Medical device locking assembly and method of use

Abstract

Systems, devices, and associated methods are provided for securely positioning and / or locking one or more medical devices within a patient's body during a procedure. A medical device includes a handle, a sheath (172) extending from the handle, and a tool (179) within the sheath and movable relative to the sheath. The handle includes an inner body (120) and an outer body (112) disposed on the inner body and movable relative to the inner body. The handle includes a first actuator (130) secured to the tool and having an actuated state that allows movement of the tool in response to movement of the outer body relative to the inner body, and a second actuator (140) secured to the sheath and having an actuated state that allows movement of the sheath in response to movement of the outer body relative to the outer body. The unactuated states of the first actuator and the second actuator prevent movement of the tool relative to the sheath.

Description

[Technical Field]

[0001] Various aspects of the present disclosure relate generally to medical systems, devices, and related methods. By way of example, the present disclosure relates, inter alia, to systems, devices, and related methods for securely positioning and / or locking one or more medical devices within a patient's body during a procedure. [Background technology]

[0002] Technological advances have provided users of medical systems, devices, and methods with the ability to perform increasingly complex procedures on subjects. One challenge in the field of minimally invasive surgery, such as endoscopy, laparoscopy, and thoracoscopy, among other surgical procedures, is associated with providing control of medical devices regarding access and manipulation of such devices during the procedure. Placing such medical devices within a patient's body can be difficult. Additionally, maintaining the desired position of the device after placement without the need for continued manual control of the device is not reliable. Limitations of medical devices that facilitate access for other devices within the patient's body for placement can prolong the procedure, limit its effectiveness, and / or result in patient injury due to device failure or breakage. Summary of the Invention [Problem to be solved by the invention]

[0003] Aspects of the present disclosure relate, among other aspects, to systems, devices, and methods for accessing a target treatment site with a medical device having a locking assembly that facilitates placement of the device. Each of the aspects disclosed herein can include one or more of the features described in connection with any of the other disclosed aspects. [Means for solving the problem]

[0004] According to one example, a medical device includes a handle, a sheath extending from the handle, and a tool within the sheath and movable relative to the sheath. The handle includes an inner body and an outer body disposed over the inner body. The outer body is movable relative to the inner body. The handle includes a first actuator secured to the tool. The first actuator has an actuated state that allows movement of the tool relative to the sheath in response to moving the outer body relative to the inner body. The handle includes a second actuator secured to the sheath. The second actuator has an actuated state that allows movement of the sheath relative to the tool in response to moving the second actuator relative to the outer body. The inactuated state of the first actuator and the inactuated state of the second actuator prevent movement of the tool relative to the sheath.

[0005] Any of the medical devices described herein can have any of the following features: longitudinal movement of the second actuator causes the sheath to move longitudinally relative to the inner body and the outer body; the first actuator, when in an unactuated state, prohibits movement of the outer body relative to the inner body; the second actuator, when in an unactuated state, prohibits movement of the sheath relative to the inner body and the outer body; the inner body includes a plurality of teeth extending along the exterior of the inner body; the first actuator includes one or more teeth configured to engage with one or more of the plurality of teeth of the inner body when in the unactuated state; and a first spring disposed between the first actuator and the outer body, the first spring configured to bias the first actuator radially outward relative to the outer body and maintain the first actuator in the unactuated state. The first actuator is in an actuated state, where one or more teeth of the first actuator are spaced apart from all of the teeth of the inner body when a radially inward force exceeding the bias of the first spring is applied to the first actuator. The inner body includes a plurality of teeth extending along an exterior of the inner body. The second actuator includes one or more teeth configured to engage with one or more of the teeth of the inner body when in an unactuated state. Further, the second actuator includes a second spring disposed between the second actuator and the outer body, the second spring configured to bias the second actuator radially outward relative to the outer body and maintain the second actuator in an unactuated state. The second actuator is in an actuated state, where one or more teeth of the second actuator are spaced apart from all of the teeth of the inner body when a radially inward force exceeding the bias of the second spring is applied to the second actuator. The first actuator includes one or more first teeth configured to engage one or more of the plurality of teeth of the inner body when in an unactuated state, and a first spring disposed between the first actuator and the outer body, the first spring configured to bias the first actuator radially outward relative to the outer body and maintain the first actuator in an unactuated state.The first actuator is in an actuated state, where one or more teeth of the first actuator are spaced apart from all of the plurality of teeth of the inner body when a radially inward force exceeding the bias of the first spring is applied to the first actuator. The handle further includes an active connector configured to communicatively couple the sheath to the electrosurgical generator, the sheath including an electrically conductive material, and the active connector coupled to the sheath through the second actuator.

[0006] According to another example, a medical device includes a sheath, a tool within the sheath and movable relative to the sheath, and a handle disposed on the sheath and movable relative to the sheath. The handle includes an inner body, an outer body disposed on the inner body and movable relative to the inner body, a first actuator configured to move the tool relative to the sheath and inner body when in an actuated state, and a second actuator configured to move the sheath relative to the inner body, outer body, and tool when in an actuated state. The first actuator and the second actuator engage the inner body when in an unactuated state, thereby prohibiting movement of the tool and sheath.

[0007] Any of the medical devices described herein can have any of the following features: further including a plurality of teeth extending along the exterior of the inner body and one or more teeth extending from the first actuator and configured to engage with one or more of the plurality of teeth on the inner body when in an unactuated state; further including a first spring disposed between the first actuator and the outer body and configured to bias the first actuator radially outward relative to the outer body to maintain the first actuator in an unactuated state; the first actuator is in an actuated state such that when a radially inward force exceeding the bias of the first spring is applied to the first actuator, the one or more teeth on the first actuator are spaced apart from all of the plurality of teeth on the inner body; and further including one or more teeth extending from the second actuator and configured to engage with one or more of the plurality of teeth on the inner body when in an unactuated state. The inner body further includes a second spring disposed between the second actuator and the outer body and configured to bias the second actuator radially outward relative to the outer body to maintain the second actuator in an inactivated state, wherein the second actuator is in an activated state such that when a radially inward force exceeding the bias of the second spring is applied to the second actuator, one or more teeth of the second actuator are spaced apart from all of the plurality of teeth of the inner body.

[0008] According to another example, a medical instrument includes a sheath and a tool movable within the sheath. The medical instrument includes a first actuator, a second actuator, an outer body, and an inner body movable within the outer body. When the first actuator is in an actuated state, it is operable to allow movement of the tool relative to the sheath and movement of the outer body relative to the inner body. When the second actuator is in an actuated state, it is operable to allow movement of the sheath relative to the tool and relative to the outer and inner bodies. When the first and second actuators are in an unactuated state, they are collectively operable to prohibit movement of the tool relative to the sheath and movement of the sheath relative to the tool and inner body.

[0009] It is to be understood that both the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of the invention, as claimed. The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate exemplary aspects of the present disclosure and, together with the description, serve to explain the principles of the disclosure. [Brief explanation of the drawings]

[0010] [Figure 1] 1 is a side view of an exemplary medical system including a medical device and a medical instrument, the medical device having a first actuator and a second actuator, according to an embodiment of the present disclosure. [Figure 2] FIG. 2 is a top view of the medical device of FIG. 1 according to an embodiment of the present disclosure. [Figure 3] 2 is a partially exploded side view of the medical device of FIG. 1 according to an embodiment of the present disclosure. [Figure 4] 2 is a cross-sectional side view of a first actuator of the medical device of FIG. 1 in an actuated state, according to an embodiment of the present disclosure. [Figure 5] 2 is an exploded side view of a first actuator of the medical device of FIG. 1 according to an embodiment of the present disclosure. [Figure 6] 2 is a cross-sectional side view of a second actuator of the medical device of FIG. 1 in an unactuated state, according to an embodiment of the present disclosure. [Figure 7] 2 is an exploded side view of a second actuator of the medical device of FIG. 1 according to an embodiment of the present disclosure. [Figure 8] FIG. 10 is a side view of another exemplary medical system including a medical device and a medical instrument, the medical device including a first actuator and a second actuator, according to an embodiment of the present disclosure. [Figure 9] 9 is a cross-sectional side view of a second actuator of the medical device of FIG. 8 in a locked state, according to an embodiment of the present disclosure. [Figure 10] 9 is an exploded side view of a second actuator of the medical device of FIG. 8 according to an embodiment of the present disclosure. DETAILED DESCRIPTION OF THE INVENTION

[0011] Examples of the present disclosure include systems, devices, and methods for controlling one or more components of a medical instrument at a target site within the body, where, among other things, the components typically require manual control or manipulation to access the target site. Reference will now be made in detail to embodiments of the present disclosure, examples of which are illustrated in the accompanying figures. Wherever possible, the same or similar reference numbers will be used throughout the figures to refer to the same or similar parts. The term "distal" refers to the part of the device that is furthest from the user when introducing the device into a patient. In contrast, the term "proximal" refers to the part that is closest to the user when placing the device within a 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 comprising a list of elements does not necessarily include only those elements, but may include other elements not expressly listed or that are inherent in such process, method, article, or apparatus. The term "exemplary" is used in the sense of "example" rather than "ideal." As used herein, the terms "about," "substantially," and "approximately" indicate a range of values ​​within + / - 10% of the stated value.

[0012] Examples of the present disclosure can be used to facilitate control and placement of a medical instrument tool / device at a target treatment site by providing one or more mechanisms and / or assemblies for securing the tool / device at the target treatment site. For example, some examples utilize a first actuator and a second actuator on a medical device for selective control and / or manipulation of components of the medical instrument received within the medical device. The medical device can include an inner body defining a lumen configured to receive the medical instrument therein, and an outer body disposed on the inner body and movable relative to the inner body. The medical instrument can include a sheath and a tool disposed within the sheath. The first actuator can be disposed on the outer body and coupled to a tool (e.g., an access cannula, needle, etc.) of the medical device, and the second actuator can be disposed on the outer body and coupled to a sheath of the medical instrument. The first actuator can be configured to move the tool relative to the sheath and move the outer body relative to the inner body, and the second actuator can be configured to move the tool relative to the sheath and move the second actuator relative to the outer body.

[0013] Examples of the present disclosure may relate to devices and methods for performing various medical procedures and / or treating the large intestine (colon), small intestine, cecum, esophagus, any other portion of the digestive tract, and / or any other suitable patient anatomical structure (collectively referred to herein as the "target treatment site"). The devices and associated methods may be used laparoscopically, endoscopically, or in any other open or minimally invasive procedure, including thoracoscopic and ENT procedures. Reference will now be made in detail to the examples of the present disclosure described above and shown in the accompanying figures. Wherever possible, the same reference numbers will be used throughout the figures to refer to the same or similar parts.

[0014] 1 shows a schematic diagram of an exemplary medical system 100. The medical system 100 can include a medical device 110 and a medical instrument 170. In this example, the medical device 110 has a handle including an outer body 112 and an inner body 120, the outer body 112 having a longitudinal length defining a lumen sized, shaped, and configured to receive the inner body 120. As described in more detail herein, the outer body 112 is configured to move relative to the inner body 120, and vice versa. The inner body 120 of the medical device 110 has a longitudinal length defining a lumen sized, shaped, and configured to receive the medical instrument 170.

[0015] In this example, the inner body 120 includes a rack portion having a plurality of teeth 122 extending along the exterior surface of the inner body 120. The plurality of teeth 122 extend along a predetermined portion (e.g., the longitudinal length) of the inner body 120 corresponding to the range of motion of the outer body 112 relative to the inner body 120. Accordingly, it should be understood that the rack portion including the plurality of teeth 122 can extend from only a portion of the longitudinal length of the inner body 120 up to the entire longitudinal length of the inner body 120, and along various other suitable lengths and / or surfaces of the inner body 120 other than those shown and described herein, without departing from the scope of this disclosure. The medical device 110 may further include an end cap 114, an active pin or connector 116, and a rotation assembly 118 disposed on and / or coupled to the outer body 112. The end cap 114 of the medical device 110 may be disposed at the proximal end of the outer body 112 and configured to enclose the lumen of the outer body 112.

[0016] Additionally, the medical instrument 170 of the medical system 100 may include a catheter having a sheath 172, a cannula 176, and a needle 179. The cannula 176 may be disposed within a lumen of the sheath 172, and the needle 179 may be disposed within a lumen of the cannula 176 and may extend at least partially outward from a tip 178 of the cannula 176. While a needle 179 is described herein, it should be understood that the exemplary medical instrument 170 of the present disclosure may be a tool having any end effector, including, but not limited to, a grasper, a snare, forceps, scissors, etc. In this example, the position, orientation, and / or configuration of the needle 179 relative to the cannula 176 is defined such that the distal end of the needle 179 is maintained in an extended position relative to the tip 178 of the cannula 176. Sheath 172 has a tip 174 and a longitudinal length defined by the distance between tip 174 and a proximal end (not shown) of sheath 172. Cannula 176 of medical instrument 170 includes a tip 178 and has a longitudinal length defined by the distance between tip 178 and a proximal end (not shown) of cannula 176. As described in more detail herein, one or more components of medical device 110 may be configured and operable to position medical instrument 170 relative to a target treatment site within a patient (e.g., the patient's anatomy). For example, medical instrument 170 may be operable to pierce a target treatment site with needle 179 when needle 179 is extended distal to tip 174, or may be capable of performing a medical procedure with a desired end effector.

[0017] 1 , in some examples, medical instrument 170 may include, and / or be operable to facilitate access of one or more tools and / or devices to the target treatment site via cannula 176, in addition to, needle 179. In this case, upon removal of needle 179 from the lumen of cannula 176, one or more additional tools and / or devices may be received through the lumen of cannula 176 and extended outwardly and distally therefrom via tip 178 of cannula 176. Further, in some examples, medical instrument 170 may be operable to electrosurgically dilate the target treatment site via sheath 172. In this case, sheath 172 comprises an electrosurgical sheath and tip 174 comprises an electrosurgical tip. It should be understood that in other examples, medical instrument 170 may include a variety of other suitable tools, configurations, hypotubes, and / or components other than those shown and described herein. By way of illustration, in some instances, medical device 170 may include an electrosurgical end (e.g., a cystotome needle) that omits tip 178, such as for delivering a stent during a procedure. In other instances, medical device 170 omits components configured for electrical activation.

[0018] 2 , the outer body 112 of the medical device 110 may include one or more slots 109 disposed therethrough. In this case, the lumen of the outer body 112 may be accessible via the one or more slots 109. In this example, the outer body 112 includes a pair of slots 109 formed along the longitudinal length of the outer body 112 and disposed along opposite sides of the outer body 112, such as along the top and bottom surfaces of the outer body 112. As described in more detail below, the one or more slots 109 of the outer body 112 are configured to slidingly receive one or more components of the medical device 110, such as the second actuator 140, therein.

[0019] In this example, the inner body 120 of the medical device 110 may further include one or more slots 124 disposed therethrough. In this case, the lumen of the inner body 120 may be accessible via the one or more slots 124. In this example, the inner body 120 includes a pair of slots 124 formed along the longitudinal length of the inner body 120 and disposed along opposing sides of the inner body 120, such as along the top and bottom surfaces of the inner body 120. As described in more detail below, the one or more slots 124 of the inner body 120 are configured to slidingly receive one or more components of the medical device, such as the first actuator 130 and / or the second actuator 140. As shown, the one or more slots 109 of the outer body 112 are radially aligned with the one or more slots 124 of the inner body 120, although it should be understood that in other examples, the slots 109 may be radially offset relative to the slots 124.

[0020] 3 , the end cap 114 may include one or more snap features 115 disposed along the exterior of the end cap 114 for coupling the end cap 114 to the outer body 112. In this example, the one or more snap features 115 are configured to engage and snap into openings 113 formed on the distal end of the outer body 112. An active pin 116 of the medical device 110 may be coupled to the end cap 114, the active pin 116 being operable to establish electrical communication with a medical instrument 170 disposed within the lumen of the inner body 120. For example, the active pin 116 may include a connector 117 configured to be received within the end cap 114 and operable to communicatively couple the active pin 116 to one or more components of the medical instrument 170, such as an electrosurgical sheath 172. In this case, the active pin 116 is operable to establish an electrosurgical connection between the electrosurgical sheath 172 of the medical instrument 170 and an auxiliary device, such as an electrosurgical generator, power source, controller, or other device operable to generate high frequency electricity or RF current (not shown).

[0021] 3 , the rotation assembly 118 of the medical device 110 can be coupled to the end cap 114 at a proximal end of the end cap 114 opposite the outer body 112. For example, the rotation assembly 118 can include a coupling feature 119 that is received within the end cap 114 to secure the rotation assembly 118 to the end cap. In this case, it should be appreciated that with the rotation assembly 118 coupled to the end cap 114 and the end cap 114 coupled to the outer body 112 via the snap feature 115, the end cap 114 and the rotation assembly 118 can move simultaneously with the outer body 112. In this example, at least a portion of the rotation assembly 118 extends outward and proximally from the end cap 114 to facilitate access of the rotation assembly 118 to a user of the medical system 100. Coupling feature 119 of rotation assembly 118 is further configured to engage a proximal end of a medical instrument 170 disposed within the lumen of inner body 120 when coupling feature 119 is received within end cap 114. Rotation assembly 118 engages and is coupled to cannula 176 of medical instrument 170 within inner body 120.

[0022] In this example, the rotation assembly 118 is configured to move (e.g., rotate) relative to the end cap 114, the outer body 112, and the inner body 120. Thus, with the rotation assembly 118 coupled to the medical instrument 170 via the coupling features 119, the rotation assembly 118 is operable to move (e.g., rotate) the cannula 176 of the medical instrument 170 relative to the medical device 110. For example, the rotation assembly 118 rotates the medical instrument 170 within the lumens of the outer body 112 and the inner body 120. As described above, it should be appreciated that with the needle 179 disposed within the cannula 176, the rotation assembly 118 is operable to move (e.g., rotate or actuate) the needle 179 along with the cannula 176 relative to the outer body 112 and the inner body 120. In some examples, the rotation assembly 118 may include a rotatable knob, wheel, and / or other suitable actuator for rotating the cannula 176 of the medical instrument 170 relative to the medical device 110. It should be appreciated that in other examples, the rotation assembly 118 may engage other and / or additional components of the medical instrument 170 other than those shown and described herein.

[0023] Although not shown, it should be appreciated that the rotating assembly 118 includes a lumen extending therethrough and the coupling feature 119. The lumen of the rotating assembly 118 may be sized, shaped, and configured to receive one or more tools and / or devices of the medical instrument 170 therethrough, such as a needle 179. In this example, it should be understood that with the rotating assembly 118 coupled to the cannula 176, the lumen of the rotating assembly 118 may be aligned with, coupled to, and / or in communication with the lumen of the cannula 176. Thus, the rotating assembly 118 may be configured and operable to facilitate access to the lumen of the cannula 176, the tip 178 of the cannula 176. As can be seen in FIGS. 1-2 , the proximal end of the needle 179 may be received through the rotating assembly 118, and the sharpened distal end of the needle 179 may be disposed adjacent to the tip 178 of the cannula 176. In some examples, needle 179 may be removed from the lumen of cannula 176 by withdrawing needle 179 proximally through the lumen of rotation assembly 118 .

[0024] 1 , the medical device 110 may further include a first actuator 130 and a second actuator 140 disposed on the outer body 112. In this example, the first actuator 130 and the second actuator 140 are disposed on the outer body 112 and are movable relative to one another. As described in further detail herein, the first actuator 130 is fixed to and / or coupled to the outer body 112 and configured to move the outer body 112 relative to the inner body 120 in response to actuation of the first actuator 130. In this example, the first actuator 130 is integral with the outer body 112, such that the first actuator 130 forms a unitary structure with the outer body 112. However, it should be appreciated that a unitary structure of the first actuator 130 and the outer body 112 may not be required in other examples. Additionally, second actuator 140 is fixed to and / or coupled to inner body 120 and configured to move inner body 120 relative to outer body 112 in response to actuation of second actuator 140. For example, second actuator 140 may be coupled to inner body 120 through outer body 112, such as via one or more of the pairs of slots 109 formed on outer body 112.

[0025] The medical device 110 further includes a distal housing 160 disposed at a distal end of the inner body 120 opposite the outer body 112. The distal housing 160 of the medical device 110 defines a lumen sized, shaped, and configured to receive one or more components of the medical device 110 therethrough, such as at least a portion of the inner body 120, a medical instrument 170, etc. The distal housing 160 of the medical device 110 may further include a housing tip 162 and a screw (fastener) 164. In this example, the housing tip 162 includes an opening sized and shaped to facilitate egress of the medical instrument 170 from the lumen of the distal housing 160 and / or the lumen of the inner body 120. The screw 164 is configured to engage an exterior surface of the inner body 120 (i.e., the portion disposed within the lumen of the distal housing 160) to fixedly couple the inner body 120 to the distal housing 160. In this case, the screw 164 is movable (e.g., rotatable) relative to the distal housing 160 to selectively engage and / or disengage the inner body 120 received within the distal housing. It should be appreciated that various other suitable fastening elements, clamps, pins, etc. are also contemplated without departing from the scope of the present disclosure.

[0026] 4-5, a schematic of the first actuator 130 is depicted with the outer body 112 and the inner body 120 disposed within the first actuator 130. The first actuator 130 of the medical device 110 is disposed at the distal end 111 of the outer body 112. In this example, the body of the first actuator 130 can include a top housing 132 and a bottom housing 134, which are coupled to one another with the outer body 112 and the inner body 120 disposed therebetween. Furthermore, the top housing 132 and the bottom housing 134 are disposed relative to the outer body 112 such that at least a portion of the housings 132, 134 is disposed over the distal end 111 of the outer body 112. The first actuator 130 can further include a button top 133 received within the top housing 132 and a button bottom 135 received within the bottom housing 134. It should be appreciated that the button top 133 and button bottom 135 of the first actuator 130 may be a unitary structure, such as a ring disposed around the outer body 112 such that the buttons 133, 135 are integral with one another. In other examples, the button top 133 and button bottom 135 may be coupled to one another, thereby forming an assembly, whereby movement of the button top 133 and / or button bottom 135 results in corresponding movement of the opposing buttons 133, 135.

[0027] The top housing 132 of the first actuator 130 includes a recess 131 for receiving the button top 133 such that the button top 133 extends at least partially outward from the top housing 132. In this case, the button top 133 is partially exposed in the recess 131, facilitating a user of the medical device 110 to access the button top 133 for actuation. The button bottom 135 of the first actuator 130 is disposed within the bottom housing 134 such that it is entirely enclosed therein. In other examples, the button bottom 135 can extend at least partially outward from the bottom housing 134, thereby exposing the button bottom 135 therefrom. As described above, the button top 133 and the button bottom 135 of the first actuator 130 form a unitary structure, such that the button bottom 135 is configured to move simultaneously with the button top 133. Thus, manual depression of the button top 133 (e.g., towards the outer body 112) can result in simultaneous depression and / or movement (e.g., away from the outer body 112) of the button bottom 135 when actuating the first actuator 130.

[0028] 4-5 , first actuator 130 can further include biasing mechanism 138. In this example, biasing mechanism 138 includes, for example, a spring disposed within upper housing 132, with biasing mechanism 138 disposed between button top 133 and the exterior surface of outer body 112. More specifically, the exterior of outer body 112 includes cavity 139 adjacent distal end 111 of outer body 112, which cavity is sized and shaped to receive biasing mechanism 138 therein. In other examples, biasing mechanism 138 can include a variety of other suitable devices beyond those shown and described herein without departing from the scope of the present disclosure. It should be understood that with biasing mechanism 138 disposed below button top 133, in a resting state, biasing mechanism 138 is configured to exert a radially outward force (e.g., away from outer body 112) against button top 133. Thus, button top 133 is biased to the extended position (i.e., unactuated state) by biasing mechanism 138, as shown in Figure 4. As described in more detail herein, depression of first actuator 130 may occur in response to applying a radially inwardly directed force to button top 133 that exceeds the radially outward force generated by biasing mechanism 138.

[0029] 4 , the button bottom 135 of the first actuator 130 may include one or more teeth 136 extending outward therefrom toward the rack portion of the inner body 120. For example, with the first actuator 130 disposed over and / or at least partially extending from the distal end 111 of the outer body 112, the one or more teeth 136 of the button bottom 135 may be configured to engage with at least a portion of the plurality of teeth 122 (i.e., the rack portion) of the inner body 112 disposed adjacent the distal end 111. In this example, the button bottom 135 of the first actuator 130 includes a pair of teeth 136, although it should be understood that in other examples, the button bottom 135 may include additional and / or fewer teeth 136. It should be appreciated that because the button top 133 and the button bottom 135 are connected to one another, the biasing mechanism 138 is configured to bias the button bottom 135 and one or more teeth 136 located thereon toward the locked position.

[0030] As described in more detail herein, the first actuator 130 is configured such that the teeth 136 of the button bottom 135 engage with the plurality of teeth 122 of the inner body 120 when the first actuator 130 is in an unactuated, resting state (i.e., in an undepressed position) as shown in FIG. 4 . In this case, with the teeth 136 of the first actuator 130 engaged (interlocked) with one or more of the plurality of teeth 122 of the inner body 120, the position of the outer body 112 (to which the first actuator 130 is secured) is longitudinally determined relative to the inner body 120. It should be appreciated, therefore, that actuation of the first actuator 130 (i.e., manual depression of the button top 133) can cause the teeth 136 of the button bottom 135 to move radially away from and disengage the plurality of teeth 122 of the inner body 120. In this case, with the first actuator 130 disengaged from the inner body 120, the first actuator 130 can move (translate) the outer body 112 relative to the inner body 120. Upon releasing the radially inward directed force on the button top 133 of the first actuator 130, the biasing mechanism 138 urges the button bottom 135 back to the locked position, in which the one or more teeth 136 are engaged with at least some of the plurality of teeth 122 on the inner body 120.

[0031] 6-7, a schematic of second actuator 140 is depicted with portions of outer body 112 and inner body 120 disposed within second actuator 140. In this example, the body of second actuator 140 may include a top housing 142 and a bottom housing 144, which are coupled to one another with portions of outer body 112 and inner body 120 disposed therebetween. Second actuator 140 may further include a button top 143 received within top housing 142 and a button bottom 145 received within bottom housing 144. It should be understood that button top 143 and button bottom 145 of second actuator 140 may be a unitary structure, such as a ring disposed around outer body 112 such that buttons 143, 145 are integral with one another. In other examples, the button top 143 and button bottom 145 can be coupled to one another, thereby forming an assembly, whereby movement of the button top 143 and / or button bottom 145 results in corresponding movement of the opposing buttons 143, 145.

[0032] The top housing 142 of the second actuator 140 includes a recess 141 for receiving the button top 143 such that the button top 143 extends at least partially outward from the top housing 142. In this case, the button top 143 is partially exposed in the recess 141, facilitating a user of the medical device 110 to access the button top 143 for actuation. The button bottom 145 of the second actuator 140 is disposed within the bottom housing 144 such that it is entirely enclosed therein. In other examples, the button bottom 145 can extend at least partially outward from the bottom housing 144, thereby exposing the button bottom 145 therefrom. As described above, the button top 143 and the button bottom 145 of the second actuator 140 form a unitary structure, such that the button bottom 145 is configured to move simultaneously with the button top 143. Thus, manual depression of the button top 143 (e.g., towards the outer body 112) can result in simultaneous depression and / or movement (e.g., away from the outer body 112) of the button bottom 145 when the second actuator 140 is actuated.

[0033] 6-7 , second actuator 140 may further include biasing mechanism 148. In this example, biasing mechanism 148 may include, for example, a spring disposed within upper housing 142, with biasing mechanism 148 disposed between button top 143 and retainer 147 of second actuator 140. In other examples, biasing mechanism 148 may include a variety of other suitable devices beyond those shown and described herein without departing from the scope of this disclosure. It should be understood that with biasing mechanism 148 disposed below button top 143, biasing mechanism 148 is configured to apply a radially outward force (e.g., away from outer body 112) that presses button top 143 against itself. Thus, button top 143 is biased to the extended position such that manual depression of second actuator 140 can be effected in response to applying a radially inward force on button top 143 (e.g., in direction A) that exceeds the radially outward force generated by biasing mechanism 148. As described further herein, depression of second actuator 140 effects disengagement of inner body 120 and button bottom 145.

[0034] Retainer 147 is at least partially disposed within upper housing 142 of second actuator 140 and is positioned between button top 143 and outer body 112. Retainer 147 is configured to receive biasing mechanism 148 along a top surface of retainer 147 and includes one or more engagement features 149 disposed along a bottom surface of retainer 147. One or more engagement features 149 may include protrusions extending outward from the bottom surface of retainer 147. In this example, engagement features 149 of retainer 147 are received within the lumen of inner body 120 via slots 109 formed along the top surface of outer body 112 and slots 124 formed along the top surface of inner body 120 (see FIG. 2 ). It should be appreciated that the slots 109, 124 of the outer body 112 and the inner body 120 may be radially aligned and overlapping and / or may be positioned in register with one another such that the engagement features 149 of the retainer 147 extend through the respective pairs of slots 109, 124 into the lumen of the inner body 120.

[0035] 6-7 , the second actuator 140 may further include a thread 150 disposed within the lumen of the inner body 120. In this example, the thread 150 includes one or more openings 152 formed along an upper surface of the thread 150. The size, shape, and quantity of the openings 152 may correspond to one or more engagement features 149 (e.g., protrusions) of the retainer 147. The retainer 147 is thus configured to couple the button top 143 to the thread 150 via reception of the engagement features 149 within the openings 152. In this example, the thread 150 is disposed around and secured to the medical device 170, e.g., a sheath 172. For example, the thread 150 may be attached to the sheath 172 of the medical device 170 by an adhesive such that the thread 150 is secured relative to the medical device 170. In this example, the medical device 170 is movable relative to the lumen of the inner body 120 in response to movement of the thread 150, e.g., via movement of the second actuator 140. In other examples, it should be understood that the thread 150 may be attached to the sheath 172 of the medical instrument 170 by a variety of other devices and / or mechanisms suitable for securing the thread 150 to the medical instrument 170 .

[0036] 6 , the button bottom 145 of the second actuator 140 may include one or more teeth 146 extending outward therefrom toward the rack portion of the inner body 120. For example, with the second actuator 140 disposed on and / or extending from the outer body 112, the one or more teeth 146 of the button bottom 145 may be configured to engage with at least a portion of the plurality of teeth 122 (i.e., the rack portion) of the inner body 112 through a slot 109 formed along the bottom surface of the outer body 112. In this example, the button bottom 145 of the second actuator 140 includes a pair of teeth 146, but it should be understood that in other examples, the button bottom 145 may include additional and / or fewer teeth 146. It should be appreciated that because the button top 143 and the button bottom 145 are connected to one another, the biasing mechanism 148 is configured to bias the button bottom 145 and one or more teeth 146 located thereon toward the locked position.

[0037] As described in more detail herein, the second actuator 140 is configured such that the teeth 146 of the button bottom 145 are engaged with the plurality of teeth 122 of the inner body 120 when the second actuator 140 is in an unactuated, resting state (i.e., in an undepressed position). In this case, with the teeth 146 of the second actuator 140 engaged (interlocked) with one or more of the plurality of teeth 122 of the inner body 120, the position of the inner body 120 is longitudinally determined relative to the outer body 112 and the sheath 172. It should be appreciated, therefore, that actuation of the second actuator 140 (i.e., manual depression of the button top 143 in direction A) can cause the teeth 146 of the button bottom 145 to move radially away from and disengage the plurality of teeth 122 of the inner body 120. In this case, with second actuator 140 disengaged from inner body 120, second actuator 140 can move (e.g., translate) medical instrument sheath 172 relative to outer body 112, inner body 120, and / or cannula 176. Upon releasing the radially inward directed force on button top 143 of second actuator 140, biasing mechanism 148 urges button bottom 145 back to the locked position, in which one or more teeth 146 are engaged with at least some of the plurality of teeth 122 on inner body 120.

[0038] According to an exemplary method of using the medical system 100, the medical system 100 can be utilized in various endoscopic procedures to treat a target site (e.g., a patient's anatomy). Initially, the medical instrument 170 can be received within the medical device 110 with at least a distal portion of the sheath 172 extending distally from the distal housing 160. The tip 178 of the cannula 176 can be disposed within the sheath 172 of the medical instrument 170 by positioning the first actuator 130 at and / or near the proximal portion of the inner body 120, as shown in FIG. 1. Additionally, the sheath 172 of the medical instrument 170 can be disposed over the tip 178 of the cannula 176 by positioning the second actuator 140 at and / or near the distal end 111 of the outer body 112, as shown in FIG. 1. In this case, tip 174 of sheath 172 can enclose the distal tip of needle 179 therein, with needle 179 received within the lumen of cannula 176 and extending at least partially outward therefrom through tip 178.

[0039] Upon positioning medical system 100 at and / or near the target site, a user of medical system 100 can activate one or more components of medical system 100 to utilize components of medical instrument 170 (e.g., sheath 172, cannula 176, and / or needle 179) at the target site. In examples in which sheath 172 comprises an electrosurgical sheath and tip 174 comprises an electrosurgical tip, sheath 172 and / or tip 174 can be operable to electrosurgically dilate and / or ablate the target site in response to activation of an auxiliary device (e.g., an electrosurgical generator) coupled to medical instrument 170 via active pin 116.

[0040] As a further example, a user can actuate the second actuator 140 by exerting a radially inward force on the button top 143 (e.g., transverse to the longitudinal length of the outer body 112) to depress the biasing mechanism 148 and disengage the teeth 146 of the button bottom 145 from the plurality of teeth 122 of the inner body 120. It should be appreciated that the radially inward force must be greater than the opposing radially outward biasing force exerted by the biasing mechanism 148 against the button top 143 of the second actuator 140. In this case, with the second actuator 140 disengaged from the inner body 120, a user can move the second actuator 140 relative to the outer body 112 by exerting a slidable force on the second actuator 140 (e.g., parallel to the longitudinal length of the outer body 112).

[0041] With sled 150 secured to sheath 172 of medical device 170 and second actuator 140 secured to sled 150 via retainer 147 (see FIGS. 6-7 ), movement of second actuator 140 results in simultaneous movement of sheath 172 relative to outer body 112, inner body 120, and cannula 176. Thus, movement of second actuator 140 from distal end 111 of outer body 112 (see FIG. 1 ) toward a proximal portion of outer body 112 (e.g., adjacent end cap 114) results in retraction of sheath 172 into the lumen of outer body 112, exposing cannula 176 and needle 179. In this case, tip 174 of sheath 172 can be positioned proximally relative to the distal tip of needle 179 and tip 178 of cannula 176 for use at a target site during a procedure (see FIG. 8 ).

[0042] A user can lock second actuator 140 by releasing button top 143, thereby defining the position of second actuator 140 relative to the outer body, and consequently the position of sheath 172 and tip 174 relative to cannula 176 and needle 179. For example, removing the radially inward force from button top 143 allows the biasing force of biasing mechanism 148 to take over, thereby returning second actuator 140 to an unactuated state in which teeth 146 of button 145 engage at least some of the plurality of teeth 122 of inner body 120. Thus, the position of second actuator 140 relative to outer body 112 and the position of sheath 172 relative to cannula 176 and needle 179 remain defined without the need for continued actuation (e.g., depression) of second actuator 140 by the user. With the distal tip of needle 179 exposed from within sheath 172, the user can direct needle 179 towards the target treatment site and pierce the target site with the distal tip of needle 179.

[0043] Once the target site has been dilated, ablated, and / or punctured by the medical instrument 170, the user can further actuate the medical system 100 to utilize one or more other components of the medical device 110 and / or medical instrument 170 at the target site. Illustratively, a user can actuate the first actuator 130 by exerting a radially inward force on the button top 133 (e.g., across the longitudinal length of the outer body 112) to depress the biasing mechanism 138 and disengage the teeth 136 of the button bottom 135 from the plurality of teeth 122 of the inner body 120. It should be appreciated that the radially inward force must be greater than the opposing biasing force exerted by the biasing mechanism 138 against the button top 133 of the first actuator 130.

[0044] In this case, with the first actuator 130 disengaged from the inner body 120, a user can move the outer body 112 relative to the inner body 120 by applying a slidable force on the first actuator 130 (e.g., parallel to the longitudinal length of the outer body 112). With the rotating assembly 118 secured to the cannula 176 of the medical instrument 170 and the outer body 112 secured to the rotating assembly 118, movement of the first actuator 130 results in simultaneous movement of the rotating assembly 118 and the cannula 176 relative to the sheath 172. Thus, actuation of the first actuator 130 allows the distal end 178 of the cannula 176 to move relative to the distal end 174 of the sheath 172 and / or relative to the target site. In this case, tip 178 of cannula 176 can be extended distally relative to tip 174 of sheath 172 by translating first actuator 130 distally along inner body 120 to position the distal tip of needle 179 at another location in the target site, e.g., to puncture the target site. Additionally and / or alternatively, needle 179 can be removed from the lumen of cannula 176 and replaced with one or more other tools / devices via the lumen of rotation assembly 118.

[0045] A user can lock the first actuator 130 by releasing the button top 133, thereby defining the position of the outer body 112 relative to the inner body 120 and the position of the cannula 176 relative to the sheath 172. For example, removing the radially inward force from the button top 133 allows the biasing force of the biasing mechanism 138 to take over, thereby returning the first actuator 130 to an unactuated state (see FIG. 4 ), in which the teeth 136 of the button bottom 135 engage with at least some of the plurality of teeth 122 of the inner body 120. Thus, the position of the outer body 112 relative to the inner body 120 and the position of the cannula 176 relative to the sheath 172 of the medical instrument 170 remain longitudinally defined without requiring continued actuation (e.g., depression) of the first actuator 130 by the user.

[0046] Once the target site has been punctured by the cannula 176 and needle 179, the user can actuate the first actuator 130 and / or the second actuator 140 to reposition the cannula 176 and needle 179 within the lumen of the sheath 172. For example, the first actuator 130 can be actuated as described in detail above and moved proximally relative to the inner body 120 to retract the cannula 176 and needle 179 within the sheath 172. Alternatively, the second actuator 140 can be actuated as described above and moved distally relative to the outer body 112 to extend the tip 174 of the sheath 172 over the cannula 176 and needle 179. In such a case, with the cannula 176 and needle 179 fully disposed within the lumen of the sheath 172, the user can utilize the sheath 172 during a procedure. Further actuation of the medical system 100 can be performed by the user during a procedure to utilize components of the medical device 110 and / or medical instrument 170 at the target site, such as by actuating the first actuator 130 and / or the second actuator 140 per the steps described above. It should be understood that the steps described herein and the order in which they are presented are exemplary only, and thus additional and / or fewer steps may be included without departing from the scope of the present disclosure.

[0047] 8 shows a schematic diagram of an exemplary medical system 200 according to an example of the present disclosure. It should be understood that, except as otherwise described below, medical system 200 may be configured and operable as medical system 100 shown and described above, and accordingly, like reference numerals will be used to identify like components. Accordingly, it should be appreciated that medical system 200 functions similarly to medical system 100, except for differences expressly noted herein.

[0048] For example, the medical system 200 can include a medical device 210 and a medical instrument 170 at least partially disposed within the inner body 120 of the medical device 210. The outer body 112 of the medical device 210 can include a first actuator 130 and a second actuator 240 disposed along the exterior of the outer body 112. In this example, the second actuator 240 is substantially similar to the second actuator 140 of the medical system 100 shown and described above, except that the second actuator 240 includes an active pin (connector) 216 extending outwardly therefrom.

[0049] 9-10 , the bottom housing 244 of the second actuator 240 includes a port 212 that is sized and shaped according to the active pin 216 such that the bottom housing 244 is configured to receive the active pin 216 through the port 212. It should be understood that the active pin 216 of the medical device 210 is configured and operative similarly to the active pin 116 of the medical device 110 shown and described above. In this case, the active pin 216 of the medical device 210 is received within a lumen of the inner body 120 and is coupled, via the second actuator 240, to a medical instrument 170 disposed within the lumen. The connector 217 of the active pin 216 is received within the bottom housing 244 of the second actuator 240 through the port 212, rather than within the end cap 114 as shown and described above with respect to the medical device 110 of the medical system 100.

[0050] Thus, it should be appreciated that the active pin 216 of the medical device 210 is operable to move relative to the outer body 112 in response to movement of the second actuator 240 relative to the outer body 112. In this case, the active pin 216 remains adjacent to the sheath 172 of the medical instrument 170 during use of the medical system 200 in a procedure, such as when the sheath 172 is moved relative to the outer body 112, the inner body 120, etc.

[0051] Each of the aforementioned devices, assemblies, and methods can be used to facilitate access to a target treatment site and to increase control of auxiliary tools / devices for use at the target treatment site. By providing a medical device with a pair of actuators that can control and automatically lock multiple tools / devices of a medical instrument coupled to the medical device, a user can use various tools / devices of the medical instrument to interface with the target treatment site during a procedure without requiring continuous manual control of the medical device. In this case, the user can reduce overall procedure time, increase procedure efficiency, and / or avoid unnecessary injury to the patient's body caused by limited control of auxiliary tools / devices.

[0052] It will be apparent to those skilled in the art that various modifications and variations may be made to the disclosed devices and methods without departing from the scope of the disclosure. Other aspects of the present disclosure will be apparent to those skilled in the art from consideration of the specification and practice of the features disclosed herein. It is intended that the specification and examples be considered as illustrative only.

Claims

1. The handle and a sheath extending from the handle; a tool within the sheath and movable relative to the sheath; The handle is an inner body; an outer body disposed on the inner body and movable relative to the inner body; a first actuator secured to the tool, the first actuator having an actuated state that enables movement of the tool relative to the sheath in response to moving the outer body relative to the inner body; a second actuator secured to the sheath, the second actuator having an actuated state that enables movement of the sheath relative to the tool in response to moving the second actuator relative to the outer body; A medical device wherein the de-actuated state of the first actuator and the de-actuated state of the second actuator prevent movement of the tool relative to the sheath.

2. The medical device of claim 1 , wherein longitudinal movement of the first actuator causes the outer body to move longitudinally relative to the second actuator.

3. The medical device of claim 1 or 2, wherein longitudinal movement of the second actuator causes the sheath to move longitudinally relative to the inner body and the outer body.

4. The medical device of claim 1 , wherein the first actuator inhibits movement of the outer body relative to the inner body when in the unactuated state.

5. The medical device of claim 1 , wherein the second actuator inhibits movement of the sheath relative to the inner body and the outer body when in the unactuated state.

6. the inner body includes a plurality of teeth extending along an exterior of the inner body; 6. The medical device of claim 1, wherein the first actuator includes one or more teeth configured to engage one or more of the plurality of teeth of the inner body when in the unactuated state.

7. 7. The medical device of claim 6, further comprising a first spring disposed between the first actuator and the outer body, the first spring configured to bias the first actuator radially outward relative to the outer body and maintain the first actuator in the unactuated state.

8. 8. The medical device of claim 7, wherein the first actuator is in the actuated state in which the one or more teeth of the first actuator are spaced apart from all of the plurality of teeth of the inner body when a radially inward force that exceeds the bias of the first spring is applied to the first actuator.

9. the inner body includes a plurality of teeth extending along an exterior of the inner body; 9. The medical device of claim 1, wherein the second actuator includes one or more teeth configured to engage one or more of the plurality of teeth of the inner body when in the unactuated state.

10. 10. The medical device of claim 9, further comprising a second spring disposed between the second actuator and the outer body, the second spring configured to bias the second actuator radially outward relative to the outer body and maintain the second actuator in the unactuated state.

11. 11. The medical device of claim 10, wherein the second actuator is in the actuated state in which the one or more teeth of the second actuator are spaced apart from all of the plurality of teeth of the inner body when a radially inward force that exceeds the bias of the second spring is applied to the second actuator.

12. The medical device of claim 11 , wherein the first actuator includes one or more first teeth configured to engage one or more of the plurality of teeth of the inner body when in the unactuated state.

13. 13. The medical device of claim 12, further comprising a first spring disposed between the first actuator and the outer body, the first spring configured to bias the first actuator radially outward relative to the outer body and maintain the first actuator in the unactuated state.

14. 14. The medical device of claim 12 or 13, wherein the first actuator is in the actuated state in which the one or more teeth of the first actuator are spaced apart from all of the plurality of teeth of the inner body when a radially inward force that exceeds the bias of the first spring is applied to the first actuator.

15. 15. The medical device of claim 1, wherein the handle includes an active connector configured to communicatively couple the sheath to an electrosurgical generator, the sheath including a conductive material, and the active connector is coupled to the sheath through the second actuator.

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