Medical Device Actuators and Related Methods - Patent application

Abstract

A linkage assembly for a medical device may include a control lever, a rotatable member rotatable about a first axis, and a plurality of linkages including a first linkage, a second linkage, and a third linkage. The first linkage includes a first end coupled to the rotatable member and an opposite second end coupled to the first end of the second linkage. The second linkage includes a first end coupled to the second end of the first linkage and an opposite second end coupled to the first end of the third linkage, and the second linkage may be rotatable about a second axis parallel to the first axis. The second end of the third linkage may translate along a third axis, the second axis being offset from the third axis.

Description

[Technical field]

[0001] Various aspects of the present disclosure relate generally to devices and methods for actuators of medical devices, and more particularly to actuators for components of duodenoscopes, such as elevator levers. [Background technology]

[0002] A duodenoscope may include a handle and a sheath insertable into a body lumen of a subject. The sheath may terminate at a distal tip, which may include features such as optical elements (e.g., camera, lighting), air / water outlets, and a working channel opening. An elevator may be disposed at the distal tip and may be operable to change the orientation of a medical device / tool ​​passed through the working channel. For example, the elevator may be pivotable or otherwise movable.

[0003] An element / actuator at the handle may control an element at the distal tip. For example, a button, knob, lever, etc. may control the element at the distal tip. The elevator may be controlled via a control mechanism at the handle, such as a lever, which may be attached to a control wire attached to the elevator. When the mechanism (e.g., lever) is actuated, the wire may move proximally and / or distally, thereby raising and / or lowering the elevator. Actuating such a mechanism (e.g., lever / actuator) may, in some configurations, require the operator to exert a large amount of force and maintain such force for an extended period of time. Indeed, various procedures may require constant and repetitive manipulation of the lever throughout the procedure, such as rapidly raising and lowering the elevator or holding the elevator in a desired position. Repetitive activities, static muscle loading, and unnatural body movement postures may result in musculoskeletal problems for physicians and other medical personnel. Therefore, it may be desirable to reduce the amount of force required to raise and / or lower the elevator to allow operators to perform medical procedures more comfortably, accurately, and for longer periods of time.

[0004] The devices and methods of the present disclosure may remedy one or more of the deficiencies discussed above or address other aspects of the art. Summary of the Invention

[0005] Each of the embodiments disclosed herein may include one or more of the features described in connection with any of the other disclosed embodiments. Examples of the present disclosure relate, among other things, to devices and methods for actuating a distal end elevator. However, it may be understood by those skilled in the art that the mechanisms provided herein may be used to articulate, rotate, or otherwise manipulate the distal end of devices other than elevators.

[0006] In one example, a linkage assembly for a medical device may include a control lever, a rotatable member rotatable about a first axis, and a plurality of linkages including a first linkage, a second linkage, and a third linkage. The first linkage includes a first end coupled to the rotatable member and an opposite second end coupled to the first end of the second linkage, the second linkage includes a first end coupled to the second end of the first linkage and an opposite second end coupled to the first end of the third linkage, the second linkage being rotatable about a second axis parallel to the first axis. The second end of the third linkage may translate along the third axis, the second axis being offset from the third axis.

[0007] Any example of the linkage assembly described herein may further include a slider having a longitudinal axis. The slider may be coupled to a second end of the third linkage. The linkage assembly may be configured such that the second linkage extends perpendicular to the longitudinal axis of the slider, and the first end of the second linkage is a right end of the second linkage when viewed from above. In a configuration in which the second linkage extends perpendicular to the longitudinal axis of the slider, the first end of the second linkage is a left end of the second linkage when viewed from above. The slider is operably coupled to a control member that extends distally to a distal member. The distal member may be, for example, an elevator of the medical device. Operation of the control lever is configured to effect operation of the elevator to adjust the orientation of a tool extending through the elevator. In some embodiments, at least one of the multiple linkages is curved. The second linkage pivots about a fixed protrusion that extends along the second axis. The second linkage may be eccentrically attached to the fixed protrusion such that a first length of the second linkage extending from a first end of the second linkage to the fixed protrusion is different from a second length of the second linkage extending from the fixed protrusion to a second end of the second linkage. In any example, the first linkage may be coupled to an intermediate component, the intermediate component being coupled to the rotatable member. In any example, the multiple linkages are configured in a Z-shape.

[0008] In another example, the linkage assembly may include a slider having a longitudinal axis, the slider coupled to the second end of the third linkage, and the fixed protrusion offset from the longitudinal axis of the slider.

[0009] The control lever, the rotatable member, and the first linkage form a second type lever assembly, and the first linkage, the second linkage, and the third linkage form a first type lever assembly. Additionally or alternatively, in any example, the proximal portion of the control member may further comprise a hypotube.

[0010] In another example, a linkage assembly for a medical device may include a rotatable member configured to rotate about a first axis of rotation, a slider movable along a range of motion extending from a most retracted position of the slider to a maximum forward position of the slider, and a series of elevator linkages rotatably coupled to the rotatable member at a first end of the series of elevator linkages and rotatably coupled to the slider at a second end of the series of elevator linkages. At least one elevator linkage in the series of elevator linkages is rotatable about a second axis of rotation different from the first axis of rotation, and movement of the slider along the range of motion results in movement of a distal member coupled to the slider via a control member. A proximal portion of the control member further includes a hypotube. The distal member is an elevator of the medical device. The second axis of rotation may be perpendicular to a longitudinal axis extending longitudinally through the slider.

[0011] In another example, a linkage assembly for a medical device may include a rotatable member configured to rotate about an axis of rotation, a slider, a plurality of elevator linkages, and an elevator assembly. The plurality of elevator linkages may form a plurality of levers for operating the elevator assembly. The plurality of levers may include (i) a second type lever and (ii) a first type lever coupled to the second type lever, and the elevator assembly may be coupled to the first type lever.

[0012] It can be understood that both the foregoing general description and the following detailed description are exemplary and explanatory only and are not limiting of the invention as claimed. 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 "diameter" may refer to width if the element is not circular. The term "distal" refers to a direction away from the operator and the term "proximal" refers to a direction toward the operator. The term "exemplary" is used in the sense of "example" rather than "ideal". The term "about" or similar terms (e.g., "substantially") include values ​​of + / - 10% of the stated value. [Brief description of the drawings]

[0013] The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate aspects of the disclosure and, together with the description, serve to explain the principles of the disclosure. [Figure 1A] 1 illustrates an exemplary duodenoscope according to aspects of the present disclosure. [Figure 1B] 1 illustrates an exemplary duodenoscope according to aspects of the present disclosure. [Diagram 2] 1 illustrates a diagram of a single link lever assembly including a distal elevator according to an aspect of the present disclosure. [Figure 3A] 1 illustrates an exemplary multi-link lever assembly according to an aspect of the present disclosure. [Figure 3B] 1 illustrates an exemplary multi-link lever assembly according to an aspect of the present disclosure. [Figure 3C] 1 illustrates an exemplary multi-link lever assembly according to an aspect of the present disclosure. [Figure 3D] 1 illustrates an exemplary multi-link lever assembly according to an aspect of the present disclosure. [Figure 4A]1 illustrates an alternative exemplary multi-link lever assembly according to an aspect of the present disclosure. [Figure 4B] 1 illustrates an alternative exemplary multi-link lever assembly according to an aspect of the present disclosure. [Figure 4C] 1 illustrates an alternative exemplary multi-link lever assembly according to an aspect of the present disclosure. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0014] Aspects of the present disclosure include devices and methods for actuators of medical devices, and in particular actuators for components of duodenoscopes, such as elevator levers. The ability to manipulate distal components of a scope, such as elevators, can, for example, reduce user discomfort associated with exerting large amounts of force to actuate an actuator.

[0015] Examples of the present disclosure may relate to devices and methods for actuating, stopping, or otherwise manipulating an elevator of a duodenoscope or a portion of the distal end of a device (e.g., a scope). Various examples described herein include a series of first and second levers that are utilized to reduce the force required to actuate or stop the elevator. The reduction in force may be related to and / or equivalent to a reduction in torque. Reference will now be made in detail to the examples of the present disclosure described above and illustrated in the accompanying drawings. Wherever possible, the same reference numbers are used throughout the drawings to refer to the same or like parts.

[0016] The leverage assemblies described below are described as being used to raise / lower the elevator of a duodenoscope. Although side-directing devices are specifically discussed, the embodiments described herein may also be used with forward-facing endoscopes (e.g., endoscopes with a visual element facing longitudinally forward). In addition, it will be understood that the leverage assemblies described herein may have broader applications. For example, the leverage assemblies may also be used to control other medical device components (e.g., steering or braking components). It will also be understood that other devices may include elevators or any other distal components requiring actuation or movement for which these assemblies may be used. Other devices include, but are not limited to, sheaths, catheters, scopes, or any other suitable delivery devices or medical devices that may include one or more distal components requiring actuation or movement. This may also include non-medical devices such as borescopes. Thus, the following description and illustrations should be considered exemplary in nature and do not limit the scope of the present disclosure.

[0017] Figure 1A shows an exemplary duodenoscope 101, and Figure 1B shows a user holding the duodenoscope 101. The duodenoscope 101 includes a handle 106 and an insertion section 108. The duodenoscope 101 may also include an umbilicus 105 for purposes of connecting the duodenoscope 101 to sources of, for example, air, water, suction, power, etc., as well as imaging and / or visual equipment (not shown).

[0018] The insertion portion 108 may include a sheath or shaft 128 and a distal tip 119. The distal tip 119 may include an imaging device (e.g., a camera) and a light source (e.g., an LED or fiber optic) (not shown). The distal tip 119 may be side-oriented; that is, the imaging device and light source may face radially outward, perpendicularly, approximately perpendicularly, or otherwise transversely to a longitudinal axis of the shaft 128 and / or distal tip 119.

[0019] The distal tip 119 may also include an elevator 124 for changing the orientation of a tool inserted within the working channel of the duodenoscope 101. Mechanisms for activating or deactivating the elevator 124 are described in further detail below. Additionally, the elevator 124 may alternatively be referred to as a swing stand, a pivot stand, an elevated base, or any other suitable terminology. The elevator 124 may be pivotable, for example, via an actuation wire or another control element that extends from the handle 106 through a shaft 128 to the elevator 124.

[0020] A distal portion of the shaft 128 adjacent and / or coupled to the distal tip 119 may have a steerable section 122. The steerable section 122 may be, for example, an articulating joint. The shaft 128 and the steerable section 122 may include a variety of structures that are or may become known in the art.

[0021] The handle 106 may have one or more actuators / control mechanisms 112, 114. The control mechanisms 112, 114 may enable deflection / steering of the steerable section 122 and thus the distal tip 119. For example, the control mechanisms (e.g., knobs) 112, 114 may control the movement of the distal tip 119 leftward, rightward, upward, and / or downward. That is, the first control mechanism 112 may control the deflection of the distal tip 119 along a first plane (e.g., up, down), while the second control mechanism 114 may control the deflection of the distal tip 119 along a second plane (e.g., left, right). The second plane may be orthogonal, perpendicular, and / or transverse to the first plane. The handle 106 may further include one or more locking mechanisms 109, 110 (e.g., knobs or levers) for fixing the position of the control mechanisms 112, 114. When engaged or actuated, the locking mechanisms 109, 110 may prevent manipulation (e.g., rotation) of the control mechanisms 112, 114, thereby preventing deflection / steering of the steerable section 122 or distal tip 119 in at least one of an upward, downward, leftward, or rightward direction. Additionally, the handle 106 may include an elevator control lever 107 (interchangeably referred to herein as a "control lever," "lever," or "elevator lever"). Manipulation of the elevator control lever 107 may result in movement of the elevator 124. For example, manipulation of the elevator control lever 107 may raise and / or lower the elevator 124, as further described herein. Additionally, the port 103 may enable passage of a tool into the working channel of the duodenoscope 101 through the shaft 128 to the distal tip 119.

[0022] FIG. 1B shows a user gripping the handle 106 of the duodenoscope 101. Specifically, the user 202 places a thumb or finger on the lever 107 to operate the elevator 124. The user 202 can push, press, or otherwise urge the lever 107 upward (e.g., in direction U) to activate the elevator 124. Similarly, the user 202 can pull, press, or otherwise urge the lever 107 downward (e.g., in direction D) to stop the elevator 124, and vice versa. Activating or stopping the elevator 124 can include adjusting the angle of the elevator 124 in at least a first direction and a second direction. The illustrated lever 107 is arranged such that the user 202 operates the lever 107 with his thumb, but it can be understood by those skilled in the art that this configuration is not limited. For example, the lever 107 may be configured / positioned such that the user can utilize other fingers to operate the lever 107.

[0023] In use, an operator may insert the insertion portion 108 into a body cavity of a subject and advance the distal tip 119 to a treatment site within the body cavity. The operator may insert a tool (not shown) into the port 103 and pass the tool through the working channel of the shaft 128 toward the distal tip 119. The tool may exit the working channel at the distal tip 119. The user may use the elevator lever 107 to raise the elevator 124 and angle the tool toward a desired location (e.g., the papilla of the pancreaticobiliary duct). Once so positioned, the user may use the tool to perform a medical procedure.

[0024] FIG. 2 illustrates a single-link elevator assembly 10 for use with the duodenoscope 101 of FIG. 1A. The assembly may include a rotatable member 12 having a lever 107 as described above. The rotatable member 12 may rotate about an axis 19 when a user manipulates the lever 107. A proximal portion of the elevator linkage 14 may be rotatably coupled to the rotatable member 12 at a first lever connector 13 such that the elevator linkage 14 may move relative to the rotatable member 12, or vice versa. The first lever connector 13 may be positioned on the opposite side of the rotatable member 12 from the lever 107. A slider 16 may be rotatably coupled to a distal portion of the elevator linkage 14 at a second lever connector 15 such that the elevator linkage 14 may move relative to the slider 16, or vice versa. For example, when a user rotates the rotatable member 12 via the lever 107, the elevator linkage 14 moves proximally or distally, causing the slider 16 to move proximally or distally within the track 17. The proximal end of the control wire 20 may be fixedly or removably coupled to the distal end of the slider 16 by crimping, set screws, adhesive, or any other fastening structure commonly known in the art. Alternatively, the proximal end of the control wire 20 may extend through the proximal end of the slider 16. The control wire 20 may be held in place by crimping, set screws, adhesive, or any other means commonly known in the art. The proximal end (or any other portion) of the control wire 20 may also be constructed from a hypotube (not shown) to provide additional structural (e.g., columnar) support to the control wire 20. The control wire 20 may also extend through a Bowden cable (not shown) within the shaft to provide additional structural support within the shaft 128 of FIG. 1A. The Bowden cables may extend into a portion of the handle 106 to provide structural support as well. As shown in FIG. 2, the control wires 20 may extend through O-rings 18. The O-rings 18 may be used to contain or otherwise control the wires 20 within the handle 106, as shown in FIG. 1A.Additionally, a small amount of friction can be created between the O-ring 18 and the control wire 20 to provide a user with more precise movement of the elevator 124 located at the distal tip 119. For example, the O-ring 18 can prevent the control wire from bouncing back or returning to an undesired position when the lever 107 is released by the user.

[0025] As mentioned above, the distal tip 119 may include an elevator 124 that may be used to change the orientation of a tool (not shown) inserted into the working channel (not shown) of the duodenoscope 101. The elevator 124 may alternatively be referred to as a swing stand, a pivot stand, an elevated base, or any other suitable terminology. The elevator 124 may be pivotable about a pivot point 25, for example, via a control wire 20 or another control element that extends from a proximal portion of the elevator assembly 10 in the handle 106 of FIG. 1A to the elevator 124.

[0026] The above assembly can be classified as a series of first type levers (e.g., levers having a fulcrum between the force and the point of application). The first lever of the series is shown in box A (referred to as the first lever A) and the second lever is shown in box B of FIG. 2 (referred to as the second lever B). The first lever A receives a force applied by a user at the lever 107 to rotate the rotatable member 12 about the axis 19. That is, the axis 19 is the fulcrum of the first lever A. Rotating the lever 107 about the axis 19 moves the elevator link mechanism 14 about the first lever connector 13. In other words, the elevator link mechanism 14 is the point of application of the first lever A. The remaining intermediate components (e.g., slider 16, O-ring 18, and control wire 20) couple the first lever A with the second lever B. As lever 107 rotates about axis 19, slider 16 translates within track 17. Track 17 may define the range over which slider 16 extends proximally or distally. Lengthening track 17 increases the range over which slider 16 can move, while shortening track 17 decreases the range over which slider 16 can move. Because control wire 20 is coupled to slider 16, this movement results in translation of control wire 20 within shaft 128 of duodenoscope 101. Thus, control wire 20 exerts a load on elevator 124 to rotate elevator 124 about pivot point 25. In other words, the elevator 124 is the point of action of the second lever B, while the pivot point 25 is the fulcrum of the second lever B. This action causes the elevator 124 to start or stop.

[0027] While the combination of the two first type levers provides a significant mechanical advantage for actuating or stopping the elevator 124, the remaining figures show improvements to further increase the mechanical advantage associated with rotating the lever 107 about axis 19.

[0028] 3A-3D show an exemplary elevator lever assembly 200 for use with the duodenoscope 101, with like elements being referenced with the same reference numbers as previously described. This embodiment utilizes a series of first and second type levers (e.g., levers with a point of application between a force point (force) and a fulcrum) to provide functionality to the elevator 124 of FIG. 2. This can be accomplished by rotating the rotating member 12 via the lever 107. FIGS. 3A and 3B show the exemplary linkage assembly 200 in a first configuration (FIGS. 3A, 3B) and a second configuration (FIG. 3C). The first configuration (FIGS. 3A, 3B) can correspond to the elevator being in a lowered (e.g., open) position. The second configuration (FIG. 3C) can correspond to the elevator being in a raised (e.g., closed) position. However, these configurations are not limiting, and a user may require the elevator 124 to be raised or lowered multiple times to various degrees throughout a procedure. 3D shows an alternative view from below of the subassembly in a second configuration and includes additional components such as a handle piece 135. The handle piece 135 may be utilized to secure the linkage assembly to the handle 106 of FIG. 1. The handle piece 135 may be of various shapes and sizes and may be secured to the handle 106 by various means commonly known in the art. This may include the use of screws or other fasteners, adhesives, snap fits, or any other methods commonly known in the art.

[0029] 3A and 3B, the rotatable member 12 may be rotated about an axis 19 via a lever 107. The axis 19 may be in line with and perpendicular to the central longitudinal axis 21, as described further herein. The proximal surface of the lever 107 may include ridges, bumps, indentations, etc. to further facilitate a user's grip of the lever 107. The proximal surface may be curved or otherwise configured to provide leverage and comfort to the user. Alternatively, the proximal surface of the lever 107 may be textured, smooth, and / or cushioned to facilitate a more comfortable grip for the user. The rotatable member 12 may be rotated about the axis 19 when the lever 107 is manipulated by a user. The proximal portion of the first elevator linkage 140a may be rotatably coupled to the rotatable member 12 at the first lever connector 130a (shown in FIGS. 3B, 3D) by pins, clips, screws, or other means commonly known in the art. However, in some embodiments, the rotatable member 12 may be coupled to one or more intermediate components 150, as shown in FIGS. 3B and 3D. The intermediate components 150 may also be rotatable about the axis 19 together with the rotatable member 12. Thus, the first lever connector 130a may alternatively be coupled to one or more intermediate components 150. However, regardless of whether the first lever connector 130a is directly coupled to the rotatable member 12 or the one or more intermediate components 150, the first lever connector 130a is positioned between the lever 107 and the axis 19. This arrangement forms a second type of lever, which is described in more detail below.

[0030] The distal portion of the first elevator linkage 140a may be rotatably coupled to the second elevator linkage 140b by the second lever connector 130b. This coupling may be accomplished by the same or similar means as described above with respect to the first lever connector 130a. However, the second elevator linkage 140b pivots about a protrusion 145 extending from a proximal portion of the slider track 175. The protrusion 145 may be offset from the central longitudinal axis 21 of the slider track 175 to form a third axis. The central longitudinal axis 21 may extend through the center of the slider track 175 parallel to the central axis of the handle. The slider track 175 may be a separable component to the handle 106 or may be molded as part of the handle 106. The slider track 175 may further comprise the track 17 described above and may be of various shapes and sizes. The protrusion 145 may extend partially or completely through the second elevator linkage 140b. To maximize the mechanical advantage of this configuration, the protrusion 145 may be configured to be approximately two-thirds of the length of the second elevator linkage 140b. For example, for an elevator linkage 140b that is approximately 25 mm long, the elevator linkage 140b may pivot about the protrusion 145 approximately 14.5 mm from the proximal end of the elevator linkage 140b. The remaining third of the length of the elevator linkage 140b, i.e., 10.5 mm, may extend beyond the protrusion 145 and may be rotatably coupled to the proximal end of the third elevator linkage 140c via the third lever connector 130c. The second elevator linkage 140b may be rotatably coupled to the protrusion 145, for example, by a snap fit, clip, or other means commonly known in the art. In other words, the second elevator linkage 140b may be eccentrically mounted to the fixed protrusion 145. In one configuration, the second elevator linkage 140b may extend perpendicular to the longitudinal axis of the slider, with the first end of the second linkage being the right end of the second linkage when viewed from above.A distal end of the third elevator linkage 140c may be pivotally coupled to the slider 16 via a fourth lever connector 130d. The fourth lever connector 130d may translate along a third axis that is offset from the second axis.

[0031] However, it may be understood that the aforementioned dimensions are for illustrative purposes only, and alternative dimensions may be utilized to achieve a desired configuration of the subassembly and / or improved mechanical advantage.

[0032] As shown in FIG. 3A, the first elevator linkage 140a is rotatably coupled to a first end (e.g., a right portion) of the second elevator linkage 140b, and the third elevator linkage 140c is rotatably coupled to a second end (e.g., a left portion) of the second elevator linkage 140b. The configuration of the elevator linkages 140a, 140b, and 140c generally results in a Z-shape when the assembly is viewed from above. As described above in connection with FIG. 2, rotation of the lever 107 about the axis 19 ultimately results in activation or deactivation of the elevator 124 (FIGS. 1A, 1B, 2) at the distal tip 119 of the duodenoscope 101. More specifically, biasing the lever 107 downwardly causes the first elevator linkage 140a to extend distally. This motion then causes the second elevator linkage 140b to pivot about the projection 145, resulting in a proximal translation of the third elevator linkage 140c and the slider 16. Thus, the control wire 20 is pulled proximally and the elevator is actuated. The opposite effect can occur if the lever 107 is biased in the opposite direction. To gain mechanical advantage, this embodiment utilizes a series of second and first type levers.

[0033] A first lever in the series of levers is shown in box C (referred to as first lever C), and a second lever in the series of levers is shown in box D (referred to as second lever D). The first lever C is configured as a second type of lever. For example, the first elevator link mechanism 140a (e.g., the point of application of the first lever C) is between the axis 19 (e.g., the fulcrum of the first lever C) and the lever 107 (e.g., the application point of the first lever C). In other words, the point of application of the first lever C is between the point where the force is applied and the fulcrum. When a force is applied to the lever 107, the first elevator link mechanism 140a (e.g., the point of application) translates with respect to the axis 19 (e.g., the fulcrum). The distal portion of the first elevator link mechanism 140a then applies a force to a second lever D of the series of levers. The second lever D is configured as a first type lever. When the first elevator link mechanism 140a is translated, the second elevator link mechanism 140b pivots about the protrusion 145 (e.g., fulcrum). In other words, the first elevator link mechanism 140a applies the force necessary to translate the remaining components on the opposite side of the second elevator link mechanism 140b (e.g., point of application) around the protrusion 145 (e.g., fulcrum). That is, the fulcrum of the second lever D is between the point where the force is applied and the position of the point of application. These combinations of levers (eg, a second type lever (first lever C) followed by a first type lever (second lever D)) require less force to activate or deactivate the elevator 124 of the distal tip 119.

[0034] The dimensions of the elevator linkages 140a, 140b, 140c may be slightly different to maximize the mechanical advantage of the subassembly or to fit within the handle. For example, the distance extending from the surface of the lever 107 (e.g., where the user applies force) to the axis 19 may be about 33 mm. The proximal portion of the elevator linkage 140a may be rotatably fixed between the levers 107 at about 13 mm from the axis 19. Furthermore, the length of the elevator linkage 140a may be about 32 mm, the length of the linkage 140b may be about 25 mm, and the length of the elevator linkage 140c may be about 24 mm. In this configuration, the second elevator linkage 140b may extend perpendicular to the longitudinal axis of the slider, with the first end of the second linkage being the left end of the second linkage when viewed from above. The aforementioned exemplary lengths may achieve a mechanical advantage of 2.5 in box C and a mechanical advantage of 1.4 in box D. It may also be understood that other lengths for elevator lever 107 and one or more of elevator linkages 140a, 140b, 140c may be utilized or otherwise manipulated to fit within the handle of a medical device to achieve a desired mechanical advantage or configuration.

[0035] Similar to the method described above with respect to the embodiment of FIG. 2, an operator may insert the insertion portion 108 into a body lumen of a subject and advance the distal tip 119 to a treatment site within the body lumen. The operator may insert a tool (not shown) into the port 103 and pass the tool through the shaft 128 via the working channel toward the distal tip 119. The tool may exit the working channel at the distal tip 119. The user may raise the elevator 124 using the elevator control lever 107 to angle the tool toward a desired location (e.g., the papilla of the pancreatic bile duct). The user may use the tool to perform a medical procedure.

[0036] 4A-4C illustrate an exemplary elevator lever assembly 300, with like elements referenced with like reference numerals previously described. The configuration of FIGS. 4A-4C can operate similarly to the configuration of FIGS. 3A-3D, except for the modifications described herein. The configuration of FIGS. 4A-4C also utilizes a series of first and second type levers and includes a first elevator linkage 240a, a second elevator linkage 240b, and a third elevator linkage 240c. The configuration of elevator linkages 240a, 240b, and 240c generally results in an S-shape when the assembly is viewed from above. However, the orientation of elevator linkages 240a and 240c relative to elevator linkage 240b, as well as the placement of protrusions 145 relative to central longitudinal axis 21 of slider track 175, differs slightly from the arrangement of FIGS. 3A-3D. Specifically, the first elevator linkage 240a is rotatably coupled to a first end (e.g., a left portion) of the second elevator linkage 240b, and the third elevator linkage 240c is rotatably coupled to a second end (e.g., a right portion) of the second elevator linkage 240b. A first lever in the series of levers is shown in box E (referred to as first lever E), and a second lever in the series of levers is shown in box F (referred to as second lever F). As shown, the first lever E in the series of levers is positioned as a second type lever because the first elevator linkage 240a (e.g., a point of application) is located between the axis 19 (e.g., a fulcrum) and the lever 107 (e.g., a point of application of force). Also, the second lever F is arranged as a first type lever because the third elevator linkage 240c (e.g., point of application) and the first elevator linkage 240a (e.g., point of force application) are on opposite sides of the protrusion 145 (e.g., fulcrum). Thus, when the lever 107 is translated downward, the first elevator linkage 240a is translated downward, pushing down the first end while raising the opposite second end of the second elevator linkage 240b, thereby translating the third elevator linkage 240c upward. This configuration is shown in FIG. 4B.In addition, protrusion 145 is collinear with central longitudinal axis 21 such that central longitudinal axis 21 intersects at least a portion of protrusion 145 and central longitudinal axis 21 is perpendicular to axis 19 .

[0037] The dimensions of elevator linkages 240a, 240b, 240c may be slightly different to maximize the mechanical advantage of the subassembly or to achieve a desired configuration. The dimensions associated with lever 107 relative to axis 19 and the proximal portion of elevator linkage 240a relative to axis 19 may be similar to those described above with respect to the embodiment shown in Figures 3A-3D, but modifications may be made to accommodate a desired configuration. For example, elevator linkage 240a may be approximately 40 mm in length, linkage 240b may be approximately 22 mm in length, and elevator linkage 240c may be approximately 23.5 mm in length. The aforementioned exemplary lengths may achieve a mechanical advantage of 2.5 in box E and a mechanical advantage of 1.07 in box F. It may also be understood that other lengths or dimensions of elevator lever 107 and one or more of elevator linkages 240a, 240b, 240c may be utilized to achieve a desired mechanical advantage or alternative configuration. For example, the length of elevator linkages 240a, 240b, 240c may be increased or decreased as needed. In use, similar to the methods described above, an operator may insert insertion portion 108 into a body lumen of a subject and advance distal tip 119 to a treatment site within the body lumen. An operator may insert a tool (not shown) into port 103 and pass the tool through shaft 128 via the working channel toward distal tip 119. The tool may exit the working channel at distal tip 119. A user may raise elevator 124 using elevator control lever 107 to angle the tool toward a desired location (e.g., the papilla of the pancreatic bile duct). A user may use the tool to perform a medical procedure.

[0038] In the configurations described above with respect to Figures 3A-3D and 4A-4C, it can be understood that the elevator linkages 140a, 140b, 140c, 240a, 240b, and 240c can be constructed from a variety of biocompatible materials. This includes stainless steel, polycarbonate, titanium, and the like. Additionally, the shape of the elevator linkages 140a, 140b, 140c, 240a, 240b, and 240c can be modified depending on the desired application. For example, the elevator linkages 140a, 140b, 140c, 240a, 240b, and 240c can be curved to avoid interference between any components housed within the handle. Additionally, various shapes can be utilized to further enable better mechanical advantage. For example, elevator linkages 140a, 140b, 140c, 240a, 240b, 240c may be S-shaped, C-shaped, or otherwise configured to further allow for mechanical advantage to the user.

[0039] One advantage of the disclosed embodiments includes a reduction in the force or torque on the system. For example, the force or torque required to operate various tools may be reduced by approximately 0.1-50% as a result of the configurations described above with respect to Figures 3A-3D and 4A-4. This is due to the increased mechanical advantage within the linkage assembly.

[0040] Although the principles of the present disclosure are described herein with reference to illustrative examples for particular applications, it should be understood that 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 examples described herein. Thus, the present invention should not be considered as limited by the foregoing description.

Claims

1. A linkage assembly for a medical device A control lever; a rotatable member rotatable about a first axis; a plurality of link mechanisms including a first link mechanism, a second link mechanism, and a third link mechanism; the first linkage includes a first end coupled to the rotatable member and an opposite second end coupled to the first end of the second linkage; the second link mechanism includes a first end coupled to the second end of the first link mechanism and an opposite second end coupled to the first end of the third link mechanism, the second link mechanism being rotatable about a second axis parallel to the first axis; A linkage assembly, wherein a second end of the third linkage translates along a third axis, the second axis being offset from the third axis.

2. The linkage assembly of claim 1 , further comprising a slider having a longitudinal axis aligned with the third axis, the slider coupled to the second end of the third linkage.

3. 3. The linkage assembly of claim 2, wherein in a configuration in which the second linkage extends perpendicular to the longitudinal axis of the slider, the first end of the second linkage is a right end of the second linkage when viewed from above.

4. 3. The linkage assembly of claim 2, wherein in a configuration in which the second linkage extends perpendicular to the longitudinal axis of the slider, the first end of the second linkage is a left end of the second linkage when viewed from above.

5. The linkage assembly of claim 2 , wherein the slider is operably coupled to a control member that extends distally to a distal member.

6. The linkage assembly of claim 5 , wherein the distal member is an elevator of the medical device.

7. The linkage assembly of claim 6 , wherein operation of the control lever is configured to effect operation of the elevator to adjust an orientation of a tool extending through the elevator.

8. The linkage assembly of claim 1 , wherein at least one of the plurality of linkages is curved.

9. The linkage assembly of claim 1 , wherein the second linkage pivots about a fixed projection extending along the second axis.

10. 10. The linkage assembly of claim 9, wherein the second linkage is eccentrically attached to the fixed protrusion such that a first length of the second linkage extending from the first end of the second linkage to the fixed protrusion is different from a second length of the second linkage extending from the fixed protrusion to the second end of the second linkage.

11. 10. The linkage assembly of claim 9, further comprising a slider having a longitudinal axis, said slider coupled to a second end of said third linkage, said locking protrusion being offset from said longitudinal axis of said slider.

12. 2. The linkage assembly of claim 1, wherein: (i) the control lever, the rotatable member, and the first linkage form a second class leverage assembly; and (ii) the first linkage, the second linkage, and the third linkage form a first class leverage assembly.

13. The linkage assembly of claim 1 , wherein the first linkage is coupled to an intermediate component, the intermediate component being coupled to the rotatable member.

14. The linkage assembly of claim 5 , wherein the proximal portion of the control member further comprises a hypotube.

15. A linkage assembly according to any preceding claim, wherein the plurality of linkages are arranged in a Z-shape.

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