Medical systems, medical devices, and related methods

Abstract

The medical system includes a first medical device and a second medical device. The first medical device includes a handle and a shaft. The shaft includes a lumen. A distal portion of the shaft includes an articulation joint, the lumen extending through at least a portion of the articulation joint. The second medical instrument includes a controller and a rod. The rod is configured to be positioned within the articulation joint and within at least a portion of the lumen of the shaft. The controller is configured to control a position of the rod within the shaft. The position of the rod within the shaft controls an angle of articulation of the articulation joint.

Description

[Technical field]

[0001] The present disclosure relates generally to medical systems, devices, and methods. In particular, the present disclosure is directed to systems, devices, and methods for adjusting a joint radius of an articulatable or deflectable medical device. This application claims the benefit of priority to U.S. Provisional Patent Application No. 63 / 307,235, filed February 7, 2022, the entirety of which is incorporated herein by reference. [Background technology]

[0002] The medical device may include a handle and a shaft portion or insertion portion. The handle allows steering and physical manipulation of the shaft portion and may include controls for other operations of the device. The distal assembly may include a portion of the shaft portion and may have multiple channels or lumens for endoscopic surgery. Often, an instrument or tool may be inserted into a working channel in the shaft portion to perform a therapeutic or diagnostic procedure. The shaft portion or insertion portion may be articulated or deflected, for example, by one or more actuators on the handle. The articulation or deflection may include a predetermined angle of articulation or deflection and / or a predetermined response to the movement of one or more actuators. However, different procedures and / or different body cavities within a patient may require different manipulations, different responses to the movement of one or more actuators, and / or different articulation or deflection radii. Thus, a need exists for the shaft portion or insertion portion of an endoscopic device to have variable articulation or deflection radii and / or other controls. Summary of the Invention

[0003] According to one embodiment, a medical system may include a first medical device and a second medical device. The first medical device may include a handle and a shaft. The shaft may include a lumen. A distal portion of the shaft may include an articulation joint. The lumen may extend through at least a portion of the articulation joint. The second medical device may include a controller and a rod. The rod may be selectively positionable within at least a portion of the lumen of the shaft within the articulation joint. The controller may be configured to control a position of the rod within the shaft. A position of the rod within the shaft may control an angle of articulation of the articulation joint.

[0004] The medical system may include one or more of the following aspects: The controller may be integrated into or coupled to a portion of the handle. The controller may include a slider, a pin coupled to the slider, and a track located in a distal portion of the handle. Movement of the pin in the track may control a position of the rod within the lumen of the shaft. The track may include a central channel, a number of slots extending from the central channel, and a number of grooves extending from the number of slots. Spacing of the slots along the central channel may correspond to a length of one or more links in the articulation joint.

[0005] The control device may include a dial, a dowel extending from the dial, and a pinion coupled to the dowel. The rod may be coupled to a rack. Rotational motion of the dial may actuate linear motion of the rack to control a position of the rod within the shaft. The rack may include a plurality of teeth. Spacing of the teeth on the rack may correspond to a length of one or more links in the articulation joint.

[0006] The control device may include a screw coupled to the rod and a coupling. The screw may include male threads. The coupling may include female threads. The rod may be coupled to a distal end of the screw. Rotational movement of the screw may control the position of the rod within the shaft.

[0007] The control device may include a primary wheel, one or more secondary wheels, and an attachment element that may be coupled to a distal portion of the handle. Rotational movement of the primary wheel or the one or more secondary wheels may control the position of the rod within the shaft.

[0008] The articulation joint may include nine articulation links. Each articulation link may provide 25 degrees of articulation. The rod may have less flexibility than the articulation joint. The articulation joint may include a plurality of articulation links. A more distal articulation link may provide more articulation than a more proximal articulation link. The handle may include an instrument port on a distal portion of the handle. The instrument port is configured to receive the rod and guide the rod into the lumen of the shaft. The first medical device may include an articulation lever located on a portion of the handle. The articulation lever may be connected to the articulation joint via one or more articulation wires.

[0009] In another example, a medical device may include a rod and a controller coupled to a proximal portion of the rod. The controller may include one or more control members. Movement of the one or more control members in a first direction may advance the rod distally. Movement of the one or more control members in a second direction may retract the rod proximally. The controller may include one or more indicia indicating a position of the rod relative to the controller.

[0010] The medical device may include one or more of the following aspects: The control device may include a slider, a pin coupled to the slider, and a track. The track may include a central channel, a number of slots extending from the central channel, and a number of grooves extending from the number of slots and forming the indicia. Movement of the pin in the track may control a position of the rod relative to the control device. The control device may include a dial, a dowel extending from the dial, and a pinion coupled to the dowel. The rod may be coupled to a rack. The rack may include a number of teeth. The spacing of the teeth on the rack may correspond to a length of one or more links in the articulation joint. Rotational movement of the dial may actuate linear movement of the rack to control a position of the rod relative to the control device.

[0011] In yet another example, the method may include delivering a first medical device to a treatment site. The first medical device may include a handle and a shaft. The shaft may include an articulation joint at a distal end of the shaft. The method may include manipulating a distal portion of the first medical device. Manipulating the distal portion of the first medical device may include manipulating an actuation lever on the handle to articulate the articulation joint at a first articulation angle. The method may further include delivering a second medical device to the treatment site. The second medical device may include a control device and a rod. Delivering the second medical device to the treatment site may include delivering a portion of the rod through a port in the handle and a lumen in the shaft to the articulation joint. The method may further include positioning the second medical device relative to the first medical device. The method may also include manipulating the distal portion of the first medical device. Manipulating a distal portion of the first medical device may include manipulating the actuation lever on the handle to articulate the articulation joint at a second articulation angle less than the first articulation angle.

[0012] The method may include one or more of the following aspects: The control device may include a slider, a pin coupled to the slider, and a track. The track may include a central channel and a plurality of slots extending from the central channel. Positioning the second medical device relative to the first medical device may include manipulating the slider to move the pin within the track to control a position of the rod relative to the control device and the shaft of the first medical device.

[0013] Both the foregoing general description and the following description are exemplary and explanatory only and are not restrictive of the claimed invention. The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate examples of the disclosure and, together with the description, serve to explain the principles of the disclosure. [Brief description of the drawings]

[0014] [Figure 1] FIG. 1 illustrates a side view of an exemplary medical system including a first medical device and a second medical device, according to an embodiment of the present disclosure. [Figure 2A-2B] 2A and 2B show side and perspective views of a distal assembly portion with an articulation joint of a first medical device. [Figure 3A-3C] 3A and 3B show cross-sectional views of a distal assembly portion of a first medical device, and FIG. 3C shows an end view of a distal cap of the distal assembly of the first medical device. [Figure 4A-4E] 4A-4E show various deflections or articulations of the distal portion of the distal assembly portion under various conditions. [Figure 5A-5B] 5A and 5B show perspective and top views, respectively, of another embodiment of a second medical device. [Figure 6A-6B] 6A and 6B show perspective views of yet another embodiment of a second medical device coupled to a handle of a first medical device. [Figure 7A-7B]7A and 7B show side and cross-sectional views, respectively, of another embodiment of a second medical device coupled to a handle of a first medical device. [Figure 8] FIG. 8 illustrates a side view of yet another embodiment of a second medical device coupled to a handle of a first medical device. [Figure 9] FIG. 9 is a flow diagram of an exemplary method according to an embodiment of the present disclosure. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0015] The terms "proximal" and "distal" as used herein are used to refer to the relative locations of components of the exemplary medical system and exemplary medical device. As used herein, "proximal" refers to a location relatively closer to the outside of the body or to the medical professional using the medical system or medical device. In contrast, "distal" refers to a location relatively farther from the medical professional using the medical system or medical device or to a location closer to the inside of the body. As used herein, the terms "comprises," "comprising," "having," "including," or other variations thereof are intended to cover a non-exclusive inclusion, such that a system, device, or method comprising a list of elements does not include only those elements, but may include other elements not expressly listed or inherent thereto. Unless otherwise stated, the term "exemplary" is used in the sense of "example" rather than "ideal." As used herein, the terms "about," "substantially," and "approximately" indicate a range of values ​​within + / - 10% of the stated value.

[0016] Examples of the present disclosure include systems, devices, and methods for facilitating and / or improving the effectiveness, efficiency, cost, and / or safety of medical procedures. Embodiments of the present disclosure may relate to systems, devices, and methods for performing various medical procedures and / or for treating the larynx, trachea, bronchi (primary bronchi), lobes (secondary bronchi), segments (tertiary bronchi), bronchioles, terminal bronchioles, or any other portion of the respiratory system. Also, embodiments of the present disclosure may relate to systems, devices, and methods for performing various medical procedures and / or for treating the large intestine (colon), small intestine, cecum, esophagus, stomach, or any other portion of the gastrointestinal tract. Furthermore, embodiments of the present disclosure may relate to systems, devices, and methods for performing various medical procedures and / or for treating the kidneys, ureters, bladder, urethra, or any other portion of the urinary tract. In these embodiments, the systems, devices, and methods described herein may be used to treat any other suitable patient anatomy (collectively referred to herein as the "treatment site").

[0017] Various embodiments described herein include single-use or disposable medical devices. Some aspects of the present disclosure may be used in performing endoscopy, arthroscopes, bronchoscopes, ureteroscopes, colonoscopes, or other types of procedures. For example, the disclosed aspects may be used as or with duodenoscopes, bronchoscopes, ureteroscopes, colonoscopes, catheters, diagnostic or therapeutic tools or devices, or other types of medical devices. One or more of the elements described herein may be metal, plastic, or may include any combination of shape memory metals (such as Nitinol), shape memory polymers, polymers, or biocompatible materials.

[0018] Reference will now be made in detail to the embodiments of the present disclosure, as illustrated in the accompanying drawings described above. Where possible, the same reference numerals will be used throughout the drawings to refer to the same or like parts. One or more aspects of the medical systems, devices, and methods described herein may be combined and / or used with one or more aspects of the other medical systems, devices, and methods described herein.

[0019] 1 illustrates a medical system ("system") 100. System 100 may include a first medical device 102 and a second medical device 104. First medical device 102 may be referred to herein as an endoscope, but may be an endoscope, duodenoscope, bronchoscope, ureteroscope, colonoscope, catheter, or other type of medical device. As described in detail below, second medical device 104 may be delivered through one or more portions of first medical device 102 to assist in controlling, for example, the articulation or deflection radius or other characteristics of a distal portion of first medical device 102.

[0020] The first medical device 102 includes a handle portion ("handle") 110 and a shaft / insertion portion ("shaft") 150. The handle 102 may include one or more of a gripping surface 112, an articulation lever 114, an aspiration port 116, an instrument or irrigation port ("instrument port") 118, a shaft strain relief 120, an umbilicus strain relief 122, and an umbilicus 124 (a proximal portion of which is shown in FIG. 1). The distal end of the shaft 150 may be connected to or include a distal assembly 152. The distal assembly 152 may include an articulation joint 210 and a distal cap 220 (FIGS. 2A, 2B, and 3C). The distal assembly 152 may include one or more other devices and / or may be configured to receive other devices, such as a camera or a light illumination or lighting element (e.g., a light emitting diode or "LED"). As described herein, the first medical device 102 has a working channel that extends from the distal cap 220 of the distal assembly 152, through the articulation joint 210 and shaft 150 to the instrument port 118 of the handle 110. Thus, the working channel of the first medical device 102 may be a combination of the working channel of the distal cap 220, the working channel of the articulation joint 210, and the working channel of the shaft 150, as described in detail herein.

[0021] The gripping surface 112 of the handle 110 may help enable physical handling of the system 100 (e.g., the first medical device 102), for example, by a medical professional or other operator. The articulation lever 114 may be configured to be operable such that, when the articulation lever 114 is manipulated by an operator, it can articulate the articulation joint 210 of the first medical device 102 in a plane, for example, up and down. As described below, the articulation joint 210 can articulate over a range of about 180 degrees, about 200 degrees, about 225 degrees, etc. The suction port 116 may be a valve configured to provide suction of air and / or water (e.g., through the working channel of the first medical device 102). The instrument port 118 may be used to pass a medical instrument (e.g., part of the second medical device 104) or other tools and devices through the working channel of the first medical device 102. In one example, as described herein, the working channel of the first medical device 102 can be a tubeless working channel (e.g., an open channel with no additional tube inserted to guide an insertion instrument). The working channel can have a large cross-sectional area for receiving medical instruments as well as other tools and devices.

[0022] The shaft strain relief 120 may be configured to interface with the shaft 150 of the first medical device 102. The umbilicus 124 may be connected to the umbilicus strain relief 122. The umbilicus 124 may be configured to extend from the handle 110 for connection to, for example, an external device (e.g., a controller, computing device, processor, display device, user interface, etc.). For example, the umbilicus 124 may be used to connect the first medical device 102 to components that provide optical control of the first medical device 102, including, for example, a camera, video, lights, etc. The shaft 150 may be configured to be inserted into a patient (e.g., via one or more orifices in the patient's body) for a medical procedure.

[0023] The second medical device 104 includes a controller 106 and a mandrel or rod ("rod") 108. The rod 108 may be delivered through the handle 110 and / or shaft 150, for example through a working channel, to the distal assembly 152. The controller 106 may control the position of the rod 108. For example, the controller 106 may be coupled to the handle 110 and / or disposed adjacent to the handle 110. As described below, the controller 106 may be incorporated into and / or coupled to the handle 110. Alternatively, the controller 106 may be separate from the handle 110. Manipulation of the controller 106 may control the position of the rod 108 relative to the shaft 150 and / or distal assembly 152. For example, manipulation of the controller 106 may linearly adjust the position of the rod 108 relative to the shaft 150 and / or distal assembly 152. In these embodiments, the position of the rod 108 relative to the shaft 150 and / or the distal assembly 152 may control, for example, the articulation or deflection angle when the articulation lever 114 is manipulated. For example, the rod 108 may have a stiffness greater than that of the distal assembly 152. In other words, the rod 108 may have a flexibility less than that of the distal assembly 152. In these embodiments, the rod 108 may be a reinforcing element to increase the stiffness of the distal assembly 152. Alternatively, the rod 108 may have a flexibility comparable to that of the distal assembly 152. In one or more of these embodiments, the rod 108 may be smaller than the lumen through which the rod 108 passes (FIG. 3A). Alternatively, in one or more of these embodiments, the rod 108 may be larger, for example, closer to the size of the lumen through which the rod 108 passes (FIG. 3B). As described below, the amount of spacing between the exterior of the rod 108 and the inner wall of the lumen through which the rod 108 passes can help control the effect that the rod 108 has on the articulation of the distal assembly 152.

[0024] As described in more detail below, when rod 108 is in a first configuration (e.g., a proximally retracted position), operation of articulation lever 114 may cause a distal portion of shaft 150 or distal assembly 152 to articulate or deflect at a first angle. When rod 108 is in a second configuration (e.g., a distally extended position), operation of articulation lever 114 may cause a distal portion of shaft 150 or distal assembly 152 to articulate or deflect at a second angle, e.g., an angle less than the first angle. In these embodiments, rod 108 may be selectively movable to control the articulation or deflection angle of the distal end of shaft 150 or distal assembly 152.

[0025] FIG. 2A shows a side view of the distal assembly 152 and certain electronics extending through the shaft 150 and umbilicus 124, and FIG. 2B shows a perspective view of a portion of the distal assembly 152. The distal assembly 152 includes an articulation joint 210, a distal cap 220, a number of cables and wires 245 for connection to, for example, a camera and LEDs, a Bowden disk 230, and two articulation wires 240(1), 240(2). The cables and wires 245 in the distal assembly 152 extend through the shaft 150 and umbilicus 124 to a circuit board 250. The circuit board 250 may be at the end of the umbilicus 124 that connects to an external controller. Alternatively, the circuit board 250 may be located on or within the handle 110, a remote processor, the umbilicus, or the like. Thus, the circuit board 250 is not part of the distal assembly 152 itself, but is configured for connection to LED wiring and a camera cable that are disposed through the distal assembly 152.

[0026] Generally, articulation joint 210 may include multiple lumens (FIG. 2B) that may operate as a tubeless working channel of articulation joint 210, a lumen for receiving articulation wires 240(1), 240(2), and a lumen for receiving LED / camera wiring. Similarly, shaft 150 is disposed between handle 110 and distal assembly 152, and shaft 150 may also include multiple lumens that may operate as a tubeless working channel of shaft 150, a lumen for receiving articulation wires 240(1), 240(2), and a lumen for receiving LED / camera wiring.

[0027] The distal cap 220 of the distal assembly 152 may include a camera and one or more LEDs, for example, two LEDs. Further details of the distal cap 220 are described below in connection with FIGS. 3A-3C. The distal cap 220 may be attached to a distal end of the articulation joint 210. A cable for the camera and two sets of one or more wires for each LED may pass through the distal cap 220 and the articulation joint 210. The camera cable may include multiple wires held together by a wire harness. The Bowden disk 230 may be attached to a proximal end of the articulation joint 210. Articulation wires 240(1), 240(2) may extend from the handle 110, for example, the articulation lever 114 (not shown in FIG. 2), through the shaft 150 and the articulation joint 210 to control the movement of the articulation joint 210, for example, in an up or down direction.

[0028] FIG. 2B shows a perspective view of articulation joint 210 with distal cap 220 removed. Note that FIG. 2B shows articulation joint 210 without wires passing through lumens 221(1)-221(4). Articulation joint 210 may be a single piece element formed, for example, from injection molded polypropylene or other suitable material and / or forming process. The thickness of the outer wall of articulation joint 210 may be tapered to provide greater strength at the proximal end of articulation joint 210 (e.g., the wall is thinner at the distal end) and / or greater flexibility at the distal end of articulation joint 210. Articulation joint 210 includes a plurality of links, designated by reference numerals 212(1)-212(n). Links 212(1)-212(n) are connected by hinged portions 214(1)-214(n).

[0029] In one embodiment, the articulation joint 210 may include nine links 212. Each link 212 may provide up to about 25 degrees of motion. Thus, the nine links 212 may allow the articulation joint 210 to articulate greater than about 180 degrees, for example up to about 225 degrees. Alternatively, the distal links may provide a greater degree of motion than the proximal links. In this embodiment, the rods 108 may be positioned within one or more of the distal links to distribute the load on the articulation joint 210 from the articulation wires 240 toward the more flexible distal links. As described in more detail below, the rods 108 may be positioned incrementally within one or more links 212 of the articulation joint 210 to prevent one or more links 212 from articulating, thereby adjusting the articulation radius of the articulation joint 210. The adjusted articulation radius of articulation joint 210 may allow a user to articulate or deflect distal assembly 152 through a smaller articulation radius, for example, for more precise adjustment with less sensitivity to movement of articulation lever 114. Additionally, in some embodiments, articulation joint 210 may be encased in a thin polyurethane covering.

[0030] Articulation joint 210 may be part of distal assembly 152. Articulation joint 210 may include several lumens, for example, four lumens 221(1)-221(4). For example, first lumen 221(1) of articulation joint 210 may be configured to receive cable and wires 245 (described above in connection with FIG. 2A ) for connection to camera 222 and LEDs 224(a), 224(b). In one example, first lumen 221(1) may receive wires for each LED 224(a), 224(b) and one cable for camera 222 (e.g., the cable may include multiple wires for camera 222 held together with wires for LEDs 224(a), 224(b) using a wire harness). Second lumen 221(2) of articulation joint 210 may receive articulation wire 240(1) for connection to articulation lever 114. The third lumen 221(3) of the articulation joint 210 may receive an articulation wire 240(2) for connection with the articulation lever 114. As described above, the articulation lever 114 of the handle 110 may be configured to adjust the articulation wires 240(1), 240(2) for articulation in one plane (e.g., up / down). For example, moving the articulation lever 114 in one direction pulls one articulation wire to move in a "left" direction and moving the articulation lever 114 in another direction pulls another articulation wire to move in a "right" direction. Additionally or alternatively, if the articulation joint 210 is oriented in a different direction (e.g., rotated 90 degrees), moving the articulation lever 114 in one direction pulls one articulation wire to move in an "up" direction and moving the articulation lever 114 in another direction pulls another articulation wire to move in a "down" direction.

[0031] The fourth lumen 221(4) of the articulation joint 210 may be utilized as a working channel for the articulation joint 210. The working channel of the articulation joint 210 may be part of the working channel of the first medical device 102 (along with the working channel of the distal cap 220 and the working channel of the shaft 150, which are described in detail herein).

[0032] 3A and 3B show cross-sectional views of shaft 150, and FIG. 3C shows an end view of distal cap 220. As discussed above, shaft 150 may include several lumens. In one embodiment, shaft 150 may include four lumens 331(1)-331(4). For example, first lumen 331(1) of shaft 150 may be configured to receive cable and wires 245 (described above in connection with FIG. 2A) for connection to camera 222 and LEDs 224(a), 224(b). In one example, first lumen 331(1) may receive wires for each LED 224(a), 224(b) and one cable for camera 222 (e.g., the cable may include multiple wires for camera 222 held together with wires for LEDs 224(a), 224(b) using a wire harness). Second lumen 331(2) of shaft 150 may receive articulation wire 240(1) for connecting with articulation lever 114. Third lumen 331(3) of shaft 150 may receive articulation wire 240(2) for connecting with articulation lever 114. Fourth lumen 331(4) of shaft 150 may be utilized as a working channel for shaft 150. The working channel of shaft 150 may be part of the working channel of first medical device 102 (along with the working channel of distal cap 220 and the working channel of articulation joint 210, which are described in detail herein).

[0033] As shown in FIGURE 3C, distal cap 220 includes one or more cameras 222, one or more LEDs (e.g., two LEDs 224(a), 224(b) on either side of camera 222), articulation wires 240(1), 240(2), and opening 228 (e.g., the opening of a tubeless working channel). Articulation wires 240(1), 240(2) are two separate wires, but are shown in FIGURE 3B as forming a continuous loop.

[0034] Distal cap 220 has four lumens, indicated by reference numerals 341(1)-341(4) in FIG. 3C. Camera 222 and LEDs 224(a), 224(b) may be disposed in a first lumen (e.g., lumen 341(1)), which may at least partially coincide with lumen 331(1) of shaft 150 and lumen 221(1) of articulation joint 210. Articulation wire 240(1) may be disposed in a second lumen (e.g., lumen 341(2)). Articulation wire 240(2) may be disposed in a third lumen (e.g., lumen 341(3)). Second lumen 341(2) may at least partially coincide with lumen 331(2) of shaft 150 and lumen 221(2) of articulation joint 210. The third lumen 341(3) may at least partially coincide with the lumen 331(3) of the shaft 150 and the lumen 221(3) of the articulation joint 210. The fourth lumen (e.g., lumen 341(4)) may be utilized for a tubeless working channel of the distal cap 220. The fourth lumen 341(4) may at least partially coincide with the lumen 331(4) of the shaft 150 and the lumen 221(4) of the articulation joint 210. As described herein, the working channel of the distal cap 220 may interface with the working channel of the articulation joint 210 and the working channel of the shaft 150 to constitute the working channel of the first medical device 102. The lumens 341(1), 341(2), 341(3) of the distal cap 220 may be separate or may be in communication to form, for example, a generally C-shaped opening at the distal end of the distal cap 220.

[0035] As described above, a portion of the second medical device 104 may be inserted into the first medical device 102 and / or coupled to the first medical device 110. The rod 108 may be delivered through a portion of the handle 110 and a portion of the shaft 150 and / or distal assembly 152. For example, the rod 108 may be delivered through the instrument port 118 and a portion of the shaft 150 and / or distal assembly 152. Delivering the rod 108 through the instrument port 118 may guide the rod 108 into one or more lumens of the shaft 150, the articulation joint 210, and / or the distal cap 220. For example, delivering the rod 108 through the instrument portion 118 may guide a portion of the rod 108 into the first lumen 331(1) of the shaft 150 (FIGS. 3A and 3B). Extending rod 108 distally may also deliver a portion of rod 108 into first lumen 221(1) of articulation joint 210 (FIG. 2B). Extending rod 108 further distally may also deliver a portion of rod 108 into first lumen 341(1) of distal cap 220, where, for example, camera 222 and / or LEDs 224(a), 224(b) are located.

[0036] Alternatively, the rod 108 may be delivered through the instrument port 118 to guide a portion of the rod 108 into the fourth lumen 331(4) of the shaft 150 (FIGS. 3A and 3B). The rod 108 may also be extended distally to deliver a portion of the rod 108 into the fourth lumen 221(4) of the articulation joint 210 (FIG. 2B). The rod 108 may also be extended further distally to deliver a portion of the rod 108 into the fourth lumen 341(4) of the distal cap 220 (FIG. 3C). A user may control the position of the rod 108 with the controller 106, for example, while the controller 106 is coupled to the first medical device 102 (e.g., the handle 110) and / or while the controller 106 remains outside the first medical device 102. In these embodiments, delivering the rod 108 through the instrument port 118 may position the rod 108 within a camera lumen of the first medical device 102 or within a working channel of the first medical device 102. Also, extending the rod 108 relative to the first medical device 102 (e.g., relative to the articulation joint 210) may control articulation or deflection of the distal assembly 152 of the first medical device 102.

[0037] As discussed above, one or more rods 108 may be sized differently relative to the lumens through which one or more rods 108 extend. For example, as shown in FIG. 3A, rods 108 may be cylindrical (i.e., have a circular cross-section) and may be smaller than lumen 331(1) or lumen 331(4). Alternatively, as shown in FIG. 3B, rods 108A, 108B may be rectangular prisms (i.e., have a rectangular cross-section). Rods 108A, 108B may be sized to fit within one or more of lumen 331(1) or lumen 331(4). For example, rods 108A, 108B may approximate the size of and / or generally abut or nearly abut the interior of lumen 331(1) or lumen 331(4). In one or more embodiments, rod 108A may be sized to fit within lumen 331(1). Rod 108B can be sized to fit within lumen 331(4), e.g., larger than rod 108A. As discussed above, the amount of spacing between the exterior of rods 108A, 108B and the inner walls of lumens 331(1), 331(4) through which rod 108 passes can help control the effect rod 108 has on the articulation of distal assembly 152. For example, greater spacing between rods 108A, 108B and the inner walls of lumens 331(1), 331(4) can correspond to a greater amount of articulation when rods 108A, 108B are disposed within lumens 331(1), 331(4). On the other hand, a smaller spacing between rods 108A, 108B and the inner walls of lumens 331(1), 331(4) may correspond to a smaller amount of articulation movement when rods 108A, 108B are disposed within lumens 331(1), 331(4).

[0038] Although not shown, in some embodiments, the rod 108 may be coupled to the first medical device 102 in other ways. Although the above description discloses the rod 108 extending through one or both of the working lumen and / or camera lumen of the first medical device 102, the disclosure is not so limited. For example, one or more of the shaft 150, the distal assembly 152 (including the articulation joint 210), and / or the distal cap 220 may include a separate lumen that movably receives the rod 108. In another example, the rod 108 may be coupled adjacent (e.g., by adhesive) to the exterior of the shaft 150 and / or the distal assembly 152 without extending through a lumen of the first medical device 102. Additionally, although not shown, the rods 108, 108A, 108B may be tapered, stepped, and / or have a profile at the distal end or portion of the rods 108, 108A, 108B, which may help minimize, reduce, or otherwise control deflection of the articulation link 212. For example, the proximal portions of the rods 108, 108A, 108B may be wider or larger than the distal portions of the rods 108, 108A, 108B. In this embodiment, the articulation link 212 through which the proximal portions of the rods 108, 108A, 108B extend may have less articulation than the articulation link 212 through which the distal portions of the rods 108, 108A, 108B extend. Additionally, extending rods 108, 108A, 108B through lumen 331(1) (i.e., the camera lumen) may provide a greater degree of control over deflection of shaft 150 than inserting rods 108, 108A, 108B through lumen 331(4) (i.e., the working channel lumen). As discussed above, lumen 331(1) (i.e., the camera lumen) may be smaller than lumen 331(4) (i.e., the working channel lumen). This may result in less clearance around rods 108, 108A, 108B when they are in lumen 331(1) than when they are in lumen 331(4).As a result, distal assembly 152 may be deflectable to a lesser extent when rods 108, 108A, 108B are within lumen 331(1) than when rods 108, 108A, 108B are within lumen 331(4).

[0039] 4A-4E, for example, illustrate different articulations of the distal assembly 152 with various configurations of the second medical device 104 (i.e., the rod 108) relative to the first medical device 102. As described below, the position of the rod 108 within the first medical device 102 can control (e.g., limit and / or reduce) the articulation or deflection of the distal assembly 152 of the first medical device 102 and / or the responsiveness of the distal assembly 152 in response to movement of the articulation lever 114.

[0040] 4A and 4B show an embodiment of the system 100 with a rod 108 inserted into a working lumen of the first medical device 102, e.g., the fourth lumen 331(4) of the shaft 150, the fourth lumen 221(4) of the articulation joint 210 of the distal assembly 150, and / or the fourth lumen 341(4) of the distal cap 220. FIGS. 4A and 4B show the distal assembly 152 being deflected, e.g., by the articulation lever 114 ( FIG. 1 ), with and without the rod 108 inserted into the working lumen of the first medical device 102. Specifically, FIGS. 4A and 4B show the distal assembly 152 being deflected (e.g., up and down, respectively) without the rod 108 inserted, as shown in a dashed version of the distal assembly 152. In this configuration, as shown, the distal assembly 152 can be deflected about 135 degrees to about 225 degrees, e.g., about 180 degrees, either upwardly or downwardly relative to the longitudinal axis A of the shaft 150. Additionally, FIGS. 4A and 4B show the distal assembly 152 deflected (e.g., up and down, respectively) with the rod 108 inserted (e.g., into at least a portion of the articulation joint 210) as shown in a solid line version of the distal assembly 152. In this configuration, the distal assembly 152 can be deflected about 60 degrees to about 120 degrees, e.g., about 90 degrees, either upwardly or downwardly relative to the longitudinal axis A of the shaft 150. As described below, the distance that rod 108 is inserted into articulation joint 210 (i.e., the position of the distal end of rod 108 relative to links 212(1)-212(n) of articulation joint 210) can also control the articulation angle of articulation joint 210.

[0041] 4C and 4D show an embodiment of the system 100 with a rod 108 inserted into a camera lumen of the first medical device 102, e.g., first lumen 331(1) of the shaft 150, first lumen 221(1) of the articulation joint 210 of the distal assembly 150, and / or first lumen 341(1) of the distal cap 220. FIGS. 4C and 4D show the distal assembly 152 being deflected, e.g., by the articulation lever 114 ( FIG. 1 ), with and without the rod 108 inserted into the working lumen of the first medical device 102. Specifically, FIGS. 4C and 4D show the distal assembly 152 being deflected (e.g., up and down, respectively) without the rod 108 inserted, as shown in a dashed version of the distal assembly 152. In this configuration, as shown, the distal assembly 152 can be deflected about 135 to about 225 degrees, e.g., about 180 degrees, either upwardly or downwardly relative to the longitudinal axis A of the shaft 150. Additionally, FIGS. 4C and 4D show the distal assembly 152 deflected (e.g., up and down, respectively) with the rod 108 inserted (e.g., into at least a portion of the articulation joint 210), as shown in a solid line version of the distal assembly 152. In this configuration, the distal assembly 152 can be deflected about 60 to about 120 degrees, e.g., about 90 degrees, either upwardly or downwardly relative to the longitudinal axis A of the shaft 150. Additionally, as described below, the distance that rod 108 is inserted into articulation joint 210 (i.e., the position of the distal end of rod 108 relative to links 212(1)-212(n) of articulation joint 210) may also control the angle of articulation joint 210. As discussed above, inserting rods 108, 108A, 108B through lumen 221(1) (i.e., the camera lumen) may control or affect the deflection of articulation joint 210 to a greater degree than inserting rods 108, 108A, 108B through lumen 221(4) (i.e., the working channel lumen).

[0042] As discussed above, extending the rod 108 distally within the working lumen or camera lumen of the first medical device 102 can provide further control over the deflection angle of the distal assembly 152. For example, extending the rod 108 further distally (i.e., to a greater number of links 212 of the articulation joint 210) can further limit the deflection angle of the distal assembly 152, while retracting the rod 108 proximally (i.e., to a fewer number of links 212 of the articulation joint 210) can allow the distal assembly 152 to deflect at a greater angle. Additionally, in one or more embodiments, more than one rod 108 can be delivered through the first medical device 102, for example, one rod can be delivered to the working lumen and another rod can be delivered to the camera lumen. In this embodiment, the rods can be selectively extended and / or retracted to control the deflection of the distal assembly 152 and the distal portion of the first medical device 102.

[0043] FIG. 4E illustrates partial extension of the rod 108 through the working lumen or camera lumen of the first medical device 102. In this embodiment, the distal assembly 152 may include two deflection points 401, 403. For example, the distal assembly 152 may include a first deflection angle with respect to the longitudinal axis A of the shaft 150 at the deflection point 401. The deflection point 401 may be formed by a connection between the distal assembly 152 and the shaft 150, including the articulation joint 210 (not shown). The deflection point 403 may be formed by a remaining portion of the distal assembly 152 that is not penetrated by the rod 108. Alternatively, the distal assembly 152 may include one deflection point (i.e., the deflection point 403) formed by a transition between a portion of the distal assembly 152 through which the rod 108 penetrates and a portion of the distal assembly 152 through which the rod 108 does not penetrate.

[0044] 5A and 5B show a portion of another system 500, where similar elements to system 100 are numbered by 400. System 500 includes a first medical device 502 and a second medical device 504. As described above, first medical device 502 includes a handle 510 and a shaft (not shown). Second medical device 504 includes a controller 506 and a rod 508. In this embodiment, controller 506 may be coupled to and / or movable relative to handle 510.

[0045] For example, the handle 510 may include one or more tracks 560 (e.g., one track 560) at a distal portion of the handle 510. The track 560 may include a central channel 562 and multiple slots 564. The central channel 562 may extend substantially parallel to a longitudinal axis of the first medical device 502 and / or the handle 510. The multiple slots 564 may extend laterally from the track 560. For example, the multiple slots 564 may be spaced apart at regular intervals and alternately extend from different sides of the track 560. The slots 564 may also include grooves 566. The grooves 566 may extend from the slots 564, for example, parallel to the central channel 562. In one aspect, the handle 510 may be formed from two halves, and the track 560 may be formed by joining the two halves.

[0046] The control device 506 may include a slider 570. The slider 570 may be movably disposed adjacent the handle 510. For example, the slider 570 may include a pin 572 that extends at least partially within the handle 510. The pin 572 may be movable within the track 560. For example, manipulation of the slider 570 relative to the handle 510 (e.g., by an operator's thumb or another finger) may manipulate the pin 572 within the track 560. The pin 572 may be advanced distally or retracted proximally within the central channel 562, for example, to control distal extension or proximal retraction of the rod 508 within a distal assembly (not shown). The pin 572 may also be positioned within one or more slots 564 and / or grooves 566 that, for example, help fix the position of the slider 570 and pin 572 relative to the handle 510 and track 560, and thus fix the position of the rod 508 relative to the distal assembly (not shown).

[0047] Although not shown, the pin 572 may be coupled to, for example, a drive element inside the handle 510, which may help secure the slider 570 to the handle 510. The drive element may also help couple the slider 570 to the rod 508. Additionally, the spacing of the slots 564 may correspond to the length of the links 212(1)-212(n) of the articulation joint 210 (FIGS. 2A and 2B). In this embodiment, advancing or retracting the slider 570 and pin 572 relative to one slot 564 of the handle 510 may advance or retract the rod 508 by one link of the articulation joint in the distal assembly (FIGS. 2A and 2B). Additionally, the position of the slider 570 and pin 572 may indicate to the operator the position of the rod 508 relative to the articulation joint. For example, track 560 may include the same number of slots 564 as there are articulation links 212 in articulation joint 210 (FIG. 2B). Additionally, handle 510 and / or track 560 may include one or more indicia 573 (e.g., numerical indications) such that the position of slider 570 and / or pin 572 relative to handle 510 and / or track 560 indicates to an operator the position of rod 508 relative to the articulation joint.

[0048] 6A and 6B show a portion of another system 600, in which elements similar to system 100 are numbered with the increment of 500. FIG. 6A is a perspective view of a portion of system 600, and FIG. 6B is a partial cutaway view of a portion of system 600. System 600 includes a first medical device 602 and a second medical device 604. As described above, first medical device 602 includes handle 610 and shaft 650. Second medical device 604 includes controller 606 and rod 608. In this embodiment, controller 606 may be coupled to and / or movable relative to handle 610 (e.g., a distal portion of handle 610).

[0049] As shown in FIGS. 6A and 6B, the control device 606 may include, for example, a knob or dial 674 including a disk with a plurality of ridges and extensions that form a gripping surface. The dial 674 is connected to a dowel 676 that includes a gear or pinion 678 such that rotation of the dial 674 rotates the dowel 676 and the pinion 678 in the same direction (i.e., clockwise or counterclockwise). The dowel 676 may extend from the exterior of the handle 610 to the interior of the handle 610. The control device 606 may also include, for example, a rack 680 located within the handle 610. For example, a distal portion of the rack 680 may include a fixed portion 680A that secures the rod 608 to the rack 680. The rack 680 may also include, for example, a plurality of teeth 682 configured to engage the pinion 678.

[0050] In this embodiment, rotation of dial 674 rotates dowel 676 and pinion 678. Pinion 678 engages teeth 682 of rack 680 such that rotation of pinion 678 drives rack 680 linearly. Thus, rotation of dial 674 (clockwise or counterclockwise) drives rack 680 linearly proximally or distally to extend rod 608 distally and / or retract rod 608 proximally. Additionally, the size and / or spacing of pinion 678 and / or teeth 682 may correspond to the length of links 212(1)-212(n) of articulation joint 210 (FIGS. 2A and 2B). In this embodiment, rotating dial 674 to advance or retract rack 680 one tooth (e.g., one "click") can advance or retract rod 608 one link of the articulation joint within the distal assembly (FIGS. 2A and 2B). The dial 674 and / or the handle 610 may also include one or more indicia 673 such that the position of the dial 674 relative to the handle 610 indicates to the operator the position of the rod 608 relative to the articulation joint.

[0051] 7A and 7B show a portion of another system 700, where elements similar to system 100 are numbered by adding 600. FIG. 7A shows a side view of a portion of system 700, and FIG. 7B shows a cross-sectional view of a portion of system 700. System 700 includes a first medical device 702 and a second medical device 704. As described above, first medical device 702 includes a handle 710 and a shaft (not shown). Second medical device 704 includes a controller 706 and a rod 708. In this embodiment, controller 706 may be coupled to and / or movable relative to handle 710 (e.g., a distal portion of handle 710).

[0052] 7A and 7B, the controller 706 can include a screw 784 including, for example, a cylinder having a helical external thread. A proximal portion of the screw 784 can extend from the handle 710 of the first medical device 702. A distal portion of the screw 784 can be coupled to a proximal end of the rod 708. The controller 706 can also include a coupling 786. The coupling 786 can be coupled (e.g., fixedly or temporarily attached) to a portion of the handle 710, such as the instrument port 718. The coupling 786 can include, for example, female threads that correspond to the male threads of the screw 784. In this embodiment, the screw 784 and the coupling 786 can form an interface 788.

[0053] Rotating the screw 784 relative to the connection 786 may advance or retract the screw 784 relative to the handle 710, thereby extending the rod 708 distally and / or retracting the rod 708 proximally. Additionally, the size and / or spacing of the threads on the screw 784 and / or connection 786 may correspond to the length of the links 212(1)-212(n) of the articulation joint 210 (FIGS. 2A and 2B). In this embodiment, rotating the screw 784 an amount (e.g., a quarter turn, a half turn, a full turn, etc.) to advance or retract the screw 784 may advance or retract the rod 708 one link of the articulation joint within the distal assembly (FIGS. 2A and 2B). Additionally, the screw 784 may be fully removed from the connection 786, for example, with a screwdriver, to remove the screw 784 and the rod 708 from the first medical device 702. Alternatively or additionally, the connection 786 may be disengaged (e.g., unscrewed) from the instrument port 718, for example, to remove the connection 786, screw 784, and rod 708 from the first medical device 702. Additionally, the screw 784 may include one or more indicia (not shown) such that the position of the screw 784 relative to the connection 786 indicates to an operator the position of the rod 708 relative to the articulation joint.

[0054] FIG. 8 illustrates a portion of another system 800, with elements similar to system 100 numbered 700. FIG. 8 illustrates a side view of a portion of system 800. System 800 includes a first medical device 802 and a second medical device 804. As described above, first medical device 802 includes a handle 810 and a shaft 850. Handle 810 can include, for example, an articulation lever 814 that aids in controlling articulation of a distal portion of shaft 850. Second medical device 804 includes a controller 806 and a rod 808. In this embodiment, controller 806 can be coupled to and / or movable relative to handle 810 (e.g., a distal portion of handle 810).

[0055] As shown in FIG. 8, the controller 806 can include, for example, a primary wheel 890 that abuts a proximal portion of the rod 808. The controller 806 can also include one or more secondary wheels, for example, two secondary wheels 892A, 892B. The secondary wheels 892A, 892B can abut, for example, a proximal portion of the rod 808 opposite the primary wheel 890 such that the proximal portion of the rod 808 is positioned relative to, for example, three contact points on the rod 808 between the primary wheel 890 and the secondary wheels 892A, 892B. The primary wheel 890 and the secondary wheels 892A, 892B can be coupled to the handle 810 via an attachment element 894. In one aspect, the attachment element 894 can be coupled, for example, to a distal portion of the handle 810 opposite the umbilicus 824, and the rod 808 can be delivered into the handle 810 and shaft 850 through an instrument port (not shown) or other port. The primary wheel 890 may include a pivot 896 on a first arm 894A of the mounting element 894. The secondary wheels 892A, 892B may include pivots 898A, 898B, respectively, on a second arm 894B of the mounting element 894. Although not shown, the first arm 894A and the second arm 894B may each include two parallel arms. For example, the primary wheel 890 may be disposed between the parallel arms of the first arm 894A, and the secondary wheels 892A, 892B may be disposed between the parallel arms of the second arm 894B.

[0056] In this embodiment, rotating the primary wheel 890 (clockwise or counterclockwise) relative to the attachment element 894 can cause the rod 808 to extend distally and / or retract proximally, for example, through frictional engagement between the primary wheel 890, the rod 808, and / or the secondary wheels 892A, 892B. Alternatively or additionally, rotating one or more of the secondary wheels (clockwise or counterclockwise) can cause the rod 808 to extend or retract relative to the first medical device 802. Additionally, the size of the primary wheel 890, the size of the secondary wheels 892A, 892B, and / or the size of the attachment element 894 can correspond to the length of the links 212(1)-212(n) of the articulation joint 210 (FIGS. 2A and 2B). In this embodiment, the rod 808 can be advanced or retracted one link of the articulation joint within the distal assembly (FIGS. 2A and 2B) by rotating the primary wheels 890 (and / or secondary wheels 892A, 892B) a particular amount (e.g., a quarter turn, a half turn, a full turn, etc.). Also, the primary wheels 890 and / or secondary wheels 892A, 892B can be rotated such that the rod 808 is completely removed from the first medical device 702. Additionally, one or more of the rod 808, primary wheels 890, and / or secondary wheels 892A, 892B can include one or more indicia 873 such that the position of the rod 808, primary wheels 890, and / or secondary wheels 892A, 892B relative to the handle 810 indicates to the operator the position of the rod 808 relative to the articulation joint.

[0057] 5A-8 include a single control device and a single rod, but the disclosure is not so limited. For example, as described above, two or more rods can be delivered through the first medical device, and one or more rods can be delivered to one or more of the camera lumen, working lumen, or separate lumen of the first medical device. In these embodiments, the first control device can be coupled to an instrument port (e.g., FIGS. 6A-8) and the first rod can be delivered to the working lumen. Also, the second control device can be coupled to another port (e.g., FIGS. 6A-8) on the handle of the first medical device, and the second rod can be delivered to another lumen (e.g., the camera lumen or a separate lumen). In other embodiments, two or more rods can be delivered to the same lumen. In these embodiments, the two or more rods can be separately manipulated and positioned at various positions within the lumen.

[0058] In another embodiment, a first control device may be incorporated into the handle of the first medical device (e.g., FIGS. 5A-5B) and a first rod may be delivered into the working lumen. Also, a second control device may be incorporated into the handle of the first medical device (e.g., FIGS. 5A and 5B) and a second rod may be delivered into another lumen (e.g., the camera lumen or a separate lumen). In another embodiment, two or more rods may be delivered into the same lumen. Additionally, in another embodiment, two rods may be delivered through an instrument port. In this embodiment, two control devices may be adjacent and / or coupled to the instrument port. In these embodiments, the two or more rods may be manipulated separately and positioned at various locations within the lumen. Alternatively, two or more rods may be coupled to a single control device and limit the articulation of the articulation joint 210 to a greater amount than a single rod.

[0059] 9 illustrates a method 900 that may be performed with any of medical systems 100, 500, 600, 700, 800. Step 902 includes delivering a first medical device (e.g., first medical device 102, 502, 602, 702, or 802) to a treatment site. Delivering the first medical device to the treatment site may include delivering a shaft (e.g., shaft 150, 650, or 850) including a distal assembly (e.g., distal assembly 152) with an articulation joint (e.g., articulation joint 210).

[0060] Optional step 904 then includes manipulating a distal portion of the first medical device. Step 904 may include manipulating an actuation lever 114 on the handle 110 to deflect or articulate the distal assembly 152. For example, by manipulating the actuation lever 114, the articulation wire 240 may be manipulated to articulate the articulation joint 210 (e.g., through an articulation angle shown by the dashed lines of the distal assembly 152 in FIGS. 4A-4D ). Optionally, step 904 may further include performing a first medical procedure, for example, with an instrument delivered through the working lumen of the first medical device. Alternatively, method 900 may proceed from step 902 to step 906 without including step 904.

[0061] Step 906 includes delivering a second medical device (e.g., second medical device 104, 504, 604, 704, or 804) to the treatment site. Step 906 includes delivering the second medical device through a lumen (e.g., a camera lumen, a working lumen, or a separate lumen) of the first medical device. For example, as described above, step 906 may include delivering a rod (e.g., rod 108, 508, 608, 708, or 808) through an instrument port on the handle of the first medical device. In these aspects, step 906 may include delivering the rod to a distal portion of the first medical device, such as a distal assembly (e.g., distal assembly 152) or an articulation joint (e.g., articulation joint 210) of the first medical device. In this step, delivering the second medical device to the treatment site may include delivering the second medical device through a lumen of the first medical device to a distal portion of the first medical device. That is, the second medical device may be positioned proximal to the distal end of the first medical device. However, the second medical device may be disposed proximate to the treatment site. Delivering the rod to the distal portion of the first medical device may allow a user to articulate the distal portion of the first medical device (i.e., distal assembly 152) through a smaller articulation radius, for example, to make it less responsive to movement of articulation lever 114 to make smaller or more precise adjustments.

[0062] In one or more aspects, step 908 may include positioning the second medical device relative to the first medical device. For example, as described above, the second medical device may include a controller for controlling the longitudinal position of the rod. As described above, the controller may linearly adjust the position of the rod. For example, as described with respect to FIGS. 5A and 5B, the controller may include a slider 570 with a pin 572 movable, for example, in a track 560 in the handle of the first medical device. Alternatively, as described with respect to FIGS. 6A and 6B, the controller may include a dial 674, a pinion 678, and a rack 680. In another aspect, as described with respect to FIGS. 7A and 7B, the controller may include a screw 784 and a coupling 786. In yet another aspect, as described with respect to FIG. 8, the controller may include a primary wheel 890, one or more secondary wheels 892A, 892B, and / or a mounting element 894.

[0063] Additionally, step 910 may include manipulating a distal portion of the first medical device. Step 910 may include manipulating an actuation lever 114 on the handle 110 to deflect or articulate the distal assembly 152. For example, by manipulating the actuation lever 114, the articulation wire 240 may be manipulated to articulate the articulation joint 210 (e.g., through an articulation angle shown by the solid lines of the distal assembly 152 in FIGS. 4A-4D). In these aspects, the articulation joint may articulate at a smaller articulation angle with a second medical device disposed within the first medical device compared to the articulation angle of the first medical device in step 904. For example, as described above with respect to FIGS. 4A-4E, the second medical device may adjust (e.g., decrease) the articulation angle of the distal assembly 152. Optionally, step 910 may further include performing a second medical procedure, for example, with an instrument delivered through the working lumen of the first medical device.

[0064] Additionally, the method 900 may include the optional step of removing the second medical device from the lumen of the first medical device. Once the second medical device is removed, the first medical device may be articulated through the entire range of the first articulation angle (e.g., through the articulation angles indicated by the dashed lines of the distal assembly 152 in FIGS. 4A-4D ). Also, the second medical device may be repositioned (e.g., retracted or extended through the various links 212 of the articulation joint 210 with the control device) and / or removed from the lumen of the first medical device 102 as many times as necessary during the procedure.

[0065] The systems, devices, and methods described herein may allow for variable deflection and / or articulation of the shaft or distal assembly of the medical device. For example, different procedures and / or different body cavities or lumens of a patient may require different manipulation and / or different articulation radii. Positioning the second medical device within the lumen of the first medical device, as described herein, allows the user to adjust the articulation radius and / or articulation angle of the first medical device without the need for a separate guidewire or other elements. Furthermore, positioning the second medical device within a portion of the first medical device allows for different angles or radii of articulation. Additionally, positioning the second medical device within a portion of the first medical device may reduce the overall sensitivity of articulation or deflection such that an unintended manipulation of the articulation lever is less likely to cause the shaft or distal assembly to inadvertently contact an unintended portion of the body cavity or lumen. Embodiments of the present disclosure can assist a user in manipulating the distal end of a medical device (e.g., the distal assembly 152 of the first medical device 102) to navigate within various body cavities and / or lumens. For example, embodiments of the present disclosure can assist a user in manipulating the distal end of a medical device to traverse and / or navigate the larynx, trachea, bronchi (primary bronchi), lobes (secondary bronchi), segments (tertiary bronchi), bronchioles, terminal bronchioles, or any other portion of the respiratory system.

[0066] Other embodiments of the present disclosure will be apparent to those skilled in the art from consideration of the specification and practice of the invention disclosed herein. It is intended that the specification and examples be considered as exemplary only, with a true scope and spirit of the invention being indicated by the following claims.

[0067] One or more of the aspects of any of the medical devices described herein may be used in combination with any other medical device known in the art, such as a medical imaging system, catheter, long instrument, or other scope, such as a colonoscope, bronchoscope, ureteroscope, duodenoscope, or other type of imager. Also, one or more aspects of the medical device described herein may be used to sense, monitor, or treat tissue in any part of the human body. For example, any of the medical devices described herein may be used in medical procedures such as endoscopic cholangiopancreatography, colonoscopy, cancer screening, examination of mucinous lesions, and / or other procedures requiring removal of tissue and / or detection of tissue types.

[0068] Although the principles of the present disclosure have been described herein with reference to illustrative examples for specific applications, the present disclosure is not limited thereto. Those skilled in the art and who have access to the teachings provided herein will recognize that additional modifications, applications, and equivalent substitutions are all within the scope of the embodiments described herein. Thus, the present invention should not be considered as limited by the above description.

Claims

1. 1. A health care system comprising: A first medical device, A handle and the first medical device comprising: a shaft including a lumen, a distal portion of the shaft including an articulation joint, the lumen extending through at least a portion of the articulation joint; A second medical device, A control device; a rod; and Equipped with The rod is selectively positionable within at least a portion of the lumen of the shaft within the articulation joint, and the control device is configured to control a position of the rod within the shaft, such that the position of the rod within the shaft controls an articulation angle of the articulation joint.

2. The medical system of claim 1 , wherein the control device is integrated into or coupled to a portion of the handle.

3. 3. The medical system of claim 2, wherein the control device includes a slider, a pin coupled to the slider, and a track located in a distal portion of the handle, and movement of the pin within the track controls the position of the rod within the lumen of the shaft.

4. The medical system of claim 3 , wherein the track includes a central channel, a plurality of slots extending from the central channel, and a plurality of grooves extending from the plurality of slots.

5. The medical system of claim 4 , wherein the spacing of the plurality of slots along the central channel corresponds to a length of one or more links in the articulation joint.

6. 10. The medical system of claim 1, wherein the control device includes a dial, a dowel extending from the dial, and a pinion coupled to the dowel, and the rod is coupled to a rack.

7. The medical system of claim 6 , wherein rotational movement of the dial actuates linear movement of the rack to control the position of the rod within the shaft.

8. 8. The medical system of claim 7, wherein the rack includes a plurality of teeth, the spacing of the teeth on the rack corresponding to a length of one or more links in the articulation joint.

9. 2. The medical system of claim 1, wherein the control device includes a screw coupled to the rod and a coupling portion, the screw including male threads, the coupling portion including female threads, and the rod coupled to a distal end of the screw.

10. The medical system of claim 9 , wherein rotational movement of the screw controls the position of the rod within the shaft.

11. The medical system of claim 1 , wherein the control device includes a primary wheel, one or more secondary wheels, and a mounting element, the mounting element coupled to a distal portion of the handle.

12. 12. The medical system of claim 11, wherein the position of the rod within the shaft is controlled by the rotational movement of the primary wheel or by the rotational movement of the one or more secondary wheels.

13. 10. The medical system of claim 1, wherein the articulation joint includes nine articulation links, each of the articulation links providing 25 degrees of articulation.

14. 10. The medical system of claim 1, wherein the rod has less flexibility than the articulation joint, the articulation joint including a plurality of articulation links, a more distal articulation link providing greater articulation than a more proximal articulation link.

15. 2. The medical system of claim 1, wherein the handle includes an instrument port on a distal portion of the handle configured to receive the rod and guide the rod into the lumen of the shaft, and the first medical device includes an articulation lever located on a portion of the handle, the articulation lever connected to the articulation joint via one or more articulation wires.

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