Distal head for endoscope with enlarged working channel

Abstract

The present invention relates to a distal head for an endoscope, comprising a support (11) for a visual system, said support (11) being bounded on one side by a proximal face (11p) and on the other side by a distal face (11d) from which the visual system emerges, said support (11) being crossed by at least one hole (12) of an operating channel (9) opening into said distal face (11d) with an oval cross section that decreases from the distal face (11d) of said support towards the proximal face (11p) of said support (11).

Description

[Technical Field]

[0001] The present invention relates to the technical field of medical endoscopy in the general sense for accessing the interior of the body, such as cavities or ducts, and relates to reusable or single-use endoscopes.

[0002] The present invention more particularly relates to the distal head of such an endoscope adapted to ensure multiple functions, such as visualization, fluid delivery, fluid aspiration, instrument delivery, sample collection, or the performance of a surgical procedure.

[0003] An endoscope equipped with a distal head according to the invention finds particularly advantageous use for making it possible to access the inner surfaces of hollow organs, cavities or natural or artificial conduits of the human body in order to carry out various operations for therapeutic, surgical or diagnostic purposes.

[0004] The endoscope according to the invention is used for the examination, for diagnostic, therapeutic or surgical purposes, of any interior of the human body that is accessible by natural or artificial pathways, for example, the endoscope according to the invention can be used in the fields of the urinary tract, the digestive tract, the respiratory system, the cardiovascular system, the trachea, the paranasal sinuses, the female reproductive system, the abdominal cavity or any other part of the human body that is explored by natural or artificial pathways. [Background technology]

[0005] Generally, a medical endoscope comprises a control handle to which a tubular insertion structure is fixed, the tubular insertion structure comprising a distal head equipped with a vision system that allows for illuminating and inspecting organs, cavities or ducts of the human body, as described, for example, in WO 2014 / 106510. The tubular insertion structure upstream of the distal head comprises a deflection portion that allows for directing the distal head within the insertion path.

[0006] This tubular structure is adapted to allow one or more devices to be brought to the distal head, designed to perform different functions, such as, for example, supplying fluids, aspirating fluids, supplying instruments, collecting samples, or performing a surgical procedure. The distal head of the endoscope also comprises at least one channel, called an operating or working channel, to allow the passage of these various devices.

[0007] Therefore, such endoscopes include multifunctional distal heads configured to enable the implantation of a visual system and the passage of various devices. However, these distal heads have passageways or bulky sections limited by the minimum width of the natural or artificial access pathways through which the tubular structures engage. Given the variety of functions that endoscopes must have and the dimensional constraints imposed by the access pathways, it is difficult to configure a distal head to perform several of the endoscope's functions. This is particularly true for functions such as aspirating liquids, removing bulky objects, or using cumbersome tools such as biopsy forceps. Mucosal aspiration, which can cause bleeding, also occurs. In addition to the resulting performance degradation, the distal heads of such endoscopes are relatively complex to manufacture, increasing production costs.

[0008] U.S. Patent Application Publication No. 2017 / 0143199 describes a bronchoscope including a rigid tube defining a working channel separated from a hardware channel by an inner wall. An illumination component and an imaging component are fixed to the distal end of the hardware channel. The rigid tube is chamfered at its distal end to increase the size of the opening of the working channel and reduce the overall size of the tube's distal end. When the distal end of such a tube is reduced, its chamfered shape does not provide sufficient safety for accessing the interior of the body having a specific access passage shape. Such a shape is also less effective at ensuring good aspiration of liquids without pressure loss.

[0009] EP 1772095 describes an endoscope with an instrument adapted to pivot at its distal end. The instrument is inserted into the working channel by opening through an oval-shaped opening in a housing that houses a pivotally operable support located in the distal head. This endoscope has a very bulky distal head and is not particularly suitable for aspiration of fluids.

[0010] U.S. Patent Application Publication No. 2013 / 0150667 describes, inter alia, an endoscope having a working channel with a conductive tubular insert, one end of which is mounted in a housing located in the distal head and the other end of which is mounted in a tube. At the distal entrance, the cross section of the working channel does not change to allow for increased suction. The endoscope has a very bulky distal head. Summary of the Invention [Problem to be solved by the invention]

[0011] The present invention aims to overcome the drawbacks of the current state of the art by proposing a new distal head for an endoscope of simple and inexpensive design, adapted to fully and effectively perform the various functions of the endoscope.

[0012] The present invention also aims to propose a new distal head for an endoscope, which offers limited size while optimizing the aspiration of fluids and suppressing the above-mentioned aspiration phenomenon. [Means for solving the problem]

[0013] To achieve this objective, the distal head for an endoscope includes a support for a visual system, the support being bounded on one side by a proximal surface and on the other side by a distal surface parallel to the proximal surface and through which the visual system emerges. The support is traversed by at least one hole of an operating channel, the hole opening on the distal surface with an oval cross section whose projected area relative to the axis of the hole decreases in the direction from the distal surface of the support to the proximal surface of the support, and the oval cross section of the operating channel on the distal surface occupies an area of ​​at least 50% or more of the area of ​​the distal surface of the support.

[0014] Typically, the oval cross section of the hole of the operating channel in the distal face of the support occupies an area between 50% and 60% of the area of ​​the distal face of the support.

[0015] For example, the oval cross section of the bore of the operating channel changes from the distal face of the support to terminate in a circular cross section.

[0016] The oval cross section of the bore of the working channel preferably varies from the distal face of the support to terminate in a circular cross section at the abutment face against one end of the conduit defining the working channel.

[0017] According to one preferred exemplary embodiment, the oval cross section of the hole of the operating channel is bounded at its distal surface by a peripheral arcuate edge concentric with the outer surface of the support, the peripheral arcuate edge being connected on both sides by connecting edges to a central arcuate edge having a radius greater than the radius of the peripheral edge.

[0018] According to one alternative preferred embodiment, the support is in the form of a ring bounded on one side by a distal surface and on the other side by a proximal surface, the distal and proximal surfaces being parallel to each other and perpendicular to the longitudinal axis of the ring.

[0019] According to one alternative preferred embodiment, the bore of the working channel is bounded from the distal face of the support by an inner surface provided with spiral grooves or ribs.

[0020] The support preferably includes a mounting passage for mounting an optical lens or visual sensor and at least one light source as a video system, and the optical lens or visual sensor and at least one light source are preferably covered with a transparent protective material along the distal surface of the support.

[0021] According to one exemplary embodiment, the optical lens or visual sensor and at least one light source are embedded in the mounting passage by a transparent protective material.

[0022] For example, the support may include a cylindrical portion from a proximal surface, the cylindrical portion being extended by a constriction that narrows to a distal surface of the support at which it presents a pseudo-triangular cross section.

[0023] In fact, the passage opens into a part of the distal face between the central edge of the support, opposite the demi-circular border, and the central edge that bounds the hole.

[0024] Another object of the invention is to propose an insertion tube, connected at its proximal part to a control handle and equipped at its distal part with a distal head according to the invention.

[0025] Various other features will become apparent from the description given below, with reference to the accompanying drawings, which show, by way of non-limiting examples, embodiments of the subject matter of the invention. [Brief explanation of the drawings]

[0026] [Figure 1] FIG. 1 is a general overview of an endoscope with a distal head according to the present invention. [Figure 2] FIG. 2 shows in more detail the deflection portion of the distal head according to the present invention. [Figure 3] FIG. 3 is a perspective view of a distal head according to the present invention, viewed from its distal surface. [Figure 4] FIG. 4 is a perspective view of a distal head according to the present invention, viewed from its proximal side. [Figure 5]FIG. 5 is a plan view of a distal head according to the present invention, viewed from its distal surface. [Figure 6] FIG. 6 is a plan view of a distal head according to the present invention, viewed from its proximal surface. [Figure 7] FIG. 7 is a view similar to FIG. 4 showing the distal head with the manipulation conduit. [Figure 8] FIG. 8 is a view similar to FIG. 3 showing the distal head with the manipulation conduit. [Figure 9] FIG. 9 is a front view of another exemplary embodiment of a distal head according to the present invention. DETAILED DESCRIPTION OF THE INVENTION

[0027] FIG. 1 shows, by way of example, a medical endoscope 1 in a general sense, designed for accessing the interior of the body, e.g., a cavity or channel. In a known manner, the endoscope 1 includes an insertion tube 2 having, on one side, a proximal portion 21 connected to a control handle 3 and, on the other side, a distal portion 22 equipped with a distal head 4 according to the present invention. The insertion tube 2 is temporarily or permanently fixed to the control handle 3. This insertion tube 2, with its more or less significant length and flexibility, is intended to be introduced into natural or artificial access channels to perform various operations or functions for therapeutic, surgical, or diagnostic purposes. The insertion tube 2 is made of a semi-rigid material and has a length that can be configured between 5 cm and 2 m, adapted to the length of the duct to be examined. The insertion tube 2 can have various cross-sectional shapes, such as square, oval, or circular. This insertion tube 2, which comes into contact with tissue, human organs, or medical devices (trocars or probes), is essentially intended for single or multiple use on a patient and, moreover, can be reused after decontamination, disinfection, or sterilization.

[0028] In a known manner, the endoscope 1 according to the present invention includes a vision system V that is capable of illuminating the distal portion of the insertion tube 2 and returning images. The endoscope 1 therefore includes a vision system that is mounted inside the control handle 3 and extends inside the insertion tube 2 up to the distal head 4.

[0029] In a known manner, the endoscope 1 also includes a control mechanism 5 that allows the distal head 4 to be oriented relative to the longitudinal axis X of the insertion tube 2. For this purpose, the insertion tube 2 includes a bending, folding, or deflecting portion 6 upstream of the distal head 4 that allows the distal head 4 to be oriented relative to the longitudinal axis X of the insertion tube 2 (FIG. 2).

[0030] The control mechanism 5 can be made in any suitable way so as to allow the distal head 4 to move between a rest position, in which the insertion tube 2 is straight, and a deflected position, in which the deflection section 6 is curved. By way of non-limiting example, the control mechanism 5 can correspond to the control mechanism described in French patent 3047887. For this purpose, the control mechanism 5 comprises a manual control lever which rotates a pulley to which is fastened at least one cable mounted inside the insertion tube 2 so as to be fixed to the distal head 4.

[0031] In known manner, the endoscope 1 also includes an operating or working channel 9 extending from the control handle 3 to the distal head 4 to allow for the delivery and / or aspiration of various tools and / or fluids. This operating channel 9 is defined by a pipe or conduit 10 disposed inside the insertion tube 2 (FIGS. 7 and 8).

[0032] According to the invention, the distal head 4 comprises a ring-shaped body or support 11 bounded on the side closest to the control handle 3 by a proximal surface 11p and on the opposite side, furthest from the control handle, by a distal surface 11d from which the visual system V emerges. As shown in the drawings, this ring or support 11 is bounded on one side by a distal surface 11d and on the other side by a proximal surface 11p. The distal and proximal surfaces 11d and 11p are parallel to each other and perpendicular to the longitudinal axis of the ring or support.

[0033] As shown in FIGS. 3 and 4, the support 11 includes an outer surface extending from a proximal surface 11p. The outer surface defines a cylindrical portion 11c. The cylindrical portion 11c is extended by a narrowed portion 11e. The narrowed portion 11e tapers to a distal surface 11d of the support 11. According to the exemplary embodiment shown in FIGS. 3, 5, and 8, the distal surface 11d of the support 11 has a cross-section or pseudo-triangular profile defined by an incomplete circular edge 111. The incomplete circular edge 111 is extended on either side by connecting edges 112 to converging straight edges 113 that connect by connecting edges 114 to a central arcuate edge 115 having a radius smaller than the radius of the incomplete circular edge 111. In this manner, the narrowed portion 11e of the support has a profile that transitions from a pseudo-triangular profile to a circular profile. The circular profile is connected to the cylindrical portion 11c of the support 11 by a cylindrical connecting portion 11r. The cylindrical portion 11c has a diameter smaller than that of the cylindrical connecting portion 11r and defines a shoulder 11b, which is adapted to receive a protective sheath 61 for the deflection portion 6.

[0034] The support 11 of the distal head 4 is pierced laterally by the operating channel 9 and opens onto its distal face 11d. In the exemplary embodiment shown in the drawings (FIGS. 3 to 6), a hole 12 is arranged in the support 11 from the distal face 11d, forming the terminal part of the operating channel 9. This hole 12 extends to an abutment face 13 arranged on the support 11 and serves as a terminal junction for the conduit 10, which thus communicates with this hole 12.

[0035] 4 and 7, the support 11 has two fixing arms 14 that protrude from the proximal face 11p of the support and define a passage 14a therebetween for the conduit 10 to be supported on the abutment face 13. These two fixing arms 14 thus function as fixing clamps for the conduit 10 so that the operating channel 9 extends from the control handle 3 to the distal face 11d of the distal head 4 using the conduit 10 extending through the hole 12. The conduit 10 is thus engaged inside the housing of the support 11 so that it is supported on the abutment face 13, which is recessed from the proximal face 11p of the support. For example, each fixing arm 14 includes a stud 141 intended to cooperate with an oval opening in the deflection portion 6 to form a bayonet connection between the distal head 4 and the deflection portion 6.

[0036] According to a feature of the invention, the operating channel 9 has, at the distal head 4, a cross section which decreases in the direction of the proximal face 11p of the support 11. In the exemplary embodiment shown in the drawings, the hole 12 in the support 11 has a cross section which decreases in the direction of the proximal face 11p of the support 11. The cross section of the hole 12 is therefore smallest at the abutment face 13 and widens towards the distal face 11d of the support 11.

[0037] The operation channel 9 has a cross-section that decreases from the distal surface 11d of the support 11. In the exemplary embodiment shown in the drawings, the holes 12 have a cross-section that decreases from the distal surface 11d of the support to the abutment surface 13. Thus, the cross-section of the holes 12 is smallest at the abutment surface 13 and widens towards the distal surface 11d of the support 11. For example, the cross-section of the holes 12 gradually decreases between the distal surface 11d of the support 11 and the abutment surface 13.

[0038] According to another feature of the present invention, the operation channel 9 opens to the distal surface 11d of the support 11 with an oval cross-section. In the illustrated exemplary embodiment, the hole 12 is demarcated at the distal surface 11d by a peripheral arc-shaped edge 121 whose both sides are connected to a central arc-shaped edge 123 having a radius larger than the radius of the peripheral arc-shaped edge 122 by a connecting edge 122. For example, the peripheral edge 121 is concentric with the support 11 and more specifically with the outer surface of the support 11 (constriction 11e) and has a radius of curvature R1 in order to maximize the suction area. The central edge 123 preferably has a radius of curvature R2 such that R1 < R2 < 4×R1. In this way, the operation channel 9 opens to the distal surface 11d with an oval cross-section in which the projected area with respect to the axis of the hole 12 decreases in the direction from the distal surface 11d of the support to the proximal surface 11p of the support 11.

[0039] The oval cross-section of the operation channel 9 at the distal surface 11d of the support 11 preferably occupies an area of at least 50% or more of the area of the distal surface of the support. In other words, the oval cross-section of the hole 12 at the distal surface 11d of the support 11 occupies an area of at least 50% or more of the area of the distal surface 11d of the support. Preferably, the oval cross-section of the operation channel 9 at the distal surface 11d of the support 11 occupies an area between 50% and 60% of the area of the distal surface of the support 11. In other words, the oval cross-section of the hole 12 at the distal surface 11d of the support 11 occupies an area between 50% and 60% of the area of the distal surface of the support 11.

[0040] According to another feature of the present invention, the oval cross-section of the operation channel 9 changes from the distal surface of the support 11 and ends with a circular cross-section. In the exemplary embodiment shown in the drawings, the oval cross-section of the hole 12 changes from the distal surface of the support 11 and ends with a circular cross-section at the abutment surface 13. It should be noted that the outer shape of the cross-section of the hole 12 changes in consideration of the fact that the cross-section of the hole 12 at the distal surface 11d is larger than the cross-section of the hole 12 at the abutment surface 13.

[0041] According to another preferred embodiment, the operation channel 9 is defined from the distal surface 11 d of the support 11 by an inner surface with spiral grooves or ribs 15. In the exemplary embodiment shown in FIG. 9, the hole 12 is defined from the distal surface 11 d of the support 11 by an inner surface with spiral grooves or ribs 15. The ribs or spirals 15 are at least three in number and generate a vortex effect aimed at mixing and rotating fluids and mucus having different viscosities or shapes. This phenomenon aims to drive the fluids and mucus in a spiral shape to improve their evacuation in the operation channel 9.

[0042] According to another feature of the preferred embodiment, the support 11 includes mounting passages 16 for mounting an optical lens 17 or a visual sensor and at least one light source 18, two in the illustrated example, as the video system V. The passages 16 are disposed through the support 11, opening on the proximal surface 11p and on the distal surface 11d. The passages 16 are independent of the operation channel 9 disposed in the support 11. As shown in the drawings, the passages 16 are opened in a portion of the distal surface 11d between the central edge 115 of the support 11 and the central edge 123 defining the hole 12, opposite the incomplete circular edge 111. According to one preferred feature, the optical lens or visual sensor 17 and the light source 18 are covered with a transparent protective material 19 along the distal surface of the support.

[0043] The optical lens 17 or visual sensor and light source 18 are preferably embedded in the mounting passage 16 by a transparent protective material 19 .

[0044] Preferably, the support 11 is made of a hydrophobic material or is coated with a hydrophobic coating.

[0045] The endoscope according to the present invention has the advantage of including a distal head with a working channel 9 that has a widened portion at its distal face 11d compared to the working channels of conventional endoscopes, making it possible to reduce suction phenomena. The widening of the working channel 9 at its distal face also makes it possible to partially position tools or hold bulky objects for withdrawal when the endoscope is removed.

[0046] The present invention is not limited to the examples described and presented, since various modifications can be made without departing from its scope.

Claims

1. A distal head (4) for an endoscope comprising a support (11) for a visual system (V), said support (11) is bounded on one side by a proximal face (11p) and on the other side by a distal face (11d) parallel to said proximal face (11p) and from which said visual system (V) emerges; said support (11) is traversed by at least one hole (12) of an operating channel (9), said hole (12) opening on said distal face (11d) by an oval cross section whose projected area relative to the axis of said hole (12) decreases from said distal face (11d) of said support (11) towards said proximal face (11p) of said support (11); the oval cross section of the hole (12) of the operation channel (9) in the distal surface (11d) occupies at least 50% or more of the area of ​​the distal surface (11d) of the support (11); The support (11) includes a cylindrical portion (11c) extending from the proximal surface (11p), The cylindrical portion (11c) is extended by a narrowed portion (11e), the constriction (11e) narrows towards the distal face (11d) of the support (11) and presents a quasi-triangular cross section at the distal face (11d), the constricted portion (11e) of the support (11) has a contour that changes from a pseudo-triangular contour to a circular contour, the circular outer shape of the constriction (11e) is connected to the cylindrical part (11c) of the support (11) by a cylindrical connecting part (11r); Distal head for endoscope.

2. the oval cross section of the hole (12) of the operating channel (9) in the distal surface (11d) of the support (11) occupies an area between 50% and 60% of the area of ​​the distal surface (11d) of the support (11); The distal head of claim 1 .

3. the oval cross section of the hole (12) of the operating channel (9) changes from the distal face (11d) of the support (11) and ends in a circular cross section; A distal head according to claim 1 or 2.

4. the oval cross section of the hole (12) of the operating channel (9) changes from the distal face (11d) of the support (11) to end in a circular cross section at the abutment face (13) against one end of the conduit (10) that defines the operating channel (9); A distal head according to any one of claims 1 to 3.

5. The oval cross section of the hole (12) of the operating channel (9) has a peripheral arcuate edge (12) at the distal surface (11d) that is concentric with the outer surface (11e) of the support (11). 1 ) and The peripheral arcuate edge (12 1 ) on both sides thereof, the connecting edge (12 2 ) by the peripheral arcuate edge (12 1 ) having a central arcuate edge (12) with a radius larger than the radius of the 3 ) is connected to A distal head according to any one of claims 1 to 4.

6. said support (11) being in the form of a ring bounded on one side by said distal surface (11d) and on the other side by said proximal surface (11p), the distal surface (11d) and the proximal surface (11p) are parallel to each other and perpendicular to the longitudinal axis of the ring; A distal head according to any one of claims 1 to 5.

7. the bore (12) of the operating channel (9) is bounded from the distal face (11d) of the support (11) by an inner surface provided with spiral grooves or ribs (15); A distal head according to any one of claims 1 to 6.

8. the support (11) includes a mounting channel (16) for mounting an optical lens or a visual sensor (17) and at least one light source (18) as a video system (V); the optical lens or the visual sensor (17) and the at least one light source (18) are covered with a transparent protective material (19) along the distal surface (11d) of the support (11); A distal head according to any one of claims 1 to 7.

9. The optical lens or the visual sensor (17) and the at least the light source (18) are embedded in the mounting passage (16) arranged in the support (11) by the transparent protective material (19). The distal head of claim 8 .

10. The attachment passage (16) has an incomplete circular edge (11 1 The central edge (11) of the support (11) faces the 5 ) and the central edge (12) that defines the hole (12). 3 ) and open to a portion of the distal surface (11d) between A distal head according to claim 8 or 9.

11. An endoscope including an insertion tube (2), The insertion tube (2) has a proximal portion (2 1 ) to the control handle (3), and its distal part (2 2 ) equipped with a distal head (4) according to any one of claims 1 to 10, Endoscope.

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