Medical devices having a rotatable working channel and related methods of use

Abstract

A medical device is disclosed that includes a shaft, a handle that houses a proximal end of the shaft, a first channel extending through a lumen of the shaft, the first channel being rotatable about a longitudinal axis of the shaft and including a proximal end and a distal end, and an actuator, the distal end of the actuator configured to engage and disengage with the proximal end of the first channel, such that in the engaged position, the actuator and the first channel are rotatable.

Description

[Technical Field]

[0001] The present disclosure generally relates to a medical device including a working channel rotatable relative to a handle and shaft of the medical device. At least some embodiments of the present disclosure relate to a medical device having a working channel housed within a lumen of a medical device shaft. [Background technology]

[0002] In certain medical procedures, physicians and / or technicians need to control a medical accessory device extending through an endoscope's working channel. Such control may include rotating the accessory device within the medical device's working channel. Physicians may sometimes have difficulty rotating an accessory device extending through a fixed working channel due to frictional forces between the device and the channel. To overcome the frictional forces, physicians may apply excessive rotational force to the accessory device. This can cause a buildup of torque and tension between the accessory device and the working channel, which can 1) damage the accessory device or 2) cause the distal end of the device to over-rotate relative to the desired degree of rotation. As a result, medical procedures can be plagued by the aforementioned difficulties in controlling the accessory device. Summary of the Invention [Means for solving the problem]

[0003] According to one example, a medical device may include a shaft, a handle that houses a proximal end of the shaft, a first channel extending through a lumen of the shaft, the first channel being rotatable about a longitudinal axis of the shaft and including a proximal end and a distal end, and an actuator, the distal end of the actuator configured to engage and disengage with the proximal end of the first channel, wherein in the engaged position, the actuator and the first channel are rotatable. The actuator may include an elongate body including a lumen extending therethrough from the proximal end to the distal end of the elongate body.

[0004] In another example, the medical device may further include an actuator channel in fluid communication with the lumen of the shaft, the actuator channel extending along an axis transverse to the longitudinal axis of the shaft, the actuator channel covering at least a portion of the elongate body. The actuator may be configured to translate along the longitudinal axis of the actuator channel to engage and disengage the proximal end of the first channel, and the actuator is configured to rotate about the longitudinal axis of the actuator channel. The actuator is biased away from engagement with the proximal end of the first channel. The actuator may be spring biased.

[0005] In another example, the medical device may further include a spring wound around a portion of the elongate body extending proximally outside the actuator channel, the spring being positioned between a distal surface of the knob and a proximal surface of the actuator channel.

[0006] In another example, the distal end of the actuator may include a first plurality of distally projecting teeth, each of the first plurality of teeth separated from one another by a gap along the periphery of the distal end of the actuator, and the proximal end of the first channel may include a second plurality of proximally projecting teeth, each of the second plurality of teeth separated from one another by a gap along the periphery of the proximal end of the first channel. Each of the first plurality of teeth of the actuator may be configured to fit into a respective one of the gaps of the first channel, and each of the second plurality of teeth of the channel may be configured to fit into a respective one of the gaps of the actuator, thereby engaging the distal end of the actuator with the proximal end of the first channel.

[0007] In another example, the distal end of the shaft may include a distal abutment configured to abut the distal end of the first channel, thereby preventing the first channel from moving further distally beyond the distal abutment, and the proximal portion of the shaft may include a proximal abutment configured to prevent the first channel from moving further proximally beyond the proximal abutment.

[0008] In another example, the proximal opening of the first channel may include a ring configured to receive at least one accessory device and seal the proximal opening of the channel from fluid. The distal portion of the channel may include a holder configured to hold a distal portion of at least one accessory device that passes through the distal opening of the channel. The handle may include a knob having a disk shape. The first channel may be configured to provide suction and / or insufflation through the distal opening of the first channel.

[0009] According to another example, a medical device may include a shaft including a lumen, a handle housing a proximal portion of the shaft, the handle including an opening leading to an actuator channel in fluid communication with the shaft lumen, a first channel extending through the shaft lumen, the first channel being rotatable about a longitudinal axis of the shaft and including a proximal end and a distal end, and an actuator, a portion of the actuator enclosed within the actuator channel and configured to translate along the longitudinal axis of the actuator channel to engage the proximal end of the first channel, such that rotation of the actuator while engaged with the proximal end of the first channel causes simultaneous rotation of the first channel. The actuator may include a knob and an elongate body, the elongate body including a lumen extending through the elongate body from the proximal end to the distal end of the elongate body, the knob secured to the proximal end of the elongate body, and the knob including an opening in fluid communication with the lumen of the elongate body. The actuator may be biased away from engagement with the proximal end of the first channel. The medical device may further include a spring wound around a portion of the elongate body extending proximally outside the actuator channel, the spring being positioned between a distal surface of the knob and a proximal surface of the actuator channel, thereby biasing the actuator away from the proximal end of the first channel.

[0010] According to one example, a method of rotating an accessory device housed within a medical device, the medical device comprising: a first channel extending through a lumen of a shaft, the first channel being rotatable about a longitudinal axis of the shaft; and an actuator configured to engage with and rotate the first channel, the accessory device extending into the first channel and the first channel gripping a distal portion of the accessory device, the method may include the steps of inserting a distal end of the shaft of the medical device into a subject's body; and, after the insertion step, engaging the actuator with the channel; and rotating the actuator, thereby rotating both the channel and the accessory device relative to the shaft.

[0011] 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. [Brief explanation of the drawings]

[0012] [Figure 1] 1 is a partial cross-sectional view of a medical device according to one embodiment. [Figure 2A] 2 is a partial cross-sectional view of a portion of the medical device of FIG. 1. [Figure 2B] 1 is a partial cross-sectional view of a portion of a medical device according to another embodiment. [Figure 3A] 2 is a partial cross-sectional view of a portion of the medical device of FIG. 1. [Figure 3B] 2 is a partial cross-sectional view of a portion of the medical device of FIG. 1. [Figure 3C] 2 is a partial cross-sectional view of a portion of the medical device of FIG. 1. DETAILED DESCRIPTION OF THE INVENTION

[0013] Reference will now be made in detail to aspects of the present disclosure, examples of which are illustrated in the accompanying drawings. Wherever possible, the same or like reference numbers will be used throughout the drawings to refer to the same or like parts. The term "distal" refers to the portion of the device that is furthest from a user when introducing the device into a subject (e.g., a patient). In contrast, the term "proximal" refers to the portion of the device that is closest to a user when placing the device within a subject.

[0014] Both the foregoing general description and the following detailed description are exemplary and explanatory only and are not limiting of the claimed features. As used herein, the terms "comprises," "comprising," "having," "including," or other variations thereof, are intended to cover a non-exclusive inclusion, such that a process, method, article, or apparatus comprising a list of elements does not include only those elements, but may include other elements not expressly listed or inherent to such process, method, article, or apparatus. In this disclosure, relative terms such as "about," "substantially," "generally," and "approximately" are used to indicate a possible variation of ±10% in a stated value or characteristic.

[0015] Embodiments of the present disclosure may address one or more limitations in the art. However, the scope of the present disclosure is defined by the appended claims, not by its ability to solve a particular problem. The present disclosure relates to a medical device including a working channel. The working channel may be rotatable clockwise or counterclockwise relative to the handle and shaft of the medical device through engagement with a port key. The medical device may be, by way of example, any scope (e.g., bronchoscope, duodenoscope, endoscope, colonoscope, ureteroscope, etc.), catheter, tool, instrument, etc., having a shaft extending distally from a handle. Similarly, the working channel may extend distally from the handle within a lumen of the shaft. In some embodiments, the medical device includes a working channel that may be rotatable through engagement with a key extending through a lumen of a port on the medical device handle. The key may be in one of two states: 1) a default state in which the key is not engaged with the working channel; and 2) an engaged state in which the key is engaged with the working channel. The key may include a portion, such as a knob, that is external to the port and accessible to the user. A user may interact with (e.g., push, turn) the portion to engage the portkey with the working channel. A user may also rotate the key while in the engaged state, thereby simultaneously rotating the working channel.

[0016] The working channel is configured to receive at least one accessory device and retain a distal portion of the accessory device via any suitable means (e.g., a sphincter, a collet). Thus, when the working channel is rotated, the accessory device is similarly rotated. Such a working channel eliminates the need for a user to manually rotate an accessory device by exerting a rotational force on a proximal portion of the accessory device. Thus, the working channel minimizes the risk of damaging or whipping the accessory device. Further details regarding the keys and the manner in which they transition between the aforementioned states are discussed below with reference to FIGS. 2A-2B and 3A-3C.

[0017] Referring to FIG. 1 , a medical device 1, e.g., a bronchoscope, is shown according to one embodiment. The medical device 1 includes a flexible shaft 24 (e.g., a catheter) and a handle 5 that receives a proximal portion of the shaft 24. The proximal portion of the shaft 24 may extend along the longitudinal axis of the handle 5 and may be fixedly held within the handle 5 by any suitable means. In some embodiments, the distal end of the shaft 24 may include a distal abutment 26 that extends radially inward toward the central axis of the shaft 24. The extent to which the distal abutment 26 extends radially inward is not particularly limited, so long as a medical accessory device can extend distally through the distal opening of the shaft 24. In other embodiments, the proximal portion of the shaft 24 may also include a proximal abutment 28, which also extends radially inward toward the central axis of the shaft 24. Distal abutment 26 and proximal abutment 28 (FIG. 3A) may serve the purpose of containing working channel 12 (described in further detail below) within shaft 24. Abutments 26 and 28 may also limit the longitudinal mobility of channel 12 within shaft 24.

[0018] The medical device 1 further includes a working channel 12 extending through at least a portion of the lumen of the shaft 24. The channel 12 includes a proximal end 12a and a distal end 12b. The proximal end 12a includes a proximal opening 15 (shown in FIG. 3B) that connects to the opening of the lumen 17 of the channel 12. The proximal end 12a is configured to be engaged by another component or means. For example, the proximal end 12a may include a set of proximally protruding teeth (shown in more detail in FIGS. 2A-2C) that are configured to engage and couple with another set of teeth. However, the proximal end 12a is not limited to including teeth and may include any other suitable means configured for engagement. The distal end 12b includes a distal opening 12c that is in fluid communication with the lumen of the channel 12 and the proximal opening 15. The distal end 12b further includes a sphincter 14, or any other suitable means, configured to grip a distal portion of a medical accessory device extending through the channel 12 and out the distal opening. The manner in which the sphincter 14 is coupled to the distal end 12b is not particularly limited. For example, the sphincter 14 may be firmly fitted within the lumen 17 just proximal to the distal opening 12c of the distal end 12b by any suitable means, such as an adhesive. The material of the sphincter 14 is not particularly limited and may be, for example, a flexible rubber material such as silicone or BUNA-N. The structural shape of the sphincter 14 is also not particularly limited. For example, in some embodiments, the sphincter 14 may be an annular ring-like structure. In other embodiments, the sphincter 14 may be an elastomeric slit valve. In some other embodiments, the sphincter 14 may be in the shape of a pinhole, an O-ring, or a tapered portion of the channel 12 including a flexible pinhole opening at its distal end. Sphincter 14 may include a central opening 16 configured to securely grip at least one accessory device extending through sphincter 14. It should be noted, however, that distal end 12b is not limited to including sphincter 14, but may include any suitable means, such as a collet, configured to hold or grip a distal portion of an accessory device extending from the distal opening.

[0019] Channel 12 may be positioned within lumen 24 such that distal end 12b rests against distal abutment 26 and proximal end 12a is adjacent to and distal to the point where lumen 25 of channel 22 (shown in FIGS. 2A-2B ) and the lumen of shaft 24 meet. In some embodiments, proximal end 12a may also be positioned distal to proximal abutment 28 on the proximal portion of shaft 24. Thus, in such embodiments, channel 12 may be contained between distal abutment 26 and proximal abutment 28. Channel 12 is fitted within the lumen of shaft 24 such that the outer surface of channel 12 can be flush with the inner surface of shaft 24 while still allowing rotation of channel 12 within the lumen of shaft 24. Alternatively, channel 12 is fitted within the lumen of shaft 24 to leave some annular space between the outer surface of channel 12 and the inner surface of shaft 24 to minimize frictional forces during rotation. Channel 12 may be configured to receive accessory medical devices and also to provide suction or insufflation.

[0020] The handle 5, or any other device for actuating or controlling the medical device 1 and any tools or devices associated with the medical device 1, includes an actuator 43. The actuator 43 controls the articulation of the flexible shaft 24 and / or an articulation joint at the distal end of the flexible shaft 24 in multiple directions. The actuator 43 may be, for example, a rotatable knob that rotates about its axis to push or pull an actuation element, such as a steering wire (not shown). An actuation element, such as a cable or wire (e.g., medical-grade plastic or metal) suitable for a medical procedure, extends distally from the proximal end of the medical device 1 and connects to a distal portion of the flexible shaft 24 to control its movement. Alternatively or additionally, a user may operate the actuation element independently of the handle 5. The distal end of the actuation element may extend through the flexible shaft 24 and terminate at an articulation joint and / or the distal tip of the flexible shaft 24. For example, one or more actuation elements may be connected to the articulation joint, and actuation of the actuation elements may control the articulation joint or the distal end of the flexible shaft 24 to move in multiple directions (e.g., up and down and / or left and right). Additionally, one or more electrical cables (not shown) may extend from the proximal end of the medical device 1 to the distal end of the flexible shaft 24 and may provide electrical control for imaging, lighting, and / or other electrical devices at the distal end of the flexible shaft 24, and may transmit imaging signals from the distal end of the flexible shaft 24 to the proximal end for processing and / or display on a display.

[0021] The handle 5 may also include ports 46, 11 for introducing and / or removing tools, fluids, or other materials from the patient. The port 46 may be connected to the umbilicus for fluid introduction, suction, insufflation, and / or wiring of electronic components. The port 11 may be used to introduce accessory devices. The port 11 receives a channel 22 extending along an axis transverse to the longitudinal axis of the shaft 24. The shape and length of the channel 22 are not particularly limited. The channel 22 connects to the shaft 24, and thus the lumen 25 of the channel 22 (shown in FIGS. 2A-2B ) and the lumen of the shaft 24 are in fluid communication with each other. The channel 22 is configured to accommodate / cover at least a portion of the port key 30.

[0022] The port key 30 includes a longitudinal body 32 and a knob 34. The body 32 may be a hollow tubular body with a lumen 38 (shown in FIG. 2A) and configured to receive a medical accessory device. The length of the body 32 is not particularly limited, as long as the distal end of the body 32 can engage the proximal end 12a of the working channel 12 when the body 32 is translated toward the channel 12 (discussed further below). The distal end of the body 32 may include means for engaging the proximal end 12a of the channel 12. For example, the distal end of the body 32 may include a series of distally protruding teeth (shown in more detail in FIGS. 2A-2C), which are configured to engage and couple with a series of teeth protruding from the proximal end 12a. However, the distal end is not limited to including teeth and may include any other suitable means configured to engage the proximal end 12a. The proximal end of the body 32 may be fixed to or connected to the knob 34. The manner in which the body 32 is secured / connected to the knob 34 is not particularly limited. The knob 34 may be disk-shaped, but is not limited thereto. The knob 34 may be of any suitable shape or design that allows a user to turn or push the knob 34, thereby rotating the body 32 about the longitudinal axis of the channel 22 or translating the body 32 along the longitudinal axis of the channel 22. The knob 34 includes an opening 36 that is in fluid communication with the lumen of the body 32. The opening 36 is configured to receive a medical accessory device, which may extend through both the opening 36 and the lumen of the body 32.

[0023] As shown in FIG. 2A , at least a portion of the body 32 is enclosed within the lumen 25 of the channel 22. An annular space may be defined between the outer surface of the body 32 and the inner surface of the channel 22. Alternatively, in other embodiments, the body 32 may be flush with the inner surface of the channel 22 but may be free to translate along or rotate about the longitudinal axis of the channel 22. Additionally, a spring 42 is wrapped around the portion of the body 32 that extends proximally outside the channel 22. The spring 42 is positioned between the distal surface of the knob 34 and the proximal surface of the channel 22, and the end of the spring 42 may be coupled to these surfaces by any suitable means. Thus, expansion of the spring 42 may bias the key 30 away from engagement with the channel 22 by default. Also, coupling the spring 42 to these surfaces may prevent the key 30 from falling out of the proximal opening of the channel 22.

[0024] FIG. 2A further illustrates the presence of a channel O-ring 23 and a key O-ring 33. Both O-rings 23 and 33 are annular rings made of any suitable material, preferably a flexible rubber-like material such as silicone, BUNA-N, or the like. As shown, the channel O-ring 33 is fitted around the body 32 of the key 30 within the annular space between the outer surface of the body 32 and the inner surface of the channel 22. The longitudinal positioning of the O-ring 23 relative to the body 32 is not particularly limited. The O-ring 23 can be positioned at any suitable longitudinal position around the body 32. The O-ring 33 can function as a seal to prevent foreign matter or fluids from entering or exiting the channel 22. The key O-ring 33 may be fitted within a lumen 38 of the key 30. The longitudinal positioning of the O-ring 33 within the lumen 38 is not particularly limited. The O-ring 33 can be positioned at any suitable longitudinal position within the lumen 38. Given the annular shape of the O-ring 33, an accessory device or instrument may be inserted through a central opening in the O-ring 33. Additionally, O-ring 33 may act as a seal to prevent foreign matter or fluids from entering or exiting key 30 via lumen 38 .

[0025] 2B shows examples of different sealing means for the channel 22′ and key 30′. The channel 22′ may be configured such that the lumen 25′ includes a tapered portion 21 between the proximal and distal ends of the lumen 25′. The tapered portion 21 tapers radially inward until the inner surface of the channel 22′ contacts the body 32′, and then tapers radially outward to the diameter of the lumen 25′ proximal and distal to the taper. The tapered portion 21 effectively functions as a seal to prevent foreign matter or fluids from entering or exiting the channel 22′.

[0026] Similarly, the key 30′ may be configured such that the lumen 38′ tapers at the tapered portion 31. The lumen 38′ may be tapered such that the pinhole 37 remains in the center of the tapered portion 31. The pinhole 37 allows an accessory device or instrument to pass through the lumen 38′. The width or diameter of the pinhole 37 is not particularly limited. For example, the pinhole 37 may have a diameter similar to the width of the accessory device or instrument. However, the tapered portion 31 may be made of a flexible material that allows the pinhole 37 to flex and accommodate a device or instrument of a larger width. Considering the stretching / bending ability of the pinhole 37, the pinhole 37 may have a smaller diameter, and the tapered portion 31 may effectively function as a seal to prevent foreign matter or fluids from entering or exiting the key 30′.

[0027] As discussed above, tapered portions 21, 31 are structural features of channel 22′ and key 30′. To accommodate tapered portions 21, 31 that are more flexible relative to the rest of the channel 22′ and key 30′ structure, channel 22′ and key 30′ may be made of a rubber-like material, such as a higher durometer silicone, BUNA-N, or the like. Tapered portions 21, 31 may be the same material but with a lower durometer. This variation in durometer level may be achieved by any suitable means. For example, tapered portions 21, 31 may be injection molded onto channel 22′ and key 30′, which may be the same material (as channel 22′, key 30′) with a lower durometer.

[0028] It is further noted that the sealing means are not limited to the embodiments shown in Figures 2A and 2B. For example, device 1 may lack O-ring 23 or tapered portion 21, in which case body 32 may be flush with the inner surface of channel 22. As such, various combinations and / or configurations of the sealing means described above may be implemented.

[0029] Additionally, medical device 1 may include a strain relief 23 attached to the distal end of handle 5. Strain relief 23 may be a cover of any suitable soft material that is distally tapered and has an opening at its distal end for shaft 24. The strain relief 23 is not particularly limited and may help prevent twisting of shaft 24.

[0030] FIG. 3A shows another view of the key 30 in its default state. FIG. 3A illustrates the distal end of the body 32, which includes a series of distally protruding teeth 58, each separated from the others by an equal distance along the circumference of the distal tip of the body 32. FIG. 3A also illustrates the proximal end 12a, which includes a series of proximally protruding teeth 52, each separated from the others by an equal distance along the circumference of the proximal end 12a. As indicated by the directional arrow, the key 30 can be translated along the longitudinal axis of the channel 22, thereby transitioning from the default state to the engaged state. This may be accomplished by depressing the knob 34 with a sufficient amount of force to compress the spring 42 and drive the key 30 toward the proximal end 12a of the working channel 12. The manner in which the knob 34 is depressed is not particularly limited. Although the teeth 52, 58 are shown as multiple castellations, it is understood that the teeth 52, 58 may be any protrusion / recess and corresponding reverse configuration such that the key 30 and channel 12 are selectively engageable and disengageable.

[0031] FIG. 3B shows a view of the key 30 in an engaged state. In the engaged state, the spring 42 is compressed, and the key 30 is advanced toward the proximal end 12a. The teeth 58 of the key 30 and the teeth 52 of the channel 12 are engaged and interlocked with one another, such that each of the teeth 58 fills the separation or gap between each of the teeth 52. Once engaged, the knob 34 can be rotated about the longitudinal axis of the channel 22 and the body 32, as indicated by the directional arrow, thereby rotating the key 30 in the same direction, which in turn rotates the working channel 12. Note that the knob 34 can be rotated in either a clockwise or counterclockwise direction and is not limited to the direction indicated by the directional arrow. The manner in which the knob 34 can be rotated is not particularly limited. As previously mentioned, the distal end 12b further includes a sphincter 14 (shown in FIG. 1a) or any other suitable means configured to grip a distal portion of a medical accessory device extending out of the distal opening of the channel 12. In this manner, a medical accessory device inserted into opening 36 and extending through key 30 and channel 12 can rotate simultaneously (clockwise or counterclockwise) with channel 12 .

[0032] 3C shows a view of key 30 returned to its default state. When the pressure on knob 34 is released, key 30 is allowed to return to its default state, thereby allowing spring 42 to expand. This return is indicated by the directional arrow, and key 30 is biased back to its original position, away from engagement with channel 12.

[0033] 1A-3C, examples of how the medical device 1 can be used are further described below. The distal end of the shaft 24 of the medical device 1 can be delivered into a subject's body adjacent to an intended target site. Delivery may be via a natural body orifice, such as the mouth, nose, or anus. Imaging associated with the medical device 1 via any suitable imaging device can assist in positioning the distal end of the shaft 24. A medical accessory device (not shown) can then be inserted into the opening 36 of the key 30. The accessory device can be advanced toward the distal end of the shaft 24, past the sphincter 14, which grips the distal portion of the accessory device. Depending on the location of the subject and / or intended target site relative to the medical device 1 and / or the user of the medical device 1, the user may choose to rotate the accessory device relative to the handle 5 and shaft 24. To rotate the accessory device, the user may first press the knob 34 of the key 30 with a sufficient amount of force to compress the spring 42 and advance the key 30 toward the working channel 12. The key 30 can be advanced until the distal end of the key 30 engages the proximal end 12a of the channel 12. While engaged, the user may then rotate the knob 34 clockwise or counterclockwise to rotate the key 30, thereby rotating the channel 12 in the same direction. Rotation of the channel 12 causes simultaneous rotation of the medical accessory device grasped by the channel 12 via the sphincter 14. In this manner, the user can rotate the medical accessory device to any desired extent via rotation of the knob 34. After rotating the accessory device to the desired extent, the user can release the force applied to the knob 34 to decompress the spring 42 and return the key 30 to its default position, biased away from the channel 12.

[0034] It will be apparent to those skilled in the art that various modifications and variations can be made to the disclosed apparatus without departing from the scope of the 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 shaft, a handle that houses the proximal end of the shaft; a first channel extending through a lumen of the shaft, the first channel being rotatable about a longitudinal axis of the shaft and including a proximal end and a distal end; a medical device comprising: an actuator, wherein a distal end of the actuator is configured to engage and disengage with the proximal end of the first channel, and wherein, in an engaged position, the actuator and the first channel are rotatable.

2. The medical device of claim 1 , wherein the actuator comprises an elongate body including a lumen extending therethrough from a proximal end to a distal end thereof.

3. 3. The medical device of claim 2, further comprising an actuator channel in fluid communication with the lumen of the shaft, the actuator channel extending along an axis transverse to the longitudinal axis of the shaft, the actuator channel covering at least a portion of the elongate body.

4. 4. The medical device of claim 3, wherein the actuator is configured to translate along a longitudinal axis of the actuator channel to engage and disengage the proximal end of the first channel, and the actuator is configured to rotate about the longitudinal axis of the actuator channel.

5. The medical device of any one of claims 1 to 4, wherein the actuator is biased away from engagement with the proximal end of the first channel.

6. The medical device of claim 5 , wherein the actuator is spring biased.

7. 4. The medical device of claim 3, further comprising a spring wound around a portion of the elongate body extending proximally outside the actuator channel, the actuator further comprising a knob, the elongate body extending distally from a distal surface of the knob, and the spring positioned between the distal surface of the knob and a proximal surface of the actuator channel.

8. the distal end of the actuator includes a first plurality of distally projecting teeth, each of the first plurality of teeth separated from one another by a gap along a periphery of the distal end of the actuator; 8. The medical device of claim 1, wherein the proximal end of the first channel includes a second plurality of proximally projecting teeth, each of the second plurality of teeth being separated from one another by a gap along the circumference of the proximal end of the first channel.

9. 9. The medical device of claim 8, wherein each of the first plurality of teeth of the actuator is configured to fit into a respective one of the gaps of the first channel, and each of the second plurality of teeth of the first channel is configured to fit into a respective one of the gaps of the actuator, thereby engaging the distal end of the actuator with the proximal end of the first channel.

10. The medical device of any one of claims 1 to 9, wherein the distal end of the shaft includes a distal abutment configured to abut the distal end of the first channel, thereby preventing the first channel from moving further distally beyond the distal abutment.

11. 11. The medical device of claim 10, wherein the proximal portion of the shaft includes a proximal abutment configured to prevent the first channel from moving further proximally beyond the proximal abutment.

12. The medical device of any one of claims 1 to 11, wherein the distal portion of the first channel comprises a holder configured to hold a distal portion of at least one accessory device that passes through a distal opening of the first channel.

13. The medical device of claim 2 , wherein the actuator includes a knob having a disk shape.

14. The medical device of any one of claims 1 to 13, wherein the first channel is configured to provide suction and / or insufflation through a distal opening of the first channel.

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