Endoscopic treatment instruments

Abstract

The present invention relates to a treatment instrument (4; 104; 204; 304; 404; 504; 604; 704; 804; 904; 1004; 1104) that is engaged with the distal end of an endoscope (2), and that has a hollow body (16; 116; 216; 316; 416; 516; 616; 716; 1016; 1116) and a gripping element (18). The gripping element (18) is operated via an actuation mechanism disposed in the hollow body (16; 116; 216; 316; 416; 516; 616; 716; 1016; 1116). The gripping element (18) is formed in a cap shape, which covers the tip of the hollow body (16; 116; 216; 316; 416; 516; 616; 716; 1016; 1116). The present invention also relates to an endoscope (2) which is engaged or engageable with a treatment instrument (4; 104; 204; 304; 404; 504; 604; 704; 804; 904; 1004; 1104) according to the present invention.

Description

[Technical Field]

[0001] The present invention relates to a treatment instrument / smart function carrier / retrofit kit that can be attached (e.g., attached to the outer periphery) to the tip / end / endoscope head of an endoscope, and has a hollow body (engagement portion) and a gripping element (actuator portion), and the gripping element (actuator portion) is operated through an actuation mechanism located within the hollow body (engagement portion).Furthermore, the present invention relates to an endoscope that has an optical system at its tip and, if necessary, a working channel as well as the tip / end / endoscope head that can be attached to a treatment instrument. [Background technology]

[0002] A general treatment instrument / smart function carrier / retrofit kit is already known, as can be seen in, for example, European Patent No. 1543786. This treatment instrument has a cap-like or sleeve-like proximal attachment portion (facing the attending physician) and a distal actuator portion (facing away from the attending physician) that is operated using an operating wire. However, when examining a human body using an endoscope equipped with a general treatment instrument or an additionally equipped endoscope, the distal optical system of the endoscope head is particularly sensitive to dirt, which can adversely affect the view of the attending physician (surgeon or operator). [Prior art documents] [Patent documents]

[0003] [Patent Document 1] European Patent No. 1543786 Summary of the Invention [Problem to be solved by the invention]

[0004] The applicant of the present invention has now determined that this tendency for contamination is due to the fact that the dirt in the optical system cannot be adequately removed or cleaned with the cleaning / washing nozzles commonly used in endoscopes, as the dirt collects inside the sleeve-like engagement portion.

[0005] In light of this, the present disclosure aims to provide the above-mentioned type of treatment instrument / smart function carrier / retrofit kit for an endoscope that can be adaptively or selectively attached to an endoscope to reduce contamination of the endoscope's (tip) optical system, which restricts the operator's view.

[0006] This object is achieved by a treatment instrument or treatment device / smart function carrier / retrofit kit comprising the features of claim 1, and by an endoscope (including an optical system and a working channel, if necessary) comprising the features of claim 14 or 15. Advantageous developments of the treatment instrument are then achieved by several dependent claims.

[0007] The treatment device / smart function carrier / retrofit kit according to the present disclosure relates to a treatment device / smart function carrier / retrofit kit that can be attached (e.g., attached to the outer periphery) to the tip / end / head of an endoscope (including, if necessary, an optical system and an internal working channel disposed in the endoscope shaft), and includes a hollow body / engagement portion (sleeve) as well as a grasping element / actuator portion / actuator (preferably two grippers or forceps). The grasping element is operated by an actuation mechanism (operation wire). The distal end or distal portion of the actuation mechanism is disposed within the hollow body. In particular, the distal end or distal portion of the actuation mechanism is disposed within a recess in the outer (peripheral) wall of the hollow body. The proximal end of the actuation mechanism extends proximally (facing the attending physician) from the hollow body.

[0008] That is, the treatment instrument of the present invention has a hollow body, and an attachment member at its proximal end / end that is suitable for and has an attachment / mounting portion for receiving the distal end / end of the insertion portion (shaft) of an endoscope / endoscope head, so that the treatment instrument can be attached to the distal end / end of the insertion portion / shaft of an endoscope. The grasping element is used as a treatment element so that tissue removed from a location away from the attachment portion, or an object located away from the attachment portion, such as a foreign body or bolus, can be treated or grasped by adjusting the treatment element or grasping element. To adjust the grasping element, an actuation mechanism, particularly the distal end / end of the actuation mechanism, is directly or indirectly connected to the grasping element, particularly its proximal end / end. [Means for solving the problem]

[0009] In structural terms, a treatment device according to the present disclosure includes: A sleeve (base body) provided and arranged at the proximal end (engagement part) of the shaft or head of the endoscope so as to be attached / fitted to the shaft or head; a gripping element, such as two grippers or forked forceps, pivotally supported on the distal end (actuator part) of the sleeve; and An operating wire attached to a grasping element (gripper or bifurcated forceps) (and preferably extending through a sleeve) through which at least a closing / grasping force (and preferably also an opening force) is transmitted / applied to the grasping element (gripper or bifurcated forceps) so that it can be properly operated.

[0010] The treatment instrument according to the present disclosure is particularly distinguished by the fact that the gripping element (in its closed / gripping position) is formed as a cap or flap, or cap-like (i.e. the gripper or bifurcated forceps is preferably formed as a shell or flap type and in the gripping position forms, at least in the distal direction, preferably a hemispherical cap or flap-like) that can close the distal end of the hollow body (the open distal surface of the sleeve).

[0011] In this application, the term "closed" should be understood as meaning that the structure, in this application the gripping element, is at least largely impermeable to tissue particles, particularly tissue particles having a minimum outer diameter of 1.1 mm. In other words, the gripping portion in the closed position (gripping position) does not have any recesses with a maximum opening width of at least 1.1 mm or more, or the gap is formed as a gap that does not include any recesses with a maximum gap opening width of 1.1 mm or more.

[0012] In particular, the term "closed" should be understood as meaning that in the closed position (gripping position), the gripping elements of the treatment instrument that engage with the tip / end of the endoscope are in the distal direction, covering the lens of the optical system located at the tip of the endoscope.

[0013] In other words, the treatment instrument is distinguished by being formed so that at least the majority of the hollow body has a closed distal end surface, preferably completely closed, and by being formed so that the distal end surface of the attachment portion is closed in the distal direction when the gripping element is in the closed position.

[0014] By the term "gripping position," we understand that the structural position is the maximum structurally permitted by the mechanism of the gripping element or actuation mechanism. In other words, in the case of a gripping element such as a gripping forceps or forceps, the gripping position is defined structurally as the maximum position (set position) in which the grippers or forked forceps are in contact with each other or separated by a minimum gap due to the provided stoppers (in the gripping element or actuation mechanism). This also applies to the release position. The release position can be said to be a position related to the structural position (set position) permitted by the mechanism of the gripping element or actuation mechanism, for example, via the stoppers. Therefore, this release position is not specifically defined in this application (i.e., it can be freely set).

[0015] The design of the gripping element as a cap or flap has the advantage of reducing contamination of the optical system of the endoscope in which the treatment instrument of the present invention is mounted.

[0016] The gripping elements may be transparent, or at least partially transparent, in some areas. In particular, the gripping elements may be transparent, or at least partially transparent, to the human-visible spectrum (light wavelengths between 420 and 750 nm). Alternatively or additionally, the gripping elements may be translucent or partially translucent to infrared and ultraviolet radiation.

[0017] If the gripping elements are at least partially transparent, this has the advantage that the optical system of the endoscope equipped with the treatment instrument of the invention can be partially used even when closed by the gripping elements.

[0018] The gripping element (i.e., gripper / forked forceps) may have a flat plate portion or a simple curved shell portion on one end surface (or may be configured as a flat plate portion or shell portion), which portion is located at the distal end of the gripping element in the closed position of the gripping element. Alternatively, the gripping element may include a shell portion on one end surface that is conically widened toward the cavity, and the shell portion is located proximally at the distal end of the gripping element in the closed position of the gripping element. In particular, the flat plate portion or (three-dimensionally curved) shell portion extends perpendicular to the longitudinal axis of the cavity. In particular, the gripping element may have a flat plate portion, a simple curved shell portion, or a conically widened proximally shell portion that is at least partially transparent.

[0019] The provision of a flat plate section or a single curved shell section has the advantage of reducing the possibility of tissue damage when a stricture is encountered, for example, during an endoscope examination with a surgical instrument. The provision of a conically expanding shell section in the proximal direction allows the stricture to be gradually widened as the surgical instrument passes through. This is assisted by the opening of the surgical instrument as it passes through. If the flat plate section or single curved shell section is at least partially transparent, this simple geometric arrangement can easily accommodate any optical distortions that may occur. If the shell section is shaped to expand in the proximal direction, it will be easier to access the stricture that must be passed through.

[0020] A portion of the edge of the proximal end of the gripping element is rotatably connected to a portion of the edge of the distal end of the hollow body via a joint, the pivot axis extending tangentially to portions of both edges. In particular, the gripping element is formed in a shell shape so that the proximal end of the gripping element can be flush-fit with the distal end of the hollow body when the gripping element is in its closed position. In particular, the joint connecting the hollow body to the gripping element may be provided in the form of an extension extending distally of the hollow body.

[0021] In other words, the opposing grippers or prongs of the gripping element are hinged or adjacent to the distal end edge of the hollow body / sleeve, and the grippers or prongs are flush with the circumferential surface of the hollow body / sleeve over a wide area in the gripping (closed) position. Thus, in the gripping position of a cupola- or dome-like spherical shell-type gripper or prong, the distal end edge of the hollow body / sleeve and its circumferential surface are adjacent with only a minimal gap width, with no portion protruding from or recessed from the circumferential surface. Here, the term "adjacent" should be understood to refer to a defined axial space, and the penetration of dirt, liquid, etc. into the circumferential surface is not particularly significant.

[0022] The tangential arrangement of the joint / hinge connecting the cavity to the gripping element has the advantage that the gripping element can be configured to completely or nearly completely release the front face of the cavity in the distal direction in the open position.

[0023] The actuation mechanism includes at least one actuator, which is connected to the gripping element via, for example, at least one connecting rod, at least one push rod, or at least one flexible element. That is, the actuation mechanism includes an actuator (slide) movably supported so as to move, or primarily move, relative to the cavity, and the movement of this actuator causes rotation of the gripping element or a part or parts of the gripping element via one or more connecting rods and / or one or more push rods, or one or more flexible elements. The connecting rod and / or push rod is rotatably connected to the gripping element or a part or parts of the gripping element (i.e., one or both of the gripper / bifurcated forceps) via a swivel / hinge. The connecting rod and / or push rod is rigidly connected to the actuator via the swivel / hinge. The flexible element is rigidly connected to each of the gripping element and the actuator.

[0024] When the actuator is moved toward the cavity, the gripping elements open, and conversely, when the actuator is moved toward the proximal end of the cavity, the gripping elements close.

[0025] A flexible element is flexible insofar as it is reversibly deformed when the actuator is displaced to allow the transmission of force, or motion, from the actuator to the gripping element.

[0026] The connecting rod is connected via a joint to a further (extended) part of the base edge of the, in particular shell-type, gripping element or gripping part (relative to the part provided at the joint connecting the gripping element or gripping part to the hollow body) so as to be rotatable about a pivot axis. The pivot axis is arranged perpendicular to the further part. In particular, the pivot axis of the joint connecting the hollow body to the gripping element or gripping part runs parallel to the joint connecting the gripping element or gripping part to the connecting rod. In particular, the joint connecting the hollow body to the gripping element or gripping part or the joint connecting the gripping element or gripping part to the connecting rod is arranged on two different, in particular two opposite, sides of the gripping element or gripping part.

[0027] The arrangement of connecting the gripping element or gripping part to a connecting rod has the advantage that the internal space for accommodating the cavity and closed gripping element can be increased.

[0028] The grasping element has two grasping parts (i.e., gripper / forked forceps). One of the two grasping parts may be rigidly connected to the cavity body. The other of the two grasping parts may be rotatably and slidably connected to the cavity body. That is, the movable grasping part is connected to the cavity body via a swivel joint or a sliding joint.

[0029] At least one connecting rod and / or at least one flexible element connects the gripper movably connected to the cavity to the actuator, in particular further actuators and further connecting rods and / or further push rods or further flexible elements are provided, which further connecting rods and / or further push rods or further flexible elements connect the gripper movably connected to the cavity to the further actuator.

[0030] The tip of the actuator and the tip of the further actuator are in particular arranged on two opposite sides of the cavity.

[0031] Alternatively, the gripping element may have two gripping parts, both of which are pivotally or slidingly connected to the cavity body, i.e., the two movable gripping parts are connected to the cavity body via swivel joints or slider joints, respectively.

[0032] A connecting rod and / or a push rod or a flexible element connects the actuator to one of the two gripping parts, and another connecting rod and / or a push rod or a flexible element is provided to connect the actuator to the other of the two gripping parts. In particular, the treatment instrument includes a further actuator, which is connected to each of the two movable gripping parts via another connecting rod and / or a push rod or a flexible element. In the configuration in which one gripping part is movably connected to the hollow body, as well as in the configuration in which both gripping parts are movably connected to the hollow body, the tip of the actuator and the tip of the further actuator are located on two opposite sides of the hollow body.

[0033] The actuator and / or further actuator and the tip of the actuator and / or further actuator extend symmetrically above or within a plane extending centrally between the two gripping elements, i.e. the gripping elements are shaped like clamshell grabs used in excavators.

[0034] In particular, two gripping parts movably connected to the hollow body are arranged opposite each other, and the tips of the actuator and / or further actuator extend centrally between the two gripping parts.

[0035] If only one of the two gripping sections is pivotally attached to the hollow body, the manufacturing of the treatment instrument can be relatively simple. If both gripping sections are pivotally attached to the hollow body, there is an advantage that the tissue to be grasped by the treatment instrument can be more easily visualized before grasping.

[0036] According to one aspect of the present invention, the treatment tool or gripping element may have more than two gripping parts. All gripping parts are pivotally or slidingly connected to the cavity, i.e., all gripping parts are connected to the cavity via at least one swivel joint or at least one slider joint. Alternatively, at least one of the gripping parts of the treatment tool may be configured with more than two gripping parts so as to be rigidly connected to the cavity.

[0037] In a treatment instrument having more than two gripping parts, each of the gripping parts pivotally or slidably connected to the cavity is driven by a separate actuator. In other words, the treatment instrument includes as many actuators as there are gripping parts pivotally or slidably connected to the cavity. Therefore, each actuator is connected to a corresponding gripping part via a (separate) connecting rod, a (separate) push rod, or a (separate) flexible element. Alternatively, multiple gripping parts pivotally or slidably connected to the cavity are driven using a joint actuator. That is, the joint actuator is connected to the multiple gripping parts by multiple connecting rods and push rods or multiple flexible elements, and the multiple gripping parts are adjusted by displacing the joint actuator. Alternatively, the treatment instrument may be configured with more than two gripping parts with multiple joint actuators. That is, multiple actuators are used to drive the multiple gripping parts.

[0038] The actuator tips are arranged on either side of the cavity according to the number and arrangement of the grippers. In particular, in the arrangement of the actuator tips, a connecting rod, push rod, or flexible element is configured to connect each of the grippers movably connected to the cavity to the actuator centrally with respect to the respective gripper. This arrangement is preferred because it results in no or only a small force in addition to the force required to move the gripper or grippers, which causes a twist within the joint.

[0039] The gripping element, or at least one gripping portion, has a recess with a maximum opening width of 1.1 mm or less. The recess is particularly arranged on the gripping element, in a central region on the distal end or end face of the gripping element when the gripping element is in its closed position. In particular, the recess may extend across the gripping portions forming the gripping element, either equally or in different gripping portions. In particular, in a preferred embodiment having two gripping portions, the recess extends partially into one of the two gripping portions and partially into the other of the two gripping portions. In particular, the recess is arranged in the shape of a round or circular cylindrical opening.

[0040] Advantageously, the grasping element may be provided with a recess having a maximum sliding opening width of 1.1 mm or less when in the closed position. By limiting the recess extent, the grasping element has the further advantage of being able to prevent unwanted tissue penetration.

[0041] The endoscope of the present invention includes a distal end that engages the treatment instrument of the present invention, the proximal end of the treatment instrument's actuation mechanism being guided along the exterior surface of the endoscope.

[0042] An alternative or additional aspect of the present invention involves an endoscope having a distal end with a lens of an optical system at its distal end and attached to a treatment instrument. The treatment instrument includes a hollow body and a gripping element. The gripping element is operated via an actuation mechanism having a distal end residing within the hollow body. The actuation mechanism includes a proximal end extending proximally from the hollow body and guided along the exterior surface of the endoscope.

[0043] The gripping element is formed in a cap shape that moves to a closed position, and is formed so that the gripping element, or a portion of the gripping element, covers the lens of the optical system of the endoscope in the distal direction when the treatment instrument is attached to the distal end of the endoscope in the closed position of the gripping element.

[0044] In this way, the gripping element has the advantage of not only gripping function but also protecting the lens, and its function is expanded.

[0045] The endoscope has an irrigation channel through which a cleaning fluid is delivered to an irrigation channel outlet opening located on the distal end face of the endoscope. The gripping element is configured so that when a treatment instrument is attached to the distal end of the endoscope, the gripping element, or a portion of the gripping element, in the closed position of the gripping element at least partially covers the irrigation channel outlet opening in the distal direction. Furthermore, the gripping element is configured so that when the treatment instrument is engaged with the distal end of the endoscope and the gripping element is closed, the inner surface of the gripping element facing the proximal end is interposed between the irrigation channel outlet opening, i.e., at least the cleaning fluid delivered to the irrigation channel outlet opening, when the gripping element is closed and the cleaning fluid is delivered to the irrigation channel outlet opening, away from the lens of the optical system and also away from the irrigation channel outlet surface. After being discharged from the irrigation channel outlet opening, the cleaning fluid impinges on the inner surface of the gripping element facing the proximal end and splashes back onto the lens of the optical system.

[0046] Thus, the cleaning fluid is not only used to clean the tissue being removed away from the endoscope, but also to clean the lenses of the endoscope's optical system. [Brief explanation of the drawings]

[0047] In the following, the present invention will be described in detail based on preferred embodiments with reference to the accompanying drawings, in which: [Figure 1] 1 is a perspective view of a first embodiment of a treatment instrument of the present invention, showing the state in which the treatment instrument is attached to an endoscope in an open position. [Figure 2] 2 is a perspective view of the distal end of the treatment instrument shown in FIG. 1 in the first embodiment in the closed position. [Figure 3] 3 is a longitudinal section of the distal end of the treatment instrument in FIG. 2 of the first embodiment in the closed position in partial plane III of FIG. 2; [Figure 4]4 is a longitudinal section of the tip of the first embodiment of FIG. 1 in the open position of partial plane IV shown in FIG. 1; [Figure 5] 3 is a front view of the treatment instrument in FIG. 2 of the first embodiment in a closed position indicated by an arrow V in FIG. 2. [Figure 6] 6 is a front view of the treatment instrument of FIG. 1 in the first embodiment in the open position of the arrow VI of FIG. 1; [Figure 7] FIG. 2 is a rear view of the distal end of the treatment instrument of the first embodiment in the closed position. [Figure 8] FIG. 2 is a rear view of the distal end of the treatment instrument of the first embodiment in the open position. [Figure 9] FIG. 10 is a perspective view of a second embodiment of the treatment instrument of the present invention, showing the state where it is attached to an endoscope in the open position. [Figure 10] FIG. 5 is a longitudinal sectional view corresponding to FIG. 4 of a treatment instrument according to a third embodiment of the present invention. [Figure 11] FIG. 10 is a perspective view of a treatment instrument according to a fourth embodiment of the invention in a closed position. [Figure 12] FIG. 10 is a perspective view of a treatment instrument according to a fourth embodiment of the invention in an open position. [Figure 13] 1 is a schematic longitudinal sectional view of a treatment instrument according to the present invention. [Figure 14] Figures 14A and 14B are schematic cross-sectional views illustrating various shapes of actuation mechanisms in the first and second embodiments, and Figure 14C is a schematic cross-sectional view corresponding to Figures 14A and 14B of a treatment instrument according to a fifth embodiment having an alternative shape of actuation mechanism. [Figure 15] 14 is a schematic cross-sectional view corresponding to FIG. 13 of a treatment instrument according to a sixth embodiment having a further alternative shape of actuation mechanism. [Figure 16] FIG. 16 is a schematic cross-sectional view of a treatment instrument according to a sixth embodiment, corresponding to FIGS. 14A, 14B and 14C. [Figure 17] 14 is a schematic longitudinal sectional view of the treatment instrument of the present invention, corresponding to FIG. 13. [Figure 18A] FIG. 16 is a schematic cross-sectional view of a treatment tool according to a fourth embodiment, corresponding to FIGS. 14A, 14B, and 14C. [Figure 18B]FIG. 18B is a schematic cross-sectional view of the treatment tool according to the seventh embodiment, corresponding to FIG. 18A. [Figure 19] FIG. 18 is a schematic vertical cross-sectional view of the eighth embodiment, corresponding to FIG. 17. [Figure 20] FIG. 18C is a cross-sectional view of a treatment instrument according to an eighth embodiment, corresponding to FIGS. 18A and 18B. [Figure 21] 10 is a longitudinal section of a processing device according to a ninth embodiment of the invention, corresponding to FIG. 3, in a closed position. [Figure 22] 10 is a longitudinal section of a processing device according to the ninth embodiment of the invention, corresponding to FIG. 4, in an open position. [Figure 23] 10 is a longitudinal section of a treatment device according to the tenth embodiment of the invention, corresponding to FIG. 3, in a closed position. [Figure 24] 10 is a longitudinal section of a processing device according to the tenth embodiment of the invention, corresponding to FIG. 4, in an open position. [Figure 25] 11 is a longitudinal section of a treatment device according to an eleventh embodiment of the invention, corresponding to FIG. 3, in a closed position. [Figure 26] 11 is a longitudinal section of a processing device according to the invention, corresponding to FIG. 4, according to an eleventh embodiment, in the open position. [Figure 27] 11 is a front cross-sectional view of a processing device according to an eleventh embodiment of the invention, corresponding to FIG. 5, in a closed position. [Figure 28] 11 is a rear cross-sectional view of a processing tool according to an eleventh embodiment of the invention in a closed position, corresponding to FIG. 7. [Figure 29] FIG. 22 is a longitudinal sectional view of the treatment instrument of the twelfth embodiment in the closed position, corresponding to FIG. 3. [Figure 30] 12 is a longitudinal section corresponding to FIG. 4 of the twelfth embodiment in the open position. In the individual figures, the same or functionally similar features are provided with the same reference numerals. DETAILED DESCRIPTION OF THE INVENTION

[0048] Basically, the present invention relates to a treatment tool 4, shown in FIG. 1, which can be added to a (commercially available) flexible-shaft endoscope 2. Endoscopes 2 of this type are well known in the art and will only be described superficially. Typically, the endoscope 2 has an endoscope head 6 (as seen, for example, in FIG. 3), in which various functional units 8 are briefly described. For example, they may include the outlet for the primary or internal endoscope working channel, an optical system for image processing, a lamp, and / or an irrigation channel opening (FIG. 6).

[0049] Furthermore, the endoscope 2 typically has a flexible shaft 10 having a passively fixed portion and preferably an actively bendable (articulated) portion, and further has a handle 12, which contains various operating elements and terminals for connecting various functional units 8 to the base portion or similar portions. In particular, an inlet 14 of the primary working channel is located on the handle 12.

[0050] The treatment instrument 4 has a hollow body 16 at its tip, in which a gripping element 18 including two opposing gripping portions 20, 22 is disposed. The two gripping portions 20, 22 are rotatably supported on corresponding portions at the tip of the hollow body 16 via joints 24 and / or 26, respectively.

[0051] The two gripping portions 20, 22 are connected to corresponding connecting rods 32, 34 via joints 28, 30, respectively, so that they can be adjusted from the open or opened position in FIG. 1 to the closed position in FIG.

[0052] The two connecting rods 32, 34 are in turn connected to the distal end of an actuator 36. Preferably, the actuator 36 is configured so that a fixing element forms the distal end of the actuator 36, and this fixing element is connected to a push-pull wire extending proximally from the fixing element. In this manner, the fixing element and the push-pull wire form the actuator 36.

[0053] A tube 38 extends proximally from the distal end of the hollow body 16. In place of the tube 38, a flexible spiral wire including a coating may be disposed.

[0054] A secondary endoscope exterior working channel 40 extends from the proximal end of the hollow body 16 through the tube 38 to the proximal end of the tube 38, and also extends from the distal end of the hollow body 16 through the exterior wall of the hollow body 16 to the proximal end of the hollow body 16. The actuator 36 and its fixed portion and push-pull wires are movably supported within the secondary working channel 40.

[0055] To facilitate shifting of the actuator 36, a slide 42 is disposed at the proximal end of the actuator 36 and / or the proximal end of the push-pull wire, and the slide is movably connected to two guide rails 44. The two guide rails are parallel to each other and extend proximally from the proximal end of the tube 38. A ring 46 is disposed at the proximal end of the guide rail 44, and both ends of the guide rail 44 are connected, with the slide 42 thus fitting within the guide rail 44. To shift the actuator 36, the person operating the treatment instrument 4 places the thumb of either hand within the ring 46 and grasps it between the index finger and middle finger, and adjusts the slide 42 by moving the index finger and middle finger relative to the thumb.

[0056] To allow connection to the endoscope head 6, the hollow body 16 has a substantially circular cylindrical recess 48 at its proximal end, configured for pressure insertion of the endoscope head (see Figures 3 and 4). Alternatively, or additionally, a clip fastener may be disposed on the hollow body 16 for connection to the endoscope head.

[0057] Three stoppers 50 are provided at the tip of the recess 48, and these three stoppers are evenly spaced apart on the inner circumference of the hollow body 16 to limit the maximum insertion depth of the endoscope head 6. Alternatively, the stoppers may be unevenly spaced on the inner circumference of the hollow body 16.

[0058] Distal to stopper 50, cavity 16 has a substantially circular cylindrical recess 52 that extends distally of cavity 16. Its inner diameter is larger than the inner diameter of recess 48 at the proximal end of cavity 16. Alternatively, recesses 48, 52 may be equal, or the inner diameter of recess 48 may be larger than the inner diameter of recess 52.

[0059] The two gripping portions 20, 22 are formed in a shell or blade shape, and form a hood-shaped structure that completely closes the hollow body 16 in the distal direction when in the closed position as shown in Figures 3, 5, and 7. In this way, when the treatment instrument 4 of the present invention is attached to the endoscope 6, the gripping portions 20, 22 in the closed position can block impurities from entering the endoscope head 6 and / or the lens of the optical system of the endoscope 6.

[0060] Each of the two gripping portions 20, 22 has a gripping piece 54. Each gripping piece 54 has a plurality of protrusions and recesses that are complementary to one another. When the gripping portions 20, 22 are in the closed position, the protrusions of the gripping piece 54 of one gripping portion 20 are inserted into the recesses of the gripping piece 54 of the other gripping portion 22, and the protrusions of the gripping piece 54 of one gripping portion 22 are inserted into the recesses of the gripping piece 54 of the other gripping portion 20, thereby achieving the closed position. Alternatively, the gripping pieces 54 may be flat, and when the gripping portions 20, 22 are in the closed position, the gripping pieces 54 may be in flush contact (flat engagement).

[0061] The joints 24, 26 connecting the gripping portions 20, 22 to the hollow body 16 have swivel axes that extend tangentially to the outer periphery of the hollow body 16. In this way, the gripping portions 20, 22 are folded outward, completely releasing the tip of the recess 52 in the open position shown in FIGS.

[0062] The first embodiment of the treatment instrument 4 of the present invention disclosed in FIGS. 1-8 has only one actuator 36 and therefore only one endoscope external working channel 40 is disclosed.

[0063] To provide a stronger gripping force than the treatment instrument 4 of the first embodiment, the treatment instrument 104 of the present invention, according to the second embodiment shown in Figure 9, further includes a second actuator 136, a second tube 138, and a second endoscope external working channel 140. The second actuator 136 is connected to the gripping sections 20, 22 by the (first) actuator 36 via connecting rods 32, 34. The connecting rods 32, 34 of the second actuator 136 are pivotally connected to the gripping sections 20, 22 via joints 28, 30. The second actuator 136 and its respective connecting rods 32, 34, joints 28, 30, and second working channel 140 are located on one side of the hollow body 116. On the opposite side, the first actuator 36, connecting rods 32, 34, joints 28, 30 of the first actuator 36, and working channel 40 are located. The second actuator 136 and its tip, the connecting rods 32 and 34, as well as the joints 28 and 30 of the second actuator 136, the second working channel 140, and its tip are located at one end of the hollow body 116. In other words, this is located opposite the side where the (first) actuator 36, its tip, and the (first) working channel 40, its end, are located.

[0064] The first tube 38 and the second tube 138 are connected to each other at their base ends. The first actuator and the second actuator 136 are connected to each other at their base ends and are operated by a slide 142 as in the first embodiment.

[0065] According to the first two embodiments, the grippers 20, 22 are connected to their respective actuators 36 and / or 136 via fixed connecting rods 32, 34. Alternatively, according to the third embodiment, as seen in Figure 10, the connection between the actuators 36 and / or 136 and the grippers 20, 22 is made by means of flexible elements 232 and / or 234. The flexible elements 232 and / or 234 are connected to the actuators 36 and / or 136 in a rigid or flexibly rigid manner so as to avoid the need for joints 28, 30, or to the corresponding grippers 20 and / or 22 in a similarly rigid or flexibly rigid manner.

[0066] Each of the treatment instruments 4, 104, 204 according to the first, second, and third embodiments of the invention has two gripping portions 20, 22, which are pivotally connected to each other and to the hollow body 16, 116, and / or 216. According to the fourth embodiment, the treatment instrument 304 of the invention also has two gripping portions 320, 322, one of which (grip 320) is pivotally connected to the hollow body 316, and the other (grip 322) is rigidly or flexibly connected to the hollow body 316. As with the treatment instruments 4, 104, 204 according to the first, second, and third embodiments, the two gripping portions 320, 322, when in the closed position (see FIG. 11), together form a hood-shaped structure that closes the distal end of the hollow body 316. In contrast to the gripping portions 20, 22, which are identical in shape, the gripping portions 320, 322 are different in shape from each other. The gripper 322 fixed to the hollow body essentially forms a distally projecting protrusion or a distally projecting groove-shaped tongue. Only the gripper 320 pivotally attached to the hollow body 320 is shell-shaped or blade-shaped. The actuation mechanism for adjusting the gripper 320 corresponds to the actuation mechanism for adjusting the grippers 20 and 22.

[0067] In comparison of the embodiments, the treatment instrument of the present invention may include one or two actuators. Figures 14A and 14B show schematic cross-sectional views of two alternatives taken along line XIV-XIV in Figure 13 for the first and second embodiments, illustrating the arrangement of the actuators 36, 136. According to the first embodiment, a single actuator 36 is movably supported within the cavity 116, and the distal end of the actuator extends toward the joining surface together with the gripping piece 54 when the gripping pieces 20, 22 are in the closed position. According to the second embodiment, two actuators 36, 136 are movably supported within the cavity 116, and the distal ends of the two actuators 36, 136 extend toward the joining surface together with the gripping piece 54 when the gripping pieces 20, 22 are in the closed position. To enable this, the two actuators 36, 136 in the second embodiment, or their distal ends, are positioned on opposite sides of the cavity 116.

[0068] However, in the fifth and sixth embodiments, the treatment instruments 404 and / or 504 of this invention may each be provided with two actuators 436, 437 and / or 536, 537. In that case, when the gripping portions 20, 22 are in the closed position, the two actuators or their tips do not extend toward the bonding surface together with the gripping piece 54.

[0069] 14C, the treatment instrument 404 of the fifth embodiment has an actuator 436 connected only to the gripping portion 20 and an actuator 437 connected only to the gripping portion 22. The two actuators 436, 437, or their tips, are arranged on the connecting side of the hollow body 416, and are therefore directly adjacent to the plane spanned by the gripping pieces 54 when the gripping portions 20, 22 are in the closed position.

[0070] 15 and 16 (a cross-sectional view taken along line XVI-XVI in FIG. 15), the treatment instrument 504 of the sixth embodiment has an actuator 536 connected only to the grip portion 20 and an actuator 537 connected only to the grip portion 22. The two actuators 536, 537, or their tips, are arranged opposite to the hollow body 516, and extend in a joining plane that is perpendicular to the pivot axes of the joints 24, 26.

[0071] The actuation of the grippers 20 and / or 22 can be made more precise by providing two actuators 436, 437 and / or 536, 537, each connected to one of the grippers 20 or 22.

[0072] The actuators 536, 537 in the sixth embodiment can be connected to the corresponding gripping portions without any intermediary (for example, connecting rods, push rods, flexible elements, etc.).

[0073] Figures 17, 18A, 18B, 19, and 20 show modified examples of the arrangement of one actuator or multiple actuators, or the tip of one actuator, or the tip of multiple actuators in the treatment instrument of the present invention in which a single gripping portion is pivotally attached to a hollow body.

[0074] Figure 18A is a schematic cross-sectional view taken along line XVIII-XVIII in Figure 17, showing the arrangement of the actuators 36 of the treatment instrument 304 of the fourth embodiment shown in Figures 11 and 12. Figure 18B is a schematic cross-sectional view taken along line XVIII-XVIII in Figure 17, showing the treatment instrument 604 of the seventh embodiment. This instrument 604 includes an actuator 636 and a second actuator 637. The tips of the two actuators 636, 637 or the two actuators 636, 637 are arranged on two opposite sides of the hollow body 616. The tips of the two actuators 636, 637 or the two actuators 636, 637 are arranged on a joint surface extending across the longitudinal central axis M of the hollow body 616.

[0075] 19 and 20 (cross-section taken along line XX-XX in FIG. 19) show an eighth embodiment in which an actuator 736 is disposed on a treatment instrument 704 having only one gripping portion 720. The gripping portion 720 is pivotally mounted to a hollow body 716, with the joint 28 between the actuator 736 and the gripping portion 720 disposed directly adjacent to the joint 24 between the gripping portion 720 and the hollow body 716. As with the treatment instrument 504 of the sixth embodiment, the configuration of this actuator 736 allows for a direct connection between the actuator 736 and the gripping portion 720 without any intervening means (e.g., a connecting rod, push rod, or flexible element).

[0076] Figures 21 and 22 show a treatment instrument 804 according to a ninth embodiment, and Figures 23 and 24 show a treatment instrument 904 according to a tenth embodiment.

[0077] The treatment instrument 804 of the ninth embodiment differs from the treatment instrument 4 of the first embodiment only in that the gripping portions 20, 22 are connected to the hollow body 16 via solid joints 824, 826 rather than via swivel joints (universal joints) 24, 26.

[0078] The treatment instrument 904 of the tenth embodiment differs from the treatment instrument 4 of the first embodiment simply in that the gripping portions 20, 22 are connected to the hollow body 16 via film-like hinges 924, 926 rather than via swivel joints 24, 26.

[0079] 25, 26, 27, and 28 show a treatment instrument 1004 according to the eleventh embodiment. The treatment instrument 1004 of the eleventh embodiment differs from the treatment instrument 4 of the first embodiment in the following two points.

[0080] First, the two gripping portions 1020, 1022 of the treatment instrument 1004 form a hood-like structure in the closed position (see FIG. 25). This structure allows the hollow body 1016 to not only be closed in the closed position, but also to form a tapered surface. In other words, the gripping portions 1020, 1022 have or are formed with a shape that expands conically toward the proximal end in the closed position. Furthermore, in addition to this configuration allowing for the removal of impurities, this geometric shape also allows for expansion to open strictures as needed. In addition to passive expansion due to the conical shape, the gripping portions 1020, 1022 can actively apply pressure to the stricture by opening, thereby assisting the opening process. The hollow body 1016 also includes a portion that expands conically toward the proximal end.

[0081] Second, the gripping portions 1020, 1022 of the twelfth embodiment differ from the gripping portions 20, 20 of the first embodiment in terms of the recess 1056. The recess 1056 is formed partially within the gripping portion 1020 and partially within the gripping portion 1022. More specifically, the gripping pieces 1054 of each gripping portion 1020, 1022 are interrupted in the center by a groove-like portion. When the gripping portions 1020, 1022 are in the closed position, the groove-like portions of the gripping portions 1020, 1022 are adjacent to each other and together form the recess 1056. The recess has a circular outer shape. The opening width or diameter of the recess 1056 is 1.1 mm. This recess 1056 allows a guidewire to pass through the closed gripping element while protecting the lens of the endoscope's optical system from damage. In particular, the gripping element 18 in the closed position can uncover the guidewire in the distal direction and completely cover all remaining functional units 8, such as the primary endoscope internal working channel, the optical system for imaging, the lamp, and / or the irrigation channel outlet opening in the distal direction.

[0082] 29 and 30 show a twelfth embodiment of the treatment instrument 1104. This twelfth embodiment of the treatment instrument 1104 differs from the first embodiment of the treatment instrument 4 in that the gripping portions 1120, 1122 are connected to the hollow body 1116 via slider joints rather than swivel joints. The slider joints 1124, 1126 allow both the gripping portions 1120, 1122 to move distally and radially outward when the gripping portions 1124, 1126 are in the open position (FIG. 30) via flexible elements 1132, 1134 that are rigidly connected to the gripping portions 1124, 1126, and allow both the gripping portions 1120, 1122 to move proximally and radially inward when the gripping portions 1124, 1126 are in the closed position (FIG. 29) via the flexible elements 1132, 1134.

[0083] In other words, in the twelfth embodiment, the gripping elements 18 of the treatment instrument 1104 are in the form of parallel grippers. [Explanation of symbols]

[0084] 2 Endoscopy 4 Treatment Instrument of First Embodiment 6 Endoscope head 8 Functional unit in the head of the endoscope 10 Endoscope shaft 12 Endoscope handle 14 Inlet of the endoscope internal working channel 16 Hollow body 18 Grasping element / grasping unit 20,22 Gripper / Gripping Branch 24, 26 Joint between hollow body gripping parts 28,30 Joint between gripper and connecting rod 32,34 Connecting rod 36 Actuator 38 tubes 40 Endoscope External Working Channel 42 slides 44 Guide rail 46 Guide rail ring 48 Recess at the base of the cavity 50 Stopper 52 Recess at the tip of the hollow body 54 Grasping piece / branch 104 Treatment instrument of the second embodiment 116 Second embodiment hollow body 136 Second Actuator 138 2nd Tube 140 Second Endoscope External Working Channel 142 Slide of the second example 204 Treatment Instrument of the Third Embodiment 216 Third embodiment hollow body 232,234 flexible elements 304 Treatment Instrument of the Fourth Embodiment 316 Fourth embodiment hollow body 320 Pivot gripper / gripping branch 322 Fixed grip part 404 Treatment instrument of the fifth embodiment 416 Hollow body of the fifth embodiment 436, 437 Actuator of the fifth embodiment 504 Treatment Instrument of the Sixth Embodiment 516 Sixth embodiment hollow body 536, 537 Actuator of the sixth embodiment 604 Treatment instrument of the seventh embodiment 616 Hollow body of the seventh embodiment 620 Pivoting Gripper / Branch of Seventh Embodiment 622 Fixed gripping portion of the seventh embodiment 636, 637 Actuator of the seventh embodiment 704 Treatment Instrument of the Eighth Embodiment 716 Eighth embodiment hollow body 720 Pivoting grip of eighth embodiment 722 Fixed gripping portion of the eighth embodiment 736 Actuator of the Eighth Embodiment 804 Treatment instrument of the 9th embodiment 824,826 Solid joints 904 Treatment Instrument of the Tenth Embodiment 924,926 Film hinge 1004 Treatment instrument of the 11th embodiment 1016 11th embodiment hollow body 1020, 1022 Grip portion of 11th embodiment 1054 Grip piece of the 11th embodiment 1056 Recess of gripping part 1104 Treatment instrument of the 12th embodiment 1116 Hollow body of the 12th embodiment 1120, 1122 Grip portion of the 12th embodiment 1124,1126 Slider joint 1132, 1134 Flexible element of twelfth embodiment

Claims

1. A treatment instrument (4; 104; 204; 304; 404; 504; 604; 704; 804; 904; 1004; 1104) configured to be connected to the tip and / or tip portion of an endoscope (2), The treatment device is a substantially sleeve-shaped hollow body (16; 116; 216; 316; 416; 516; 716; 1016; 1116) having a peripheral wall that encloses an axially extending hollow body and forms a proximal engagement portion, the hollow body being configured to be attached / mounted to an endoscope shaft or a distal end of an endoscope; a gripping element (18) supported or connected to the distal peripheral wall of the hollow body (16; 116; 216; 316; 416; 516; 716; 1016; 1116); and an actuation mechanism arranged to operate said gripping element (18) from at least a release position to a gripping position, said actuation mechanism having a proximal end extending proximally from said cavity (16; 116; 216; 316; 416; 516; 716; 1016; 1116) and a distal end received within said cavity, said distal end including a distal end adapted to face engagement with said gripping element (18) and its inner surface against said cavity; The gripping element (18) in the gripping position has a cup-like, flap-like, cupola-like, door-like or roof-like shape, so that at least when the gripping position is reached, the cavity is completely closed at the tip of the cavity body (16; 116; 216; 316; 416; 516; 716; 1016; 1116), and In the release position, the gripping element (18) completely releases the distal end face of the hollow body (16; 116; 216; 316; 416; 516; 616; 716; 1016; 1116), The actuation mechanism may be provided via at least one connecting rod (32, 34) pivotally connected to each of the actuators (36; 136; 436; 437; 536; 537; 636; 637) and the gripping elements (18), or via at least one flexible rod (32, 34) rigidly connected to each of the actuators (36; 136; 436; 437; 536; 537; 636; 637) and the gripping elements (18). at least one actuator (36; 136; 436; 437; 536; 537; 636; 637) movably supported within said hollow body (16; 116; 216; 316; 416; 516; 716; 1016; 1116) connected to a gripping element (18) via a flexible element (232; 234; 1132; 1134), wherein the gripping element (18) is operated by actuation of the actuator; Furthermore, the at least one actuator (36; 136; 436; 437; 536; 537; 636; 637) is movably supported within at least one endoscope external working channel (40; 140) extending from a distal end of the hollow body (16; 116; 216; 316; 416; 516; 616; 1016; 1116) through an outer wall of the hollow body (16; 116; 216; 316; 416; 516; 616; 1016; 1116) to a proximal end thereof; A treatment instrument characterized by:

2. 2. The treatment device (4; 104; 204; 304; 404; 504; 604; 704; 804; 904; 1004; 1104) according to claim 1, The treatment instrument is characterized in that the gripping element (18) is formed to be at least partially transparent.

3. 3. A treatment device (4; 104; 204; 304; 404; 504; 604; 704; 804; 904; 1004; 1104) according to claim 1 or 2, A treatment instrument characterized in that one end of the gripping element (18) includes a flat plate portion, a single curved shell portion, or a shell portion that conically expands radially outward toward the hollow body, which is arranged at the tip of the gripping element (18) when the gripping element (18) is in a closed position.

4. A treatment device (4; 104; 204; 304; 404; 504; 604; 704; 804; 904; 1004) according to any one of claims 1 to 3, A treatment instrument characterized in that a portion of the edge of the proximal end of the gripping element (18) is connected to a portion of the edge of the distal end of the hollow body (16; 116; 216; 316; 416; 516; 716; 1016) via a joint (24; 26; 824; 826; 924; 926) so as to be pivotable about a swivel axis, the swivel axis extending tangentially to both portions of the edge.

5. 2. The treatment device (4; 104; 304; 404; 604; 804; 904; 1004) according to claim 1, The connecting rods (32, 34) are pivotally connected via joints (28, 30) to a further portion of the edge of the proximal end of the gripping element (18) about a swivel axis, the further portion being perpendicular to the swivel axis.

6. 2. The treatment device (304; 604; 704) of claim 1, the gripping element (18) has two gripping parts (320; 322; 620; 622; 720; 722), one of which (322; 622; 722) is rigidly connected to the hollow body (316; 616; 716) and the other gripping part (320; 620; 720) is rotatably or slidably connected to the hollow body (316; 616; 716); A treatment device characterized in that at least one connecting rod (33) or at least one flexible element connects a grip part (320; 620; 720) which is rotatably or slidably connected to a hollow body (316; 616; 716).

7. 7. The treatment instrument (604) of claim 6, The treatment instrument (604) includes a further actuator (637); a further connecting rod or a further flexible element rotatably or slidably connecting a gripper (620) to the cavity (616) and connecting the gripper to a further actuator (637); The tip of the actuator (636) and the tip of the further actuator (637) are arranged on two opposite sides of the hollow body (616), A treatment instrument characterized by:

8. 2. The treatment device (4; 104; 204; 804; 904; 1004; 1104) according to claim 1, The gripping element (18) has two gripping parts (20, 22; 1020, 1022; 1120, 1122) rotatably or slidably connected to the hollow body (16; 116; 216; 1016; 1116), said at least one connecting rod (32) or at least one flexible element (232; 1132) connecting the actuator (36, 136) to one of said two gripping parts (20; 1020; 1120); a further connecting rod (34) or a further flexible element (234, 1134) connects the actuator (36, 136) to the other of the two gripping parts (22; 1022; 1122); A treatment instrument characterized by:

9. The treatment instrument (104) according to claim 8, The treatment instrument (104) has a further actuator (136), which is connected to each of the two gripping parts (20, 22) via a further connecting rod (32, 34) or a further flexible element; A treatment instrument, characterized in that the distal end of the actuator (36) and the distal end of the further actuator (136) are arranged on two opposite sides of the hollow body (116).

10. The treatment instrument (104) according to claim 1, The gripping element (18) has two gripping portions (20, 22) rotatably or slidably connected to the cavity (416), At least one connecting rod (32) or at least one flexible element connects the actuator (436) to one of the two gripping parts (20); The treatment instrument (404) has a further actuator (437) and a further connecting rod or a further flexible element, the further connecting rod or the further flexible element connects the further actuator (437) to the other of the two gripping parts (22), A treatment instrument characterized by:

11. The treatment device (4; 104; 204; 404; 804; 904; 1004; 1104) according to claim 9 or 10, The two gripping portions (20; 22; 1020, 1022; 1120, 1122) are arranged to face each other, the actuator (36; 436) and / or the further actuator (136; 437) extend symmetrically towards, on or in a plane centrally located between the two gripping parts (20, 22; 1020, 1022; 1120, 1122) in the closed state, A treatment instrument characterized by:

12. The treatment instrument (1004) according to claim 1, The gripping element (18) includes a recess (1056); The maximum opening width of this recess is 1.1 mm or less. A treatment instrument characterized by:

13. An endoscope (2) having a distal end adapted to be engaged with a treatment instrument (4; 104; 204; 304; 404; 504; 604; 704; 804; 904; 1004; 1104) according to any one of claims 1 to 12, An endoscope characterized in that the proximal end of the actuation mechanism of a treatment instrument (4; 104; 204; 304; 404; 504; 604; 704; 804; 904; 1004; 1104) is guided along the outer surface of the endoscope (2).

14. An endoscope (2) having a distal end portion with a lens (8) of an optical system at one end surface and adapted to be engaged with a treatment instrument (4; 104; 204; 304; 404; 504; 604; 704; 804; 904; 1004; 1104), Treatment instruments (4; 104; 204; 304; 404; 504; 604; 704; 804; 904; 1004; 1104) hollow bodies (16; 116; 216; 316; 416; 516; 616; 716; 1016; 1116); a gripping element (18), A treatment instrument in which a gripping element (18) includes a distal end located within a hollow body (16; 116; 216; 316; 416; 516; 616; 716; 1016; 1116), and is operable from at least a release position to a gripping position via an actuation mechanism having a proximal end extending from the hollow body (16; 116; 216; 316; 416; 516; 616; 716; 1016; 1116) and guided along the outer surface of an endoscope (2), The gripping element (18) is formed in the shape of a cap, and in a state where a treatment instrument (4; 104; 204; 304; 404; 504; 604; 704; 804; 904; 1004; 1104) is attached to the endoscope (2), the cap is in a closed position where the lens (8) of the optical system is covered by the gripping element (18) in the distal direction, and In the release position, the gripping element (18) completely releases the distal end face of the hollow body (16; 116; 216; 316; 416; 516; 616; 716; 1016; 1116), The actuation mechanism may be provided via at least one connecting rod (32, 34) pivotally connected to each of the actuators (36; 136; 436; 437; 536; 537; 636; 637) and the gripping elements (18), or via at least one flexible rod (32, 34) rigidly connected to each of the actuators (36; 136; 436; 437; 536; 537; 636; 637) and the gripping elements (18). at least one actuator (36; 136; 436; 437; 536; 537; 636; 637) movably supported within said hollow body (16; 116; 216; 316; 416; 516; 716; 1016; 1116) connected to a gripping element (18) via a flexible element (232; 234; 1132; 1134), wherein the gripping element (18) is operated by actuation of the actuator; Furthermore, the at least one actuator (36; 136; 436; 437; 536; 537; 636; 637) is movably supported within at least one endoscope external working channel (40; 140) extending from a distal end of the hollow body (16; 116; 216; 316; 416; 516; 616; 1016; 1116) through an outer wall of the hollow body (16; 116; 216; 316; 416; 516; 616; 1016; 1116) to a proximal end thereof; An endoscope characterized by:

15. The endoscope (2) according to claim 14, The endoscope (2) has an irrigation channel through which irrigation fluid is conveyed to an irrigation channel outlet opening located on the distal end face of the endoscope (2); In said state of the treatment instrument (4; 104; 204; 304; 404; 504; 604; 704; 804; 904; 1004; 1104) attached to the endoscope (2), the gripping element (18) is at least partially covered in the distal direction in a position in which the irrigation channel outlet opening is closed, The endoscope is characterized in that the inner surface of the gripping element (18) facing in the proximal direction is configured to be away from the lens (8) of the optical system and from the flushing channel outlet surface when the gripping element (18) is in a closed position, so that flushing fluid is carried to the flushing channel outlet opening, and after being discharged from the flushing channel outlet opening, hits the inner surface of the gripping element (18) facing in the proximal direction and rebounds onto the lens (8) of the optical system.

Images