ENDOSCOPE WITH INTERFACE-TYPE ORIENTATION MECHANISM - Patent application

Abstract

Disclosed herein is a medical instrument including a camera, the camera including a movable member including an outer surface having a longitudinal cross-sectional shape configured to be complementary to a longitudinal cross-sectional shape of a surface of a lumen of an elongate tube housing the movable member and to prevent rotation of the movable member relative to the elongate tube, the instrument allowing an operator to maintain a viewing orientation as the movable member is translated proximally and distally relative to the elongate tube.

Description

[Technical field]

[0001] The present disclosure relates to medical equipment, and more particularly, to a mechanism for maintaining the orientation of a telescoping camera of an endoscope system. [Background technology]

[0002] The statements in this section merely provide background information regarding the present disclosure and may not constitute prior art.

[0003] Body cavities and lumens can become blocked or develop tumors in the walls that surround them. In some cases, removal or other treatment of these blockages or tumors may be necessary. Endoscopic or other minimally invasive techniques can be employed to treat these conditions.

[0004] One type of treatment involves the use of a catheter or other endoscopic instrument that is inserted into a body lumen or cavity and toward the area where treatment is desired. Inserting an endoscope into the target area can allow visualization of the target area and identification of the desired procedure and the specific location of the area to be treated.

[0005] Generally, endoscopes are designed to operate with the same basic mechanisms, without any modifications. Endoscopes typically include a camera and a set of wheels that an operator, such as a physician, manipulates with one hand (sometimes the left) to control the deflection of the scope, and with the other hand (usually the right) to switch between the endoscope's insertion tube and accessory channel to control the advancement of the scope and instrument, respectively, within the patient's body.

[0006] In the field of endoscopy, specialized endoscopes tailored to specific procedures are becoming more and more common, with a trend moving away from reusable scopes and towards disposable scopes. The camera of some specialized endoscopes extends or extends out from the endoscope body or distal bend depending on the procedure for which the specialized endoscope is designed.

[0007] Certain anatomical regions can be difficult to navigate. For example, the gastrointestinal (GI) tract has many bends that cause the scope to remain in a particular orientation inside the lumen as the operator navigates to the target area. During procedures such as sphincterotomy or cancerous tissue resection, there may be a particular approach or scope orientation that may be more desirable that makes the procedure easier, safer, and / or more effective.

[0008] For example, during a sphincterotomy, the duodenoscope may be oriented by rotating the scope prior to cannulation so that the minor papilla is positioned approximately at the 12 o'clock position.

[0009] When a dedicated endoscope has a telescoping camera, it may be difficult to maintain the orientation of the field of view as the flexible outer tube of the endoscope is manipulated and a procedure is performed. When the telescoping camera is inside an accessory channel, if the accessory channel is moved up, down, left, or right, the camera may not rotate in sync with the channel through which it passes. Lack of synchrony can disorient the physician and make medical procedures more difficult, since most procedures involve instruments that fall into the telescoping camera's field of view at predictable angles. Summary of the Invention [Means for solving the problem]

[0010] According to one aspect of the disclosure, a medical device is provided. The medical device includes an elongate tube including a lumen extending therethrough, the elongate tube defining a longitudinal axis therethrough, the lumen including a surface having a first longitudinal cross-sectional shape. The medical device further includes a movable member extending longitudinally through at least a portion of the lumen, the movable member including a second lumen extending therethrough, the movable member including an outer surface having a second longitudinal cross-sectional shape. The medical device further includes a camera extending longitudinally through at least a portion of the second lumen. The first longitudinal cross-sectional shape and the second longitudinal cross-sectional shape are configured such that the movable member does not rotate relative to the elongate tube about the longitudinal axis as the movable member translates distally or proximally. The second longitudinal cross-sectional shape may be configured to be complementary to the first longitudinal cross-sectional shape of the surface of the lumen. The second longitudinal cross-sectional shape may be non-axisymmetric. The first longitudinal cross-sectional shape may be non-axisymmetric. The second longitudinal cross-sectional shape may be elliptical and the second longitudinal cross-sectional shape may include a major axis and a minor axis, the major axis being greater than the minor axis. The first longitudinal cross-sectional shape may be elliptical and the first longitudinal cross-sectional shape may include a second major axis and a second minor axis, the second major axis being greater than the minor axis, and the first longitudinal cross-sectional shape may be configured to be complementary to the second longitudinal cross-sectional shape. The first longitudinal cross-sectional shape may be substantially circular and the elongated tube may include an appendage configured to be complementary to the second longitudinal cross-sectional shape. The second longitudinal cross-sectional shape may include a rectangle, a square, a detent, a groove, a protruding feature, and / or an appendage configured to be complementary to the second longitudinal cross-sectional shape. The movable member may include a shape-fixing curve and the elongated tube may include a second shape-fixing curve configured to be complementary to the shape-fixing curve, and the shape-fixing curve may be configured to bias an orientation of the movable member within the elongated tube.The second medical device may include a third lumen and a medical device housed within the third lumen, the third lumen defining a second longitudinal axis therethrough, and the medical device may be configured such that the medical device does not rotate relative to the third lumen about the second longitudinal axis as the medical device translates distally or proximally relative to the third lumen. The elongate tube may include a longitudinal slot connecting an outer surface of the elongate tube and a surface of the lumen, and the medical device may further include an outer clip including an outer clip body at least partially surrounding a circumference of the outer surface of the elongate tube and a pin projecting radially inward from the outer clip body and through the longitudinal slot and configured to be complementary with a tab or groove in the second longitudinally extending cross-sectional shape. The movable member may include a member longitudinal slot connecting the outer surface and the second lumen, and an anchor connected to the camera and projecting outwardly through the member longitudinal slot, the anchor configured to prevent the camera from rotating with respect to the elongate tube about an axis parallel to the longitudinal axis and / or from translating distally and proximally beyond the longitudinal dimension of the member longitudinal slot. The movable member may include one or more additional lumens extending therein configured to house or pass accessories such as deflection cables, aspiration devices, irrigation devices, venting devices, camera lens cleaning devices, or light emitting diodes. The surface of the lumen may include a plurality of recesses equally spaced around the circumference of the lumen, and the outer surface of the movable member may include a plurality of protrusions, each configured to face one of the plurality of recesses.

[0011] According to another aspect of the present disclosure, a medical device is provided. The medical device includes an elongate member including a lumen extending therethrough, the elongate tube defining a longitudinal axis therethrough, the lumen including a surface having a first longitudinal cross-sectional shape. The medical device further includes a movable member extending longitudinally at least partially within the lumen, the movable member including a second lumen extending therethrough, the movable member including an outer surface having a second longitudinal cross-sectional shape. The medical device further includes a camera extending longitudinally at least partially within the second lumen. The second longitudinal cross-sectional shape is configured to be complementary to the first longitudinal cross-sectional shape of the surface of the lumen. The first longitudinal cross-sectional shape and the second longitudinal cross-sectional shape are configured to prevent the movable member from rotating relative to the elongate tube about the longitudinal axis when the movable member translates distally or proximally. The second longitudinal cross-sectional shape may be non-axisymmetric. The second longitudinal cross-sectional shape may be elliptical, the second longitudinal cross-sectional shape may include a major axis and a minor axis, the major axis being greater than the minor axis, the second longitudinal cross-sectional shape may include a rectangle, a square, a tab, a groove, and / or a protruding feature.

[0012] According to yet another aspect of the present disclosure, a medical device is provided, the medical device including a lumen extending therein, the elongated tube defining a longitudinal axis therethrough, the lumen including a surface having a first longitudinal cross-sectional shape. The medical device further includes a movable member extending longitudinally at least partially within the lumen, the movable member including a second lumen extending therein, the movable member including an outer surface having a second longitudinal cross-sectional shape. The medical device further includes a camera extending longitudinally at least partially within the second lumen. The second longitudinal cross-sectional shape is elliptical and includes a major axis and a minor axis, the major axis being greater than the minor axis. The second longitudinal cross-sectional shape is configured to be complementary to the first longitudinal cross-sectional shape of the surface of the lumen. The first longitudinal cross-sectional shape and the second longitudinal cross-sectional shape are configured to prevent the movable member from rotating relative to the elongated tube about the longitudinal axis as the movable member translates distally or proximally.

[0013] Other areas of application will become apparent from the description provided herein. It should be understood that the description and specific examples are intended for purposes of illustration only and are not intended to limit the scope of the present disclosure.

[0014] In order that the present disclosure may be better understood, various embodiments thereof will now be described, by way of example, with reference to the accompanying drawings, in which components are not necessarily drawn to scale and in which like reference numerals refer to corresponding parts throughout the different views, and in which: [Brief description of the drawings]

[0015] [Figure 1] 1 shows a distal end view of an example endoscopic catheter according to the principles of the present disclosure. [Diagram 2] 1 illustrates a distal end view of an example steerable endoscopic system according to the principles of the present disclosure. [Figure 2A] 1 illustrates a distal end view of another example of a steerable endoscopic system according to the principles of the present disclosure. [Diagram 3] 1 shows a perspective view of a distal end portion of yet another example of a steerable endoscopic system according to the principles of the present disclosure. [Figure 4] 1 shows a perspective view of a distal end portion of another example of an endoscopic catheter according to the principles of the present disclosure. [Diagram 5] 1 shows a perspective view of a distal end portion of yet another example of an endoscopic catheter including a camera and a light emitting diode in accordance with the principles of the present disclosure. [Figure 6] 1 shows a perspective view of a distal end portion of yet another example steerable endoscopic system including an example outer clip according to the principles of the present disclosure. [Figure 7] 13 shows a perspective view of another example of an outer clip according to the principles of the present disclosure; [Figure 8] 1 illustrates a partial longitudinal cross-sectional view of a steerable endoscopic system according to the principles of the present disclosure, including a longitudinal cross-sectional view of an outer clip; [Figure 9] 1 shows a perspective view of a distal end portion of an example catheter sleeve according to the principles of the present disclosure. [Figure 10] FIG. 10 shows a view of the inner surface of the distal end portion of the example catheter sleeve of FIG. 9 when the catheter sleeve is cut open lengthwise and laid flat. [Figure 11] 10 shows a perspective view of a distal end portion of yet another example of a steerable endoscopic system including the catheter sleeve of FIG. 9 according to the principles of the present disclosure. [Figure 12] FIG. 12 illustrates a distal end view of the example steerable endoscopic system shown in FIG. [Figure 13] FIG. 12 illustrates a side view of a distal end portion of the example steerable endoscopic system shown in FIG. [Figure 14] FIG. 14 illustrates a side view of the distal end portion of the example steerable endoscopic system shown in FIG. 13 with the catheter inserted proximally into the catheter sleeve and rotated circumferentially relative to the position of the catheter in FIG. 13. [Figure 15] FIG. 15 illustrates a side view of the distal end portion of the example steerable endoscopic system shown in FIG. 13 with the catheter inserted proximally into the catheter sleeve relative to the position of the catheter in FIG. 14 such that the distal ends of the catheter and catheter sleeve are flush. [Figure 16] 1 illustrates a perspective view of a distal end portion of yet another example of a steerable endoscopic system including a shape setting curve in accordance with the principles of the present disclosure. [Figure 17] FIG. 13 illustrates a perspective view of a distal end portion of yet another example of a steerable endoscopic system according to the principles of the present disclosure, including a plurality of pins protruding from an inner surface of an endoscopic catheter, each of the plurality of pins fitting into one of a plurality of slots on a collar formed on the outer surface of the endoscopic catheter. [Figure 18] 18 shows a distal end view of the example steerable endoscopic system of FIG. 17. [Figure 19] 1 shows a perspective view of yet another example of a steerable endoscopic system including a plurality of collars formed on an outer surface of an endoscopic catheter and a plurality of pins formed on an inner surface of the endoscopic catheter in accordance with the principles of the present disclosure. [Figure 20]1 illustrates a distal end view of another example of a steerable endoscopic system including a plurality of pins formed on the outer surface of an endoscopic catheter and a plurality of slots in a collar formed on the inner surface of a catheter sleeve in accordance with the principles of the present disclosure. [Figure 21] 1 shows a perspective view of the distal end of another example steerable endoscopic system having an example endoscopic catheter including a male V-section and a catheter sleeve including a female V-section in accordance with the principles of the present disclosure. [Figure 22] 22 illustrates a longitudinal cross-sectional view of the example steerable endoscopic system shown in FIG. 21 , sectioned along axis AA. [Diagram 23] 1 shows a perspective view of the distal end of another example steerable endoscopic system having an example endoscopic stem including a male V-shaped portion and a catheter sleeve including a female V-shaped portion in accordance with the principles of the present disclosure. [Figure 24] 24 illustrates a longitudinal cross-sectional view of the example steerable endoscopic system shown in FIG. 23 , sectioned along axis BB. [Diagram 25] 1 illustrates a distal end view of yet another example of a steerable endoscopic system including an endoscopic catheter having an elliptical longitudinal cross-sectional shape and a pivot arm having an elliptical longitudinal cross-sectional shape in accordance with the principles of the present disclosure. [Figure 26] FIG. 26 illustrates a side view of the distal end of the example steerable endoscopic system shown in FIG. 25. [Figure 27] FIG. 28 shows a longitudinal cross-sectional view of the example steerable endoscopic system shown in FIGS. 26 and 27, taken along axis CC. [Figure 28] 1 illustrates a side view of a distal end of yet another example endoscopic catheter including a male V-section in accordance with the principles of the present disclosure. [Figure 29] FIG. 29 shows a perspective view of the example endoscopic catheter shown in FIG. 28. [Diagram 30] FIG. 30 shows a top view of the example endoscopic catheter shown in FIGS. 28 and 29. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0016] The drawings described herein are for illustration purposes only and are not intended to limit the scope of the present disclosure in any way.

[0017] The following description is merely exemplary in nature and is not intended to limit the disclosure, application, or uses. Corresponding reference numerals indicate like or corresponding parts and features throughout the drawings.

[0018] In attaching reference labels to elements in each drawing, it should be noted that the same elements have the same labels even if the same elements are shown in different drawings. Furthermore, in describing one aspect of the present disclosure, if it is determined that a detailed description of a related well-known structure or function would make the gist of one aspect of the present disclosure unclear, the same will be omitted.

[0019] In the following discussion, the terms "proximal" and "distal" are used to describe the opposing axial ends of the instrument and the axial ends of the functional members of the various components. The term "proximal" is used in its conventional sense to refer to the end of the instrument (or component) that is closest to the medical practitioner during use of the assembly. The term "distal" is used in its conventional sense to refer to the end that is first inserted into a patient or that is closest to the patient during use. The term "longitudinal" is used to refer to an axis that is aligned with the proximal-distal axis of the instrument (or component). The terms "radially" and "radially" are used to refer to elements, surfaces, or assemblies that may extend perpendicularly from a longitudinal axis relative to one another. The terms "circumferential", "circumferentially", and "circumferential" are used to refer to elements, surfaces, or assemblies that radius-surround a longitudinal axis relative to one another.

[0020] In the discussion that follows, the terms "non-axisymmetric" and "non-axisymmetric" are used herein to refer to an element having a shape that lacks axial symmetry, or a lack of rotational symmetry about a central axis.

[0021] As used herein, the terms "ellipse", "elliptical" and "elliptically shaped" refer to a geometric shape in the form of a closed curve obtained by the intersection of a cone or cylinder with a plane. An ellipse has a major axis and a minor axis, each of which it is axially symmetric about. An ellipse encircles two foci, such that for every point on the ellipse, the sum of the distances to the two foci is constant. A circle is an example of an ellipse obtained by the intersection of a cone or cylinder with a plane perpendicular to the height of the cone or cylinder, where the two foci are the same point.

[0022] The use of the articles (a, an, the) and similar referents in relation to describing this disclosure (particularly in relation to the claims at the end of the document) shall be construed to refer to both the singular and the plural, unless otherwise indicated herein or clearly contradicted by context. The use of the term "plurality" is defined by the applicant in its broadest sense, and means a number greater than one, overriding any other implied definition or limitation, either before or after, unless the applicant clearly asserts otherwise. The indication of ranges of values ​​herein merely serves as a shorthand method of individually referring to each of the values ​​falling within the range, unless otherwise indicated herein, and each of the values ​​is incorporated in the specification as if it were individually indicated herein. All methods described herein can be performed in any suitable order, unless otherwise indicated herein or clearly contradicted by context.

[0023] As used herein, the terms "comprise(s), include(s)," "having, has," "can," "contain(s)," and variations thereof are intended to be open-ended transitional phrases, terms, or words that do not exclude the possibility of additional actions or structures. The present description also contemplates other examples of "comprising," "consisting of," and "consisting essentially of" the examples or elements presented herein, whether or not expressly stated.

[0024] In describing the elements of this disclosure, 1 st , 2 nd Terms such as, first, second, A, B, (a), (b), etc. may be used herein. These terms are used only to distinguish one element from another and do not limit the corresponding elements without regard to the nature or order of the corresponding elements.

[0025] Unless otherwise specifically defined, all terms used herein, including technical or technical terms, have the same meaning as commonly understood by one of ordinary skill in the art to which this disclosure pertains. Such terms are to be interpreted as meanings equivalent to the contextual meaning in the relevant field, as defined in commonly used dictionaries.

[0026] As used herein, the term "about" when used in relation to a stated numerical value or range means a deviation of no more than ±15% from that numerical value. For example, numerical values ​​that vary by ±15%, ±14%, ±10%, or ±5%, etc., meet the definition of "about" unless a narrower definition is given in a specific instance.

[0027] 1, a distal end view of an example endoscopic catheter 100 is shown. Endoscopic catheter 100 includes longitudinal deflection cable lumens 102, 104, 106, 108, parallel to a longitudinal axis, a camera lumen 112, and a light emitting diode lumen 110. Endoscopic catheter 100 further includes additional longitudinal lumens 118, 119, and 120, each of which is parallel to the longitudinal axis and may be individually configured for aspiration, irrigation, venting, camera lens cleaning, and / or accessory passage, or may be configured to house an aspiration device, an irrigation device, a venting device, a camera lens cleaning device, or a light emitting diode, or to pass an accessory.

[0028] The endoscopic catheter 100 has an exterior surface having a longitudinal cross-sectional shape other than circular. Examples of non-circular longitudinal cross-sectional shapes may include square, rectangular, or elliptical. The longitudinal cross-sectional shape of the exterior surface of the endoscopic catheter 100 may include one or more longitudinal ridges, or tabs or grooves. The endoscopic catheter 100 has an exterior surface having an elliptical longitudinal cross-sectional shape, and the longitudinal cross-sectional shape of the exterior surface of the endoscopic catheter 100 includes a dimension that includes a major axis 114 and a minor axis 116.

[0029] The longitudinal cross-sectional shape of the outer surface of the endoscopic catheter 100 can provide a mating feature, where the longitudinal cross-sectional shape of the outer surface of the endoscopic catheter 100 is complementary to and / or approximates the longitudinal cross-sectional shape of the inner surface of the catheter sleeve 126, as shown in FIG. 2.

[0030] 2 illustrates a steerable endoscope system 130 in which the endoscopic catheter 100 is contained within a catheter sleeve 126. The catheter sleeve 126 is an elongate tube that includes an inner surface that includes mating features such that the longitudinal cross-sectional shape of the inner surface of the catheter sleeve 126 is complementary to and / or approximates the longitudinal cross-sectional shape of the outer surface of the endoscopic catheter 100. The catheter sleeve 126 has an inner surface that has a longitudinal cross-sectional shape that is elliptical, and the longitudinal cross-sectional shape of the inner surface of the catheter sleeve 126 includes dimensions that include a major axis 122 and a minor axis 124. The major axis 122 is larger than the major axis 114 only to the extent that the endoscopic catheter 100 can translate proximally or distally relative to the catheter sleeve 126, but not rotate about the longitudinal axis relative to the catheter sleeve 126. The minor axis 124 is larger than the minor axis 116 only to the extent that the endoscopic catheter 100 translates proximally and distally relative to the catheter sleeve 126, but does not rotate about its longitudinal axis relative to the catheter sleeve 126. The mating feature provided by the complementary longitudinal cross-sectional shapes of the outer surface of the endoscopic catheter 100 and the inner surface of the catheter sleeve 126 advantageously allows the endoscopic camera within the camera lumen 112 to rotate in unison with the catheter sleeve 126 and as the endoscopic catheter 100 translates distally and proximally or is advanced distally or retracted proximally relative to the catheter sleeve 126. Additionally, the endoscopic catheter 100 is substantially prevented, substantially limited, or prevented from rotating relative to the catheter sleeve 126 by the mating feature. By maintaining a rotational viewing orientation of the endoscopic camera in the camera lumen 112 relative to the catheter sleeve 126 as the steerable endoscopic system 130 is operated, the steerable endoscopic system 130 may avoid disorientation and / or problems commonly experienced by operators of endoscopic systems without mating features.

[0031] In a particular example, the catheter sleeve of the steerable endoscopic system 130 may have an inner surface with a circular longitudinal cross-sectional shape, while the outer longitudinal cross-sectional shape of the endoscopic catheter 100 is elliptical. To provide an elliptical longitudinal cross-sectional shape of the inner surface of the catheter sleeve that is complementary to and / or approximating the elliptical longitudinal cross-sectional shape of the outer surface of the endoscopic catheter 100, in a second process, the distal end of the catheter sleeve may be reshaped to be complementary to and / or approximating the elliptical longitudinal cross-sectional shape of the outer surface of the endoscopic catheter 100. The second process may include applying heat to the distal end of the catheter sleeve and then reshaping the distal end of the catheter sleeve to be complementary to and / or approximating the elliptical longitudinal cross-sectional shape of the outer surface of the endoscopic catheter 100. The second process may further include using a tool to reshape the heated distal end of the catheter sleeve to be complementary and / or approximate the elliptical longitudinal cross-sectional shape of the exterior surface of the endoscopic catheter 100. The endoscopic catheter 100 may extend distally from the catheter sleeve 126 and retract proximally into the catheter sleeve 126. When the endoscopic catheter 100 is fully retracted into the catheter sleeve 126, the distal end of the endoscopic catheter 100 is configured such that a hard stop is achieved where the distal end of the endoscopic catheter 100 is flush with the distal end of the catheter sleeve 126. The distal end of the endoscopic catheter 100 cannot be retracted proximally beyond the distal end of the catheter sleeve 126.

[0032] 2A, a distal end view of another example steerable endoscopic system 200 is shown. The steerable endoscopic system 200 includes an endoscopic catheter 100 having an outer surface with an elliptical longitudinal cross-sectional shape including dimensions including a major axis 114 and a minor axis 116. The steerable endoscopic system 200 further includes a catheter sleeve 202 having an inner surface with a substantially circular longitudinal cross-sectional shape. The inner cross-sectional diameter of the catheter sleeve 202 is larger than the major axis 114, thereby preventing the camera within the camera lumen 112 from rotating in unison with the catheter sleeve 202. The steerable endoscopic system 200 includes a mating feature in the form of an attachment portion 204 that may be configured to complement an inner surface of the catheter sleeve 202, such that the inner surface of the catheter sleeve 202 with the attachment portion 204 is complementary to and / or approximates the elliptical longitudinal cross-sectional outer surface of the endoscopic catheter 100. 2A, the attachment portion 204 may complement the dimensions of the circular inner surface of the catheter sleeve 202, reducing the diameter of the circular inner surface of the catheter sleeve 202 to just slightly greater than the dimension of the minor axis 116, thereby preventing the endoscopic catheter 100 from rotating relative to the catheter sleeve 202. In other examples, the attachment portion 204 may complement the inner surface of the catheter sleeve 202 by including a profile configured to complement or approximate one or more longitudinal ridges, grooves, tabs, or rectangular or square shapes on the outer surface of the endoscopic catheter 100.

[0033] 3, a perspective view of a distal end portion of another example steerable endoscopic system 300 is shown. The steerable endoscopic system 300 includes an endoscopic catheter 304 that includes a mating feature, where the outer surface of the endoscopic catheter 304 has a non-axisymmetric cross-sectional shape extending in the longitudinal direction. The mating feature may include a groove or recess in the outer surface of the endoscopic catheter 304 that is parallel to the longitudinal axis of the steerable endoscopic system 300. The endoscopic catheter 304 includes longitudinal deflection cable lumens 312, 314, 316, 318, a camera lumen 308, and a light emitting diode lumen 310, each of which are parallel to the longitudinal axis. The endoscopic catheter 304 further includes additional longitudinal lumens 320 and 322, each of which is parallel to the longitudinal axis and may be individually configured for aspiration, irrigation, venting, camera lens cleaning, and / or the passage of accessories, or may be configured to house a suction device, an irrigation device, a venting device, a camera lens cleaning device, or a light emitting diode, or to pass accessories. The steerable endoscopic system 300 includes a catheter sleeve 302, which is an elongated tube, including an inner surface having a non-axisymmetric shape in cross section extending longitudinally, including a pin 306 integral with the catheter sleeve 302. The pins 306 protrude inwardly from the inner surface of the catheter sleeve 302 parallel to the longitudinal axis and are complementary to and / or approximate grooves or recesses in the outer surface of the endoscopic catheter 304 such that the rotational viewing orientation of the endoscopic catheter 304 is maintained as the steerable endoscopic system 300 is operated and the endoscopic catheter 304 is translated proximally and distally relative to the catheter sleeve 302, or advanced distally or pulled back proximally.

[0034] 4, a perspective view of a distal end portion of yet another example endoscopic catheter 400 is shown. The endoscopic catheter 400 includes longitudinal deflection cable lumens 408, 410, 412, 414, a camera lumen 404, and a light emitting diode lumen 406, each of which is parallel to a longitudinal axis. The endoscopic catheter 400 further includes additional longitudinal lumens 420 and 422, each of which is parallel to a longitudinal axis and may be individually configured for aspiration, irrigation, ventilation, camera lens cleaning, and / or the passage of accessories, or may be configured to store an aspiration device, an irrigation device, a ventilation device, a camera lens cleaning device, or a light emitting diode, or to pass accessories. A retractable camera 424 may be stored in the camera lumen 404 and may be advanced distally or retracted proximally within the camera lumen 404 relative to the endoscopic catheter 400. The endoscopic catheter 400 includes a mating feature, which may include an anchor 418 and a slot 416. The slot 416 is an opening connecting the exterior surface of the endoscopic catheter 400 to the camera lumen 404, and extends from a point proximal to the distal surface of the endoscopic catheter 400 in a longitudinal direction parallel to the longitudinal axis of the endoscopic catheter 400. An anchor 418 protrudes from the telescopic camera 424 through the slot 416 to maintain the rotational viewing orientation of the telescopic camera 424. The telescopic camera 424 may be advanced distally and retracted proximally relative to the endoscopic catheter 400 along the longitudinal dimension of the slot 416. The anchor 418 functions as a rotational stop to prevent the telescopic camera 424 from rotating within the camera lumen 404 relative to the endoscopic catheter 400, and as a translational stop to prevent the telescopic camera 424 from advancing distally or retracting proximally beyond the longitudinal distance range allowed by the longitudinal dimension of the slot 416.

[0035] Referring to FIG. 5, a perspective view of a distal end portion 502 of another example endoscopic catheter 500 is shown. The endoscopic catheter 500 includes a mating feature whereby the outer surface of the endoscopic catheter 500 has a non-axisymmetric cross-sectional shape extending in the length direction. The mating feature may include a groove 516 on the outer surface of the endoscopic catheter 500 parallel to the longitudinal axis of the endoscopic catheter 500. The groove 516 is complementary to and / or approximates an inner surface of a catheter sleeve having a non-axisymmetric cross-sectional shape extending in the length direction, including a pin integral with the catheter sleeve and extending inwardly from the inner surface of the catheter sleeve parallel to the longitudinal axis of the endoscopic catheter. The endoscopic catheter 500 includes longitudinal deflection cable lumens 508, 510, 512, 514, a camera lumen 504, and a light emitting diode lumen 506, each of which are parallel to the longitudinal axis. The camera lumen 504 houses a telescoping camera 522. Light emitting diode lumen 506 houses a light emitting diode 520. Endoscopic catheter 500 further includes additional longitudinal lumens 516 and 518, each of which is parallel to the longitudinal axis and may be individually configured for aspiration, irrigation, venting, camera lens cleaning, and / or the passage of accessories, or may be configured to house an aspiration device, an irrigation device, a venting device, a camera lens cleaning device, or a light emitting diode, or to pass an accessory.

[0036] 6, a perspective view of a distal end portion of another example steerable endoscopic system 600 is shown including an example outer clip 606. The steerable endoscopic system 600 includes a telescoping endoscopic catheter 604 and an outer clip 606 attached to the telescoping endoscopic catheter 604 by a connector 610 and a button 608. The button 608 is configured to engage the telescoping endoscopic catheter 604. The connector 610 may radially fit into a slot 612 in the stem sleeve 602. The outer clip 606 may substantially surround the circumference of the catheter sleeve 602. The outer clip 606 may be part of and / or attached to a larger scope instrument, and the telescoping endoscopic catheter 604 and catheter sleeve 602 may be configured as an accessory that is stored within the lumen. The outer clip 606 may prevent, substantially inhibit, or substantially limit the telescoping endoscopic catheter 604 and catheter sleeve 602 from rotating about the longitudinal axis of such accessory lumen housing the steerable endoscopic system 600 with respect to a larger scope instrument. The telescoping endoscopic catheter 604 includes longitudinal deflection cable lumens 618, 620, 622, 624, a camera lumen 630, and a light emitting diode lumen 616, each of which is parallel to the longitudinal axis. The camera lumen 630 houses the camera 614. The telescoping endoscopic catheter 604 further includes additional longitudinal lumens 626 and 628, each of which is parallel to the longitudinal axis and may be individually configured for aspiration, irrigation, insufflation, camera lens cleaning, and / or the passage of accessories, or may be configured to house an aspiration device, an irrigation device, an insufflation device, a camera lens cleaning device, or a light emitting diode, or to pass an accessory. The telescoping endoscopic catheter 604 can be advanced distally or retracted proximally through the catheter sleeve 602. The steerable endoscopic system 600 can be stored within an accessory lumen of a larger instrument, and the endoscopic catheter 604 and catheter sleeve 602 can be advanced distally and retracted proximally together.The slot 612 is an opening in the catheter sleeve 602 that extends longitudinally and proximally from a point proximal to the distal surface of the telescoping endoscopic catheter 604, parallel to the longitudinal axis of the steerable endoscopic system 600. The camera 614 does not advance distally and retract proximally relative to the telescoping endoscopic catheter 604 along the longitudinal dimension of the slot 612, but may advance distally and retract proximally with the telescoping endoscopic catheter 604 along the longitudinal dimension of the slot 612. The outer clip 606 may function as a rotational stop to prevent the telescoping endoscopic catheter 604 from rotating relative to the catheter sleeve 602, and as a translational stop to prevent the telescoping endoscopic catheter 604 from advancing distally or retracting proximally relative to the catheter sleeve 602 beyond the longitudinal distance allowed by the longitudinal dimension of the slot 612. The outer surface of the telescoping endoscopic catheter 604 may have a longitudinal cross-sectional shape that is complementary to and / or approximates the longitudinal cross-sectional shape of the inner surface of the catheter sleeve 602. In the example of a steerable endoscopic system 600 shown in FIG. 6, the outer surface of the telescoping endoscopic catheter 604 has a circular longitudinal cross-sectional shape that is complementary to and / or approximates the circular longitudinal cross-sectional shape of the inner surface of the catheter sleeve 602.

[0037] Referring to FIG. 7, a perspective view of another example outer clip 700 is shown. The outer clip 700 includes an arcuate outer clip body 702 having a substantially circular longitudinal cross-sectional shape configured to substantially surround the outer circumference of a catheter sleeve of a steerable endoscopic system. The outer clip 700 may be part of and / or attached to a larger scoping instrument, and a telescoping endoscopic catheter and catheter sleeve may be configured as an accessory stored within a lumen. The longitudinal cross-sectional shape of the outer clip 700 is symmetrical, and at the arcuate midpoint of the cross-section of the outer clip body 702 is a pin 704 that projects radially inwardly from the outer clip body 702 parallel to the longitudinal axis of the steerable endoscopic system in which the outer clip 700 is included. The pin 704 extends along the entire longitudinal dimension of the outer clip 700. The pin 704 may be complementary to and / or approximate a mating feature of the telescoping endoscopic catheter and / or catheter sleeve, such that a camera within the camera lumen of the endoscopic catheter maintains a rotational viewing orientation when a steerable endoscopic system including the outer clip 700 is operated and a telescoping endoscopic catheter of the steerable endoscopic system including the outer clip 700 is advanced distally and pulled back proximally within a catheter sleeve of the steerable endoscopic system including the outer clip 700.

[0038] 8, a partial longitudinal cross-sectional view of a steerable endoscopic system 800 is shown, including a partial longitudinal cross-sectional view of an outer clip 700. The outer clip 700 includes an arcuate outer clip body 702 having a substantially circular cross-sectional shape configured to substantially surround the outer circumference of a catheter sleeve 802. The longitudinal cross-sectional shape of the outer clip 700 is symmetrical, and at the arcuate midpoint of the cross-section of the outer clip body 702 is a pin 704 that projects radially inwardly from the outer clip body 702 parallel to the longitudinal axis of the steerable endoscopic system 800. The pin 704 extends along the entire longitudinal dimension of the outer clip 700. The endoscopic catheter 804 includes a mating feature, which may be a longitudinal slot 806 in the outer surface of the endoscopic catheter 804, such that the outer surface of the endoscopic catheter 804 has a longitudinal cross-sectional shape that is non-axisymmetric. The pin 704 protrudes through a longitudinal slot in the catheter sleeve 802 and occupies a slot 806 that is complementary to and / or approximates a slot in the endoscopic catheter 804. The slot 806 may connect the exterior surface of the endoscopic catheter 804 with a longitudinal lumen that extends longitudinally through the endoscopic catheter 804 parallel to the longitudinal axis and the deflection cable lumens 808, 810.

[0039] Referring to FIG. 9, a perspective view of a distal end portion of another example catheter sleeve 900 is shown. The catheter sleeve 900 is an elongated tube that includes an outer surface 902 having a circular longitudinal cross-sectional shape. An inner surface 906 of the catheter sleeve 900 includes a plurality of recesses 904 that are equally spaced along a distal end of the inner surface 906. Examples of the plurality of recesses 904 can include 2, 3, 4, 5, 6, 7, 8, 9, or 10 or more recesses that are equally spaced along a distal end of the inner surface 906. The inner surface 906 of the catheter sleeve 900 includes a plurality of angled portions 908, each of which extends from the distal end of the catheter sleeve 900 to one of the plurality of recesses 904. The plurality of angled portions 908 are configured to lead into the plurality of recesses 904. The example catheter sleeve 900 shown in Figure 9 includes a plurality of recesses 904, including four recesses equally spaced at 90° increments along the distal end of the inner surface 906. A view of the inner surface 906 of a distal end portion of the catheter sleeve 900 is shown in Figure 10 when the catheter sleeve 900 is cut open lengthwise and placed as an open catheter sleeve 1000. The open catheter sleeve 1000 includes a plurality of recesses 904 equally spaced along the distal end of the inner surface 906.

[0040] Referring to FIG. 11, a perspective view of a distal end portion of another example steerable endoscopic system 1100 including the catheter sleeve 900 of FIG. 9 is shown. The steerable endoscopic system 1100 includes an endoscopic catheter 1102. The endoscopic catheter includes a distal exterior surface 1106. The distal portion of the endoscopic catheter 1102 may have a different longitudinal cross-sectional diameter than the proximal portion of the endoscopic catheter 1102. As shown in FIG. 11, the distal portion of the example endoscopic catheter 1102 has a larger cross-sectional diameter than the remainder of the endoscopic catheter 1102. The endoscopic catheter 1102 includes longitudinal deflection cable lumens 1114, 1116, 1120, 1122, a camera lumen 1104, and a light emitting diode lumen 1112, each of which are parallel to a longitudinal axis. The camera lumen 1104 houses a camera 1110. The endoscopic catheter 1102 further includes additional longitudinal lumens 1124 and 1126, each of which is parallel to the longitudinal axis and may be individually configured for aspiration, irrigation, venting, camera lens cleaning, and / or the passage of accessories, or may be configured to house an aspiration device, an irrigation device, a venting device, a camera lens cleaning device, or a light emitting diode, or to pass an accessory. The endoscopic catheter 1102 includes a mating feature on the distal outer surface 1106, which includes a plurality of protrusions 1108 equally spaced around the circumference of the distal outer surface 1106. Examples of the plurality of protrusions 1108 may include 2, 3, 4, 5, 6, 7, 8, 9, or 10 or more protrusions equally spaced around the circumference of the distal outer surface 1106. The example of the endoscopic catheter 1102 shown in FIG. 11 includes a plurality of protrusions 1108 including four protrusions equally spaced at 90° increments along the distal outer surface 1106. The plurality of ramps 908 are configured to expand radially around the plurality of protrusions 1108 to provide a tactile sensation to a user that the plurality of protrusions 1108 are fitted within the plurality of recesses 904 when the outer surface 902 is placed in its "locked" or "home" position as shown in FIG. 15.The number of protrusions constituting the example plurality of protrusions 1108 of the endoscopic catheter 1102 of the example steerable endoscopic system 1100 is equal to the number of recesses constituting the plurality of recesses 904 of the catheter sleeve 900 of the example steerable endoscopic system 1100. Each protrusion of the plurality of protrusions 1108 of the endoscopic catheter 1102 is configured to oppose one recess of the plurality of recesses 904 when the endoscopic catheter 1102 is pulled proximally back into the catheter sleeve 900, thereby preserving the rotational viewing orientation of the endoscopic catheter 1102 as the steerable endoscopic system 1100 is steered. FIG. 12 shows a distal end view of the steerable endoscopic system 1100.

[0041] 13-15, a side view of the distal end portion of the steerable endoscope system 1100 is shown. As shown in FIG. 13, the plurality of protrusions 1108 of the endoscope catheter 1102 are circumferentially positioned between the plurality of recesses 904 of the catheter sleeve 900. When the distal end portion of the endoscope catheter 1102 is pulled back proximally into the catheter sleeve 900, the endoscope catheter 1102 is rotated in one circumferential direction and the catheter sleeve 900 is rotated in a second circumferential direction opposite to the first direction, as shown in FIG. 14. Each of the plurality of protrusions 1108 faces one of the plurality of recesses 904, and the distal end surface of the endoscope catheter 1102 is flush with the distal end surface of the catheter sleeve 900, and the endoscope catheter 1102 cannot rotate any further relative to the catheter sleeve 900. The plurality of protrusions 1108 thereby act as mating features such that the rotational viewing orientation of the endoscopic catheter 1102 is maintained as the steerable endoscopic system 1100 is steered.

[0042] 16, a perspective view of a distal end portion of a steerable endoscopic system 1200 includes an endoscopic catheter 1204 having a curved shape-fixing feature. The endoscopic catheter 1204 resides within a catheter sleeve 1202, which has a curved shape-fixing feature similar to that of the endoscopic catheter 1204, which may be complementary and / or similar to the curved shape-fixing feature of the endoscopic catheter 1204. The curved shape-fixing feature of the endoscopic catheter 1204 acts as a mating feature by biasing the orientation of the endoscopic catheter 1204 within the similar curved shape-fixing feature of the catheter 1202, thereby preserving the rotational viewing orientation of the endoscopic catheter 1204 as the steerable endoscopic system 1200 is steered.

[0043] In examples of the steerable endoscopic system of the present disclosure, the mating features may be configured to substantially prevent or substantially limit rotation of the endoscopic catheter relative to the catheter sleeve, but the mating features may not extend in the length direction. For example, the inner surface of the catheter sleeve may include equally spaced protruding features at a particular circumference of the catheter sleeve, which are configured to fit into equally spaced complementary slots of a collar integral with the outer surface of the endoscopic catheter at the particular circumference and extending radially outward therefrom. The collar may be configured to oppose the protruding features or pins, thereby preventing proximal or distal translation of the endoscopic catheter relative to the catheter sleeve, except when the protruding features or pins are aligned with the slots of the collar. When the protruding features or pins are aligned with the slots of the collar, the endoscopic catheter may translate in a distal or proximal direction relative to the catheter sleeve as the protruding features or pins fit into the slots of the collar. The catheter sleeve may have multiple circumferences along the longitudinal dimension of the catheter sleeve with protruding features disposed thereon, and the endoscopic catheter may have multiple collars along the longitudinal dimension of the endoscopic catheter. In another example, the inner surface of the catheter sleeve may have a smaller diameter at a particular circumference due to a collar integral with and protruding therefrom, except for equally spaced slots extending from the opposite side of the outer surface of the endoscopic catheter and configured to be complementary to the equally spaced protruding features integral therewith. The smaller diameter of the longitudinal cross section including the collar may be configured to oppose the protruding features or pins, thereby preventing the endoscopic catheter from translating in a proximal or distal direction relative to the catheter sleeve, except when the protruding features or pins are aligned with the slots of the collar. When the protruding features or pins are aligned with the slots of the collar, the endoscopic catheter may translate in a distal or proximal direction relative to the catheter sleeve as the protruding features or pins enter the slots of the collar.The catheter sleeve may have multiple circumferences with collars disposed along the longitudinal dimension of the catheter sleeve, and the endoscopic catheter may have multiple circumferences with equally spaced protruding features or pins protruding therefrom.

[0044] 17, a perspective view of a distal end portion of yet another example steerable endoscopic system 1300 is shown. The steerable endoscopic system 1300 includes an endoscopic catheter 1304, which includes a mating feature, and an outer surface 1306 of the endoscopic catheter 1304 includes a collar 1308 integral with the endoscopic catheter 1304 and protruding from the outer surface 1306 along the circumference of the outer surface 1306. The collar 1308 includes a number of slots 1310 cut from the collar 1308 that are equally spaced around the circumference. The example steerable endoscopic system 1300 shown in FIG. 17 includes a number of slots 1310 that are evenly spaced at 90 degrees around the circumference of the collar 1308, as illustrated in the distal end view of the steerable endoscopic system 1300 shown in FIG. The steerable endoscopic system 1300 also includes a catheter sleeve 1302 that includes a plurality of pins 1312 that project radially inward from an inner surface of the catheter sleeve 1302 and are evenly spaced around the circumference of the inner surface of the catheter sleeve 1302. The example of a steerable endoscopic system 1300 shown in FIG. 17 includes a plurality of pins 1312 that are evenly spaced at 90 degrees around the circumference of the inner surface of the catheter sleeve 1302. The plurality of pins 1312 are configured to be complementary to and / or approximate the plurality of slots 1310. The collar 1308 is configured to oppose the plurality of pins 1312 and thus prevent translational movement of the endoscopic catheter 1304 in a proximal or distal direction relative to the catheter sleeve 1302 except when the plurality of pins 1312 are aligned with the plurality of slots 1310. When the pins 1312 are aligned with the slots 1310, the endoscopic catheter 1304 may translate distally or proximally relative to the catheter sleeve 1302 as the pins 1312 enter the slots 1310. Because distal or proximal translation of the endoscopic catheter 1304 relative to the catheter sleeve 1302 is only possible when the pins 1312 are aligned with the slots 1310, the rotational viewing orientation of the endoscopic catheter 1304 is maintained as the steerable endoscopic system 1300 is steered and the endoscopic catheter 1304 translates proximally and distally.

[0045] 19, another example steerable endoscopic system 1400 is shown. The steerable endoscopic system 1400 includes an endoscopic catheter 1406 having an exterior surface 1404. The exterior surface 1404 of the endoscopic catheter 1406 includes a plurality of collars 1408 that protrude from the exterior surface 1404 and are integral with the endoscopic catheter 1408 and are evenly spaced apart along its length. Each collar of the plurality of collars 1408 includes a plurality of slots that are evenly spaced apart along the circumference of the exterior surface 1404. The steerable endoscopic system 1400 also includes a catheter sleeve 1402. The catheter sleeve includes a plurality of pins along the circumference of an interior surface of the catheter sleeve 1402. The plurality of pins are designed to be complementary with each of the plurality of slots of the plurality of collars 1408. When the plurality of pins align with the respective plurality of slots of each of the plurality of collars 1408, the endoscopic catheter 1406 can be translated distally or proximally relative to the catheter sleeve 1402. In another example of a steerable endoscopic system according to the present disclosure, in addition to the collars, the catheter sleeve includes a plurality of pins, each of the plurality of pins being circumferentially along the inner surface of the catheter sleeve, and each of the plurality of pins being equally spaced longitudinally from each of the other plurality of pins. In yet another example of a steerable endoscopic system, the catheter sleeve may include a plurality of pins, while the endoscopic catheter includes a collar.

[0046] 20, a distal end view of another example steerable endoscopic system 1500 is shown. The steerable endoscopic system 1500 includes a catheter sleeve 1502 and an endoscopic catheter 1506. The catheter sleeve 1502 includes a collar 1504 that projects inwardly from an inner surface of the catheter sleeve 1502. The catheter sleeve 1502 includes a plurality of slots 1512 that are equally spaced at 90 degree intervals around the circumference of the collar 1504. The endoscopic catheter 1506 includes a plurality of pins 1510 that project outwardly from an outer surface 1508 of the endoscopic catheter 1506 and are equally spaced at 90 degree intervals around the circumference of the outer surface 1508. The endoscopic catheter 1506 includes a plurality of pins 1510 that are evenly spaced at 90 degree intervals around the circumference of the outer surface 1508 of the endoscopic catheter 1506. The plurality of pins 1510 are configured to be complementary to and / or approximate the plurality of slots 1512. The collar 1504 is configured to oppose the pins 1510 and thereby prevent proximal or distal translation of the endoscopic catheter 1506 relative to the catheter sleeve 1502 except when the pins 1510 are aligned with the slots 1512. When the pins 1510 are aligned with the slots 1512, the endoscopic catheter 1506 may translate distally or proximally relative to the catheter sleeve 1502 as the pins 1510 enter the slots 1512. Because distal or proximal translation of the endoscopic catheter 1506 relative to the catheter sleeve 1502 is only possible when the pins 1510 are aligned with the slots 1512, the rotational viewing orientation of the endoscopic catheter 1506 is maintained as the steerable endoscopic system 1500 is steered and the endoscopic catheter 1506 translates proximally and in the proximal direction. In another example of a steerable endoscopic system according to the present disclosure, the catheter sleeve may include a plurality of collars spaced equally apart along its length. In yet another example of a steerable endoscopic system according to the present disclosure, the endoscope catheter may include a plurality of pins spaced equally apart along its length.In yet another example of a steerable endoscopic system according to the present disclosure, the endoscopic catheter may include a plurality of pins equally spaced longitudinally on an outer surface of the endoscopic catheter, and the catheter sleeve may include a plurality of collars equally spaced longitudinally on an inner surface of the catheter sleeve.

[0047] 21, a perspective view of the distal end of yet another example steerable endoscopic system 1600 is shown, comprising an example telescoping endoscopic catheter 1605 including a mating feature such as a male V-shaped protrusion ("V-section") 1601 added to an endoscopic catheter tip 1606 proximal to the endoscopic catheter tip 1606. The V-section 1601 may be configured to assist in aligning the telescoping endoscopic catheter 1605 about its longitudinal axis with respect to the pivot arm 1603 and the catheter sleeve 1604. The shape of the V-section 1601 may be configured to be complementary to and / or approximate the shape of a female V-shaped recess 1602 added to the pivot arm 1603 to assist in aligning the telescoping endoscopic catheter 1605 about its longitudinal axis with respect to the pivot arm 1603 and the catheter sleeve 1604. FIG. 22 shows a longitudinal cross-sectional view of the steerable endoscopic system 1600, cut along axis AA.

[0048] 23, a perspective view of the distal end of yet another example steerable endoscopic system 1700 is shown comprising an example telescoping endoscopic catheter 1705 including mating features such as a male V-shaped protrusion ("V-section") 1701 nested within a pivot arm 1703 and a catheter sleeve 1704. The V-section 1701 may be configured to complement and / or approximate the shape of a female V-shaped recess 1702 added to the pivot arm 1703 to assist in aligning the telescoping endoscopic catheter 1705 about its longitudinal axis with respect to the pivot arm 1703 and catheter sleeve 1704. FIG. 24 shows a longitudinal cross-sectional view of the steerable endoscopic system 1700, cut along axis BB.

[0049] Referring to Figure 25, a distal end view of yet another example steerable endoscopic system 1800 is shown, comprising an example telescoping endoscopic catheter 1803 having an elliptical longitudinal cross-sectional shape. Figure 26 shows a side view of the distal end of the steerable endoscopic system 1800. The pivot arm 1801 may include an opening 1804 having an elliptical longitudinal cross-sectional shape configured with a major axis and a minor axis, such that the telescoping endoscopic catheter 1803 may fit into the opening 1804 of the pivot arm 1801, i.e., the ability of the telescoping endoscopic catheter 1803 to rotate about a longitudinal axis relative to the pivot arm 1801 may be at least limited. The catheter sleeve 1802 may include an elliptical longitudinal cross-sectional shape configured with a major axis and a minor axis, such that the ability of the telescoping endoscopic catheter 1803 to rotate about a longitudinal axis relative to the catheter sleeve 1802 may be at least limited. FIG. 27 shows a longitudinal cross-sectional view of a cut along CC of a steerable endoscopic system 1800.

[0050] Referring to Figure 28, a distal end view of yet another example telescoping endoscopic catheter 1900 is shown. The telescoping endoscopic catheter 1900 may include a mating feature, such as a V-shaped protrusion ("V-shaped portion") 1901 at the proximal end of the distal catheter tip 1903, which may be configured to aid in alignment of the telescoping endoscopic catheter 1903 with respect to the pivot arm 1801. Figure 29 shows a perspective view of the telescoping endoscopic catheter 1900. Figure 30 shows a top view of the telescoping endoscopic catheter 1900.

[0051] While the present disclosure has been described by way of example and with reference to the accompanying drawings, the disclosure is not limited thereto and various modifications and changes may be made thereto by those skilled in the art to which the disclosure pertains without departing from the spirit and scope of the disclosure.

[0052] The subject matter of the present disclosure may also relate to the following aspects, among others:

[0053] A first aspect relates to a medical device comprising: an elongate tube including a lumen extending therethrough defining a longitudinal axis therethrough, the lumen including a surface having a first longitudinally extending cross-sectional shape; a movable member extending longitudinally at least a portion of the lumen, the movable member including a second lumen extending therethrough and including an outer surface having a second longitudinally extending cross-sectional shape; and a camera extending longitudinally at least a portion of the second lumen, the first longitudinally extending cross-sectional shape and the second longitudinally extending cross-sectional shape configured to prevent the movable member from rotating about the longitudinal axis relative to the elongate tube as the movable member translates distally or proximally.

[0054] A second embodiment relates to the medical device of embodiment 1, wherein the second longitudinal cross-sectional shape is configured to be complementary to the first longitudinal cross-sectional shape of the lumen surface.

[0055] A third aspect relates to the medical device of aspect 1 or 2, wherein the second longitudinal cross-sectional shape is non-axisymmetric.

[0056] A fourth aspect relates to the medical device of any one of aspects 1 to 3, wherein the cross-sectional shape extending in the first length direction is non-axisymmetric.

[0057] A fifth aspect relates to the medical device of aspect 1 or 2, wherein the second longitudinal cross-sectional shape is elliptical, the second longitudinal cross-sectional shape comprising a major axis and a minor axis, the major axis being greater than the minor axis.

[0058] A sixth aspect relates to the medical device of aspect 5, wherein the first longitudinal cross-sectional shape is elliptical, the first longitudinal cross-sectional shape including a second major axis and a second minor axis, the second major axis being proportionally larger than the minor axis, and the first longitudinal cross-sectional shape is configured to be complementary to the second longitudinal cross-sectional shape.

[0059] A seventh aspect relates to the medical device of aspect 5, wherein the first longitudinal cross-sectional shape is generally circular and the elongate tube includes an attachment portion configured to be complementary to the second longitudinal cross-sectional shape.

[0060] An eighth aspect relates to the medical device of aspect 1 or 2, wherein the second longitudinally extending cross-sectional shape comprises a rectangle, a square, a tab, a groove, and / or a protruding feature.

[0061] A ninth aspect relates to the medical device of aspect 8, including an attachment portion having a first longitudinal cross-sectional shape configured to be complementary to a rectangle, a square, a protrusion, a groove, a protruding feature, and / or a second longitudinal cross-sectional shape.

[0062] A tenth aspect relates to the medical device of any of aspects 1-9, wherein the movable member includes a shape-fixing curve and the elongated tube includes a second shape-fixing curve configured to be complementary to the shape-fixing curve, and the shape-fixing curve is configured to bias the orientation of the movable member within the elongated tube.

[0063] An eleventh aspect relates to a second medical device including a third lumen and a medical device of any of aspects 1-10 housed within the third lumen, wherein the third lumen defines a second longitudinal axis therein parallel to the longitudinal axis, and the medical device is configured to prevent rotation of the medical device about the second longitudinal axis relative to the third lumen when the medical device translates distally or proximally relative to the third lumen.

[0064] A twelfth aspect relates to the medical device of any of aspects 1-11, wherein the elongated tube includes a longitudinal slot connecting an outer surface of the elongated tube with a surface of the lumen, and the medical device further includes an outer clip including an outer clip body at least partially surrounding a circumference of the outer surface of the elongated tube, and a pin projecting radially inward from the outer clip body and configured to project through the longitudinal slot and be complementary to a second longitudinally extending detent or groove of a cross-sectional shape.

[0065] A thirteenth aspect relates to the medical device of any of aspects 1 to 12, wherein the movable member includes a member longitudinal slot connecting the outer surface and the second lumen, and an anchor connected to the camera and protruding outwardly through the member longitudinal slot, the anchor configured to prevent the camera from rotating about an axis parallel to the longitudinal axis of the elongated tube and / or from translating distally and proximally beyond the longitudinal dimension of the member longitudinal slot.

[0066] A fourteenth aspect relates to the medical device of any of the first to thirteenth aspects, wherein the movable member includes one or more additional lumens extending therethrough and configured to accommodate or pass accessories such as a deflection cable, a suction device, an irrigation device, a ventilation device, a camera lens cleaning device, or a light emitting diode.

[0067] A fifteenth aspect relates to the medical device of any of aspects 1 to 14, wherein the surface of the lumen includes a plurality of recesses equally spaced around the circumference of the lumen, and the outer surface of the movable member includes a plurality of protrusions, each of which is configured to be complementary to one of the plurality of recesses.

[0068] In addition to the features described in each of the independent aspects above, some examples may exhibit, individually or in combination, optional features described in dependent aspects and / or disclosed in the preceding description and illustrated in the drawings.

Claims

1. In medical devices, an elongate tube including a lumen extending therethrough, the elongate tube defining a longitudinal axis therethrough, the lumen including a surface having a first longitudinally extending cross-sectional shape; a movable member extending longitudinally at least partially within the lumen, the movable member including a second lumen extending therein and including an outer surface having a second longitudinally extending cross-sectional shape; a camera extending longitudinally at least partially within the second lumen; Including, A medical device, wherein the first longitudinal cross-sectional shape and the second longitudinal cross-sectional shape are configured to prevent the movable member from rotating about the longitudinal axis relative to the elongated tube when the movable member translates in a distal or proximal direction.

2. The medical device of claim 1 , wherein the second longitudinal cross-sectional shape is configured to be complementary to the first longitudinal cross-sectional shape of the surface of the lumen.

3. The medical device of claim 1 , wherein the second longitudinal cross-sectional shape is non-axisymmetric.

4. The medical device of claim 1 , wherein the first longitudinal cross-sectional shape is non-axisymmetric.

5. the second longitudinal cross-sectional shape is elliptical; The medical device of claim 1 , wherein the second longitudinally extending cross-sectional shape includes a major axis and a minor axis, the major axis being greater than the minor axis.

6. the first longitudinal cross-sectional shape is elliptical; the first longitudinal cross-sectional shape includes a second major axis and a second minor axis, the second major axis being greater than the minor axis; 6. The medical device of claim 5, wherein the first longitudinal cross-sectional shape is configured to be complementary to the second longitudinal cross-sectional shape.

7. the first longitudinal cross-sectional shape is substantially circular; The medical device of claim 5 , wherein the elongate tube includes an appendage configured to complement the second longitudinal cross-sectional shape.

8. 10. The medical device of claim 1, wherein the second longitudinally extending cross-sectional shape comprises a rectangle, a square, a tab, a groove, and / or a protruding feature.

9. 9. The medical device of claim 8, wherein the first longitudinal cross-sectional shape comprises a rectangle, a square, a tab, a groove, a protruding feature, and / or an appendage configured to be complementary to the second longitudinal cross-sectional shape.

10. the movable member includes a shape-fixed curve; the elongate tube includes a second shape-fixing curve configured to be complementary to the shape-fixing curve; The medical device of claim 1 , wherein the shape-fixing curve is configured to bias an orientation of the movable member within a tube of the elongate wand.

11. 13. A second medical device comprising a third lumen and the medical device of claim 1 housed within the third lumen, The third lumen defines a second longitudinal axis therethrough that is parallel to the longitudinal axis, and the second medical instrument is configured to prevent the medical instrument from rotating about the second longitudinal axis relative to the third lumen when the medical instrument is translated distally or proximally relative to the third lumen.

12. the elongated tube includes a longitudinal slot connecting an outer surface of the elongated tube with the surface of the lumen; An outer clip comprising: an outer clip body at least partially circumferentially surrounding an outer surface of the elongate tube; a pin projecting radially inwardly from said outer clip body and configured to project through said longitudinal slot and be complementary to said second longitudinally extending cross-sectional tab or groove; The medical device of claim 1 , further comprising an outer clip comprising:

13. the movable member includes a member longitudinal slot connecting the outer surface and the second lumen, and an anchor connected to the camera and projecting outwardly through the member longitudinal slot; 2. The medical device of claim 1, wherein the anchor is configured to prevent the camera from rotating relative to the elongated tube about an axis parallel to the longitudinal axis and / or from translating distally and proximally beyond a longitudinal dimension of the member longitudinal slot.

14. 10. The medical device of claim 1, wherein the movable member includes one or more additional lumens extending therethrough and configured to accommodate or pass accessories such as a deflection cable, a suction device, an irrigation device, a ventilator, a camera lens cleaner, or a light emitting diode.

15. the surface of the lumen includes a plurality of recesses equally spaced around a circumference of the lumen; The medical device of claim 1 , wherein the outer surface of the movable member includes a plurality of protrusions, each of which is configured to be complementary with one of the plurality of recesses.

16. A medical device, an elongate tube including a lumen extending therethrough, the elongate tube defining a longitudinal axis therethrough, the lumen including a surface having a first longitudinally extending cross-sectional shape; a movable member extending longitudinally at least partially within the lumen, the movable member including a second lumen extending therein and including an outer surface having a second longitudinally extending cross-sectional shape; a camera extending longitudinally at least partially within the second lumen; Including, the second longitudinal cross-sectional shape is configured to be complementary to the first longitudinal cross-sectional shape of the surface of the lumen; A medical device, wherein the first longitudinal cross-sectional shape and the second longitudinal cross-sectional shape are configured to prevent the movable member from rotating about the longitudinal axis relative to the elongated tube when the movable member translates in a distal or proximal direction.

17. 17. The medical device of claim 16, wherein the second longitudinal cross-sectional shape is non-axisymmetric.

18. the second longitudinal cross-sectional shape is elliptical; 17. The medical device of claim 16, wherein the second longitudinally extending cross-sectional shape includes a major axis and a minor axis, the major axis being greater than the minor axis.

19. 17. The medical device of claim 16, wherein the second longitudinally extending cross-sectional shape comprises a rectangle, a square, a tab, a groove, and / or a protruding feature.

20. A medical device, an elongate tube including a lumen extending therethrough, the elongate tube defining a longitudinal axis therethrough, the lumen including a surface having a first longitudinally extending cross-sectional shape; a movable member extending longitudinally at least partially within the lumen, the movable member including a second lumen extending therein and including an outer surface having a second longitudinally extending cross-sectional shape; a camera extending longitudinally at least partially within the second lumen; Including, the second longitudinal cross-sectional shape is elliptical and includes a major axis and a minor axis, the major axis being greater than the minor axis; the second longitudinal cross-sectional shape is configured to be complementary to the first longitudinal cross-sectional shape of the surface of the lumen; A medical device, wherein the first longitudinal cross-sectional shape and the second longitudinal cross-sectional shape are configured to prevent the movable member from rotating about the longitudinal axis relative to the elongated tube when the movable member translates in a distal or proximal direction.

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