Refillable water reservoir for an endoscope

Abstract

A method and system for refilling a container during an endoscopic procedure. An exemplary container may extend from a first end to a second end and may include a container having a small-diameter stem extending from the first end, a water outlet, a gas inlet, and a port, wherein the small-diameter stem defines an opening for receiving fluid. The port may be a sealing ring defining an opening extending from a first end to a second end of the sealing ring, wherein the opening is in fluid communication with an opening of the container, a cap positioned adjacent to the first end of the opening of the sealing ring, and a biasing mechanism disposed between the container and the sealing ring.

Description

Technical Field

[0001] The present disclosure generally relates to medical fluid containers and methods, and more particularly to refillable containers for supplying fluid and / or gas to an endoscope.

Background Art

[0002] Conventionally, endoscope devices have been widely used to perform diagnostic and / or therapeutic procedures. During an endoscopic procedure, a physician may use a combination of air, irrigation, and lens cleaning fluid as a means to flush debris, clean the optics, and ventilate the working lumen. To enable these capabilities, compressed gas from either a processor or an alternative source is used to increase the pressure within a fluid bottle, either to ventilate the working lumen or to clean the endoscope's lens. Additionally, a peristaltic pump can be used to irrigate debris from the working lumen. One challenge faced during endoscopic procedures is that the common water bottles and tubing sets used can only hold up to one liter of water and are not designed to be refilled. This may require a nurse / technician to change the water bottle multiple times a day. This can introduce multiple opportunities for contamination of the tubing set, either by contact with non-sterile surfaces or by dropping the tubing on the floor.

[0003] The improvements of the present disclosure may be useful in light of these considerations.

Summary of the Invention

[0004] This summary of the disclosure is provided to facilitate understanding and those skilled in the art will understand that each of the various aspects and features of the disclosure can be advantageously used, in some cases separately or in other cases in combination with other aspects and features of the disclosure. Limitations with respect to the scope of the claimed subject matter are not intended by inclusion or non-inclusion of elements, components, etc. in this summary. Thus, while the disclosure is presented with respect to aspects or embodiments, it should be understood that individual aspects can be claimed separately or in combination with aspects and features of their embodiments or any other embodiments.

[0005] In a first example, a reservoir arranged and configured to couple to an endoscope for use in endoscopic procedures is a container configured to contain a fluid, the container extending from a first end to a second end and having a small-diameter stem extending from the first end, the small-diameter stem defining an opening for receiving the fluid, and may include a container, a water outlet, a gas inlet, and a port. The port is a sealing ring defining an opening extending from a first end to a second end of the sealing ring, the opening being in fluid communication with the opening of the container, and may include a sealing ring, a cap positioned adjacent to the first end of the opening of the sealing ring, and a biasing mechanism disposed between the container and the sealing ring.

[0006] Instead of or in addition to any of the above examples, in another example, the water outlet may include a water supply tube including a first lumen extending through a first end, a second end, and the water supply tube, the first lumen being in fluid communication with the bottom of the container, the second end of the water supply tube being positioned outside the container, the gas inlet may include a gas supply tube including a second lumen extending through a first end, a second end, and the gas supply tube, the second lumen being operably in fluid communication with the container, and the second end of the gas supply tube being positioned outside the container.

[0007] Instead of, or in addition to, any of the above examples, in another example, the biasing mechanism may be configured to bias the sealing ring away from the first end of the container.

[0008] Instead of, or in addition to, any of the above examples, in another example, the sealing ring may be movable between a first configuration configured to fluidly seal the opening of the container and a second configuration configured to provide a fluid path through the opening of the sealing ring and the opening of the container from outside the container.

[0009] Instead of, or in addition to, any of the above examples, in another example, when in the second configuration, the sealing ring may be pressed toward the first end of the container.

[0010] Instead of, or in addition to, any of the above examples, in another example, the sealing ring may extend around at least a portion of the small-diameter stem of the container. Instead of, or in addition to, any of the above examples, in another example, the cap may be held in a fixed orientation relative to the container.

[0011] Instead of, or in addition to, any of the above examples, in another example, the reservoir may further include a tether extending between the interior of the container and the cap.

[0012] Instead of, or in addition to, any of the above examples, in another example, the tether may include a first end coupled to the cap and a second end disposed inside the container.

[0013] Instead of, or in addition to, any of the above examples, in another example, the second end of the tether may be deformable between a first extended configuration and a second folded configuration.

[0014] Instead of, or in addition to, any of the above examples, in another example, when the second end of the tether is in the first expanded configuration, the second end of the tether may have a width greater than the width of the opening of the container.

[0015] Instead of, or in addition to, any of the above examples, in another example, when the second end of the tether is in the second folded configuration, the second end of the tether may have a width smaller than the width of the opening of the container.

[0016] Instead of, or in addition to, any of the above examples, in another example, the biasing mechanism may be configured to bias the sealing ring towards the cap. Instead of, or in addition to, any of the above examples, in another example, the diameter of the opening of the sealing ring may be substantially constant from the second end to an intermediate position, and may form a tapered first end region by increasing from the intermediate position to the first end.

[0017] Instead of, or in addition to, any of the above examples, in another example, the outer diameter of the cap may be tapered and may be configured to fit with the tapered first end region of the opening of the sealing ring.

[0018] Instead of, or in addition to, any of the above examples, in another example, the small-diameter stem may comprise a hollow cylindrical stem. Instead of, or in addition to, any of the above examples, in another example, the reservoir may further comprise an O-ring disposed between the sealing ring and the small-diameter stem of the container.

[0019] Instead of, or in addition to, any of the above examples, in another example, the system may comprise any one of the reservoirs of the above examples and a filling bottle having a mouth, the mouth being configured to engage the surface of the sealing ring along an outer periphery located beyond the outermost extent of the cap.

[0020] In another example, a reservoir arranged and configured to couple to an endoscope for use in endoscopic procedures may comprise a container configured to contain a fluid and having an inlet opening for receiving the fluid, a water outlet, a gas inlet, and a port. The port may comprise a housing having a small-diameter stem defining an inlet opening in a housing for receiving a fluid, the housing further comprising an outlet opening, a sealing ring defining an opening extending from a first end to a second end, the opening of the sealing ring being in fluid communication with the inlet opening of the housing, a cap positioned adjacent to the first end of the opening of the sealing ring, and a biasing mechanism disposed between the housing and the sealing ring. The reservoir may further comprise a flexible tubing line providing fluid communication between the outlet opening of the housing and the inlet opening of the container.

[0021] Instead of, or in addition to, any of the above examples, in another example, the water outlet may comprise a water supply tube including a first end, a second end, and a first lumen extending through the water supply tube, the first lumen being in fluid communication with the bottom of the container, the second end of the water supply tube being positioned outside the container, the gas inlet may comprise a gas supply tube including a first end, a second end, and a second lumen extending through the gas supply tube, the second lumen being operably in fluid communication with the container, and the second end of the gas supply tube being positioned outside the container.

[0022] Instead of, or in addition to, any of the above examples, in another example, the biasing mechanism may be configured to bias the sealing ring away from the first end of the housing.

[0023] Instead of, or in addition to, any of the above examples, in another example, the sealing ring may be movable between a first configuration configured to fluidly seal the inlet opening of the housing and a second configuration configured to provide a fluid path through the opening of the sealing ring and the inlet opening of the housing from outside the housing.

[0024] Instead of, or in addition to, any of the above examples, in another example, when in the second configuration, the sealing ring may be pressed towards the housing. Instead of, or in addition to, any of the above examples, in another example, the sealing ring may extend around at least a portion of the small diameter stem of the housing.

[0025] Instead of, or in addition to, any of the above examples, in another example, the cap may be held in a fixed orientation relative to the housing. Instead of, or in addition to, any of the above examples, in another example, the reservoir may further include a tether extending between the interior of the housing and the cap.

[0026] Instead of, or in addition to, any of the above examples, in another example, the tether may include a first end coupled to the cap and a second end disposed inside the housing.

[0027] Instead of, or in addition to, any of the above examples, in another example, the second end of the tether may be deformable between a first extended configuration and a second folded configuration.

[0028] Instead of, or in addition to, any of the above examples, in another example, when the second end of the tether is in the first expanded configuration, the second end of the tether may have a width greater than the width of the inlet opening of the housing.

[0029] Instead of, or in addition to, any of the above examples, in another example, when the second end of the tether is in the second folded configuration, the second end of the tether may have a width smaller than the width of the inlet opening of the housing.

[0030] Instead of, or in addition to, any of the above examples, in another example, the biasing mechanism may be configured to bias the sealing ring towards the cap. Instead of, or in addition to, any of the above examples, in another example, the diameter of the opening of the sealing ring may be substantially constant from the second end to an intermediate position, and may form a tapered first end region by increasing from the intermediate position to the first end.

[0031] Instead of, or in addition to, any of the above examples, in another example, the outer diameter of the cap may be tapered and may be configured to fit with the tapered first end region of the opening of the sealing ring.

[0032] Instead of, or in addition to, any of the above examples, in another example, the small diameter stem may comprise a hollow cylindrical stem. Instead of, or in addition to, any of the above examples, in another example, the reservoir may further comprise an O-ring disposed between the sealing ring and the small diameter stem of the housing.

[0033] Instead of, or in addition to, any of the above examples, in another example, the system may comprise a reservoir of any one of the above examples and a filling bottle having a mouth, the mouth being configured to engage the surface of the sealing ring along an outer periphery located beyond the outermost extent of the cap.

[0034] In another example, a reservoir arranged and configured to couple to an endoscope for use in endoscopic procedures is a container configured to contain a fluid, the container extending from a first end to a second end and having a small-diameter stem extending from the first end, the small-diameter stem defining an opening for receiving the fluid, and may further comprise a water inlet, a gas inlet, and a port. The port is a sealing ring defining an opening extending from a first end to a second end of the sealing ring, the opening being in fluid communication with the opening of the container; a cap positioned adjacent to the first end of the opening of the sealing ring and configured to selectively form a fluid-tight seal with the sealing ring; and a biasing mechanism disposed between the container and the sealing ring. The sealing ring may be movable between a first closed configuration and a second open configuration.

[0035] Instead of, or in addition to, any of the above examples, in another example, when in the first configuration, the biasing mechanism may be configured to bias the sealing ring against the cap.

[0036] Instead of, or in addition to, any of the above examples, in another example, when in the second open configuration, a force may be applied to the first end of the sealing ring such that the sealing ring moves away from the cap.

[0037] Instead of, or in addition to, any of the above examples, in another example, the reservoir may further comprise a tether extending between the interior of the container and the cap.

[0038] Instead of, or in addition to, any of the above examples, in another example, the tether may include a first end coupled to the cap and a second end disposed inside the container.

[0039] Instead of, or in addition to, any of the above examples, in another example, the second end of the tether may be deformable between a first extended form and a second folded form.

[0040] Instead of, or in addition to, any of the above examples, in another example, when the second end of the tether is in the first extended form, the second end of the tether may have a width greater than the width of the opening of the container.

[0041] Instead of, or in addition to, any of the above examples, in another example, when the second end of the tether is in the second folded form, the second end of the tether may have a width smaller than the width of the opening of the container.

[0042] In another example, a reservoir arranged and configured to couple to an endoscope for use in an endoscopic procedure is a container configured to contain a fluid, the container extending from a first end to a second end and having a small-diameter stem extending from the first end, the small-diameter stem defining an opening for receiving the fluid, and may include a container, a water inlet, a gas inlet, and a port partially disposed around the small-diameter stem of the container. The port may be a sealing ring defining an opening extending from a first end to a second end of the sealing ring, the opening being in fluid communication with the opening of the container, an O-ring disposed between the sealing ring and the small-diameter stem of the container, a cap positioned adjacent to the first end of the opening of the sealing ring, and a biasing mechanism disposed between the first end of the container and the second end of the sealing ring, the biasing mechanism being configured to bias the sealing ring into a sealing configuration with the cap. The sealing ring may be configured to move from the sealing configuration to an open configuration in response to a force applied to the first end of the sealing ring.

[0043] These and other features and advantages of the present disclosure will become readily apparent from the following detailed description, and the scope of the claimed invention is set forth in the appended claims. 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 spirit of the present disclosure.

Brief Description of the Drawings

[0044]

Figure 1

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DETAILED DESCRIPTION OF THE INVENTION

[0045] While the present disclosure can accept various modifications and alternative forms, details thereof are shown by way of example in the drawings and are described in detail. However, it should be understood that the intention is not to limit the invention to the specific embodiments described. On the contrary, the intention is to cover all modifications, equivalents, and alternative forms that fall within the spirit and scope of the present disclosure.

[0046] The present disclosure is described herein with reference to exemplary medical systems that may be used in endoscopic medical procedures. However, it should be noted that the reference to this particular procedure is provided for convenience only and is not intended to limit the present disclosure. Those skilled in the art will recognize that the concepts underlying the disclosed devices and related methods of use may be utilized in any suitable procedure, medical or otherwise. The present disclosure can be understood with reference to the following description and the accompanying drawings, in which the same or similar reference numerals are used to refer to the same or similar parts throughout the drawings.

[0047] The term "distal" refers to the portion that is furthest from the user when introducing the device into the patient. Conversely, the term "proximal" refers to the portion that is closest to the user when positioning the device within the patient. 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 apparatus that comprises a list of elements does not necessarily include only those elements, but may include other elements not expressly listed or inherent to such process, method, article, or apparatus. The term "exemplary" is used in the sense of "an example" rather than "an ideal." Further, as used herein, the terms "about," "approximately," and "substantially" indicate a range of values within + / - 10% of the stated or implied value. Further, terms indicating the geometric shape of a component / surface refer to both the exact shape and an approximate shape.

[0048] Embodiments of the present disclosure are described specifically with reference to a bottle (e.g., a container, reservoir, etc.) and a tube assembly or set. Such embodiments may be used, for example, for various different purposes, including facilitating patient ventilation, facilitating lens cleaning, and / or assisting in flushing / suctioning debris by perfusing the working channel during an endoscopic procedure, to supply fluid and / or gas to an endoscope.

[0049] This disclosure includes a description of containers and tube sets suitable for use with an endoscopic system for supplying fluid and / or gas to an endoscope. However, the devices, systems, and methods herein can be implemented in other medical systems that require fluid and / or gas delivery and for various other purposes.

[0050] Note that references herein to "embodiments," "some embodiments," "other embodiments," etc., indicate that the described embodiments may include certain features, structures, or characteristics, but not all embodiments necessarily include that particular feature, structure, or characteristic. Further, such phrases do not necessarily refer to the same embodiment. Additionally, when a particular feature, structure, or characteristic is described in connection with an embodiment, unless explicitly stated otherwise or clearly stated to the contrary, it will be within the knowledge of one of ordinary skill in the art to bring about such feature, structure, or characteristic in connection with other embodiments. That is, the various individual elements described below can be combined or arranged with each other to form other additional embodiments or to complement and / or enhance the described embodiments, as would be understood by one of ordinary skill in the art, even if not explicitly shown in a particular combination.

[0051] As used in this specification and the appended claims, the singular forms "a," "an," and "the" include plural referents unless the context clearly dictates otherwise. As used in this specification and the appended claims, the term "or" is generally used in the sense of "and / or" unless the context clearly dictates otherwise.

[0052] Conventionally, endoscopic devices have been widely used to perform diagnostic and / or therapeutic procedures. During an endoscopic procedure, a physician may use a combination of air, irrigation, and lens cleaning fluid as a means to flush debris, clean the optical portion, and ventilate the working lumen. To enable these capabilities, compressed gas from either a processor or an alternative source is used to increase the pressure within a fluid bottle that either ventilates the working lumen or cleans the endoscope's lens. Additionally, a peristaltic pump can be used to irrigate debris from the working lumen. One of the challenges faced during an endoscopic procedure is that the common water bottles and tube sets used hold only up to one liter of water and are not designed to be refilled. This may necessitate a nurse / technician to replace the water bottle multiple times a day. This can introduce multiple opportunities for contamination to the tube set, either by contact with non-sterile surfaces or by dropping the tube on the floor. Disclosed herein are methods and systems for reducing or eliminating the need to disconnect the tube set and use a second bottle.

[0053] Referring to FIGS. 1-2, an exemplary endoscope 100 and system 200 that may include an elongate shaft 100a inserted into a patient are shown. A light source 205 feeds illumination light to a distal portion 100b of the endoscope 100 that may house an imaging device (e.g., a CCD or CMOS imaging device) (not shown). The light source 205 (e.g., a lamp) is housed within an image processing unit 210 that processes signals input from the imaging device and outputs the processed video signals to a video monitor (not shown) for viewing. Also, the image processing unit 210 functions as a component of the air / water supply circuit by housing a pressurizing pump 215, such as an air supply pump, within the unit.

[0054] The endoscope shaft 100a may include a distal tip portion 100c provided at the distal portion 100b of the shaft 100a and a flexible bending portion 105 proximal to the distal tip portion 100c. The flexible bending portion 105 may include a joint (not shown) for assisting in manipulating the distal tip portion 100c. On the end face 100d of the distal tip portion 100c of the endoscope 100, there is a gas / lens cleaning liquid nozzle 220 for supplying gas to ventilate the patient's interior in the treatment area and for supplying water to clean the lens covering the imaging device. The perfusion opening 225 of the end face 100d supplies perfusion fluid to the patient's treatment area. An illumination window (not shown) for transmitting illumination light to the treatment area and an opening 230 to a working channel 235 extending along the shaft 100a for passing tools to the treatment area may also be included on the face 100d of the distal tip portion 100c. The working channel 235 extends along the shaft 100a to a proximal channel opening 110 positioned distally of the operation handle 115 of the endoscope 100. A biopsy valve 120 may be utilized to seal the channel opening 110 against unwanted fluid outflow.

[0055] The operation handle 115 may include a knob 125 for providing remote four-direction steering of the distal tip portion via a wire connected to a joint within the bendable flexible portion 105 (for example, one knob controls up and down steering and another knob controls left and right steering). A plurality of video switches 130 for remotely operating the video processing unit 210 may be arranged on the proximal end side of the handle 115. Further, the handle 115 is provided with two valve wells 135. One of the valve wells 135 may receive a gas / water valve 140 for operating the ventilation gas and lens water supply operations. The gas supply line 240a and the lens cleaning liquid supply line 245a extend distally from the gas / water valve 140 along the shaft 100a and converge at the distal tip portion 100c proximal to the gas / cleaning liquid nozzle 220 (Figure 2). The other valve well 135 receives a suction valve 145 for operating the suction operation. The suction supply line 250a extends distally along the shaft 100a from the suction valve 145 to a junction in fluid communication with the working channel 235 of the endoscope 100.

[0056] The operation handle 115 is electrically and fluidly connected to the video processing unit 210 via the flexible umbilical 260 and a connector portion 265 extending therebetween. The flexible umbilical 260 has a gas (e.g., air or CO2) supply line 240b, a lens cleaning fluid supply line 245b, a suction supply line 250b, an irrigation supply line 255b, an optical guide (not shown), and an electrical signal cable (not shown). When the connector portion 265 is inserted into the video processing unit 210, it connects a light source 205 in the video processing unit to the optical guide. The optical guide extends along the length of the umbilical 260 and the endoscope shaft 100a and transmits light to the distal tip portion 100c of the endoscope 100. When the connector portion 265 is inserted into the video processing unit 210, it also connects an air pump 215 to the gas supply line 240b within the umbilical 260.

[0057] A water reservoir or container 270 (e.g., a water bottle) is fluidly connected to the endoscope 100 through a connector portion 265 and an umbilical 260. A length of gas supply tube 240c passes from one end positioned within a void 275 between the top 280 of the reservoir 270 (e.g., a bottle cap) and the remaining water 285 within the reservoir, to a removable gas / lens cleaning fluid connection 290 outside of the connector portion 265. The removable gas / lens cleaning fluid connection 290 may be removable from the connector portion 265 and / or the gas supply tube 240c. The gas feed line 240b from the umbilical 260 branches within the connector portion 265 and is in fluid communication with the gas supply tube 240c at the removable gas / lens cleaning fluid connection 290, as well as an air pump 215. A length of lens cleaning fluid tube 245c passes through the top 280 of the reservoir 270 to the same removable connection 290 as the gas supply tube 240c of the connector portion 265 with one end positioned at the bottom of the reservoir 270. In other embodiments, the connections may be separate and / or separable from each other. The connector portion 265 also has a removable irrigation connection 293 for an irrigation supply tube (not shown) extending from an irrigation water source (not shown) to an irrigation feed line 255b within the umbilical 260. The removable irrigation connection 293 may be removable from the connector portion 265 and / or the irrigation supply tube (not shown). In some embodiments, the irrigation water is supplied from a water source (not shown) independent of the water reservoir 270, via a pump (e.g., a peristaltic pump). In other embodiments, the irrigation supply tube and the lens cleaning fluid tube 245c may draw water from the same reservoir. The connector portion 265 may also include a removable suction connection 295 for a suction feed line 250b and a suction supply line 250a fluidly connecting a vacuum source (e.g., hospital house suction) (not shown) to the umbilical 260 and the endoscope 100. The removable suction connection 295 may be removable from the connector portion 265 and / or the suction feed line 250b and / or the vacuum source.

[0058] The gas supply line 240b and the lens cleaning liquid supply line 245b are fluidly connected to the valve well 135 for the gas / water valve 140, and the operation of the gas / water valve within the well is configured to control the supply of gas or lens cleaning liquid to the distal tip 100c of the endoscope 100. The suction supply line 250b is fluidly connected to the valve well 135 for the suction valve 145, and the operation of the suction valve within the well is configured to control the suction applied to the working channel 235 of the endoscope 100.

[0059] Referring to FIG. 2, an exemplary operation of an endoscope system 200 including an endoscope such as the above-described endoscope 100 will be described. Air from the air pump 215 within the video processing unit 210 flows through the connection portion 265, branches through the gas supply line 240b within the umbilical 260 to the gas / water valve 140 on the operating handle 115, and flows through the gas supply tube 240c via the connection 290 on the connector portion 265 to the water reservoir 270. When the gas / water valve 140 is in the neutral position and the user's finger is not on the valve, air is allowed to flow out of the valve to the atmosphere. In the first position, the user's finger is used to block the ventilation to the atmosphere. Gas is allowed to flow down from the valve 140 through the gas supply line 240a and out of the distal tip 100c of the endoscope 100, for example, to insufflate the treatment site of the patient. When the gas / water valve 140 is pushed downward to the second position, the gas is blocked from exiting the valve, allowing the pressure of the air passing through the air pump 215 to rise within the water reservoir 270. By pressurizing the water source, water passes from the lens cleaning liquid tube 245c, through the connector portion 265, the umbilical 260, through the gas / water valve 140, down the lens cleaning liquid supply line 245a, converges with the gas supply line 240a before exiting the distal tip 100c of the endoscope 100 via the gas / lens cleaning liquid nozzle 220, and is extruded. The air pump pressure may be calibrated to provide lens cleaning water at a relatively low flow rate compared to the supply of irrigation water.

[0060] The flow rate of the lens cleaning fluid is governed by the gas pressure within the water reservoir 270. As water is pushed out from the reservoir 270 through the lens cleaning fluid tube 245c, when the gas pressure within the water reservoir 270 begins to drop, the air pump 215 maintains a substantially constant pressure by replenishing the lost air supply within the reservoir 270, which in turn provides a substantially constant lens cleaning fluid flow rate. In some embodiments, a filter (not shown) may be disposed within the path of the gas supply tube 240c to filter out undesirable contaminants or particulate matter from passing into the water reservoir 270. In some embodiments, an outflow check valve or other one-way valve configuration (not shown) may be disposed within the path of the lens cleaning fluid supply tube and may serve to prevent water from flowing back into the reservoir 270 after passing through the valve.

[0061] Since the main use is to remove debris that obscures the user's view from the patient's treatment site, relatively high flow rates of irrigation water are typically required compared to lens cleaning fluid. Irrigation is typically achieved by use of a pump (e.g., a peristaltic pump) as described. In embodiments having a separate water source for irrigation, a tube disposed at the bottom of the water source passes through the top of the water source and is routed to the head upstream of the pump. The tube downstream of the pump is connected via an irrigation connection 293 on a connector portion 265 to an irrigation feed line 255b within the umbilical 260 and an irrigation supply line 255a of the endoscope 100. When irrigation water is required, the fluid is drawn from the water source by operating the irrigation pump, such as by depressing a foot switch (not shown), passes through the irrigation connection 293, through the irrigation feed line 255b within the umbilical, and down the irrigation supply line within the shaft 100a of the endoscope to the distal tip 100c. A vent (not shown) may be included at the top 280 of the water reservoir 270 to equalize the pressure within the water source when water is drawn from the irrigation supply tube. The vent allows air to enter the water source, preventing the accumulation of negative pressure within the water source, which could create a vacuum that undesirably draws substances from the patient through the endoscope towards the water source. In some embodiments, an outflow check valve or other one-way valve configuration (not shown), similar to the lens cleaning fluid tube 245c, is disposed within the path of the irrigation supply tube to help prevent backflow into the reservoir after the water has passed through the valve.

[0062] Figures 3A-3D are schematic diagrams showing the operation of one embodiment of a hybrid system 300 in which supply tubes for irrigation and lens cleaning fluid are connected to a single water reservoir and drawn from the single water reservoir. It is contemplated that fluids other than water (e.g., but not limited to, saline) may be used. The hybrid system 300 includes a single water reservoir 305, a cap 310 for the reservoir, a gas supply tube 240c, a lens cleaning fluid supply tube 245c, a perfusion pump 315 with a footswitch 318, an upstream perfusion tube 320, and a downstream perfusion supply tube 255c. The cap 310 may be configured to be securely sealed and attached to the water reservoir 305, typically by a threaded arrangement. The cap 310 may include a gasket for sealing the cap 310 to the reservoir 305. The gasket may be an O-ring, flange, collar, and / or the like and may be formed from any suitable material. Several through openings (325a, 325b, 325c) are provided in the cap 310 to receive the gas supply tube 240c, the lens cleaning fluid supply tube 245c, and the upstream perfusion supply tube 320, respectively. In FIGS. 3A-3D, the illustrated system includes separate tubes for gas supply, lens cleaning, and perfusion.

[0063] In other embodiments, the gas supply tube 240c and the lens cleaning fluid tube 245c may be combined in a coaxial arrangement. Some exemplary coaxial arrangements are described in U.S. Patent Application No. 17 / 558,239, titled "INTEGRATED CONTAINER AND TUBE SET FOR FLUID DELIVERY WITH AN ENDOSCOPE," and U.S. Patent Application No. 17 / 558,256, titled "TUBING ASSEMBLIES AND METHODS FOR FLUID DELIVERY," both by the same applicant, the disclosures of which are incorporated herein by reference. For example, the gas supply tube may define a lumen of a diameter large enough to surround a lens cleaning fluid tube of a smaller diameter coaxially received within the gas supply tube, and air may be supplied to a water source within an annular space surrounding the lens cleaning fluid tube to pressurize the water reservoir (see, e.g., gas and lens cleaning fluid supply tubes 240c, 245c). The lens cleaning fluid supply tube may be configured to exit the lumen defined by the coaxial gas supply tube in any suitable sealed manner, such as an opening, a joint, a collar, etc., to transition from a coaxial arrangement to a parallel arrangement at a removable gas / lens cleaning fluid connection to an endoscope connector portion (e.g., connector portion 265 of FIG. 2).

[0064] In various embodiments, different configurations of valves (not shown) may be incorporated into the various embodiments disclosed herein, including the tubes of systems 200, 300. For example, placing an inlet check valve in the path of gas supply tube 240c can help prevent backflow into air pump 215. In this way, the pressure increase in water reservoir 305 serves to maintain a positive pressure in the water source even when a large amount of water can be removed from the water source during the perfusion function by creating a pressure differential between the water source and gas supply tube 240c. This arrangement cancels out any time differences in the air delivered from air pump 215 to water reservoir 305 that could otherwise create a negative pressure vacuum in the water reservoir. Similarly, incorporating an outflow check valve, such as a one-way valve with an inlet / outlet and valve insert, into lens cleaning fluid supply tube 240c, upstream perfusion supply tube 320, and / or downstream perfusion supply tube 255c can help prevent backflow of water from either or both the lens cleaning fluid tube and the perfusion tube in the case of a negative pressure situation, as described.

[0065] More generally, in many embodiments, a check valve can refer to any type of configuration for allowing fluid to flow passively in only one direction. For example, a check valve can include or refer to one or more of a ball check valve, a diaphragm check valve, a swing check valve, an inclined disk check valve, a flapper valve, a stop check valve, a lift check valve, an in-line check valve, a duckbill valve, a pneumatic backflow preventer, a reed valve, or a flow check. Thus, a check valve as used herein is distinct and different from an active valve (e.g., a stopcock valve, a solenoid valve, a peristaltic pump) that operates in a binary fashion as an on / off valve or switch that allows flow to be turned on or off.

[0066] During operation of the system of FIGS. 3A - 3D, the flow of water for irrigation can be achieved by operating irrigation pump 315. The flow of water for lens cleaning can be achieved by depressing gas / water valve 140 on operating handle 115 of endoscope 100. These functions may be performed independently of or simultaneously with each other. When performing lens cleaning and irrigation simultaneously, when fluid is removed from water reservoir 305, by controlling the pressure within the system, while maintaining lens cleaning fluid supply tube 240c at a pressure necessary to achieve substantially low flow rate lens cleaning, the pressure reduction within water reservoir 305 due to supplying high flow rate irrigation can be offset. When using the lens cleaning function, the irrigation function, or both functions simultaneously, when the pressure drops within the water reservoir, the reduced pressure may be offset by air pump 215 via gas supply tube 240c.

[0067] The schematic configuration of FIGS. 3A - 3D is emphasized to show the different flow paths made possible by hybrid system 300 having a supply tube 320 for irrigation and a supply tube 240c for lens cleaning fluid, both connected to and drawn from a single water reservoir 305. As shown in FIG. 3A, endoscope 100 is in a neutral state with gas / water valve 140 in the open position. The neutral state delivers neither gas nor lens cleaning fluid to the distal tip of the endoscope. Rather, gas (pressure) is delivered from pressurized air pump 215 along path A, through gas supply line 240b within umbilical 260 via connector portion 265, and vented to the atmosphere through the gas / water valve. Since the system is open at the vent hole of gas / water valve 140, there is no accumulation to pressurize water reservoir 305, and thus no water is pushed out through lens cleaning fluid supply tube 240c.

[0068] As shown in FIG. 3B, the endoscope 100 is in a gas delivery state where the gas / water valve 140 is in the first position. At the distal tip 100c, for example, when gas is required to clean the end face 100d of the distal tip or to insufflate the patient's body within the treatment area, the user closes the vent hole within the gas / water valve 140 with a thumb, finger, etc. (first position). In this state, gas (pressure) is delivered from the air pump 215 along path B, flows through the gas supply line 240b within the umbilical 260 via the connector portion 265. The gas passes through the gas / water valve 140, follows the gas supply line 240a within the endoscope shaft 100a, and exits from the gas / lens cleaning fluid nozzle 220 at the distal tip 100c. Since the system is open at the gas / lens water nozzle 220, there is no accumulation to pressurize the water reservoir, and thus no water is pushed out through the lens cleaning fluid supply tube 240c.

[0069] As shown in FIG. 3C, the endoscope 100 is in a lens cleaning liquid delivery state where the gas / water valve 140 is in the second position. At the distal tip 100c, for example, when lens cleaning liquid is required to clean the end face 100d of the distal tip 100c, the user depresses the valve 140 to the farthest point within the valve well 135 while keeping the vent hole in the gas / water valve closed. The second position blocks the gas supply to both the atmosphere and the gas supply line 240a within the endoscope, and opens the gas / water valve 140 so that the lens cleaning water can pass through the lens cleaning liquid supply line 245a within the endoscope shaft 100a and exit from the gas / lens cleaning liquid nozzle 220 at the distal tip 100c. In this state, the gas (pressure) travels along path C from the air pump 215, through the branch line within the connector portion 265, exits from the gas supply tube 240c, and is delivered to the water reservoir 305. The gas (pressure) pressurizes the surface of the remaining water 285 within the reservoir 305 and pushes the water up from the lens cleaning liquid supply tube 245c to the connector portion 265. The pressurized lens cleaning water passes through the lens cleaning liquid feed line 245b within the umbilical 260, and is further pushed out through the gas / water valve 140. Since the system 300 is closed, the gas pressure is not released to the atmosphere or delivered to the patient, but rather it is possible to build and maintain a calibrated pressure level within the water reservoir 305. This pressure is converted to a specific range of flow rates of the lens cleaning liquid along with the endoscope's feed and supply lines and the external tubing.

[0070] As shown in FIG. 3D, the endoscope 100 is in a perfusion delivery state. This may be done simultaneously or at a different time from the delivery of gas and / or lens cleaning fluid. When perfusion is required at the distal tip 100c, for example, when visibility in the treatment area is poor or blocked by debris, the user activates the perfusion pump 315 (e.g., by depressing the footswitch 318) to deliver water along path D. When the pump 315 is activated, water is suctioned from the water reservoir 305 through the upstream perfusion supply tube 320 and delivered to the connector portion 265 along the downstream perfusion supply tube 255c. The perfusion pump head pressure further pushes the perfusion water through the perfusion feed line 255b within the umbilical 260, through the perfusion supply line 255a within the endoscope shaft 100a, and out through the perfusion opening 225 at the distal tip portion 100c without passing through the gas / water valve 140. The perfusion pump pressure may be calibrated with the endoscope's perfusion feed line and supply line as well as the external tubes to deliver a perfusion fluid at a certain range of flow rates.

[0071] FIG. 4 is a schematic diagram showing a further embodiment of a hybrid system 400 that includes a video processing unit 210, a connector portion 265, a peristaltic perfusion pump 315, a water reservoir 405 and a top 407, coaxial gas and lens cleaning fluid supply tubes 410, upstream and downstream perfusion supply tubes 320, 255c, and an alternative gas (e.g., CO2) supply tube 415. A length of the alternative gas supply tube 415 passes from one end positioned within a gas gap 275 (see FIG. 2) between the top 407 of the water reservoir 405 and the remaining water 285 within the reservoir, through an additional opening 420 at the top of the reservoir, to a removable connection 425 for an alternative gas source (e.g., a CO2 hospital gas source). When an alternative gas supply such as CO2 gas is desired, the air pump 215 on the video processing unit 210 may be turned off, whereby CO2 gas rather than air is flowed into the water reservoir 405 to pressurize the water surface. Generally, the flow of CO2 through the endoscope 100 is similar to the flow of air. In the neutral state, the CO2 gas backflows upwardly through the gas supply tube 240c to the connector portion 265, flows upwardly through the gas feed line 240b, and is vented to the atmosphere through the gas / water valve 140. In the first position, the user closes the vent hole within the gas / water valve 140, and the CO2 gas is flowed through the gas / water valve into the gas supply line 240a within the endoscope shaft 100a and exits from the gas / lens cleaning fluid nozzle 220 at the distal tip 100c. In the second position, the user presses the valve 140 to the bottom of the valve well 135 and keeps the vent hole within the gas / water valve closed. The second position blocks the supply of CO2 gas to both the atmosphere and the gas supply line 240a within the endoscope 100 and opens the gas / water valve 140 to allow the lens cleaning water to pass through the lens cleaning fluid supply line 245a within the endoscope shaft 100a and exit from the gas / lens cleaning fluid nozzle 220 at the distal tip 100c. The gas (pressure) within the reservoir 405 is maintained by the delivery gas passing through the alternative gas (e.g., CO2) supply tube 415. The perfusion function can be achieved in a manner similar to the operation described above with respect to FIG. 3D.

[0072] As described above, it may be desirable to reduce the chance that the tube sets 240c, 245c, 320, 410, 415 are contaminated during replacement of the water reservoir by providing refillable water reservoirs 270, 305, 405. FIG. 5 shows a schematic cross-sectional view of an exemplary refillable fluid reservoir 500. The reservoir 500 may be configured for use within an endoscopic system and includes components similar to the endoscope and endoscopic system described with respect to FIGS. 1-4, although not all features may be described or shown herein if they are not relevant to the fluid circuit of the system. The reservoir 500 includes a container 502 configured to hold a fluid 542. In some embodiments, the container 502 may be configured to hold a fluid in the range of about 5 liters (L) to about 10 L. However, the container 502 may be configured to hold less than 5 L or more than 10 L if so desired.

[0073] The container 502 extends from a first end or distal end 504 to a second end or proximal end 506. A small-diameter stem 508 may extend away from the first end 504 in a direction opposite to the second end 506 of the container 502. Generally, the stem 508 is in fluid communication with the opening 524 of the container 502 and is configured to selectively provide a fluid connection between the exterior of the container 502 and the interior 540 of the container 502 to enable the fluid 542 to be transferred into the container 502, and may be a hollow cylindrical stem. The stem 508 may have a diameter or cross-sectional dimension that is smaller than the diameter or cross-sectional dimension of the first end 504 or the second end 506 of the container 502. In some cases, the container 502 and / or the stem 508 may have a generally cylindrical shape. However, this is not essential. The container 502 and / or the stem 508 may take any desired shape.

[0074] Port 510 may be disposed adjacent to stem 508 of container 502. Port 510, together with stem 508, may selectively fluidly couple a fill bottle or water bottle 570 (see, e.g., FIG. 6) to container 502, enabling fluid to pass from fill bottle 570 into interior 540 of container 502. Port 510 may include a sealing ring 512, a cap 514, and a biasing mechanism 516. Each of sealing ring 512, cap 514, and biasing mechanism 516 may be formed as separate components that are assembled together to form port 510. Generally, sealing ring 512 may be movable between a closed configuration (FIG. 5) for use of reservoir 500 during an endoscopic procedure and an open configuration (FIG. 6) for refilling reservoir 500. Port 510 is shown as adjacent to a first end 504, i.e., the top, of container 502, but port 510 may be positioned at other locations on container 502 as desired. In some embodiments, port 510 may be at an end of a flexible attachment that is in fluid communication with stem 508. Such an arrangement may allow fill bottle 570 to be engaged with port 510 before fill bottle 570 is inverted, which is envisioned to limit leakage when fill bottle 570 is inverted.

[0075] The sealing ring 512 extends from a first end, i.e., a distal end 518, to a second end, i.e., a proximal end 520. The opening 522 extends from the first end 518 to the second end 520 of the sealing ring 512. The opening 522 may have a substantially circular cross-section and may have a diameter that is substantially the same as or larger than the outer diameter (or cross-sectional dimension) of the stem 508 such that the stem 508 can be received within the opening 522. The opening 522 may be disposed around at least a portion of the outer surface of the stem 508. In some embodiments, an O-ring 526 or other sealing member may be disposed between the inner wall of the opening 522 and the outer surface of the stem 508. When provided in this way, the O-ring 526 may provide a fluid-tight seal between the stem 508 and the port 510. This may enable the container 502 to be pressurized. The O-ring 526 may be positioned within a groove or recess formed in the outer surface of the stem 508 to maintain the O-ring 526 in a desired configuration when the sealing ring 512 is displaced, although this is not essential. Also, the O-ring 526 may be positioned within a groove or recess formed in the inner surface of the sealing ring 512 to maintain the O-ring 526 in a desired configuration when the sealing ring 512 is displaced, although this is not essential. The O-ring 526 may be positioned to provide an airtight and liquid-tight connection between the sealing ring 512 and the stem 508 when the sealing ring is in either a closed configuration (FIG. 5) or an open configuration (FIG. 6). In other embodiments, the inner wall of the opening 522 may contact the outer surface of the stem 508 to form a fluid-tight seal.

[0076] The diameter of the opening 522 may decrease from a first diameter at the first end 518 to a second, smaller diameter at an intermediate position 528 between the first end portion 518 and the second end 520 to form a tapered first end region 530. The diameter of the opening 522 may be substantially constant from the intermediate position 528 to the second end 520, although this is not essential. The diameter of the opening 522 is contemplated to be able to take any desired configuration. For example, in some embodiments, the diameter may be tapered or decrease in size from the first end 518 to the second end 520. The tapered first end region 530 may be configured to mate with the outer diameter or outer surface of the cap 514, as will be described in more detail herein.

[0077] The sealing ring 512 extends radially outward from the opening 522. The outer surface 532 of the sealing ring 512 may extend radially beyond the outermost extent 534 of the cap 514 such that the first end face 536 is configured to engage the mouth of the filling bottle 570 (see, for example, FIG. 6). In some embodiments, the outer diameter of the sealing ring 512 is tapered and may increase from the first end 518 to the second end 520. The tapered outer diameter is envisioned to be able to form a gas-tight and liquid-tight connection with a range of diameters of the mouth of the filling bottle, for example, by inserting the first end 518 of the sealing ring 512 into the mouth of the filling bottle such that the tapered outer diameter engages the mouth of the filling bottle (not shown). However, this is not essential. In some embodiments, the outer diameter of the sealing ring 512 may be substantially constant, although in other embodiments, the outer diameter may decrease from the first end 518 to the second end 520.

[0078] The cap 514 may generally have the shape of a truncated cone. For example, the diameter of the cap 514 may decrease from a first diameter adjacent to the first end, i.e., the distal end 538, to a second diameter adjacent to the second end, i.e., the proximal end 544. The inclination of the outer surface 546 of the cap 514 may generally match the inclination of the tapered first end region 530 of the opening 522 of the sealing ring 512 such that a fluid tight seal is formed between the sealing ring 512 and the cap 514 when the sealing ring 512 is biased towards the cap 514. The cap 514 may be held distally spaced from the stem 508 by the biasing force of the biasing mechanism 516 and / or the pressure within the interior 540 of the container 502. The tether 548 may extend between the second end 544 of the cap 514 and the interior 540 of the container 502. For example, the first end 550 of the tether 548 may be coupled to the second end 544 of the cap 514 and the second end 552 of the tether 548 may be positioned within the interior 540 of the container 502. The second end 552 of the tether 548 may include one or more radially extending elongate arms 554a, 554b (collectively, 554). The arms 554 may be deformable or movable between a first extended configuration (shown in FIG. 5) and a second folded configuration. The arms 554 may have a thickness smaller than the diameter of the opening 524 such that water and / or air can flow through the arms 554 and through the opening 524. For example, the arms 554 may have a generally rod-like shape that can be of various cross-sections (e.g., circular, triangular, rectangular, or other polygonal cross-sections). However, other shapes may be used as needed.

[0079] In the expanded configuration, arm 554 may extend at an angle with respect to the longitudinal axis of tether 548. In some embodiments, arm 554 may extend substantially orthogonally to the longitudinal axis of tether 548 in a "T-shaped" configuration, as shown in FIG. 5. However, this is not essential. Arm 554 may extend at any angle with respect to the longitudinal axis of tether 548 that allows the second end 552 of tether 548 to have a width greater than the diameter of the opening 524 of the container. In the folded configuration, arm 554 may be biased toward the longitudinal axis of tether 548, reducing its outer profile. This may enable arm 554 to be inserted through stem 508 into the interior 540 of container 502. Arm 554 can return to its expanded first configuration when the compressive force is released. In the expanded configuration, arm 554 has a width greater than the inner diameter of stem 508. Thus, when the second end 552 of tether 548 is inserted into the interior 540 of container 502, the arms 554 of tether 548 resist removal of cap 514 from reservoir 500. For example, arm 554 engages the inner surface of container 502 to resist removal of cap 514.

[0080] Biasing mechanism 516 may be positioned between sealing ring 512 and container 502. In some embodiments, biasing mechanism 516 may be positioned between the second end 520 of sealing ring 512 and the first end 504 of container 502. Biasing mechanism 516 may be a mechanism configured to apply a distal force to sealing ring 512. Some exemplary but non-limiting biasing mechanisms may include, but are not limited to, coil springs, wave springs, compressible elastomers, shape memory rings or coils, bellows, hydraulic cylinders, etc. In some cases, biasing mechanism 516 may be substantially cylindrical, disposed around stem 508 of container 502, and radially spaced from stem 508. Biasing mechanism 516 may be configured to compress in response to a proximal force applied to sealing ring 512 and then to allow proximal movement of sealing ring 512, as described in more detail herein.

[0081] The reservoir 500 may include a gas inlet 560 and a water outlet 562 for coupling to gas supply and water supply tubes. In some embodiments, the gas inlet 560 and / or the water outlet 562 may be one or more ports for coupling to separately provided gas supply lines and / or water supply lines. In other embodiments, the gas inlet 560 and / or the water outlet 562 may be part of a gas supply tube 564 or a water supply tube 566. For example, the reservoir 500 may be connected in fluid communication with a gas supply / alternate gas supply tube (or gas supply tube) 564 and a lens cleaning fluid supply / perfusion supply tube (or water supply tube) 566. The gas supply tube 564 extends from a second end outside the reservoir 500 through a reservoir opening 568 at or adjacent to the first end 504 of the container 502. The shared gas supply tube 564 may terminate within the reservoir gap at or below the opening 568, but as shown, does not extend into the remaining fluid 542 within the container 502. However, in some cases, the gas supply tube 564 may extend into the fluid 542. For example, the opening 568 may be at the bottom or side of the container 502 such that the shared gas supply tube 564 terminates within the fluid and gas bubbles through the fluid 542 to pressurize the container 502. The lumen extends through the gas supply tube 564 to receive a flow of air and / or gas. The lumen of the gas supply tube 564 is operably in fluid communication with the interior of the reservoir 500. The water supply tube 566 extends from a second end outside the reservoir 500 through the reservoir opening 568 and terminates at a first end within the remaining fluid 542 at or substantially at the bottom of the container 502. In some embodiments, the water supply tube 566 may terminate at the opening 568. For example, if the opening 568 is at or adjacent to the second end 506 of the container 502, an immersion tube may not be required. The lumen extends through the water supply tube 566 to receive a flow of fluid therethrough. The lumen of the lens cleaning fluid supply / perfusion supply tube 566 is selectively operably in fluid communication with the bottom of the container 502.In the illustrated embodiment, the gas supply tube 564 and the water supply tube 566 may enter the container 502 through a single or common opening 568. For example, the gas supply tube 564 and the water supply tube 566 may be coaxially arranged as shown. However, this is not essential. In some cases, the gas supply tube 564 and the water supply tube 566 may extend in a side-by-side arrangement or may be separately connected to the container 502 at different locations. The opening 568 may include a grommet, heat seal, or other sealing mechanism configured to seal the container 502 liquid-tightly and pressure-tightly around the tubes 564, 566.

[0082] A portion of the gas supply tube 564 and a portion of the lens cleaning liquid supply tube 566 may each extend from the reservoir 500 and may be connected in fluid communication with the endoscope at the gas / lens cleaning liquid connection on the umbilical connector portion 265. The gas supply tube 564 is connected in fluid communication with a gas pump (not shown) and / or a gas supply line (not shown), and the lens cleaning liquid supply tube 566 is connected in fluid communication with a lens cleaning liquid supply line (not shown) within the connector portion 265. Although not explicitly shown, a perfusion supply tube may be coupled to the water supply tube 566 via a manifold to supply perfusion fluid from the reservoir 500, or a separate perfusion supply tube may be provided. For example, a perfusion supply tube (not shown) may extend from a second end external to the reservoir 500 through a reservoir opening (not shown) and terminate at a first end within the remaining fluid 542 at or substantially at the bottom of the container 502.

[0083] Next, referring to FIG. 6, it is contemplated that by displacing the sealing ring 512 in the proximal direction, the reservoir 500 can be filled and refilled as needed. Refilling of the reservoir 500 may be performed during or between procedures, as needed. The water may be sterile water or non-sterile water, as desired. For example, sterile water may be used for therapeutic procedures, while non-sterile water may be used for diagnostic procedures. Since the outer surface of the connection port 510 is non-sterile, the exterior can be wiped with a disinfectant prior to filling / refilling and subsequent contact with sterile water. It is contemplated that refilling the reservoir 500 with sterile water or non-sterile water provides more adaptability and can reduce the need to have the same amount of sterile water during storage. Further, refilling the reservoir 500 via port 510 can also eliminate or significantly reduce the potential for cross-contamination by removing the need to disconnect the reservoir 500 from the tubes 564, 566 throughout the day and removing the need to replace the water container.

[0084] In FIG. 6, the second end 552 of the tether 548 is not shown in order to more clearly illustrate the flow of water and air between the filling bottle 570 and the container 502. However, it should be understood that the second end 552 of the tether 548 remains within the container 502 during filling of the container 502. To fill the container 502, the mouth 572 of the filling bottle 570 is placed on or over the sealing ring 512. In the illustrated embodiment, the mouth 572 of the filling bottle 570 is disposed relative to the first end face 536 of the sealing ring 512. However, in some cases, the mouth 572 of the filling bottle 570 may be disposed relative to the tapered outer surface 532 of the sealing ring 512. A proximal force is applied to the filling bottle 570, thereby compressing the biasing mechanism 516 and allowing the sealing ring 512 to move proximally toward the container. When the container 502 is pressurized during use, the positive pressure inside the container 502 maintains the cap 514 in a fixed relationship relative to the container 502. In other words, when the sealing ring 512 moves proximally, the cap 514 remains relatively fixed so as to define a gap 556 between the outer surface 546 of the cap 514 and the tapered first end region 530. The gap 556 allows water to flow down into the container 502 along flow path A while air rises into the filling bottle 570 along flow path B. As the water flow continues into the container 502, buoyancy maintains the cap 514 in a form spaced from the sealing ring 512. When the filling bottle 570 is empty and / or when the container 502 is filled to the desired amount, the proximal force on the filling bottle 570 can be removed. Thereby, the proximal force on the biasing mechanism 516 is removed and the biasing mechanism 516 presses the sealing ring 512 distally until the sealing ring 512 engages the cap 514, as shown in FIG. 5. In some cases, more than one filling bottle 570 may be used to fill the container 502.

[0085] FIG. 7 shows a schematic cross-sectional view of another exemplary refillable fluid reservoir 600. Reservoir 600 may be configured for use within an endoscopic system and includes components similar to those of the endoscope and endoscopic system described with respect to FIGS. 1-4, although not all features may be described or shown herein if not relevant to the fluid circuit of the system. Reservoir 600 includes a container 602 configured to hold a fluid 642. In some embodiments, container 602 may be configured to hold a fluid in the range of about 5 liters (L) to about 10 L. However, container 602 may be configured to hold less than 5 L or more than 10 L if so desired.

[0086] Container 602 extends from a first end, i.e., a distal end 604, to a second end, i.e., a proximal end 606. A small-diameter stem 608 may extend distally away from the first end 604 in a direction opposite to the second end 606 of container 602. Generally, stem 608 is in fluid communication with an opening 624 of container 602 and is configured to selectively provide a fluid connection between the exterior of container 602 and the interior 640 of container 602 to enable fluid 642 to be transferred into container 602, and may be a hollow cylindrical stem. In some embodiments, stem 608 may have a diameter or cross-sectional dimension smaller than that of the first end 604 or the second end 606 of container 602, although this is not essential. In some cases, container 602 and / or stem 608 may have a generally cylindrical shape. However, this is not essential. Container 602 and / or stem 608 may take any desired shape.

[0087] Port 610 may be connected to the stem 608 of the container 602 via a flexible tube line 680. For example, a first end 682 of the flexible tube line 680 may be fluidly coupled to the port 610, while a second end 684 of the line 680 is fluidly coupled to the container 602 via the stem 608. In some examples, the stem 608 may be omitted, and the flexible tube line 680 may be directly coupled to the opening 624 of the container 602 or another port. The flexible tube line 680 may be a separate component from the container 602 and / or the port 610, or may be formed as an integral structure with the container 602 and / or the port 610. The port 610, together with the stem 608, may selectively fluidly couple a filling bottle or a water bottle to the container 602, enabling fluid to pass from the filling bottle into the interior 640 of the container 602. The port 610 may include a sealing ring 612, a cap 614, a biasing mechanism 616, and a housing 690. Each of the sealing ring 612, the cap 614, the biasing mechanism 616, and the housing 690 may be formed as separate components assembled together to form the port 610. Generally, the sealing ring 612 may be movable between a closed configuration (FIG. 7) for using the reservoir 600 during an endoscopic procedure and an open configuration (not shown) for refilling the reservoir 600. The sealing ring 612 is thought to be able to function in a manner similar to that described with respect to FIG. 6. Separating the port 610 from the container 602 may enable the filling bottle to be engaged with the port 610 before inverting the filling bottle, which is assumed to limit or eliminate leakage when inverting the filling bottle.

[0088] The housing 690 extends from a first end, i.e., a distal end 692, to a second end, i.e., a proximal end 694. The small-diameter housing stem 696 may extend distally away from the first end 692 in a direction opposite to the second end 694 of the housing 690. Generally, the housing stem 696 is in fluid communication with the interior of the housing 690 via the opening 698 and the flexible tubing 680 and is configured to selectively provide a fluid connection between the exterior of the container 602 and the interior 640 of the container 602 to enable the fluid 642 to be transferred into the container 602, and may be a hollow cylindrical stem. In some embodiments, the housing stem 696 may have a diameter or cross-sectional dimension smaller than the diameter or cross-sectional dimension of the first end 692 or the second end 694 of the housing 690, but this is not essential. In some cases, the housing 690 and / or the housing stem 696 may have a generally cylindrical shape. However, this is not essential. The housing 690 and / or the housing stem 696 may take any desired shape.

[0089] The sealing ring 612 extends from a first end, i.e., a distal end 618, to a second end, i.e., a proximal end 620. The opening 622 extends from the first end 618 to the second end 620 of the sealing ring 612. The opening 622 may have a generally circular cross-section and may have a diameter approximately the same as or larger than the outer diameter (or cross-sectional dimension) of the housing stem 696 such that the housing stem 696 can be received within the opening 622. The opening 622 may be disposed around at least a portion of the outer surface of the housing stem 696. In some embodiments, an O-ring 626 or other sealing member may be disposed between the inner wall of the opening 622 and the outer surface of the housing stem 696. When provided in this manner, the O-ring 626 may provide a fluid-tight seal between the housing stem 696 and the port 610. This may enable pressurization of the container 602. The O-ring 626 may be positioned within a groove or recess formed in the outer surface of the housing stem 696 to maintain the O-ring 626 in a desired configuration when the sealing ring 612 is displaced, although this is not essential. Also, the O-ring 626 may be positioned within a groove or recess formed in the inner surface of the sealing ring 612 to maintain the O-ring 626 in a desired configuration when the sealing ring 612 is displaced, although this is not essential. The O-ring 626 may be positioned to provide an airtight and liquid-tight connection between the sealing ring 612 and the housing stem 696 when the sealing ring is in either a closed configuration (FIG. 7) or an open configuration (not shown). In other embodiments, the inner wall of the opening 622 may contact the outer surface of the housing stem 696 to form a fluid-tight seal.

[0090] The diameter of the opening 622 may decrease from a first diameter at the first end 618 to a second, smaller diameter at an intermediate position 628 between the first end 618 and the second end 620 to form a tapered first end region 630. The diameter of the opening 622 may be substantially constant from the intermediate position 628 to the second end 620, although this is not essential. The diameter of the opening 622 is contemplated to be able to take any desired configuration. For example, in some embodiments, the diameter may be tapered or decrease in size from the first end 618 to the second end 620. The tapered first end region 630 may be configured to fit with the outer diameter or outer surface of the cap 614, as will be described in more detail herein.

[0091] The sealing ring 612 extends radially outward from the opening 622. The outer surface 632 of the sealing ring 612 may extend radially beyond the outermost extent 634 of the cap 614 such that the first end face 636 is configured to engage the mouth of the filling bottle. In some embodiments, the outer diameter of the sealing ring 612 is tapered and may increase from the first end 618 to the second end 620. The tapered outer diameter is contemplated to be able to form a gas-tight and liquid-tight connection with a range of diameters of the mouth of the filling bottle, for example, by inserting the first end 618 of the sealing ring 612 into the mouth of the filling bottle such that the tapered outer diameter engages the mouth of the filling bottle (not shown). However, this is not essential. In some embodiments, the outer diameter of the sealing ring 612 may be substantially constant, while in other embodiments, the outer diameter may decrease from the first end 618 to the second end 620.

[0092] The cap 614 may generally have a frustoconical shape. For example, the diameter of the cap 614 may decrease from a first diameter adjacent to the first end, i.e., the distal end 638, to a second diameter adjacent to the second end, i.e., the proximal end 644. The inclination of the outer surface 646 of the cap 614 may generally coincide with the inclination of the tapered first end region 630 of the opening 622 of the sealing ring 612 such that a fluid-tight seal is formed between the sealing ring 612 and the cap 614 when the sealing ring 612 is biased towards the cap 614. The cap 614 may be held distally spaced from the housing stem 696 by the biasing force of the biasing mechanism 616 and / or the pressure in the interior 640 of the container 602. The tether 648 may extend between the second end 644 of the cap 614 and the interior of the housing 690. For example, the first end 650 of the tether 648 may be coupled to the second end 644 of the cap 614 and the second end 652 of the tether 648 may be positioned inside the housing 690. The second end 652 of the tether 648 may include one or more radially extending elongate arms 654a, 654b (collectively, 654). The arms 654 may be deformable or movable between a first expanded configuration (shown in FIG. 7) and a second folded configuration (not shown). The arms 654 may have a thickness smaller than the diameter of the opening 698 of the housing 690 such that water and / or air can flow through the arms 654 and through the opening 698. For example, the arms 654 may have a generally rod-like shape that can have various cross-sections (e.g., circular, triangular, rectangular, or other polygonal cross-sections). However, other shapes may be used as needed.

[0093] In the extended configuration, arm 654 may extend at an angle with respect to the longitudinal axis of tether 648. In some embodiments, arm 654 may extend substantially orthogonally to the longitudinal axis of tether 648 in a "T-shaped" configuration as shown in FIG. 7. However, this is not essential. Arm 654 may extend at any angle with respect to the longitudinal axis of tether 648 that allows second end 652 of tether 648 to have a width greater than the diameter of opening 698 of housing 690. In the folded configuration, arm 654 may be biased toward the longitudinal axis of tether 648 to reduce its outer profile. This may enable arm 654 to be inserted through housing stem 696 into the interior of housing 690. Arm 654 may be able to return to its expanded first configuration when the compressive force is released. In the extended configuration, arm 654 has a width greater than the inner diameter of housing stem 696. Thus, when second end 652 of tether 648 is inserted into the interior of housing 690, arm 654 of tether 648 resists removal of cap 614 from housing 690. For example, arm 654 may engage the inner surface of housing 690 to resist removal of cap 614.

[0094] Biasing mechanism 616 may be positioned between sealing ring 612 and housing 690. In some embodiments, biasing mechanism 616 may be positioned between second end 620 of sealing ring 612 and first end 692 of housing 690. Biasing mechanism 616 may be a spring or other mechanism configured to apply a distal force to sealing ring 612. In some cases, biasing mechanism 616 may be substantially cylindrical and disposed around housing stem 696 of housing 690 and radially spaced from housing stem 696. Biasing mechanism 616 may be configured to compress in response to a proximal force applied to sealing ring 612 and then to allow proximal movement of sealing ring 612, as described in more detail herein.

[0095] To assemble port 610 with housing 690, O-ring 626 may be placed on housing stem 696 of housing 690 (or together with seal ring 612). Next, biasing mechanism 616 may be disposed around housing stem 696. The second end of biasing mechanism 616 may be supported by the first end 692 of housing 690. Next, seal ring 612 may be disposed around housing stem 696. The second end 620 of seal ring 612 may contact the first end of biasing mechanism 616. Next, cap 614 can be installed by inserting the second end 652 of tether 648 through housing stem 696 into the interior of housing 690. The second end 652 of tether 648 engages housing 690 to prevent cap 614 from coming off the container. Further, the outer surface 646 of cap 614 engages the tapered first end region 630 of seal ring 612 to secure seal ring 612 and biasing mechanism 616 to housing 690.

[0096] The reservoir 600 may include a gas inlet 660 and a water outlet 662 for coupling to gas supply and water supply tubes. In some embodiments, the gas inlet 660 and / or the water outlet 662 may be one or more ports for coupling to separately provided gas supply lines and / or water supply lines. In other embodiments, the gas inlet 660 and / or the water outlet 662 may be part of the gas supply tube 664 or the water supply tube 670. For example, the reservoir 600 may be connected in fluid communication with a gas supply / alternate gas supply tube (or gas supply tube) 664 and a lens cleaning fluid supply / perfusion supply tube (or water supply tube) 670. The gas supply tube 664 extends from a second end outside the reservoir 600 through a reservoir opening 668 at or adjacent to the first end 604 of the container 602. The shared gas supply tube 664 may terminate within the reservoir gap at or below the opening 668, but as shown, does not extend into the remaining fluid 642 within the container 602. However, in some cases, the gas supply tube 664 may extend into the fluid 642. For example, the opening 668 may be at the bottom or side of the container 602 such that the shared gas supply tube 664 terminates within the fluid and gas bubbles through the fluid 642 to pressurize the container 602. The lumen extends through the gas supply tube 664 to receive an air and / or gas flow. The lumen of the gas supply tube 664 is operably in fluid communication with the interior of the reservoir 600. The water supply tube 670 extends from a second end outside the reservoir 600 through the reservoir opening 668 and terminates at a first end within the remaining fluid 642 at or substantially at the bottom of the container 602. In some embodiments, the water supply tube 670 may terminate at the opening 668. For example, if the opening 668 is at or adjacent to the second end 606 of the container 602, an immersion tube may not be required. The lumen extends through the water supply tube 670 to receive a fluid flow. The lumen of the lens cleaning fluid supply / perfusion supply tube 670 is selectively operably in fluid communication with the bottom of the container 602.In the illustrated embodiment, the gas supply tube 664 and the water supply tube 670 may enter the container 602 through a single or common opening 668. For example, the gas supply tube 664 and the water supply tube 670 may be coaxially arranged as shown. However, this is not essential. In some cases, the gas supply tube 664 and the water supply tube 670 may extend in a side-by-side arrangement or may be separately connected to the container 602 at different locations. The opening 668 may include a grommet, heat seal, or other sealing mechanism configured to seal the container 602 around the tubes 664, 670 in a liquid-tight and pressure-tight manner.

[0097] A portion of the gas supply tube 664 and a portion of the lens cleaning liquid supply tube 670 may each extend from the reservoir 600 and may be connected in fluid communication with the endoscope at the gas / lens cleaning liquid connection on the umbilical connector portion 265. The gas supply tube 664 is connected in fluid communication with a gas pump (not shown) and a gas supply line (not shown), and the lens cleaning liquid supply tube 670 is connected in fluid communication with a lens cleaning liquid supply line (not shown) within the connector portion 265. Although not explicitly shown, a perfusion supply tube may be coupled to the water supply tube 670 via a manifold or a separate perfusion supply tube may be provided to supply perfusion fluid from the reservoir 600. For example, a perfusion supply tube (not shown) may extend from a second end external to the reservoir 600 through a reservoir opening (not shown) and terminate at a first end within the remaining fluid 642 at or substantially at the bottom of the container 602.

[0098] It is contemplated that by displacing the seal ring 612 in the proximal direction, the reservoir 600 can be filled and refilled as needed. The reservoir 600 can be filled / refilled in a manner similar to the reservoir 500 described above. Refilling of the reservoir 600 may be performed during or between procedures as needed. The water may be sterile water or non-sterile water, as desired. For example, sterile water may be used for therapeutic procedures, while non-sterile water may be used for diagnostic procedures. Since the outer surface of the connection port 610 is non-sterile, the exterior may be wiped with a disinfectant prior to filling / refilling and subsequent contact with sterile water. Refilling the reservoir 600 with sterile water or non-sterile water is contemplated to provide more adaptability and reduce the need to have the same amount of sterile water during storage. Further, refilling the reservoir 600 via the port 610 can also eliminate or significantly reduce the potential for cross-contamination by removing the need to disconnect the reservoir 600 from the tubes 664, 670 throughout the day and removing the need to replace the water container.

[0099] To fill the container 602, the mouth of the filling bottle is placed on or covering the sealing ring 612. Depending on the size of the mouth, the mouth of the filling bottle may be placed against the first end face 636 of the sealing ring 612 or against the tapered outer surface 632 of the sealing ring 612. The flexible tubing 680 is intended to be able to keep the filling bottle upright until the mouth engages the sealing ring 612. This can prevent or limit spillage from the filling bottle during its inversion. Once engaged with the sealing ring 612, the filling bottle may be inverted and a proximal force may be applied to the filling bottle, thereby compressing the biasing mechanism 616 and allowing the sealing ring 612 to move proximally towards the housing 690. When the container 602 is pressurized during use, the positive pressure inside the container 602 spreads through the flexible tubing 680 and maintains the cap 614 in a fixed relationship with respect to the housing 690. In other words, when the sealing ring 612 moves proximally, the cap 614 remains relatively fixed so as to define a gap between the outer surface 646 of the cap 614 and the tapered first end region 630. The gap allows water to flow down into the container 602 through the flexible tubing 680 while air rises into the filling bottle through the flexible tubing 680. As the water flow continues into the container 602, buoyancy maintains the cap 614 in a form separated from the sealing ring 612. When the filling bottle is empty and / or when the container 602 is filled to the desired amount, the proximal force on the filling bottle can be removed. This removes the proximal force on the biasing mechanism 616, and the biasing mechanism 616 presses the sealing ring 612 distally until the sealing ring 612 engages the cap 614, as shown in FIG. 7. In some cases, more than one filling bottle may be used to fill the container 602.

[0100] FIG. 8 shows a side view of a portion of another exemplary tether 700. The tether 700 may be configured to extend between the caps 514, 614 and the container 502 and / or the housing 690. For example, the first end 702 of the tether 700 may be coupled to the caps 514, 614, and the second end 704 of the tether 700 may be positioned inside the container 502 and / or the housing 690. The second end 704 of the tether 700 may include one or more radially extending elongate arms 706a, 706b (collectively, 706). The arms 706 may be deformable or movable between a first extended configuration (shown in FIG. 8) and a second folded configuration (not shown). The arms 706 may have a thickness smaller than the diameter of the openings 524, 698 of the container 502 or the housing 690 such that water and / or air can flow through the arms 706 and through the openings 524, 698. For example, the arms 706 may have a generally rod-shaped configuration. However, other configurations may be used as needed.

[0101] In the extended configuration, the arm 706 may extend at an angle with respect to the longitudinal axis of the tether 700. In some embodiments, the arm 706 may extend at an angle with its free end pointed towards the first end 702 of the tether 700 in an arrow or "V" configuration as shown in FIG. 7. However, this is not essential. The arm 706 may extend at any angle with respect to the longitudinal axis of the tether 700 that allows the second end 704 of the tether 700 to have a width greater than the diameter of the opening 524, 698 of the container 502 or the housing 690. In the folded configuration, the arm 706 may be biased towards the longitudinal axis of the tether 700 to reduce its outer profile. This may enable the arm 706 to be inserted through the housing stem 696 into the interior of the housing 690 or through the stem 508 into the interior 540 of the container 502. The arm 706 can return to its expanded first configuration when the compressive force is released. In the expanded configuration, the arm 706 has a width greater than the inner diameter of the stem 508 or the housing stem 696. Thus, when the second end 704 of the tether 700 is inserted into the interior of the housing 690, the arm 706 of the tether 700 resists the removal of the caps 514, 614 from the container 502 or the housing 690. For example, the arm 706 engages the inner surface of the container 502 or the housing 690 to resist the removal of the caps 514, 614.

[0102] FIG. 9 shows a perspective view of a portion of another exemplary tether 800. The tether 800 may be configured to extend between the caps 514, 614 and the container 502 and / or the housing 690. For example, a first end 802 of the tether 800 may be coupled to the caps 514, 614, and a second end 804 of the tether 800 may be positioned inside the container 502 and / or the housing 690. The second end 804 of the tether 800 may include a ferrule 806 configured to be secured to an intermediate portion 808. The ferrule 806 may be a sheath configured to surround a portion of the intermediate portion 808. In some cases, the ferrule 808 may be made of a material that is more rigid than the intermediate portion 808, but this is not essential. The ferrule 806 may generally include an enclosed connection portion 810 and a free end 812. The connection portion 810 may be coupled to the intermediate portion 808, but the free end 812 is not coupled. The free end 812 may be movable between a first extended configuration (shown in FIG. 8) and a second folded configuration (not explicitly shown). In some cases, the free end 812 may define a cavity 814 configured to receive the intermediate portion 808 when the ferrule 806 is in the folded configuration. The ferrule 806 may have a thickness that is less than the diameter of the openings 524, 698 of the container 502 or the housing 690 such that water and / or air can flow through the ferrule 806 and through the openings 524, 698.

[0103] In the extended configuration, the distal fitting 806 may extend at an angle with respect to the longitudinal axis of the tether 800. In some embodiments, the distal fitting 806 may extend substantially orthogonally to the intermediate portion 808. However, this is not essential. The distal fitting 806 may extend at any angle with respect to the longitudinal axis of the tether 800 that allows the second end 804 of the tether 800 to have a width greater than the diameter of the opening 524, 698 of the container 502 or the housing 690. In the folded configuration, the free end 812 of the distal fitting 806 may be biased toward the intermediate portion 808 of the tether 800 to reduce its outer profile. This allows the distal fitting 806 to be inserted into the interior of the housing 690 through the housing stem 696 or into the interior 540 of the container 502 through the stem 508. The distal fitting 806 can return to its expanded first configuration when the compressive force is released. In the expanded configuration, the distal fitting 806 has a width greater than the inner diameter of the stem 508 or the housing stem 696. Thus, when the second end 804 of the tether 800 is inserted into the interior of the housing 690, the distal fitting 806 of the tether 800 resists removal of the caps 514, 614 from the container 502 or the housing 690. For example, the distal fitting 806 engages the inner surface of the container 502 or the housing 690 to resist removal of the caps 514, 614.

[0104] As will be appreciated, the lengths of the perfusion, lens cleaning fluid, gas supply, and alternative gas supply tubes may have any suitable size (e.g., diameter). Additionally, the size (e.g., diameter) of the tubes may vary depending on the application. In one non-limiting embodiment, the perfusion supply tube may have an inner diameter of about 6.5 mm and an outer diameter of about 9.7 mm. The lens cleaning fluid supply tube may have an inner diameter of about 5 mm and an outer diameter of about 8 mm. The gas supply tube may have an inner diameter of about 2 mm and an outer diameter of about 3.5 mm. The alternative gas supply tube may have an inner diameter of about 5 mm and an outer diameter of about 8 mm.

[0105] It will be apparent to those skilled in the art that various modifications and variations can be made to the disclosed devices without departing from the scope of the present disclosure. 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. The specification and examples are to be considered as exemplary only, and it is intended that the true scope and spirit of the invention be indicated by the following claims.

[0106] All of the apparatus and methods described herein are examples of apparatus and / or methods implemented in accordance with one or more principles of the present disclosure. These examples are not the only way to implement these principles, but are merely examples. Accordingly, references to elements or structures or features in the drawings should be recognized as references to examples of embodiments of the present disclosure and should not be understood as limiting the present disclosure to the specific elements, structures, or features illustrated. Other examples of ways to implement the disclosed principles will occur to those skilled in the art upon reading the present disclosure.

[0107] In the foregoing description and in the following claims, the following will be understood. As used herein, the phrases "at least one", "one or more", and "and / or" are open-ended expressions that are both conjunctive and disjunctive in operation. The term "a" or "an" entity, as used herein, refers to one or more of that entity. Thus, the terms "a" (or "an"), "one or more", and "at least one" can be used interchangeably herein. All references to directions (e.g., proximal, distal, superior, inferior, above, below, left, right, lateral, longitudinal, front, rear, top, bottom, up, down, vertical, horizontal, radial, axial, clockwise, counterclockwise, etc.) are used only for purposes of identification to assist the reader's understanding of the disclosure and / or to distinguish the regions of related elements from one another, and do not particularly limit the related elements with respect to the position, orientation, or use of the disclosure. References to connection (e.g., attached, coupled, connected, and joined) should be construed broadly and, unless otherwise indicated, may include intermediate members between assemblies of elements and relative movement between elements. Thus, references to connection do not necessarily imply that two elements are directly connected and in a fixed relationship to one another. References to identification (e.g., primary, secondary, first, second, third, fourth, etc.) are not intended to imply importance or precedence and are used to distinguish one feature from another.

[0108] The foregoing discussion has been presented for purposes of illustration and description and is not intended to limit the present disclosure to one or more of the forms disclosed herein. It will be understood that various additional, modifications, and substitutions may be made to the embodiments disclosed herein without departing from the concepts, spirit, and scope of the present disclosure. In particular, it will be apparent to those skilled in the art that the principles of the present disclosure may be embodied in other forms, structures, arrangements, ratios, and with other elements, materials, and components without departing from its concepts, spirit, or scope, or its characteristics. For example, various features of the present disclosure may be grouped together in one or more aspects, embodiments, or configurations for the purpose of streamlining the present disclosure. However, it should be understood that the various features of a particular aspect, embodiment, or configuration of the present disclosure may be combined in alternative aspects, embodiments, or configurations. The present disclosure may be used with many modifications to the structures, arrangements, ratios, materials, components, etc. used in the practice of the present disclosure that are particularly adapted to specific environments and operational requirements without departing from the principles of the present disclosure. For example, elements shown as integrally formed may be composed of multiple parts, or elements shown as multiple parts may be integrally formed, the operation of an element may be reversed, or otherwise changed, the size or dimensions of an element may be changed, and the features and components of the various embodiments may be selectively combined. Accordingly, the presently disclosed embodiments should be considered illustrative in all respects and not restrictive, and the scope of the claimed invention is indicated by the appended claims and is not limited to the foregoing description.

[0109] The following claims are hereby incorporated by reference into this detailed description, and each claim stands on its own as a separate embodiment of the present disclosure. In the claims, the term "comprising" does not exclude the presence of other elements or steps. Further, a plurality of means, elements or method steps, even if listed individually, may be implemented by, for example, a single unit or processor. Additionally, individual features may be included in different claims, which may, in some cases, be advantageously combined, and being included in different claims does not imply that a combination of features is not feasible and / or not advantageous. Moreover, references to the singular do not exclude the plural. Terms such as "a", "an", "first", "second", etc. do not exclude a plurality. The reference signs in the claims are provided merely as illustrative examples and should in no way be construed as limiting the scope of the claims.

Claims

1. A reservoir arranged and configured to be coupled to an endoscope for use in endoscopic procedures, a container configured to contain a fluid, the container extending from a first end to a second end and having a small-diameter stem extending from the first end, the small-diameter stem defining an opening for receiving the fluid, a container, a water outlet, a gas inlet, a port, wherein the port is a sealing ring defining an opening, the opening extending from a first end to a second end of the sealing ring, the opening being in fluid communication with the opening of the container, a sealing ring, a cap positioned adjacent to the first end of the opening of the sealing ring, and a biasing mechanism disposed between the container and the sealing ring comprising a port, a reservoir.

2. The water outlet comprises a water supply tube including a first end, a second end, and a first lumen extending through the water supply tube, the first lumen being in fluid communication with the bottom portion of the container, the second end of the water supply tube being positioned outside the container, The gas inlet comprises a gas supply tube including a first end, a second end, and a second lumen extending through the gas supply tube, the second lumen being in operable fluid communication with the container, the second end of the gas supply tube being positioned outside the container, the reservoir according to claim 1.

3. The biasing mechanism is configured to bias the sealing ring away from the first end of the container, the reservoir according to claim 1 or 2.

4. The sealing ring is movable between a first configuration configured to fluidly seal the opening of the container and a second configuration configured to provide a fluid path through the opening of the sealing ring and the opening of the container from outside the container, the reservoir according to any one of claims 1 to 3.

5. When in the second configuration, the sealing ring is pressed towards the first end of the container, the reservoir according to claim 4.

6. The reservoir according to any one of claims 1 to 5, further comprising a tether extending between the interior of the container and the cap.

7. The reservoir according to claim 6, wherein the tether comprises a first end coupled to the cap and a second end disposed within the interior of the container. Claim 8 The reservoir according to claim 7, wherein the second end of the tether is deformable between a first extended configuration and a second folded configuration. Claim 9 When the second end of the tether is in the first extended configuration, the second end of the tether has a width greater than the width of the opening of the container. The reservoir according to claim 10, wherein when the second end of the tether is in the second folded configuration, the second end of the tether has a width less than the width of the opening of the container. Claim 10 The reservoir according to any one of claims 1 to 9, wherein the biasing mechanism is configured to bias the sealing ring towards the cap. Claim 11 The reservoir according to any one of claims 1 to 10, wherein the diameter of the opening of the sealing ring is substantially constant from the second end to an intermediate position, and increases from the intermediate position to the first end to form a tapered first end region. Claim 12 The reservoir according to claim 11, wherein the outer diameter of the cap is tapered and is configured to fit with the tapered first end region of the opening of the sealing ring. Claim 13 The reservoir according to any one of claims 1 to 12, wherein the small-diameter stem includes a hollow cylindrical stem. Claim 14 The reservoir according to any one of claims 1 to 13, further comprising an O-ring disposed between the sealing ring and the small-diameter stem of the container. Claim 15 A system comprising the reservoir according to any one of claims 1 to 14 and a filling bottle having a mouth, the mouth being configured to engage the surface of the sealing ring along an outer periphery located beyond the outermost extent of the cap.

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