Endoscope elevator actuator

Abstract

The medical device comprises a handle body, a flexible shaft coupled to the handle body, a distal tip coupled to a distal end of the shaft and including a movable element, and an actuator coupled to the handle body and configured to move the movable element upon actuation, the actuators including first contact elements each having an outer contact surface configured for contact by a user's finger, each of the outer contact surfaces being at least one of angled and recessed relative to the other outer contact surfaces to provide multiple contact positions between the finger and the actuator.

Description

[Technical field]

[0001] The present disclosure relates generally to elevator actuators for medical devices. More specifically, embodiments of the present disclosure relate to elevator actuator types for endoscopes or other medical devices, among other aspects. [Background technology]

[0002] During cannulation of the common bile duct during an Endoscopic Retrograde Cholangiopancreatography (ERCP) procedure, a medical professional uses his or her thumb to operate the elevator actuator of the endoscope, for example to facilitate guidewire access to the desired duct. During cannulation, the medical professional operates the elevator actuator by moving it up and down with his or her thumb to articulate the distal tip (elevator) of the endoscope. Once the desired angular position of the endoscope elevator relative to the papilla is established, the medical professional must hold the elevator actuator in place to maintain the desired angular position.

[0003] Cannulation of the common bile duct with current elevator actuators presents technical challenges to even the most experienced medical professionals. For example, medical professionals with smaller hands may have difficulty reaching the elevator actuator while simultaneously holding the grip of the endoscope handle, for example. Furthermore, difficulty reaching the elevator actuator may result in inefficient operation of the elevator actuator. This may increase the time it takes the medical professional to establish the desired angular position of the endoscope elevator, increasing the overall ERCP procedure time. Repetitive thumb movements during an ERCP procedure may contribute to musculoskeletal injuries. Additionally, in the tortuous positions typical of endoscopic procedures, the wire mechanism inside the endoscope for transmitting the actuation force from the actuator to the elevator may become stiff, and additional effort may be required to move the elevator actuator. Endoscopes and other medical devices with elevator actuators that improve ergonomics may help address one or more of these or other issues. Summary of the Invention

[0004] According to an example, a medical device may include a handle body, a flexible shaft coupled to a distal end of the handle body, a distal tip coupled to the distal end of the shaft and which may include a movable element, and an actuator coupled to the handle body and configured to move the movable element upon actuation, the actuators may include first contact elements each having an outer contact surface configured for contact by a user's finger, each of the outer contact surfaces being at least one of angled and recessed relative to the other outer contact surfaces to provide multiple contact positions between the finger and the actuator.

[0005] In another example, each outer contact surface may include a linear projection extending transversely to the proximal-to-distal axis of the medical device. The outer contact surfaces may include a central contact surface, a proximal contact surface proximal to the central contact surface, and a distal contact surface distal to the central contact surface, the central contact surface projecting radially outward relative to the proximal and distal contact surfaces. The proximal contact surface may be angled inwardly toward the handle body relative to the central contact surface, the distal contact surface may be angled inwardly toward the handle body relative to the central contact surface, the ends of the proximal contact surface may be recessed and angled relative to the corresponding ends of the central contact surface, and the ends of the distal contact surface may be recessed and angled relative to the corresponding ends of the central contact surface. A first end of the central contact surface may overhang the proximal contact surface to define a first gap between the central contact surface and the proximal contact surface, and a second end of the central contact surface may overhang the bottom contact surface to define a second gap between the central contact surface and the distal contact surface. The actuator may further include a connector having a first end coupled to a radially inner surface of a first contact element of the actuator and a second end coupled to the ring. The ring may couple the actuator to the handle body and define a central opening surrounding a structure of the medical device for articulating the distal end of the medical device. The ring may rotate about the structure for articulating the distal end of the medical device. The actuator may include a second connector having a first end coupled to a radially inner surface of a second contact element of the actuator and a second end coupled to the ring at a location on the ring opposite a location on the ring where the first connector is coupled to the ring. The first contact element and the second contact element may be positioned relative to the handle body such that a user contacting the first contact element with the thumb of a hand may contact the second contact element with another finger of the hand. One of pushing up and pushing down the first contact element and the other of pushing up and pushing down the second contact element simultaneously may rotate the actuator about the handle body. The second contact element may include a proximal portion and a distal portion, and the proximal portion may project radially outward relative to the distal portion.The proximal and distal portions of the second contact element may each include a radially outer contact surface that may be convex, and the proximal, distal, and central contact surfaces of the first contact element may each be convex. Each of the proximal and distal contact surfaces of the first contact element may be concave. The movable element may be an elevator configured to pivot about a portion of the distal tip and deliver a tool from the distal tip at a plurality of angles relative to the distal tip.

[0006] According to one example, a medical device may include a handle body, a flexible shaft coupled to a distal end of the handle body, a distal tip coupled to the distal end of the shaft, the distal tip may include an elevator configured to pivot about a portion of the distal tip and deliver a tool from the distal tip at multiple angles relative to the distal tip, and an actuator coupled to the handle body and configured to pivot the elevator upon actuation, the actuator may include a contact element extending radially outward from the handle body and extending longitudinally in a proximal-distal direction, the contact element may include a proximal contact surface, a distal contact surface, and a central contact surface between the proximal and distal contact surfaces and projecting radially outward relative to the proximal and distal contact surfaces, and a connector having a first end coupled to an inner surface of the contact element and a second end coupled to a ring, the ring having an opening surrounding a structure for articulating the distal end of the flexible shaft. The proximal contact surface, the distal contact surface, and the central contact surface may each include a linear projection extending transversely to a proximal-to-distal axis of the medical device. The actuator may include a second connector having a first end coupled to an inner surface of the second contact element and a second end coupled to the ring opposite a location where the first connector is coupled to the ring.

[0007] According to one example, a medical device may include a handle body, a flexible shaft coupled to a distal end of the handle body, a distal tip coupled to the distal end of the shaft, the distal tip may include an elevator configured to pivot about a portion of the distal tip and deliver a tool from the distal tip at multiple angles relative to the distal tip, and an actuator coupled to the handle body and configured to pivot the elevator upon actuation, the actuator extending radially outward from the handle body and may include a relatively flat central portion, a top ridge that is angled and recessed relative to the central portion, and a bottom ridge that is angled and recessed relative to the central portion. The central portion may include a central contact surface, the top ridge may include a proximal contact surface, the bottom ridge may include a distal contact surface, the proximal contact surface may be angled inwardly toward the handle body relative to the central contact surface, the distal contact surface may be angled inwardly toward the handle body relative to the central contact surface, ends of the proximal contact surface may be recessed and angled relative to corresponding ends of the central contact surface, and ends of the distal contact surface may be recessed and angled relative to corresponding ends of the central contact surface. [Brief description of the drawings]

[0008] The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate various exemplary embodiments and, together with the description, serve to explain the principles of the disclosed embodiments. [Figure 1A] FIG. 1 is a perspective view of an exemplary endoscope, according to aspects of the present disclosure. [Figure 1B] FIG. 1 is a perspective view of an exemplary endoscope, according to aspects of the present disclosure. [Figure 2A] FIG. 1 is a perspective view of a user's hand holding an exemplary endoscope, according to aspects of the present disclosure. [Figure 2B] FIG. 1 is a perspective view of a user's hand holding an exemplary endoscope, according to aspects of the present disclosure. [Figure 3A] FIG. 1 is a perspective view of an exemplary elevator actuator according to an aspect of the present disclosure. [Figure 3B]FIG. 1 is a perspective view of an exemplary elevator actuator according to an aspect of the present disclosure. [Figure 3C] FIG. 1 is a perspective view of an exemplary elevator actuator according to an aspect of the present disclosure. [Figure 4A] FIG. 1 is a perspective view of a user's hand holding an exemplary endoscope, according to aspects of the present disclosure. [Figure 4B] FIG. 1 is a perspective view of a user's hand holding an exemplary endoscope, according to aspects of the present disclosure. [Diagram 5] FIG. 1 is a perspective view of an exemplary elevator actuator according to an aspect of the present disclosure. [Figure 6A] FIG. 1 is a perspective view of an exemplary elevator actuator according to an aspect of the present disclosure. [Figure 6B] FIG. 1 is a perspective view of an exemplary elevator actuator according to an aspect of the present disclosure. [Figure 6C] FIG. 1 is a perspective view of an exemplary elevator actuator according to an aspect of the present disclosure. [Figure 6D] FIG. 1 is a perspective view of an exemplary elevator actuator according to an aspect of the present disclosure. [Figure 7] FIG. 1 is a perspective view of a user's hand holding an exemplary endoscope, according to aspects of the present disclosure. [Figure 8A] FIG. 1 is a perspective view of an exemplary elevator actuator according to an aspect of the present disclosure. [Figure 8B] FIG. 1 is a perspective view of an exemplary elevator actuator according to an aspect of the present disclosure. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0009] Reference will now be made in detail to the embodiments of the present disclosure, examples of which are illustrated in the accompanying drawings. Wherever possible, the same or similar reference numbers are used throughout the drawings to refer to the same or similar parts. The term "distal" refers to the part of the device that is furthest from the user when it is introduced into the patient. Conversely, the term "proximal" refers to the part of the device that is closest to the user when it is placed within the patient. Throughout the figures contained in this application, arrows labeled "P" and "D" are used to indicate the proximal and distal directions in the figures. As used herein, the terms "comprises", "comprising", or any other variation thereof, are intended to cover a non-exclusive inclusion, such that a process, method, article, or device that includes a list of elements does not include only those elements, but may include other elements not expressly listed or inherent to such process, method, article, or device. The term "exemplary" is used in the sense of "example" rather than "ideal". Additionally, relative terms such as, for example, "about", "substantially", "approximately", etc. are used to indicate a possible variation of ±10% of a stated numerical value or range.

[0010] 1A and 1B show perspective views of an exemplary endoscope 101. The endoscope 101 may include a handle assembly 106 and a flexible tubular shaft 108. The handle assembly 106 may include a biopsy port 102, a biopsy cap 103, an image capture button 104, an elevator actuator 107, a first locking lever 109, a second locking lever 110, a first control knob 112, a second control knob 114, a suction button 116, an air / water button 118, a handle body 120, and an umbilicus 105. Any of the actuators, elevators, knobs, levers, ports, or caps of the endoscope 101 may serve any purpose and are not limited by any particular use, which may be implied by the individual naming of each component as used herein. The umbilicus 105 may extend from the handle body 120 to auxiliary devices such as a control unit, a water supply, or a vacuum source. Thus, the umbilicus 105 can transmit signals between the endoscope 101 and the control unit to control the lighting and imaging components of the endoscope 101 and / or receive image data from the endoscope 101. The umbilicus 105 can also provide fluid for irrigation from the water supply and / or suction to the distal tip 119 of the shaft 108. Buttons 116 and 118 control valves for suction and fluid supply, respectively.

[0011] The shaft 108 may include an articulating section 122 for deflecting the distal tip 119 upward, downward, left, and / or right. Knobs 112 and 114 may be used to control such deflection, and locking levers 109 and 110 may lock the knobs 112 and 114, respectively, in a desired position. The handle body 120 may be tapered, narrowing as the handle assembly 106 extends distally, such that the profile of the handle body 120 is smaller at its distal end than its proximal end.

[0012] The distal tip 119 may include an imaging device 124 (e.g., a camera) and a light source 126 (e.g., an LED or fiber optic). The distal tip 119 may be oriented sideways. That is, the imaging device 124 and the light source 126 may face radially outward, perpendicularly, nearly perpendicularly, or otherwise transversely relative to the longitudinal axis of the shaft 108 and the distal tip 119.

[0013] Distal tip 119 may also include an elevator 128 for changing the orientation of a tool inserted within the working channel of endoscope 101. Elevator 128 may alternatively be referred to as a swing stand, pivot stand, elevated base, or any other suitable terminology. Elevator 128 may be pivotable, for example, via an actuation wire or another control element that extends from elevator actuator 107 on handle assembly 106, through shaft 108 to elevator 128.

[0014] Although the term endoscope may be used herein, it should be understood that other devices may be used in connection with the devices of the present disclosure, including, but not limited to, duodenoscopes, colonoscopes, ureteroscopes, bronchoscopes, laparoscopes, sheaths, catheters, or any other suitable delivery device or medical device.

[0015] The embodiments of the present disclosure improve the ergonomics and usability of the elevator actuator, and, as non-limiting exemplary advantages, among other aspects, help reduce strain on the medical professional's thumb, improve control of the distal tip of the endoscope, and increase the compatibility of the endoscope among medical professionals with different hand sizes. In various embodiments, the elevator actuator pivots or rotates about a portion of the handle body. The elevator actuator includes multiple radially outermost surfaces that a user can contact, individually or simultaneously, e.g., via the thumb, to apply force to the actuator. These radially outermost surfaces are distinct from one another and may be, for example, angled and / or recessed relative to one another.

[0016] 2A and 2B show perspective views of an exemplary user's left hand 201 gripping the handle assembly 106 of the endoscope 101. In a first position of the user's left hand 201 (shown in FIG. 2A), the user's thumb 202 is located below a typical elevator actuator 107. There is a space between the user's thumb 202 and the umbilicus 105. The user's thumb 202 may be used to operate the elevator actuator 107 and the image capture button 104. In a second position of the user's left hand 201 (shown in FIG. 2B), the user's thumb 202 covers the elevator actuator 107. In the second position, the user's thumb 202 may contact the umbilicus 105. The user's index finger 204 may contact and / or be used to operate the suction button 116. A user's middle finger 206 may be used to contact and / or operate the air / water button 118. As shown in FIGS. 2A and 2B, the length of the elevator actuator 107 may not be long enough to be accessed from any given gripping position of the handle assembly 106 by the user's left hand 201. For example, the thumb 202 of a user with a small left hand 201 may have difficulty accessing the elevator actuator 107 when operating the suction button 116 with the index finger 204 and / or operating the air / water button 118 with the middle finger 206. As another example, a user with a large left hand 201 may not have adequate support of the umbilicus 105 during operation of the elevator actuator 107.

[0017] 3A-3C show perspective views of an exemplary long centrally accessible elevator actuator 306. The elevator actuator 306 may include an extension 307 that extends radially outward from beneath the first control knob 112 and then curves around the outer surface of the handle body 120 to a lateral extension 311. The lateral extension 311 may extend laterally with minimal space between its terminal free end 313 and the umbilicus 105. The lateral extension 311, due to its additional length compared to a typical elevator actuator, may allow the user's thumb 202 to more easily access the elevator actuator 306 even when the user is operating the suction button 116 with the index finger 204 and / or the air / water button 118 with the middle finger 206. The elevator actuator 306 may extend beyond the outer surface of the handle body 120 to form a gap between the inner surface of the elevator actuator 306 and the outer surface of the handle body 120. In some examples, elevator actuator 306 may be made of a plastic and / or rubber material, or any other suitable material. Elevator actuator 306 may include grip lines 308 on its outer surface. Each grip line 308 may be a thin, linear protrusion extending outward from an adjacent portion of the outer surface having grip line 308. Each grip line 308 may extend side-to-side, transversely, or substantially perpendicular to the proximal / distal direction. Grip lines 308 may increase friction between a glove on a user's hand and elevator actuator 306. Grip lines 308 may reduce pinching and / or poking effects on a surface area of ​​user's thumb 202 compared to elevator actuators that include sharp ribs on their outer surface.

[0018] The elevator actuator 306 may include a central region 314 that is relatively flat / planar (except for the grip line 308), a top ridge 310, and a bottom ridge 312. The outwardly facing surface of the top ridge 310 may be angled inwardly toward the handle body 120 relative to the outwardly facing surface of the central region 314. Both ends of the top ridge 310 (the free end and the end closest to the knob 112) may be recessed and angled relative to the corresponding ends of the central region 314 (including the free end 313). The outwardly facing surface of the bottom ridge 312 may be angled inwardly toward the handle body 120 relative to the outwardly facing surface of the central region 314. Both ends of the bottom ridge 312 (the free end and the end closest to the knob 112) may be recessed and angled relative to the corresponding ends of the central region 314 (including the free end 313). Each of the central region 314, the top ridge 310, and the bottom ridge 312 may include a grip line 308. A user may move the elevator actuator 306 upward by pushing upward on the bottom ridge 312 of the elevator actuator with the tip region of the thumb 202 or the distal interphalangeal (DIP) joint. A user may move the elevator actuator 306 downward by pushing downward on the top ridge 310 of the elevator actuator 306 with the tip region of the thumb 202 or the DIP joint. In another example, a user may move the elevator actuator 306 upward or downward by pushing upward or downward on the central flat region 314 of the elevator actuator 306 with the tip region of the thumb 202 or the DIP joint. The top surface 316 of the elevator actuator 306 may be flat and have a smooth texture. The bottom surface (not shown) of the elevator actuator 306 may be substantially similar to the top surface 316. The use of terms such as "top" or "upper" and "bottom" or "lower" as modifiers of a structure in the embodiments of the present disclosure refers to the relative position of that structure when the endoscope is in a typical position in use, such as the position shown in the figures.

[0019] 4A and 4B show perspective views of an exemplary user's left hand 201 gripping the handle assembly 106 of the endoscope 101. The user's index finger 204 and middle finger 206 may be used to operate the suction button 116 and the air / water button 118. The user may position the thumb 202 of the left hand 201 over the elevator actuator 107 and move the thumb 202 downward to move the elevator actuator 107 along a circular path from a first position (shown in FIG. 4A ) to a second position (shown in FIG. 4B ). As shown in FIG. 4B , the user's palm 208 may move away from the handle body 120 as the thumb 202 moves from the first position to the second position. A space may be formed between the user's palm 208 and the handle body 120. When the user's palm 208 moves away from the handle body 120 , the user may lose support of the umbilicus 105 and their grip on the handle body 120 .

[0020] FIG. 5 illustrates a perspective view of an exemplary extended elevator actuator 506 coupled to another portion of the handle assembly 106 of the endoscope 101, along with an exploded view of the elevator actuator 506 not coupled to the remainder of the endoscope 101. The elevator actuator 506 may include a contact arm 507 having a central body element 508 and top and bottom extension elements 510 and 512 recessed from the central body element 508. The central body element 508 projects further outward from the handle body 120 relative to elements 510 and 512. The contact arm 507 extends longitudinally in an up-down direction generally parallel to the longitudinal axis of the handle body 120. In other words, the contact arm 507 has a length in the proximal / distal direction that is greater than its width perpendicular to that direction. The contact arm 507 is curved to be convex toward the user of the endoscope. The top extension element 510 and the bottom extension element 512 may extend in opposite directions from either side of the central body element 508. The central body element 508 may be wider than the top extension element 510 and the bottom extension element 512. The bottom end of the central body element 508 may overhang an outer surface of the bottom extension element 512 to form a recess / gap 518 between the elements 508 and 512. Similarly, the top end of the central body element 508 may overhang an outer surface of the top extension element 514 to form a recess / gap 516. These recesses 516 / 518 may aid a user in gripping the contact arm 507. The outer surfaces of the central body element 508, the top extension element 510, and the bottom extension element 512 may include gripping protrusions 514. Each gripping protrusion 514 protrudes from an adjacent portion of the outer surface having the gripping protrusion. Each gripping protrusion 514 extends side-to-side, transversely, or substantially perpendicular to the proximal / distal direction. The gripping protrusions 514 can provide improved gripping capabilities, for example, when a user is wearing wet gloves.

[0021] By placing thumb 202 on top extension element 510 or bottom extension element 512 and pressing against the top or bottom end of central body element 508, respectively, user's thumb 202 can more easily access and operate elevator actuator 506 without losing grip. By using top extension element 510 and bottom extension element 512, the tip of user's thumb 202 can remain in the same position on elevator actuator 506 while moving elevator actuator 506 up or down via a scrolling action. In another example, a user can move elevator actuator 506 up or down by placing thumb 202 on central body element 508 and pressing central body element 508 up or down with tip region or DIP joint of thumb 202.

[0022] Elevator actuator 506 may further include a connector 524 that couples contact arm 507 to ring 520. One end of connector 524 couples to an inner surface contact of arm 507 and the other end of connector 524 couples to a radially outer surface of ring 520. Connector 524 may include a bend 526 that aligns with a feature on handle body 120.

[0023] The ring 520 may include an opening 522 that aligns with features of the handle assembly 106 of the endoscope 101. The bend 526 and opening 522 may allow the elevator actuator 506 assembly to be positioned between the handle body 120 and the control knob 112 of the endoscope 101. The opening 522 accommodates structure connecting the contact arm 507 and knobs 112 and 114 to structure within the handle body 120 to control the pivoting of the elevator and the articulation of the articulation section 122. The opening 522 in the ring 520 may lie in a plane that includes a portion of the contact arm 507.

[0024] 6A-6D show perspective views of an exemplary extended elevator actuator 606 coupled to another portion of the handle assembly 106 of the endoscope 101, along with an exploded view of the actuator 606 not coupled to the remainder of the endoscope 101. The elevator actuator 606 may include a first contact arm 607 coupled to a second contact arm 609 by a ring 620, a first connector 624, and a second connector 628.

[0025] As shown in FIG. 6A, the first contact arm 607 extends radially outward from the handle body 120 and is curved to be convex toward a user of the endoscope 101. As shown in FIG. 6B, the second contact arm 609 extends radially outward from the handle body 607 in an opposite direction from the first contact arm 607 and faces away from a user of the endoscope 101. The second contact arm 609 is positioned near the suction button 116 and / or air / water button of the handle assembly 106. In one example, the first contact arm 607 and the second contact arm 609 allow the elevator actuator 606 to be operated by the user's thumb 202 and middle finger 206, respectively, which can reduce the actuation effort on the user's thumb 202 by distributing some of that effort to the middle finger 206, which can reduce musculoskeletal injuries as discussed above.

[0026] The elements of elevator actuator 606 have the same or similar structure and function as similar elements of elevator actuator 506. Specifically, first contact arm 607, central body element 608, top extension element 610, bottom extension element 612, gripping protrusion 614, recess 616, recess 618, ring 620, opening 622, first connector 624, and flexure 626 are the same or similar to contact arm 507, central body element 508, top extension element 510, bottom extension element 512, gripping protrusion 514, recess 516, recess 518, ring 520, opening 522, connector 524, and flexure 526.

[0027] The second connector 628 can connect the second contact arm 609 to the ring 620 on a side of the ring 620 opposite the side where the first contact arm 607 connects to the ring 620. The second contact arm 609 can include a top portion 634 and a bottom portion 638 that meet by a recess 632. The recess 632 is a surface that faces downward and connects the outer contact surface of the top portion 634 to the outer contact surface of the bottom portion 632 such that the top portion 634 includes a ledge 636 that projects radially outward relative to the bottom portion 638. Similar to the first contact arm 607, the top portion 634 and the bottom portion 638 can include gripping protrusions 630 on their outer contact surfaces to improve gripping capabilities. The ledge 636 can be pressed by a user's middle finger 206 to move the second contact arm 609 upward. The user's middle finger 206 can press down on the top 634 to move the second contact arm 609 downward. In one example, the user's middle finger 206 can be used to actuate the elevator actuator 606 by moving the second contact arm 609 up and down, thereby reducing the load on the user's thumb 202 operating the first contact arm 607. In another example, the first contact arm 607 and the second contact arm 609 can be operated simultaneously or individually by the user's thumb 202 and middle finger 206, respectively.

[0028] 7 shows the thumb 202 of a user's left hand 201 covering a typical elevator actuator 107 of an endoscope 101. The typical elevator actuator 107 includes sharp ribs 124 on its outer convex surface that can pinch the surface of the user's thumb 202 and cause discomfort if held for an extended period of time.

[0029] 8A-8B show perspective views of an example elevator actuator 706 that may include a longitudinally (proximal to distal) extending contact element 707. The contact element 707 may include an upper portion 718 that extends inwardly from a central bump 710. The contact element 707 may include a lower portion 720 that extends inwardly from an opposite side of the central bump 710. An outer contact surface of the upper portion 718 is angled relative to an outer contact surface of the lower portion 720. Each of the outer contact surfaces of the upper portion 718 and the lower portion 720 may be curved inwardly such that these surfaces are concave to provide thumb support and improved thumb contact. An inner surface 722 of the contact element 707 may be curved inwardly and may also exhibit a concave surface. The exterior surfaces of center bump 710, upper portion 718, and lower portion 720 may include rubber gripping protrusions 708 protruding from adjacent portions of their exterior surfaces to improve gripping capabilities and comfort. In some examples, elevator actuator 706 may be made of natural and / or synthetic rubber materials.

[0030] Contact element 707 may be coupled to ring 714 by connector 712. Connector 712 may couple to an inner surface 722 of upper portion 718 at or near an edge of upper portion 718. Ring 714 may include an opening 716 that aligns with features of handle assembly 106 of endoscope 101. Ring 714 and opening 716 may have the same or similar structure, positioning, and function as ring 520 and opening 522.

[0031] In one example, a user's thumb 202 can push the lower portion 720 in an upward direction (as shown in FIG. 8B) to move the elevator actuator 706 upward. In one example, a user's thumb 202 can push the upper portion 718 in a downward direction (as shown in FIG. 8B) to move the elevator actuator 706 downward. In one example, the central bump 710 can act as a stopper to prevent the user's thumb 202 from slipping from the upper portion 720 to the lower portion 718 and vice versa.

[0032] It will be apparent to those skilled in the art that various modifications and variations can be made in the disclosed devices and methods without departing from the scope of the disclosure. Other aspects of the disclosure will be apparent to those skilled in the art from consideration of the specification and practice of the features disclosed herein. It is intended that the specification and embodiments be considered as illustrative only.

Claims

1. The handle body and a flexible shaft coupled to a distal end of the handle body; a distal tip coupled to a distal end of the shaft and including a movable element; a medical device comprising: an actuator coupled to the handle body and configured to move the movable element upon actuation, the actuators including first contact elements each having an outer contact surface configured for contact by a user's finger, each outer contact surface being at least one of angled and recessed relative to the other outer contact surfaces to provide multiple contact positions between the finger and the actuator.

2. The medical device of claim 1 , wherein each of the outer contact surfaces includes a linear projection extending transversely to a proximal-to-distal axis of the medical device.

3. 2. The medical device of claim 1, wherein the outer contact surface includes a central contact surface, a proximal contact surface proximal to the central contact surface, and a distal contact surface distal to the central contact surface, the central contact surface projecting radially outward relative to the proximal and distal contact surfaces.

4. 4. The medical device of claim 3, wherein the proximal contact surface is angled inwardly toward the handle body relative to the central contact surface, the distal contact surface is angled inwardly toward the handle body relative to the central contact surface, ends of the proximal contact surface are recessed and angled relative to corresponding ends of the central contact surface, and ends of the distal contact surface are recessed and angled relative to corresponding ends of the central contact surface.

5. 4. The medical device of claim 3, wherein a first end of the central contact surface overhangs the proximal contact surface to define a first gap between the central contact surface and the proximal contact surface, and a second end of the central contact surface overhangs the distal contact surface to define a second gap between the central contact surface and the distal contact surface.

6. 10. The medical device of claim 1, wherein the actuator further includes a first connector having a first end coupled to a radially inner surface of the first contact element of the actuator and a second end coupled to a ring.

7. The medical device of claim 6 , wherein the ring couples the actuator to the handle body and defines a central opening surrounding structure of the medical device for articulating the distal end of the medical device.

8. The medical device of claim 7 , wherein the ring rotates about the structure for articulating the distal end of the medical device.

9. 7. The medical device of claim 6, wherein the actuator includes a second connector having a first end coupled to a radially inner surface of a second contact element of the actuator and a second end coupled to the ring at a position on the ring opposite to the position at which the first connector is coupled to the ring.

10. 10. The medical device of claim 9, wherein the first contact element and the second contact element are positioned relative to the handle body such that a user who touches the first contact element with the thumb of their hand can touch the second contact element with another finger of their hand.

11. 10. The medical device of claim 9, wherein the actuator is rotated about the handle body by simultaneously pushing one of the first contact element up and down and the other of the second contact element up and down.

12. The medical device of claim 9 , wherein the second contact element includes a proximal portion and a distal portion, the proximal portion projecting radially outward relative to the distal portion.

13. 13. The medical device of claim 12, wherein the proximal and distal portions of the second contact element each include a radially outer contact surface that is convex, and the proximal, distal, and central contact surfaces of the first contact element each are convex.

14. The medical device of claim 3 , wherein each of the proximal and distal contact surfaces of the first contact element is concave.

15. 15. The medical device of any one of claims 1 to 14, wherein the movable element is an elevator configured to pivot about a portion of the distal tip and to deliver tools from the distal tip at multiple angles relative to the distal tip.

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