End effector control mechanism

Abstract

The medical device includes a mounting device having a longitudinal axis, a pivot arm having a first end pivotally attached to the mounting device, an end effector pivotally attached to a second end of the pivot arm and configured to move from a first configuration to a second configuration, and a longitudinally extending body attached to a proximal end of the end effector, wherein proximal movement of the longitudinally extending body rotates the end effector from the first configuration to the second configuration, the end effector being generally parallel to the longitudinal axis of the mounting device in the first configuration and the end effector being angled relative to the longitudinal axis of the mounting device in the second configuration.

Description

[Technical Field]

[0001] The present disclosure relates to minimally invasive (e.g., endoscopic and / or laparoscopic) medical devices and related methods of use. In embodiments, the present disclosure relates to, among other aspects, one or more control mechanisms for end effectors, e.g., tissue fastening devices such as stapler devices, and related methods of use. [Background technology]

[0002] Technological developments have provided users of medical systems, devices, and methods with the ability to perform increasingly complex procedures on subjects. For example, joining tissue in a subject's gastrointestinal tract or elsewhere in the body is one type of procedure that can present challenges. Surgical devices are known that grasp or clamp tissue between opposing jaw structures and then join the tissue with surgical fasteners. The fasteners may include surgical staples. In some procedures, a cutting instrument may be provided to cut the tissue joined by the fasteners. Drawbacks to these systems may include, for example, the fact that the target site must be accessed through a tortuous path and / or a path having a small cross-sectional diameter. As a result, the target site may not be adequately accessible to staple and / or cut the tissue using a scope, increasing treatment time and / or cost and / or potentially causing trauma to the patient (e.g., requiring a more invasive procedure to access the target site). The present disclosure may address one or more of these problems or other problems in the art. However, the scope of the present disclosure is defined by the appended claims, not by its ability to address a particular problem. Summary of the Invention

[0003] According to one aspect, a medical device includes an attachment device having a longitudinal axis, a pivot arm having a first end pivotally attached to the attachment device, an end effector pivotally attached to a second end of the pivot arm and configured to move from a first configuration to a second configuration, and a longitudinally extending body attached to a proximal end of the end effector, wherein proximal movement of the longitudinally extending body is configured to rotate the end effector from the first configuration to the second configuration, wherein in the first configuration the end effector is generally parallel to the longitudinal axis of the attachment device and in the second configuration the end effector is angled relative to the longitudinal axis of the attachment device.

[0004] Distal movement of the longitudinally extending body may be configured to distally move the end effector. Distal movement of the longitudinally extending body may be configured to pivot the pivot arm relative to the distal end of the attachment device.

[0005] The medical device may further include a locking mechanism for moving from a locked position to an unlocked position, and the locking mechanism may be configured to prevent pivotal movement of the end effector when the locking mechanism is in the locked position.

[0006] The locking mechanism may be spring biased into the locked position. The medical device may further include a lock wire extending proximally from the lock mechanism, and the lock mechanism may be configured to move from the locked position to the unlocked position in response to a force on the lock wire in the proximal direction sufficient to overcome the spring force.

[0007] The locking mechanism may include a locking slot disposed on the pivot arm and a pawl. In the second configuration, the angle defined by the end effector and the longitudinal axis may be greater than or equal to 20 degrees and less than or equal to 50 degrees.

[0008] Movement toward the longitudinally extending body may be configured to move the second end of the pivot arm radially outward from the longitudinal axis. The attachment mechanism has a proximal end that may be configured to be attached to the distal end of a catheter.

[0009] The longitudinally extending body may extend along the exterior surface of the catheter from the end effector to the proximal end of the catheter. The attachment mechanism may include a proximal body and a pair of spaced apart arms extending distally from the proximal body, each of the pair of arms may include an opening, each opening may be configured to receive a pivot arm pin that secures the pivot arm to the attachment mechanism, and a first pivot axis may be defined about the pivot arm pin.

[0010] A first protrusion may extend from an inner surface of a first arm from the pair of arms toward the longitudinal axis, a second protrusion may extend from a second arm from the pair of arms toward the longitudinal axis, and the pivot arm may include a pair of openings configured to mate with the first and second protrusions, and contact between the pair of openings and the first and second protrusions may define a proximalmost movement of the pivot arm.

[0011] The end effector may include a pair of jaws pivotally connected to one another, an actuation wire may be operably connected to at least one of the pair of jaws and may extend through a lumen in the longitudinally extending body from the end effector to the proximal end of the medical device, and actuation of the actuation wire may be configured to pivot the pair of jaws relative to one another.

[0012] The pivot arm may include a pair of openings at the second end, each opening configured to receive an end effector pin that secures the end effector to the pivot arm, and the second pivot axis may be defined about the end effector pin.

[0013] According to another aspect, a medical device includes a catheter having a longitudinal axis, an attachment mechanism coupled to a distal end of the catheter, a pivot arm pivotally connected to the attachment mechanism at a first end of the pivot arm and configured to rotate about a first pivot axis, an end effector pivotally connected to a second end of the pivot arm and configured to rotate about a second pivot axis, and a longitudinally extending body configured to move proximally and distally, wherein movement of the longitudinally extending body is configured to pivot the pivot arm about the first axis and the second axis.

[0014] The end effector can be configured to move between a first configuration in which the end effector can be generally parallel to the longitudinal axis of the catheter and a second configuration in which the end effector can be angled relative to the longitudinal axis of the catheter.

[0015] The second end of the pivot arm and the distal end of the end effector can be configured to extend along parallel axes when the longitudinally extending body is in the first configuration, and the second end of the pivot arm and the distal end of the end effector can be configured to extend in opposite radial directions when the longitudinally extending body is in the second configuration.

[0016] According to yet another aspect, a medical method includes advancing an end effector of a medical device to a target site within a patient, the end effector attached to a distal end of a catheter by an attachment device, the end effector being positioned in an in-line orientation such that the end effector is parallel to a longitudinal axis of the catheter, the medical method includes actuating a longitudinally extending body connected to a proximal end of the end effector to move the end effector from the in-line orientation to an active orientation, the end effector being angled relative to the longitudinal axis of the catheter in the active orientation, and the medical method includes placing an object between a first jaw and a second jaw of the end effector via a medical tool extending from the distal end of the catheter, and actuating a control mechanism to pivot the first jaw relative to the second jaw to perform a procedure on tissue.

[0017] The method may further include moving the lock wire proximally to disengage the locking mechanism, allowing the end effector to move from the active orientation, rotating the end effector from the active orientation to an in-line orientation, and removing the end effector from the patient. [Brief explanation of the drawings]

[0018] The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate various exemplary embodiments and, together with the description, serve to explain the principles of the disclosed embodiments. [Figure 1A] FIG. 1A is an enlarged schematic view of a distal end of a medical device including an end effector, according to one embodiment. [Figure 1B] FIG. 1B is a perspective view of the proximal end of a medical device, according to one embodiment. [Figure 2] FIG. 2 is a perspective view of a pivot arm and end effector of the medical device of FIG. 1A, according to one embodiment. [Figure 3] FIG. 3 is a top view of the pivot arm and end effector of FIG. 2, according to one embodiment. [Figure 4]FIG. 4 is a side view of the pivot arm and end effector of FIG. 2, according to one embodiment. DETAILED DESCRIPTION OF THE INVENTION

[0019] The present disclosure will be described with reference to exemplary medical systems and medical tools for accessing a target site and providing a control mechanism for controlling the orientation of an end effector relative to the medical tool, for example, to grasp, cut, and / or staple tissue. This can provide improved medical tool functionality and / or assist medical professionals in improving access to the target site, which can improve tissue cutting and / or fastening. However, it should be noted that reference to any particular device and / or any 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 application methods can 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 like elements are referred to with the same reference numerals.

[0020] For ease of description, portions of the disclosed devices and / or their components are referred to as proximal and distal portions. Note that the term "proximal" is intended to refer to the portion of the device closer to the user, while the term "distal" is used herein to refer to the portion further away from the user. Similarly, "distally extending" indicates that a component extends in the distal direction, and "proximally extending" indicates that a component extends in the proximal direction. Furthermore, as used herein, the terms "about," "approximately," and "substantially" indicate a range of values ​​within + / - 10% of the stated or suggested value. Additionally, terms indicating the geometry of a component / surface refer to exact and approximate shapes.

[0021] Embodiments of the present disclosure may be used to fasten tissue in an endoluminal space or to facilitate the process. According to one example, the fastening device may be a tissue stapling apparatus that may include a cutting or severing mechanism (e.g., an integrated knife) and a stapling mechanism (e.g., a stapler). The fastening device may be delivered to the target tissue site through an endoscope working channel. Alternatively, the fastening device may be attached to the distal end of an endoscope. All or a portion of the fastening device may be metal (such as stainless steel, titanium, or cobalt chrome), plastic (such as polyetheretherketone (PEEK)), or may include a shape memory metal (such as nitinol), a shape memory polymer, a polymer, or any combination of materials.

[0022] Although reference is made herein to fastening devices having a control mechanism for controlling the orientation of the fastening device, the described control mechanism can be used with any set of jaws or other end effectors pivotally connected together at the distal end of a catheter, sheath, tube, or the like. The control mechanism allows for pivotal movement of the end effector about one or more pivot points at the distal end of the endoscope, which can provide improved grasping of tissue. For example, the control mechanism may allow the end effector to be positioned parallel to or along the longitudinal axis of the endoscope during insertion of the end effector into the target site, and then, once the end effector reaches the target site, allow the end effector to rotate about one or more pivot points and reposition to grasp tissue. In this manner, the end effector and endoscope can navigate tortuous paths within the body.

[0023] 1A and 1B show distal and proximal portions, respectively, of an apparatus 10 according to an example of the present disclosure. The apparatus 10 may include a medical device including a scope (e.g., a colonoscope, endoscope, duodenoscope, etc.) and an end effector (e.g., end effector 100 of FIG. 1A). The scope may be used for imaging, providing light to a target site, and / or introducing instruments to a target site, and the surgical stapling apparatus is configured to engage and apply multiple fasteners to bodily tissue during minimally invasive procedures, such as those using a scope. In some embodiments, the device including the end effector may be a suturing apparatus for delivering sutures for tissue closure during a minimally invasive surgical procedure. While the apparatus 10 may be used to apply sutures, clips, or other fasteners, it will be described primarily in the context of grasping tissue in preparation for performing additional procedures on the tissue, such as stapling and / or cutting the tissue.

[0024] As shown in FIGS. 1A and 1B , the grasping or stapling device of apparatus 10 may include a handle assembly 30 at its proximal end, an end effector 100 at its distal end, and a longitudinally extending body 50 (e.g., a shaft, catheter, etc.) connecting the distal end of handle assembly 30 to the proximal end of end effector 100. The longitudinally extending body 50 may extend to any length suitable for an endoscopic or laparoscopic procedure. In some examples, the longitudinally extending body 50 may be configured to be disposed within a working channel of an endoscope. Alternatively, the longitudinally extending body 50 may extend along the exterior surface of the endoscope, for example, if the endoscope includes only a single lumen and / or if the diameter of the endoscope's lumen(s) is too small to accommodate the longitudinally extending body 50. In some examples, the longitudinally extending body 50 and end effector 100 are disposed on the exterior of an endoscope to reduce the cross-sectional area of ​​an endoscope used with the device 10, which may allow the device 10 to be manipulated along a tortuous path to access a target site.

[0025] The longitudinally extending body 50 may be detachable from the handle assembly 30 to facilitate insertion of the longitudinally extending body 50 into the working channel of an endoscope or a channel of another device, for example, by backloading the longitudinally extending body 50 into the working channel. In some examples, the longitudinally extending body 50 may be flexible, steerable, and / or rotatable about its axis. The longitudinally extending body 50 may include a lumen (or multiple lumens) for disposing an actuation wire (e.g., actuation wire 52) therein to actuate the end effector 100 or any other portion of the apparatus 10 via the handle assembly 30. The longitudinally extending body 50 may be configured to accept multiple actuation wires or a single actuation wire. In some examples, the longitudinally extending body 50 may be fixedly coupled to the end effector 100, while in other examples, the longitudinally extending body 50 may be detachably or releasably coupled to the end effector 100. Unless otherwise stated, any wires or actuating devices described herein may extend from the handle assembly 30 to the end effector 100 through a lumen in the longitudinally extending body 50. Alternatively or additionally, one or more of these actuating wires or devices (e.g., wire 119a) may extend from the handle assembly 30 to the end effector 100 outside of (e.g., adjacent to) the longitudinally extending body 50.

[0026] The longitudinally extending body 50 of the device 10 may be inserted into or attached to a catheter 60 of an endoscope, and the end effector 100 may be positioned relative to the catheter 60 as shown in FIG. 1A and further described herein. The catheter 60 may be the central shaft of a scope (e.g., a colonoscope, endoscope, duodenoscope, etc.). The catheter 60 may include one or more central lumens through which medical tools, imaging cables, and / or illumination cables may extend. The imaging and illumination cables may connect to and control imaging and light-emitting devices, respectively, at the distal end of the catheter 60. A medical tool, such as a grasping tool, or the device 10 itself may be inserted into and extend through one or more lumens of the catheter 60, or may extend distally from the distal-most end of the catheter 60. The one or more medical tools may be used to grasp tissue at a target site and / or to perform a medical procedure on tissue at the target site. These tools may be used with the device 10.

[0027] The endoscope handle may include actuators, including knobs and / or buttons, for controlling medical tools, imaging devices, and light-emitting devices. Ports or other openings in the endoscope handle or the proximal end of the catheter 60 may provide access to one or more lumens of the catheter 60 and may allow medical tools or other devices to be introduced into those lumens. The handle assembly 30 of the apparatus 10 may be manipulated by a user in conjunction with the endoscope handle and / or may be positioned relative to the endoscope handle.

[0028] The handle assembly 30 of the device 10 may include a handle 32 and a body 34. The handle 32 may include a fixed portion 32a and an actuator portion 32b. The fixed portion 32a of the handle 32 may be fixedly coupled to the body 34. The actuator portion 32b may include a circular or oval portion or ring for placement of a user's fingers therein, which can assist the user in holding the handle assembly 30. In some examples, the actuator portion 32b of the handle 32 may be an actuator, which may be pivotally coupled to the body 34 and movable relative to the fixed portion 32a of the handle 32. In some examples, the actuator portion 32b of the handle 32 may be coupled to a proximal portion of an actuation wire, such as the actuation wire 52, via an adjustable coupler 36, as described herein. In other examples, the actuator portion 32b of the handle 32 may be configured to control any other mechanism of the device 10, such as actuation of staple deployment from the end effector 100. It will be appreciated that the actuation wire 52 may be sufficiently stiff to be pushed distally and pulled proximally.

[0029] In some examples, the handle assembly 30 may include a movable cover 38 pivotally coupled to the housing 34 at a pivot point 38b. In FIG. 1B, the cover 38 is shown in an open position, exposing the interior of the body 34. The cover 38 may be coupled to a proximal portion of the body 34 and, when disposed in a closed configuration, may cover the interior components of the handle assembly 30, for example, when a distal-most end 38a of the cover 38 is disposed adjacent to a surface 34a of the body 34. The cover 38 may be disposed to cover the interior components of the body 34 (e.g., in a closed configuration) via a coupling mechanism, such as a snap-fit ​​mechanism, at a distal portion of the cover 38 and a distal portion of the handle assembly 30. When in the closed configuration, the cover 38 may cooperate with the body 34 to form a pair of slots (not shown). When the distal portion of the cover 38 is decoupled from the distal portion of the body 34, a user may rotate or pivot the cover 38 at the pivot point 38b to access the interior components of the handle assembly 30.

[0030] The handle assembly 30 may include one or more adjustable couplers 36, 39 that may be configured to receive a portion of an actuation wire, such as the actuation wire 52. Any of the adjustable couplers 36, 39 may be movable vices to clamp the actuation wire 52 and securely couple the actuation wire 52 to the adjustable coupler 36, 39. In some examples, the adjustable couplers 36, 39 may be movable via a screw to adjust the coupler 36, 39 to couple or uncouple the actuation wire 52 to or from the coupler 36, 39 or to adjust the tension of the actuation wire 52. The couplers 36, 39 may be used in the movement of additional wires as described herein.

[0031] The adjustable coupler 39 may be coupled to the longitudinal actuator 31 and may be longitudinally movable by translating the longitudinal actuator 31 along the body 34. The longitudinal actuator 31 may be partially disposed within the housing 34 and may be longitudinally slidable within two slots formed when the cover 38 is disposed over the internal components of the handle assembly 30 in a closed configuration. The longitudinal actuator 31 may include a pair of opposing circular or oval portions or rings, each circular portion defining an opening for a user to place one or more fingers therein. In some examples, the longitudinal actuator 31 may be coupled to the actuation wire 52, such as via the adjustable coupler 39 or via a different coupler within the body 34, and may be configured to control staple deployment from the end effector 100. In other examples, the longitudinal actuator 31 may be configured to control any other mechanism of the device 10, such as proximal / distal movement of the actuation wire 52. Alternatively, two actuators may be used, with a first actuator for actuating the cutting device and a second actuator for actuating the stapling device. Handle assembly 30 is only one example of an actuation device for end effector 100, and any other handle assembly suitable for actuating end effector 100 may be used.

[0032] The end effector 100 may include a pair of jaws, such as, for example, the anvil 120 and body 130 of a stapler device (also shown in FIG. 4 ), which may be coupled to the distal end of the catheter 60 via an attachment device 110. For example, the attachment device 110 may be connected to the distal end of a longitudinally extending body 50, and the proximal end of the end effector 100 may be attached to the longitudinally extending body 50 via adhesive, laser welding, or the like. The attachment between the proximal end of the attachment device 110 and the distal end of the longitudinally extending body 50 may be sufficient to receive distal and proximal forces such that the end effector 100 may pivot about one or more axes and / or move distally and proximally, as described herein. The distal end of the actuator and / or one of the jaws (e.g., the anvil 120) may be attached to the distal end of the actuation wire 52. In this manner, the anvil 120 and / or body 130 of the end effector 100 can be actuated via the longitudinal actuator 31 .

[0033] 1 and 2 , the pivot arm 111 may be pivotally attached to the end effector 100 via one or more pins 111 a (which may define a pivot axis) (though only one pin 111 a is shown in the figures, it is contemplated that multiple pins 111 may be included, e.g., to increase the range of motion). One or more protrusions 132 may extend from a side of the end effector 100 (e.g., from a side of the body 130) and may receive the pins 111 a through pinholes (not shown) in the protrusions 132, thereby securing the pins 111 a relative to the protrusions 132. The pins 111 a define a pivot axis for the pivot arm 111 and the end effector 100. The pin 111a may be received in an opening (not shown) at the distal end of the pivot arm 111 (FIG. 2), thereby securing the pivot arm 111 to the protrusion 132 about a pivot axis and allowing the end effector 100 to pivot relative to the pivot arm 111.

[0034] The pivot arm 111 may include an opening (not shown) at its proximal end. The opening may be connected to the distal end of the attachment mechanism 110. For example, one or more pins 112a, 112b (the pins 112a, 112b may define a pivot axis) may connect the opening at the proximal end of the pivot arm 111 to a corresponding opening at the distal end of the attachment mechanism 110. The pins 112a, 112b may attach or secure the pivot arm 111 to the attachment mechanism 110 via the pivot axis. Because the pins 112a, 112b define the pivot axis, the pivot arm 111 may pivot relative to the attachment mechanism 110.

[0035] 2 and 3, the pivot arm 111 includes recesses 114a, 114b disposed on the upper and lower supports of the pivot arm 111. The recesses 114a, 114b each have a partially circular shape, but are not limited to such. The recesses 114a, 114b can cooperate with the protrusions 118a, 118b on the attachment mechanism 110 to provide a proximal stop for the pivot arm 111. As described herein, the pivot arm 111 can rotate about the pins 112a, 112b until the recesses 114a, 114b contact the protrusions 118a, 118b, preventing further proximal rotation of the pivot arm 111.

[0036] The pivot arm 111 may include an opening 116 in a surface of the pivot arm 111, shown in an orientation depicted in FIG. 2 as the top surface of the pivot arm 111, although it should be understood that this orientation may change as the catheter 60 and end effector 100 are manipulated during use. The opening 116 may receive and cooperate with a locking mechanism 119, e.g., a pawl, to maintain the position of the pivot arm 111 when the pivot arm 111 is angled relative to the longitudinal axis A of the catheter 60 (FIGS. 1-3). The locking mechanism 119 may be pivotally mounted to the body 130 of the end effector 100 or may be pivotally mounted to a protruding arm 132 of the end effector 100 (FIG. 4). The locking mechanism 119 may include a spring (not shown) or other biasing member that biases or urges the locking mechanism 119 into a closed position, e.g., toward the opening 116. When pivot arm 111 rotates about the pivot axis defined by pins 111a and 112a, 112b, locking mechanism 119 may be biased into opening 116, e.g., locking slot, when locking mechanism 119 and opening 116 are aligned. Locking mechanism 119 may prevent rotational movement of end effector 100 and / or pivot arm 111 when locking mechanism 119 is disposed within and locked to opening 116.

[0037] Wire 119a may be attached to locking mechanism 119 and may be pulled proximally to overcome a spring force and disengage locking mechanism 119 from opening 116, thereby allowing rotational movement of end effector 100 and / or pivot arm 111. It will also be appreciated that a user may move wire 119a distally to move locking mechanism 119 into opening 116 and lock relative movement of pivot arm 111 and / or end effector 100 about the axis of rotation defined by pins 111a and 112a, 112b. It will be appreciated that pivot arm 111 may include multiple openings 116 to allow a user to lock pivot arm 111 at multiple angles relative to longitudinal axis A of catheter 60. For example, the pivot arm 111 may include two, three, or more openings 116, with the location of each opening 116 defining the angle of the end effector 100 relative to the longitudinal axis A. For example, the angle formed by the end effector 100 and the longitudinal axis A may be between 0 degrees and 90 degrees, between about 20 degrees and about 50 degrees, or about 45 degrees.

[0038] As shown in FIG. 2 , attachment device 110 may include a body 110c defining an opening at its proximal end and walls 110a, 110b extending from the distal end of body 110c to form a U-shaped opening. The inner wall of body 110c defining the opening in attachment device 110 may have a diameter larger than the diameter of the outer surface of endoscopic catheter 60. In this manner, attachment device 110 may slide onto the distal end of catheter 60 and may be removably or permanently attached via adhesive, laser welding, threads, etc. Additionally, medical tools, imaging devices, and / or light-emitting devices attached to or extending from catheter 60 may access a target site through the opening in attachment device 110. Alternatively, it will be appreciated that the outer wall of the proximal end of the attachment device 110 may have a smaller diameter than the inner wall of the catheter 60, such that the attachment device 110 is configured to slide into the lumen of the catheter 60 and be removably or permanently attached to the catheter 60 using adhesives, laser welding, threads, etc.

[0039] As described herein, protrusions 118a, 118b extend from the inner surface of walls 110a, 110b of attachment device 110 toward longitudinal axis A (FIG. 2). In some embodiments, protrusions 118a, 118b can impede rotational movement of pivot arm 111 when pivot arm 111 reaches a predetermined maximum rotational angle (e.g., about 90 degrees) relative to longitudinal axis A of catheter 60.

[0040] Pivot arm 111 and end effector 100 can be moved from a first position (e.g., an in-line position) (FIG. 3) in which at least a portion of pivot arm 111 and / or end effector 130 extends distally of the distal-most end of catheter 60 and each is generally parallel to longitudinal axis A, to a second position (e.g., an inclined position) (FIG. 1) can be achieved when at least a portion of pivot arm 111 and / or end effector 130 is moved proximally by rotating pivot arm 111 and / or end effector 130 about an axis defined by pins 111a and / or 112a, 112b.

[0041] A method of operating the device 10 will now be described. The device 10 can be introduced into the body through a natural orifice (e.g., the mouth or anus) or through an incision or other medically induced opening. The end effector 100 can be advanced to a target site within the body, for example, by pushing the catheter 60 and / or the longitudinally extending body 50 distally. The end effector 100 can be advanced with the catheter 60 in a closed configuration, e.g., a configuration in which the end effector 100 is parallel to the longitudinal axis A of the catheter 60, which allows the end effector 100 and catheter 60 to have a narrower profile and therefore more easily navigate one or more tortuous paths within the body.

[0042] Once the end effector 100 reaches a target site within the body, the angle of the end effector 100 relative to the longitudinal axis A can be adjusted. For example, a user may move the longitudinally extending body 50 proximally, which may cause the end effector 100 to rotate about a pivot axis defined by pin 111a and / or the pivot arm 111 to rotate about a pivot axis defined by pins 112a and 112b. As the user moves the longitudinally extending body 50 proximally, the distal end of the end effector 100 may move toward and / or across the longitudinal axis A ( FIG. 1 ) such that an intermediate portion of the end effector 100 is disposed along the longitudinal axis A. As the end effector 100 rotates, the distal end of the pivot arm 111 may move radially outward, e.g., away from the longitudinal axis A, in the proximal direction. When the end effector 100 is rotated from the in-line position (first position) to the working position (second position), the locking mechanism 119 can be forced or biased into the opening 116 to lock the end effector 100 in the desired working position. Alternatively or additionally, the user can move the wire 119a distally, which can move the locking mechanism 119 into the opening 116. Although operation is described as being performed using the locking mechanism 119, it will be understood that the end effector 100 need not be locked in a position prior to actuating the anvil 120 and body 130 of the end effector 100.

[0043] Once the locking mechanism 119 is moved into the opening 116, the user can move the actuation wire 52 proximally and distally, pivot the anvil 120 relative to the body 130, grasp tissue, staple tissue, and / or perform other medical procedures on tissue at the target site. The user can also use any tools, imaging devices, and / or light-emitting devices associated with the catheter 60. During the medical procedure, the user can change the angle of the end effector 100 relative to the longitudinal axis A. In some examples, changing the angle of the end effector 100 relative to the longitudinal axis A may require the user to move the wire 119a proximally to disengage the locking mechanism 119 from the opening 116. Once the locking mechanism 119 is moved out of the opening 116, the user can move the longitudinally extending body 50 proximally and distally to change the angle of the end effector 100 relative to the longitudinal axis A. Once the desired angle is achieved, the position of the end effector 100 can be locked by pushing the wire 119a distally and / or by a biasing member moving the locking mechanism 119 into one or more openings 116, as described herein.

[0044] Once the medical procedure is performed, the device 10 may be removed from the body. The wire 119a may be moved proximally, thereby moving the locking mechanism 119 out of the opening 116. The user may then push the longitudinally extending body 50 distally so that the end effector 100 and pivot arm 111 approach an in-line orientation. Once the end effector 100 and pivot arm 111 achieve an in-line orientation, the device 10 may be removed from the body by pulling the catheter 60 proximally. In some examples, the user may apply a distal force to the longitudinally extending body 50 during removal of the device 10 to ensure that the end effector 100 and pivot arm 111 maintain an in-line orientation. Alternatively, a locking mechanism (such as the locking mechanism 119) may maintain the in-line position of the end effector 100 and pivot arm 111 during removal.

[0045] While exemplary medical systems have been described, it will be understood that the particular arrangement of elements in these fastening systems is not limited. Furthermore, the size, shape, and / or material of the fastening system is not limited. As described herein, a control mechanism for controlling the position of the end effector relative to the longitudinal axis of the scope is included. The performance of various medical procedures can be improved by allowing a user to insert the end effector in an in-line orientation, thereby reducing the size of the device, move the end effector to an operating position, and perform one or more medical operations using the end effector.

[0046] 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. It is intended that the specification and examples be considered as exemplary only, with a true scope and spirit of the invention being indicated by the following claims.

Claims

1. A medical device comprising: a mounting device having a longitudinal axis; a pivot arm having a first end pivotally attached to the mounting device; an end effector pivotally mounted to a second end of the pivot arm and configured to move from a first configuration to a second configuration; a longitudinally extending body attached to a proximal end of the end effector, wherein proximal movement of the longitudinally extending body is configured to rotate the end effector from the first configuration to the second configuration, wherein the end effector is parallel to the longitudinal axis of the mounting device in the first configuration and the end effector is angled relative to the longitudinal axis of the mounting device in the second configuration; and a locking mechanism configured to move from a locked position to an unlocked position; the locking mechanism is configured to prevent pivotal movement of the end effector when the locking mechanism is in the locked position, the locking mechanism including a locking slot disposed on the pivot arm and a pawl.

2. The medical device of claim 1 , wherein distal movement of the longitudinally extending body is configured to move the end effector in the distal direction.

3. The medical device of claim 2 , wherein distal movement of the longitudinally extending body is configured to pivot the pivot arm relative to a distal end of the attachment device.

4. The medical device of claim 1 , wherein the locking mechanism is biased to the locked position by a spring.

5. A medical device, a mounting device having a longitudinal axis; a pivot arm having a first end pivotally attached to the mounting device; an end effector pivotally mounted to a second end of the pivot arm and configured to move from a first configuration to a second configuration; a longitudinally extending body attached to a proximal end of the end effector, wherein proximal movement of the longitudinally extending body is configured to rotate the end effector from the first configuration to the second configuration, wherein the end effector is parallel to the longitudinal axis of the mounting device in the first configuration and the end effector is angled relative to the longitudinal axis of the mounting device in the second configuration; and a locking mechanism configured to move from a locked position to an unlocked position, the locking mechanism configured to prevent pivotal movement of the end effector when the locking mechanism is in the locked position; a lock wire extending from the locking mechanism in the proximal direction; wherein the locking mechanism is configured to move from the locked position to the unlocked position in response to a force on the lock wire in the proximal direction sufficient to overcome a spring force.

6. The medical device of any one of claims 1 to 3 and 5, wherein in the second configuration, the angle defined by the end effector and the longitudinal axis is greater than or equal to 20 degrees and less than or equal to 50 degrees.

7. 7. The medical device of any one of claims 1-3 and 5-6, wherein the proximal movement of the longitudinally extending body is configured to move the second end of the pivot arm radially outward from the longitudinal axis.

8. The medical device of claim 1, wherein the attachment device has a proximal end configured to be attached to the distal end of a catheter.

9. The medical device of claim 8 , wherein the longitudinally extending body extends along an outer surface of the catheter from the end effector to a proximal end of the catheter.

10. A medical device as described in any one of claims 1 to 3 and 5 to 6, wherein the mounting device includes a proximal body and a pair of spaced apart arms extending distally from the proximal body, each of the pair of spaced apart arms including an opening, each opening configured to receive a pivot arm pin that secures the pivot arm to the mounting device, and a first pivot axis defined about the pivot arm pin.

11. A medical device, a mounting device having a longitudinal axis; a pivot arm having a first end pivotally attached to the mounting device; an end effector pivotally mounted to a second end of the pivot arm and configured to move from a first configuration to a second configuration; a longitudinally extending body attached to a proximal end of the end effector, wherein proximal movement of the longitudinally extending body is configured to rotate the end effector from the first configuration to the second configuration, wherein the end effector is parallel to the longitudinal axis of the mounting device in the first configuration and the end effector is angled relative to the longitudinal axis of the mounting device in the second configuration; and a proximal body; and a pair of spaced apart arms extending distally from the proximal body. each of the pair of spaced apart arms includes an opening configured to receive a pivot arm pin that secures the pivot arm to the mounting device, a first pivot axis defined about the pivot arm pin; a first protrusion extending from an inner surface of a first arm from the pair of spaced-apart arms toward the longitudinal axis, a second protrusion extending from a second arm from the pair of spaced-apart arms toward the longitudinal axis, the pivot arm including a pair of openings configured to mate with the first and second protrusions, and contact between the pair of openings and the first and second protrusions defines a proximal-most movement of the pivot arm.

12. 12. The medical device of claim 11, wherein the end effector includes a pair of jaws pivotally connected to one another, an actuation wire operably connected to at least one of the pair of jaws and extending through a lumen in the longitudinally extending body from the end effector to a proximal end of the medical device, and actuation of the actuation wire is configured to pivot the pair of jaws relative to one another.

13. 13. The medical device of claim 12, wherein the pivot arm includes a pair of openings at the second end, each opening configured to receive an end effector pin that secures the end effector to the pivot arm, and a second pivot axis defined about the end effector pin.

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