the present invention. DETAILED DESCRIPTION OF THE INVENTION

[0011] The present invention relates to an instrument tip, and more particularly to an endoscope tip for positioning an endoscopic instrument. Aspects of the invention are described in detail below, with examples illustrated in the accompanying drawings. Wherever possible, the same reference numerals are used throughout the drawings to refer to identical or similar parts. The term "distal" refers to the portion of the instrument furthest from the user of the instrument when it is being introduced into a patient's body. Conversely, the term "proximal" refers to the portion of the instrument closest to the user when it is positioned within a patient's body. The terms "anterior" and "posterior" refer to directions or regions extending perpendicular to the proximal and distal directions. While the following description refers to an "endoscope" or "endoscopic viewing," the principles or aspects of this description may be used with any suitable introducer sheath or device, even if the introducer sheath or device does not include one or more features generally associated with an "endoscope." The following general and detailed descriptions are exemplary and explanatory only and do not limit the claimed features. Additionally, as used herein, the terms "comprises," "comprising," or variations thereof are intended to cover a non-exclusive inclusion, such that a process, method, component, or apparatus consisting of a series of elements does not necessarily include only those elements, but may also include other elements not expressly stated or essential to such process, method, component, or apparatus. Also, the term "exemplary" is used to mean "example" rather than "best."

[0012] 1 illustrates a device 100 for placing an instrument 102. The device 100 may be any type of endoscope, such as a duodenoscope. The instrument 102 may include any suitable instrument, such as a guidewire, cutting or grasping forceps, a biopsy device, a snare loop, an injection needle, a dissection blade, scissors, a retractable basket, a retrieval device, an ablation or electrophysiology catheter, a stent placement device, a surgical stapling device, a balloon catheter, or a laser delivery device. In one example, the device 100 cannulate a patient's papilla during an ERCP procedure to facilitate placement of the instrument 102 therein.

[0013] The device 100 includes a shaft 104. The shaft 104 includes a tube 106 that is sufficiently flexible to bend, rotate, and twist while being inserted through and within a patient's tortuous anatomy to a target site within the patient's body. The shaft 104 includes one or more lumens (not shown) extending therethrough, including, for example, a control wire lumen for receiving one or more control wires, a working lumen for receiving the instrument 102, a fluid lumen for delivering fluids, an illumination lumen for receiving at least a portion of an illumination assembly (not shown), and an imaging assembly lumen for receiving at least a portion of an imaging assembly (not shown).

[0014] The device 100 also includes a tip 108 at the distal end of the shaft 104. The tip 108 is attached to the distal end of the shaft 104. For example, the tip 108 may be a cap configured to receive the distal end of the shaft 104. The tip 108 may include one or more openings that communicate with the lumen of the shaft 104. For example, the tip 108 may include control wire openings 110, 112 through which one or more control wires exit a control wire lumen of the shaft 104, a working opening 114 through which the instrument 102 exits a working lumen of the shaft 104, a fluid opening or fluid nozzle 116 through which fluid exits a fluid lumen of the shaft 104, an illumination opening or illumination window 118 through which light is emitted, and an imaging opening or imaging window 120 that receives light used by an imaging device to form an image. Although not shown in FIG. 1, the illumination opening 118 may include a light-emitting portion (e.g., a light-emitting diode, etc.) connected to a cable or wire extending through the illumination lumen of the shaft 104, and the imaging opening 120 may include an imaging device (e.g., a CCD imager, complementary metal oxide semiconductor, etc.) connected to a cable or wire extending through the imaging lumen of the shaft 104.

[0015] The control wire openings 110, 112 are located on a distal-facing surface 124 of the tip section 108. The working opening 114 is located on a distal-facing surface 126 of the tip section 108. The distal-facing surface 126 is set back proximally from the distal-facing surface 124. The illumination opening 118 and the imaging opening 120 are located on the forward-facing surface 128. The fluid opening 116 is located on the distal-facing surface 124 and opens toward the illumination opening 118 and the imaging opening 120 for flowing an irrigation fluid across the illumination opening 118 and the imaging opening 120, for example, to flush away bodily fluids or debris.

[0016] The working opening 114 opens into a cavity 130 in the tip 108. The cavity 130 is formed by a distally facing surface 126, laterally facing sidewalls 132, 134, a rearwardly facing surface 136, and a forwardly facing surface 138 of the elevator portion 140. The instrument 102 is positioned to extend distally out of the working opening 114 and into the cavity 130 and engage the forwardly facing surface 138 of the elevator portion 140. The forwardly facing surface 138 of the elevator portion 140 may, for example, include a recess 168 (e.g., a slot, groove, cavity, etc.) formed therein. The recess 168 may receive at least a portion of the instrument 102 and exert a holding or gripping force on the instrument 102.

[0017] Elevator portion 140 is cantilevered and has a proximal end 142 fixed to distally-facing surface 126 and a free distal end 144. Elevator portion 140 includes a proximal portion 146 and a distal portion 148. Proximal portion 146 is thinner than distal portion 148 to allow proximal portion 146 to bend more easily. This is because distal portion 148 is stiffer than proximal portion 146 due to its thickness. In some instances, proximal portion 146 bends while distal portion 148 remains unbent.

[0018] The proximal portion 146 may have a rectangular cross-sectional shape to facilitate bending along the anterior-posterior direction. Additionally or alternatively, the length (along the proximal-distal direction) of the proximal portion 146 is greater than the width (along the lateral direction perpendicular to the proximal-distal direction) of the proximal portion 146, and the width of the proximal portion 146 is greater than the height / thickness (along the anterior-posterior direction) of the proximal portion 146. Additionally or alternatively, the proximal portion 146 may have a generally constant thickness from the distal-facing surface 126 all the way to the proximal end of the distal portion 148, although at the proximal end of the distal portion, the elevation portion 140 may have an abrupt increase in thickness. The forward-facing surface 138 is angled (e.g., sloped) relative to the proximal portion 146 to facilitate engagement between the forward-facing surface 138 and the instrument 102. Additionally or alternatively, one or more of the rearward-facing surface of the proximal portion 146 and the forward-facing surface of the proximal portion 146 are generally planar or generally perpendicular to one or more of the laterally-facing side walls 132, 134.

[0019] The proximal portion 146 functions as a living hinge, allowing the distal portion 148 of the elevator portion 140 to move relative to the rest of the tip portion 108. As the proximal portion 146 bends, the distal portion 148 moves along an arcuate path that covers a distance in the proximal-distal and anterior-posterior directions. In some examples, the elevator portion 140 is integral with the rest of the tip portion 108. For example, as shown in FIG. 2, the tip portion 108 is a single, unitary, injection-molded component. The tip portion 108 may be formed from a polymeric material, such as polyethylene, polypropylene, or other suitable polymer. The tip portion 108 may be formed from other suitable processes and materials to form the tip portion 108 as a single piece from the same material throughput.

[0020] The distal portion 148 may be thicker than the proximal portion 146 to provide a space for the passageway 150. The thickness of the distal portion 148 ensures that the distal portion 148 does not bend, so that the curvature of the elevator portion 140 is limited to the proximal portion 146. The passageway 150 may be a through-hole extending between opposite laterally facing surfaces 152, 154 of the elevator portion 140. The passageway 150 receives the control wire 122. For example, a first portion 156 of the control wire 122 extends distally from the control wire opening 110 to the laterally facing surface 152 and the passageway 150 (see FIG. 3). A second portion 158 of the control wire 122 extends distally from the control wire opening 112 to the laterally facing surface 154 and the passageway 150. A third portion (not shown) of the control wire 122 extends through the passageway 150. The first portion 156 , second portion 158 , and third portion of the control wire 122 form a U-shaped region of the control wire 122 .

[0021] Channels 160, 162, 164, and 166 are provided in sidewall 132, side-facing surface 152, side-facing surface 154, and sidewall 134 for receiving a portion of control wire 122. The received portion of control wire 122 slides along channels 160 and 166 as control wire 122 is retracted into and extended out of control wire openings 110 and 112. In the illustrated example, passageway 150 opens into channels 162 and 164. The control wire 122 is tensioned through the passageway 150 by biasing the lifting section 140 rearward to expose the passageway 150 from behind the side walls 132, 134, inserting the control wire 122 through the passageway 150, aligning the control wire 122 with the channels 160, 162, 164, 166, and inserting the control wire 122 into the control wire openings 110, 112.

[0022] By pulling on one or both of the first and second portions 156, 158 of the control wire 122, a user can retract the control wire 122 into the control wire openings 110, 112. This retraction causes the proximal portion 146 of the elevator portion 140 to bend as the distal portion 148 of the elevator portion 140 is pulled toward the distally-facing surface 124. Figures 3 and 4 show the tip portion 108 when the elevator portion 140 is at rest, while Figure 5 shows the tip portion 108 when a force is applied by the control wire 122 to the distal portion 148 of the elevator portion 140, causing the proximal portion 146 of the elevator portion 140 to bend. Pulling on both the first and second portions 156, 158 of the lifting section 140 securely pulls the lifting section 140 toward the distally facing surface 124 with little or no twisting or torque, ensuring that the instrument 102 is positioned at the desired site.

[0023] The instrument 102 may be retained in the recess 168 of the distal portion 148 as the distal portion 148 is pulled toward the distal-facing surface 124. When the distal portion 148 is biased, it biases and adjusts the position of the instrument 102. The instrument 102 may extend, retract, or rotate (twist) out of the working lumen or working opening 114 of the shaft 104 before, during, or after being biased by the distal portion 148. Continued pulling on the control wire 122 may cause the distal portion 148 to lock the instrument 102 against the protrusion 170 on the distal-facing surface 124, thereby locking the instrument 102 in place relative to the tip 108. When locked, the instrument 102 is prevented from extending, retracting, or rotating, or these actions are disabled. In one example, protrusion 170 has a shape complementary to the shape of recess 168 to facilitate retaining or locking instrument 102 between protrusion 170 and distal portion 148. For example, protrusion 170 has a wedge shape. When the user releases the pull on control wire 122 or extends it distally, proximal portion 146 essentially transitions to its uncurved shape, causing distal portion 148 to move back away from distally-facing surface 124 and toward the orientation shown in FIGS. 2-4 , thereby unlocking instrument 102.

[0024] The device 100 includes a handle 172 coupled to the proximal end of the shaft 104. The handle 172 may include one or more lumens (not shown) that communicate with the lumen of the shaft 104. The handle 172 may also include one or more ports that open into the one or more lumens of the handle 172. For example, the instrument 102 is inserted into the port 174 before the working lumen of the shaft 104. In one example, the handle 172 includes a cable 176. The cable 176 connects one or more external systems (not shown) to the device 100. The cable 176 may, for example, connect the handle 172 to a fluid supply, an illumination source, an imaging processor, a display, etc.

[0025] The handle 172 may also include a drive mechanism 178. The drive mechanism 178 may include one or more knobs, buttons, levers, switches, or other suitable drives for controlling at least one of the biasing of the shaft 104, the delivery of fluid, the application of illumination, and the imaging functions. In one example, the drive mechanism 178 may be operatively connected to a proximal portion of the control wire 122 that extends proximally into the handle 172 from the control wire openings 110, 112. A device user may manipulate the drive mechanism 178 to selectively apply a pulling force and / or a pushing force to the control wire 122 to adjust the position of the elevator 140 and thereby adjust the position of the instrument 102.

[0026] FIG. 6 shows another embodiment of tip 108'. Tip 108' is similar to tip 108, except that tip 108' is formed of separate components and connected together at joint 109'. In one example, tip 108' on a first side of joint 109' is a single, unitary component, while tip 108' on a second side of joint 109' is another single, unitary component. By forming the components separately and then connecting them, one material can be used for one component and a different material (with different properties) can be used for the other component. For example, to facilitate bending of the lift section, the component on the left side of joint 109' can be formed of a more flexible material than the material used to form the component on the right side of joint 109'.

[0027] In the example shown in FIG. 6 , the components to the left of the connection portion 109′ include the elevator portion, working openings, control wire openings, distally facing surface, laterally facing sidewalls, and rearward facing surface, similar to those in the tip portion 108. The components to the right of the connection portion 109′ include the fluid openings, laterally facing sidewalls, forward facing surface, imaging openings, and illumination openings, similar to those in the tip portion 108. However, it should be understood that the connection portion 109′ can separate the tip portion 108′ in any other suitable manner. It is contemplated that the connection portion 109′ can be along a straight line traversing the tip portion 108′ or can include one or more curves or corners as it traverses the tip portion 108′. It is contemplated that the connection portion 109′ can separate the tip portion 108′ into multiple components.

[0028] 7A and 7B show another embodiment of the proximal portion 146' of the elevator section. The proximal portion 146' may include one or more features thereon to precisely adjust the curvature of the proximal portion 146'. In one example, the proximal portion 146' may include cutouts or recesses 147' (e.g., notches, grooves, slots, holes, etc.) formed in thinner portions of the proximal portion 146' to facilitate curvature. Additionally or alternatively, the proximal portion 146' may include protrusions (e.g., ridges, spines, etc.) (not shown) formed in thicker portions of the proximal portion 146' to limit curvature. The cutouts, recesses, or protrusions may be on the rearward-facing surface of the proximal portion 146', the forward-facing surface of the proximal portion 146', or one or more side-facing surfaces of the proximal portion 146'.

[0029] 8A and 8B show another embodiment of an elevator 140' that includes multiple recesses 168', 169'. The recesses 168', 169' can have different properties. For example, one of the recesses 168', 169' can be wider, deeper, or longer than the other. Recess 168' can be sized to hold a larger instrument, while recess 169' can be sized to hold a smaller instrument.

[0030] Those skilled in the art will recognize that various modifications and variations can be made in the disclosed systems and methods without departing from the scope of the invention. Those skilled in the art will also recognize other aspects of the present disclosure by considering the specification and practicing the features described herein. Accordingly, the specification and examples are intended to be illustrative only.

[0031] (Appendix 1) a shaft having a distal end; a tip disposed at the distal end of the shaft, the tip comprising: a first channel disposed along a surface of the tip; an opening formed in the surface of the tip, and an instrument inserted through the shaft extending distally out of the opening; and a lifting portion that engages with the tool, the lifting portion comprising: a proximal end secured to the surface of the tip; a proximal portion extending distally from the proximal end; a distal portion extending distally from the proximal portion and having a width defined between opposing side walls; a second channel disposed along at least one of the opposing side walls of the distal portion; a passageway extending through the width of the distal portion; When the elevator section is in a lowered position, a control wire is received within the first channel, the second channel, and the passage, and a force applied to the elevator section bends the proximal section and biases the distal section to an elevated position without bending the distal section, and when the elevator section moves to the elevated position, the control wire slides along the first channel while being held within the second channel and the passage.

[0032] (Appendix 2) 10. The device of claim 1, wherein the distal portion has a larger cross-sectional area than the proximal portion. (Appendix 3) 3. The device of claim 1 or 2, wherein the distal portion is thicker than the proximal portion along an anterior-posterior direction, the anterior-posterior direction being perpendicular to the proximal-distal direction.

[0033] (Appendix 4) 4. The device of any one of claims 1 to 3, wherein the tip is constructed from a single material. (Appendix 5) 5. The device according to any one of claims 1 to 4, wherein the lifting section is made of a single material.

[0034] (Appendix 6) 6. The device according to any one of claims 1 to 5, wherein the outer surface of the lifting section and the surface of the tip section are part of a continuous surface.

[0035] (Appendix 7) 7. The device of any one of claims 1 to 6, wherein an outer surface of the distal portion of the lifting section is continuous with an outer surface of the proximal portion of the lifting section.

[0036] (Appendix 8) 8. The device of any one of claims 1 to 7, wherein the proximal portion has a linear resting configuration when the lifting portion is in the lowered position and a curved configuration when the lifting portion is in the raised position, and the proximal portion moves along an arcuate path forward and proximally relative to the distal portion when the proximal portion transitions from the resting configuration to the curved configuration.

[0037] (Appendix 9) a shaft having a distal end; a tip disposed at the distal end of the shaft, the tip comprising: an instrument opening, and an instrument inserted through said shaft extending distally out of said instrument opening; a pair of first channels disposed on opposite sides of the tip portion; an elevator portion that engages the instrument when the instrument extends distally out of the instrument opening, the elevator portion including a pair of second channels and a passageway extending through the interior of the elevator portion and disposed between the pair of second channels; a control wire coupled to the elevator portion, and a proximal pulling force applied to the control wire biasing the elevator portion; a first control wire opening, a second control wire opening, a first portion of the control wire extending from the first control wire opening to one of the pair of first channels, one of the pair of second channels, and the passageway, a second portion of the control wire extending from the second control wire opening to the other of the pair of first channels, the other of the second channel, and the passageway, and a third portion of the control wire extending through the passageway to couple the first portion of the control wire to the second portion of the control wire; A device in which a first portion of the control wire is received within one of the pair of first channels, one of the pair of second channels, and the passage when the lifting unit is in a lowered position, and when the lifting unit moves to a raised position, the first portion of the control wire slides along one of the pair of first channels while being held within one of the pair of second channels and the passage.

[0038] (Appendix 10) 10. The device of claim 9, further comprising a handle at a proximal end of the shaft, the handle comprising a drive mechanism for exerting a proximal force on the control wire, the drive mechanism operably connected to a first portion of the control wire and a second portion of the control wire, and configured to simultaneously exert a proximal pulling force on the first portion and the second portion of the control wire.

[0039] (Appendix 11) 11. The device of claim 9 or 10, wherein the lifting portion has opposing sides, at least one of the sides having at least one of the pair of second channels that receives at least a second portion of the control wire.

[0040] (Appendix 12) 12. The apparatus of claim 11, wherein at least one opening in the passage is in each channel of the pair of second channels.

[0041] (Appendix 13) 13. The device according to any one of claims 9 to 12, wherein the tip portion has side walls on opposing sides of the lifting portion.

[0042] (Appendix 14) 14. The device of claim 13, wherein at least one of the side walls includes at least one of the pair of first channels that receives at least a first portion of the control wire.

[0043] (Appendix 15) 15. The device of any one of claims 9 to 14, wherein the tip is a single piece, a single polymeric component.

[0044] (Appendix 16) A shaft and a distal tip, the distal tip comprising: a first channel in an inner wall of the distal tip; and a lifting unit configured to move between a first position and a second position, the lifting unit comprising: a second channel provided on an outer wall of the lifting section; and A third channel is provided inside the lifting section. a distal tip; Equipped with The first channel, the second channel, and the third channel are each configured to receive at least a portion of a control wire when the elevator unit is located in the first position, and are configured to move the control wire from the first channel and be maintained within the second channel and the third channel when the elevator unit moves to the second position. Device.

[0045] (Appendix 17) the distal tip includes an opening for receiving an instrument inserted within the shaft such that the instrument extends distally out of the distal tip; 17. The device of claim 16, wherein the lifting portion is configured to bias the instrument against the distal tip when the control wire moves out of the first channel and the lifting portion moves to the second position.

[0046] (Appendix 18) The lifting unit is a proximal portion fixed relative to the inner wall; 17. The device of claim 16, comprising a distal portion movable relative to the proximal portion and having a width defined between the inner wall and opposing side walls of the lifting portion.

[0047] (Appendix 19) 19. The device of claim 18, wherein the third channel has a longitudinal length that is less than the width of the distal portion, and the third channel is surrounded by the distal portion.

[0048] (Appendix 20) 19. The device of claim 18, wherein the lifting section is configured to bend at a portion intermediate the proximal and distal sections without bending the proximal and distal sections when moving from the first position to the second position.

[0049] (Appendix 21) 17. The apparatus of claim 16, wherein the lifting section includes an opening in the outer wall and in the second channel, the third channel opening into the second channel at the opening such that the opening allows access to the third channel from the outer wall.

[0050] (Appendix 22) 22. The apparatus of claim 21, wherein the lifting section includes a second opening in a second outer wall opposite the outer wall, the third channel opening into the second opening such that the second opening allows access to the third channel from the second outer wall.

[0051] (Appendix 23) 23. The device of claim 22, wherein the control wire received in the second channel extends through the opening into the third channel and exits the third channel at the second opening.

[0052] (Appendix 24) A shaft, a distal tip, the distal tip comprising: a first channel extending along an inner surface of the distal tip; and a lifting unit configured to move between a lowered position and an elevated position, the lifting unit comprising: a second channel extending along an outer surface of the lifting section; and a third channel extending through the lifting section; a distal tip; Equipped with When the lifting unit is in the lowered position, the first channel is configured to receive a first portion of a control wire, the second channel is configured to receive a second portion of the control wire, and the third channel is configured to receive a third portion of the control wire; When the lifting unit is in the raised position, the first channel is configured to guide the first portion of the control wire out of the first channel, the second channel is configured to maintain the second portion of the control wire within the second channel, and the third channel is configured to maintain the third portion of the control wire within the third channel. Device.

[0053] (Appendix 25) 25. The device of claim 24, wherein the first channel opens to the inner surface of the distal tip, the second channel opens to the outer surface of the lifting section, and the third channel is enclosed within the lifting section.

[0054] (Appendix 26) 25. The device of claim 24, wherein the elevator is configured to move in response to proximal movement of the control wire relative to the shaft, and an instrument inserted into the shaft and received in the elevator is biased when the elevator moves from the lowered position to the raised position.

[0055] (Appendix 27) 27. The device of claim 26, wherein the distal tip includes a first opening and a second opening, the first opening and the second opening each being located on an outer surface of the distal tip, and the first opening being larger in size than the second opening.

[0056] (Appendix 28) 28. The device of claim 27, wherein the first opening is configured to receive the instrument from the shaft and the second opening is configured to receive the first portion of the control wire from the shaft.

[0057] (Appendix 29) 25. The device of claim 24, wherein the first channel is configured such that when the lifting section moves from the lowered position to the raised position, the first portion of the control wire moves radially outward from the first channel.

[0058] (Appendix 30) 30. The device of claim 29, wherein the first channel is configured such that when the lifting section moves from the raised position to the lowered position, a first portion of the control wire moves radially inward into the first channel.

[0059] (Appendix 31) A shaft and a distal tip, the shaft configured to receive a control wire extending distally outward from the distal tip, the distal tip comprising: a first channel disposed on opposing inner surfaces of the distal tip; and an elevator disposed between the opposing inner surfaces of the distal tip, the elevator having a second channel on opposing outer surfaces of the elevator; the first channel and the second channel receive the control wire when the elevator portion is not biased against the opposing inner surfaces, and when the elevator portion is biased against the inner surfaces, the first channel releases the control wire, and the control wire moves out of the first channel and is maintained within the second channel. Device.

[0060] (Appendix 32) 32. The device of claim 31, wherein the first channel is configured such that the control wire exits the first channel when the control wire moves proximally relative to the shaft to bias the lifting portion.

[0061] (Appendix 33) 32. The device of claim 31, wherein the first channel has an arc length that defines a semicircular shape along the opposing inner surfaces of the distal tip.

[0062] (Appendix 34) 32. The apparatus of claim 31, wherein the second channel has an arc length that defines a semicircular shape along the opposing outer surfaces of the lifting section.

[0063] (Appendix 35) the opposing inner surfaces of the distal tip at least partially define an opening in the shaft at the distal tip, such that the opening is located between the opposing inner surfaces; 32. The device of claim 31, wherein the lifting portion is positioned distally from the opening such that the opposing outer surfaces of the lifting portion are not positioned between the opposing inner surfaces.

Claims

1. A shaft and a distal tip including an inner wall and a first channel disposed in the inner wall; an elevating section including an outer wall and a second channel provided in the outer wall; Equipped with When the lifting section moves to a first position, the first channel and the second channel are each configured to receive a portion of a control wire, and when the lifting section moves to a second position, the control wire is configured to move outward from the first channel and be maintained within the second channel.

2. 2. The device of claim 1, wherein the shaft is configured to receive an instrument extending distally outward from the distal tip, and the elevator is configured to bias the instrument against the distal tip when moving from the first position to the second position, thereby moving the control wire outward from the first channel.

3. 2. The device of claim 1, wherein the lifting section comprises a proximal portion fixed relative to the inner wall and a distal portion movable relative to the proximal portion, the distal portion having a width defined between the outer wall of the lifting section and an opposite outer wall.

4. The device of claim 3 , wherein the elevator section is configured to move from the first position to the second position without bending the proximal and distal sections.

5. The device of claim 3 , wherein the lifting portion comprises an opening located within the second channel and a passageway extending across the width of the distal portion and terminating at the opening.

6. 6. The apparatus of claim 5, wherein the elevator section includes a second opening located in an outer wall opposite the outer wall of the elevator section, the passage terminating at the second opening.

7. 7. The device of claim 6, wherein the control wire received in the second channel enters the passage at the opening and exits the passage at the second opening.

8. The device of claim 5 , wherein the passage has a length that is less than the width of the distal portion.

9. A shaft and a distal tip including an inner surface and a first channel extending along the inner surface; a lifting section including an outer surface and a second channel extending along the outer surface; Equipped with When the lifting section moves to a lower position, the first channel receives a proximal portion of the control wire and the second channel receives a distal portion of the control wire, and when the lifting section moves to an upper position, the proximal portion of the control wire is guided out of the first channel and the distal portion of the control wire is held within the second channel.

10. 10. The device of claim 9, wherein the first channel is at least partially open along the inner surface of the distal tip to receive the proximal portion of the control wire, and the second channel is at least partially open to the outer surface of the lift section to receive the distal portion of the control wire.

11. 10. The device of claim 9, wherein the control wire is configured to move the elevator to the upper position in response to the proximal portion moving proximally relative to the distal tip, such that an instrument received in the elevator is biased against the distal tip.

12. 10. The device of claim 9, wherein the control wire is configured to move the elevator to the lower position in response to the proximal portion moving distally relative to the distal tip, such that an instrument received in the elevator is longitudinally aligned with the distal tip.

13. The device of claim 9 , wherein the proximal portion of the control wire exits the first channel when the elevator moves from the lower position to the upper position.

14. The device of claim 9 , wherein the proximal portion of the control wire enters the first channel when the elevator moves from the upper position to the lower position.

15. 10. The device of claim 9, wherein the distal portion of the control wire remains fixed relative to the second channel when the elevator moves between the lower position and the upper position.

16. A shaft and a distal tip including an inner surface and a first channel disposed in the inner surface; a lifting section including an outer surface and a second channel provided on the outer surface; Equipped with When the elevator portion is not biased against the distal tip, the first channel and the second channel are each configured to receive a control wire, and when the elevator portion is biased against the distal tip, the first channel is configured to release the control wire and the second channel is configured to hold the control wire.

17. 17. The device of claim 16, wherein when the control wire is moved proximally relative to the shaft to bias the elevator portion proximally relative to the distal tip, the control wire is moved outward from the first channel and removed from the first channel.

18. 17. The device of claim 16, wherein the control wire is retained within the second channel and moves with the elevator portion when the control wire moves proximally relative to the shaft to bias the elevator portion proximally relative to the distal tip.

19. 17. The device of claim 16, wherein the elevator portion is located at least partially distal to the distal tip and the second channel is located distal to the first channel.

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