Endoscope accessory control unit and method of use

Abstract

The medical device includes a handle including a first slot, a first control device movable within the first slot in a proximal and distal direction, and a sheath extending from the handle and having a longitudinal axis, the sheath defining a first lumen extending from the handle to a distal end of the sheath. A first tube extends within the first lumen, the first tube coupled to the first control device and movable between a first position where a distal-most end of the first tube is flush with or proximal to the distal-most end of the sheath, and a second position where the distal-most end of the first tube is positioned distal to the distal-most end of the sheath. The first slot extends parallel to the longitudinal direction of the sheath.

Description

Technical Field

[0001] The present disclosure generally relates to endoscopic medical devices and related methods of use. More specifically, in some embodiments, the present disclosure relates to using one or more accessory devices or medical instruments together with an endoscope, and to independent articulation of the distal ends of each of the endoscope and one or more accessory devices or medical instruments.

Background Art

[0002] Medical tools for accessing a target site within the body may be advanced through one or more lumens of an endoscope and may extend from its distal end to manipulate the target site. Disadvantages of these endoscopic systems include, for example, limited access and operability of tools protruding from the distal end of the endoscope. For example, in many endoscopes, medical tools extend from one or more openings at the distal end face of the endoscope, limiting access and operability of these medical tools in a direction perpendicular to the distal end face. This can cause difficulties when cutting and removing tissue from a target site or performing other treatments. Additionally, multiple users (e.g., a physician and one or more technicians) may be required to operate the multiple tools and / or accessories of an endoscopic device. This can increase the number of people in the operating room, thereby increasing the risk of accidents, infections, or other troublesome problems. The present disclosure may solve one or more of these problems or other problems in the art. However, the scope of the present disclosure is not defined by its ability to solve specific problems, but by the appended claims.

Summary of the Invention

[0003] In one embodiment, the medical device includes a handle including a first slot; a first control device configured to move proximal and distally within the first slot; a sheath extending from the handle and having a longitudinal axis, defining a first lumen extending from the handle to the distal end of the sheath; and a first tube extending within the first lumen, connected to the first control device, and configured to move between a first position where the distal end of the first tube is coplane with or proximal to the distal end of the sheath, and a second position where the distal end of the first tube is located distal to the distal end of the sheath, wherein the first slot extends parallel to the longitudinal direction of the sheath.

[0004] The first tube may be configured to move between a first position and a second position when the first control device moves distally from the proximal end of the first slot. The first control device may include a locking mechanism configured to prevent the first control device from moving and to maintain the position of the first control device relative to the handle in the proximal and distal directions.

[0005] The locking mechanism may include an annular ring extending radially outward from the first tube, the annular ring contacting a portion of the handle and increasing the frictional force between the handle and the first tube, and the first control device may be configured to move within the first slot when a force sufficient to overcome the frictional force of the annular ring is applied to the first control device.

[0006] The first control device may include a joystick, and the movement of the joystick may be configured to bend the distal end of the first tube at an angle with respect to the longitudinal axis of the sheath.

[0007] The device may further include at least three articular movement wires extending from a joystick to the distal end of a first tube, the distal end of each of the at least three articular movement wires being attached to the first tube.

[0008] The first tube may include an articular movement wire lumen corresponding to each of at least three articular movement wires, and each of the at least three articular movement wires may extend within the corresponding articular movement wire lumen.

[0009] The first tube may include a tube lumen, and the device may further include a medical device configured to be inserted into the tube lumen, the distal end of the medical device may be configured to extend distal to the distal end of the sheath.

[0010] The device may further include a rotatable locking mechanism at the proximal end of the tube lumen, the rotatable locking mechanism may be configured to fluidly seal a medical device within the tube lumen when the rotatable locking mechanism is in the locked position, and the medical device may be configured to move within the tube lumen when the rotatable locking mechanism is in the unlocked position.

[0011] The medical device may include a tool at its distal end, and the apparatus may further include an actuator configured to actuate the medical device. The tool may include multiple jaws connected by a hinge, and the actuator may include a foot pedal, the multiple jaws may be configured to move from an open position to a closed position when the foot pedal is pressed, and the multiple jaws may be configured to move from a closed position to an open position when the foot pedal is released.

[0012] The device may further include a second lumen located within a sheath and extending from a handle to the distal end of the sheath, and a second tube extending within the second lumen, the second tube being configured to move between a first position in which the distal end of the second tube is either coplanar with the distal end of the sheath or proximal to the distal end of the sheath, and a second position in which the distal end of the second tube is located distal to the distal end of the sheath.

[0013] The apparatus may further include a second slot and a second control device configured to move within the second slot, the second control device may include a second joystick configured to bend the distal end of the second tube.

[0014] The first control device and the second control device may be configured to move independently of each other, and the first tube and the second tube may be configured to bend independently of each other.

[0015] The handle may include a first handle actuator and a second handle actuator configured to deflect a portion of the sheath. In another embodiment, the medical device includes a handle, a first control device and a second control device, a sheath extending from the handle and having a longitudinal axis, defining a first lumen and a second lumen, a first tube extending from the first control device into the first lumen, and a second tube extending from the second control device into the second lumen. The first control device is configured to bend a portion of the first tube, and the second control device is configured to bend a portion of the second tube, and the first tube and the second tube are configured to bend independently of each other.

[0016] The device may further include a first locking mechanism on the first control unit and a second locking mechanism on the second control unit, the first and second locking mechanisms being configured to prevent movement of the first and second control units relative to the handle.

[0017] The first control device and the second control device may be configured to move longitudinally with respect to the handle, and the first control device may be configured to move independently of the second control device.

[0018] In yet another embodiment, the method may include the steps of inserting the shaft of the insertion device into the body through an opening; advancing the insertion device so that the distal end of the insertion device is adjacent to a target site; deploying the first tube from the shaft of the insertion device through the opening at the distal end of the first lumen; advancing the first medical device outward through the lumen of the first tube and through the opening at the distal end of the first tube; and bending a portion of the first tube extending from the shaft at an angle with respect to the longitudinal axis of the shaft.

[0019] The method may further include the steps of deploying a second tube from the shaft of an insertion device through the opening of a second lumen of the shaft, advancing a second medical device through the lumen of the first tube and out through the opening at the distal end of the first tube, and bending a portion of the second tube extending from the shaft at an angle with respect to the longitudinal axis of the shaft, wherein the step of bending the first tube may include the step of activating a first joystick attached to a handle extending from the proximal end of the shaft, and the step of bending the second tube may include the step of activating a second joystick attached to a handle, wherein the first tube and the second tube may be configured to bend independently of each other. [Brief explanation of the drawing]

[0020] The accompanying drawings incorporated herein and constituting part of this specification illustrate various exemplary embodiments and, together with the description, serve to illustrate the spirit of the disclosed embodiments. [Figure 1] This is a schematic diagram of a medical system according to one embodiment. [Figure 2] This is a schematic diagram of the endoscopic system shown in Figure 1, according to one embodiment. [Figure 3] This is the proximal end of the endoscopic system shown in Figure 2, according to one embodiment. [Figure 4] This is the distal end of the endoscopic system shown in Figure 2, according to one embodiment. [Figure 5A] It is the proximal end of the endoscope system of FIG. 2 according to one embodiment. [Figure 5B] It is a view of the distal end of the endoscope system of FIG. 2 according to one embodiment. [Figure 5C] It is a view of the distal end of the endoscope system of FIG. 2 according to one embodiment. [Figure 5D] An actuator of the medical system of FIG. 1 is shown according to one embodiment. [Figure 5E] It is a view of the distal end of the endoscope system of FIG. 2 according to one embodiment. [Figure 5F] It is a view of the distal end of the endoscope system of FIG. 2 according to one embodiment. [Figure 6] It is a cross-sectional view taken along line 6-6 of FIG. 2 according to one embodiment. [Figure 7] It is a side view of the handle of the endoscope system of FIG. 2 according to one embodiment. [Figure 8] A control device of the endoscope system of FIG. 2 is shown according to one embodiment.

Mode for Carrying Out the Invention

[0021] The present disclosure is described with reference to exemplary medical systems and medical tools for accessing a target site, for example, accessing a target site from various directions and / or at various angles at the distal end of an endoscope. This can provide improved medical tool functionality and / or assist a medical professional in obtaining improved access to a target site for performing a medical procedure. However, it should be noted that any reference to any specific device and / or any specific procedure is provided for convenience only and is not intended to limit the present disclosure. Those skilled in the art will recognize that the concepts underlying the disclosed devices and methods of application can be utilized in any suitable procedure, medical or otherwise. The present disclosure can be understood by referring to the following description and the accompanying drawings, and like elements are referred to by the same reference numerals.

[0022] For ease of explanation, parts of the disclosed apparatus and / or their components are referred to as proximal and distal parts. Note that the term “proximal” is intended to refer to the part of the apparatus closer to the user, and the term “distal” is used herein to refer to the part further away from the user. Similarly, “extending distally” indicates that a component extends distally, and “extending proximally” indicates that a component extends proximally. Furthermore, where used herein, the terms “about,” “approximately,” and “substantially” indicate a range of values ​​within + / - 10% of the stated or implied value. In addition, terms describing the geometric shape of a component / surface refer to the exact shape and the approximate shape.

[0023] Referring to Figure 1, a medical system 10 according to one embodiment is shown. The medical system 10 may include a patient table 20 for supporting a patient 1000 (or a part of the patient 1000, e.g., a leg, an arm, etc.), a table 30 (or other support device) for supporting one or more actuators 30a, 30b, and a support device 40 capable of supporting an endoscope system 100 (e.g., an insertion device). The actuators 30a, 30b may receive one or more medical devices that can be delivered to a target site in the patient 1000, for example, via the endoscope system 100, as described herein. A user 1100 can operate the endoscope system 100, including actuators 40a, 40b (e.g., foot pedals which may be wireless or wired (wires not shown)), to actuate the actuators 30a, 30b and actuate one or more parts of the endoscope system 100, as described herein.

[0024] As shown in Figure 2, the endoscope system 100 includes a handle 110. The handle 110 may be supported by the support device 40 in Figure 1 via a clip, a strap (not shown), a screw (not shown) attached to a threaded member within the handle 110, or any other mounting mechanism. Although the support device 40 is shown as a three-legged support member (e.g., a tripod), the support device 40 may be a four-legged support member (e.g., a stand) or any other support device having any number of legs. The support device 40 may support the handle 110 in a fixed manner with respect to the patient 1000 and / or stand 20 so as to enable a user 1100 to perform one or more medical procedures on the patient 1000.

[0025] Continuing to refer to Figure 1, the actuators 30a and 30b may be supported on the table 30. Although two actuators 30a and 30b are shown, any number of actuators may be provided. Actuator 30a may receive the handle 150a of the first medical instrument 150 shown in Figure 2, and actuator 30b may receive the handle 150b of the second medical instrument 152 shown in Figure 2. As described herein, the actuators 30a and 30b may be actuated to actuate the first medical instrument 150 and / or the second medical instrument 152 (for example, one or more tools or end effectors at the distal ends of the first medical instrument 150 and / or the second medical instrument 152). The actuators 30a and 30b are supported by the base 30, but it will be understood that the actuators 30a and 30b may be attached to and supported by any other device of the medical system 10, including the support device 40, the patient table 20, etc.

[0026] Referring to Figure 2, the endoscopic system 100 may include a handle 110, a shaft 120 (e.g., a catheter) connected to the distal end of the handle 110, and a distal end effector 180 at the distal end of the shaft 120. The shaft 120 may be flexible and may be formed from any medical-grade material suitable for accessing tortuous pathways in the body, but the rigidity / flexibility of the shaft 120 is not limited. The endoscopic system 100 may be an endoscope, colonoscope, bronchoscope, ureteroscope, duodenoscope, or other similar device (not shown).

[0027] As shown in Figure 3, the handle 110, or similar devices for operating or controlling the endoscope system 100 and any tools, devices, or instruments associated with the endoscope system 100, include first and second actuators 42, 43. The actuators 42, 43 control the articular movement of the shaft 20 and / or the distal end 180 of the shaft 120, or of articular joints proximal to the distal end 180 of the shaft 120, in multiple directions. The actuators 42, 43 may be rotatable knobs that rotate around their axes to push / pull an actuator element 126 extending into the working lumen 124 (Figure 6) of the shaft 120. The actuator element 126, such as a medically appropriate cable or wire (e.g., medical-grade plastic or metal), extends distally from the proximal end of the endoscope system 100 and is connected to the shaft 120 to control its movement. Alternatively or additionally, the user may operate the actuator element 126 independently of the handle 110. The distal end of the actuation element 126 extends through the actuation lumen 124 of the shaft 120 and terminates at the actuation joint and / or distal end 180 of the shaft 120. It will be understood that the actuation joint may be part of the distal end 180, or the actuation joint may be attached to the distal end of the shaft 120 and the proximal end of the distal end 180. For example, one or more actuation elements 126 may be coupled to an articular joint, and the actuation of the actuation element 126 may control the actuation joint or distal end 180 of the shaft 120 to move in multiple directions.

[0028] One or more electrical cables (such as electrical cable 154b located in the imaging lumen 154a, or electrical cable 182b located in the optical lumen 182a, as shown in Figure 6) may extend from the proximal end of shaft 120 to the distal end 180 of shaft 120. The cables (e.g., cables 154b or 182b) may provide electrical control to imaging devices, illumination devices, and / or other electrical devices at the distal end 180 of shaft 120, and may carry imaging signals proximal to or distal to imaging devices 182 (e.g., a camera or other image sensor) and / or light-emitting devices 184 (Figure 5F) at the distal end 180 of shaft 120, for example, by sending signals from a user interface to imaging devices 182 and / or light-emitting devices 184, and by carrying signals from imaging devices 182 for processing and / or display on a display.

[0029] The handle 110 may also include one or more ports, such as ports 136a, 136b shown in Figure 3 and described below, or port 200 connected to the suction / wash lumen 186a shown in Figure 6. In these embodiments, ports 136a, 136b, and 200 may be used to introduce tools, fluids, or other substances into and / or remove them from the patient. As described herein, ports 136a, 136b may be used to introduce tools or instruments, e.g., first and second medical instruments 150, 152, respectively. Port 200 connected to the suction / wash lumen 186a may be connected to an umbilicus for introducing fluids and / or suction. Furthermore, the umbilicus may include wiring for electronic components (e.g., wiring connected to cables 154b and / or 182b). The distal end opening 186 of the suction lumen 186a is shown in Figure 5F.

[0030] Referring to Figure 2, the control devices 130a and 130b are connected to the handle 110 and can move in a proximal-distal direction relative to the handle 110, as indicated by arrow B (Figure 5A). The control devices 130a and 130b are positioned on the outer surface of the handle 110 and may be oriented approximately 180 degrees apart from each other around the outer circumference of the handle 110. However, it will be understood that the handle 110 may contain only one control device 130a, or three, four, or more control devices 130a, 130b, ..., 130n, and the control devices 130a and 130b may be positioned at any location around the outer circumference of the handle 110. For ease of understanding, control device 130a will be referred to, but the description of control device 130a applies equally to control device 130b (and any additional control devices on the handle 110) unless otherwise stated.

[0031] Referring to Figures 2 and 8, the control device 130a includes a joystick 132a with a ball bearing 195 attached to one end. The ball bearing 195 may be substantially spherical and may be located in a substantially spherical opening in a socket 191 of the housing 190. The ball bearing 195 is configured to move in any direction, e.g., 360 degrees, within the socket 191 when a user (e.g., doctor 1100 in Figure 1) applies force to the joystick 132a in any direction, as indicated by arrow D in Figure 5A. The ball bearing 195 may be located within the housing 190 of the socket 191, may be supported by and / or in contact with one or more inner walls of the housing 190. The inner walls of the housing 190 may define the direction of movement of the ball bearing 195.

[0032] The ball bearing 195 may have a plurality of projections 193 extending radially outward from the ball bearing 195. The projections 193 may be any element within the ball bearing 195 (e.g., slits, holes, openings, etc.) for coupling one or more actuation wires 192 to the ball bearing 195. The projections 193 may move within slots (not indicated) of the socket 191 to allow the ball bearing 195 to move in any direction as described herein. An actuation wire 192 is attached to each projection 193. Three actuation wires 192 are shown in Figure 8, but it will be understood that any number of actuation wires 192 (e.g., two, four, five, etc.) may be used based on the number of projections 193 extending from the ball bearing 195. Each actuation wire 192 extends distally from its respective projection 191 and connects to the distal end of the first tube 160 (first tube 160 shown in Figure 4) (e.g., working channel). In this way, as described below, the movement of the ball bearing 195 within the socket 191 can push or pull one or more of the actuating wires 192, and thus the distal end of the first tube 160 can be operated. It will be understood that additional wires 192 may provide improved maneuverability of the control device for the distal end of the first tube 160, as described herein. The first tube 160 may have a diameter of about 2.8 mm, but may be any size, and is not limited thereto. It will be understood that the first tube 160 may be sized to fit into the first lumen 122a, and is not limited thereto. In some examples, the diameter of the first tube 160 may be about 1.0 mm to about 10.0 mm, and the diameter of the first lumen 122a may be about 0.254 mm (about 0.010 inches) larger than the diameter of the first tube 160.

[0033] Continuing to refer to Figure 8, the proximal end of the first tube 160 extends through the opening at the distal end of the control device 130a, through the lumen (not indicated) of the control device 130a, and through the opening on the side of the control device 130a. The proximal end of the first tube 160 (identified as 138a in Figure 8) terminates in a port 136a, which may include a collet. The collet in port 136a may include a locking member 139a. The locking member 139a may include an opening covered by a movable membrane (not shown) that can provide a seal (i.e., form a fluid seal) between the locking member 139a and the shaft 170 of the first medical device 150 (Figure 2). For example, the locking member 139a may be a screw-type device and may rotate about an axis via a screw thread. When the shaft 170 of the first medical device 150 is inserted into the opening of the locking member 139a, the locking member 139a may be rotated in a first direction to lock the shaft 170 against the locking member 139a and form a seal between the shaft 170 and the locking member 139a. The locking member 139a may be rotated in a second direction opposite to the first direction to unlock the shaft 170 against the locking member 139a.

[0034] Referring to Figures 3 and 5A, the slot 114 may extend in a proximal-distal direction with respect to the longitudinal axis A of the endoscope system 100 (see Figure 2 for the longitudinal axis A). The slot 114 may be provided on both sides of the handle 110 and may be configured to allow the control devices 130a and 130b to move proximal and distal within their respective slots 114. For example, the control device 130a may be moved proximal and distal within the slot (not shown) as indicated by arrow B in Figure 5A. The control device 130b may also move proximal and distal within the slot 114 as indicated by arrow B. Movement of the control device 130a may allow the distal end of the first tube 160 to move proximal and distal in the direction indicated by arrow C shown in Figure 5B. For example, distal movement of the control device 130a may cause the most distal end of the first tube 160 to extend distal to the most distal end of the sheath 120 (shown in Figure 4). Similarly, proximal movement of the control device 130a may cause the most distal end of the first tube 160 to be coplanar with the most distal end of the sheath 120, or to extend proximal to the most distal end of the sheath 120. Similar proximal and distal movement of the control device 130b may cause similar movement of the second tube 162 (e.g., a working channel) attached to the control device 130b. Like the first tube 160, the second tube 162 may have a diameter of approximately 2.8 mm, but may be of any size, and is not limited thereto. It will be understood that the second tube 162 may be sized to fit within the first lumen 122b, and its size is not limited thereto. In some examples, the diameter of the second tube 162 may be approximately 1.0 mm to 10.0 mm, and the diameter of the first lumen 122b may be approximately 0.254 mm (approximately 0.010 inches) larger than the diameter of the second tube 162. In some cases, the diameters of the first tube 160 and the second tube 162 may be the same, and the diameters of the first lumen 122a and the first lumen 122b may be the same. However, it will be understood that these diameters may be different.

[0035] Referring to Figure 7, the gasket 210, projection, or similar device may extend from the outer surface of the first tube 160 at the proximal end of the first tube 160. Although not shown, the second tube 162 may also include the gasket 210 or other similar device. The gasket 210 may slide within the slot 114 and may contact one or more walls of the handle 110, thereby increasing friction between the gasket 210 and the handle 110. This increased friction may increase the force required to move the control devices 130a, 130b in the proximal and distal directions. In this situation, the gasket 210 may act similarly to a locking mechanism and may help prevent the proximal or distal movement of the control devices 130a, 130b relative to the handle 110 unless a sufficient proximal or distal force is applied to overcome the frictional force. In this way, the position of the distal ends of the first tube 160 and / or the second tube 162 relative to the sheath 120 can be maintained during the medical procedure until sufficient force is applied to the control devices 130a, 130b.

[0036] The gasket 210 may additionally or alternatively include additional locking members and / or additional friction-increasing members. For example, a ratchet device may be provided to prevent movement of the control devices 130a, 130b in the proximal and distal directions unless sufficient force is provided to overcome the force provided by the ratchet device. Additionally or alternatively, a plurality of protrusions may be provided along the outer surface of the handle 110 adjacent to each of the slots 114. A strap or other device may be attached to the control devices 130a, 130b, or to one or more of the plurality of protrusions, to prevent or reduce movement of the control devices 130a, 130b in the proximal or distal direction. In this way, the positions of the first and second tubes 160, 162 in the proximal / distal directions can be maintained during medical procedures.

[0037] As described above, a cross-section of the sheath 120 along line 6-6 in Figure 2 is shown in Figure 6. The sheath 120 includes a first lumen 122a and a second lumen 122b. The first tube 160 extends from the proximal end to the distal end of the sheath 120 within the first lumen 122a. The second tube 162 similarly extends from the proximal end to the distal end of the sheath 120 within the second lumen 122b. Each of the first tube 160 and the second tube 162 contains a plurality of actuating wires 192, respectively. As described herein, each set of actuating wires 192 comprises any number of wires (four in Figure 6, but not limited to that number, e.g., two, three, or more). The first tube 160 may be extruded around the actuation wire 192 such that the actuation wire 192 is surrounded by the walls of the first tube 160 and connected to the first tube 160 along its entire length. Alternatively, the actuation wire 192 may be located within each lumen 160a formed within the walls of the first tube 160, and the actuation wire 192 may be attached only to the distal end of the first tube 160. In one or more embodiments, the actuation wire 192 may be attached only to specific points along the first tube 160. The actuation wire 192 may similarly be attached within the lumen 162a of the second tube 162. In this way, movement of the joysticks 132a, 132b can cause bending (e.g., articular movement) of the distal ends of the first tube 160 and the second tube 162, respectively, as described herein.

[0038] Referring to Figures 4 and 6, the first tube 160 may extend from the handle 110 through the first lumen 122a of the shaft 120 and may move proximal and distally within the first lumen 122a. The second tube 162 may extend from the handle 110 through the second lumen 122b of the shaft 120 and may move proximal and distally within the second lumen 122b. The movement of the first tube 160 and the second tube 162 may be controlled by control devices 130a and 130b, respectively. For example, the distal movement of control device 130a, as indicated by arrow B in slot 114 (Figure 5A), may cause the first tube 160 to move distally within the first lumen 122a. Movement of the control device 130a in the proximal direction, as indicated by arrow B within slot 114, can move the first tube 160 proximal within the first lumen 122a. Similarly, movement of the control device 130b within slot 114 can move the second tube 162 proximal and distal within the second lumen 122b.

[0039] Referring to Figures 5C, 5D, and 5E, one or both of the first tube 160 and the second tube 162 can be bent (for example, articulated) at a predetermined position along the longitudinal axis of the first tube 160 or the second tube 162 by moving the corresponding joystick 132a or joystick 132b. For example, when the joystick 132a or joystick 132b is moved in the direction indicated by arrow D in Figure 5A, the actuating wire 192 is pushed or pulled, respectively, within the corresponding wire lumen 160a or 162a. This movement of the wire 192 can bend the distal end of the first tube 160 or the second tube 162. For example, the first tube 160 or the second tube 162 may be positioned along an axis parallel to the longitudinal axis A in a first position (e.g., neutral position). When the user moves the joystick 132a or joystick 132b, the distal end of the corresponding first tube 160 or second tube 162 can bend such that a portion of the first tube 160 or a portion of the second tube 162 moves from a first position to a second position, the second position including a portion of the first tube 160 or a portion of the second tube 162 extending non-parallel to the longitudinal axis A. In other words, the first tube 160 and the second tube 162 can bend independently of each other in one or more planes, for example, being omnidirectional.

[0040] Continuing to refer to Figure 6, the first tube 160 may include a lumen 166, and the second tube 162 may include a lumen 168. Referring to Figures 5C, 5D, and 5E, the shaft 170 of the first medical device 150 (Figure 2) may extend into and move within the lumen 166 of the first tube 160, and the shaft 172 of the second medical device 152 (Figure 2) may extend into and move within the lumen 168 of the second tube 162. As shown in Figures 5C, 5D, and 5E, the distal ends of the shafts 170 and 172 may include or be coupled to medical tools such as grippers, cutting devices (scissors, knives, tissue excision devices, electrodes, etc.), ablation tools, forceps (e.g., two jaws connected by a hinge), snares, or any other medical tools. As described herein, shafts 170 and 172 may extend from the most distal ends of the first tube 160 and the second tube 162, respectively, so that the tools at the distal ends of shafts 170 and 172 can be exposed at the target site. The operation of these tools, for example, opening and closing the jaws of a gripping device, is described herein.

[0041] Referring to Figure 2, each first medical instrument 150 includes a handle 150a, and the second medical instrument 152 includes a handle 152a. Although shown as plunger-type handles in Figure 2, handles 150a and 152a may be any medical handles for operating the tool at the distal end of shafts 170 and 172, respectively. Each handle 150a and 152a may be attached to one of the actuators 30a and 30b shown in Figure 1. For example, handle 150a may be attached to actuator 30a, and handle 150b may be attached to actuator 30b. Each actuator 30a and 30b may include a fixed member and a movable member. The fixed member can fix the position of the body of the handles 150a and 150b, while the movable member can fix the plunger (or movable part) of the handles 150a and 150b. As described herein, the operation of actuators 30a and 30b can move the movable member relative to the fixed member. In this way, the plungers (or movable parts) of the handles 150a and 150b can move relative to the bodies of the handles 150a and 150b, thereby allowing a tool or end effector to be operated at the distal end of the handles 150a and 150b.

[0042] Actuator 30a may be actuated via actuator 40a (either via a wired connection (not shown) or a wireless connection), and similarly, actuator 30b may be actuated via actuator 40b. Although actuators 40a and 40b are shown as foot pedals in Figure 1, the disclosure is not limited in this way, and actuators 40a and 40b may be separate user interfaces or displays, robotic actuators, etc., such as buttons, levers, knobs, etc., located on the handle 110. Alternatively or additionally, actuators 40a and 40b may be voice-activated, actuated via user movement or a specific flashing sequence (e.g., user movement captured by a camera), or by any other method known in the art.

[0043] As an example, the user may press the actuator 40a with their foot, thereby moving the plunger of the actuator 30a and the handle 150a. This moves the jaws of the tool at the distal end of the first medical device 150 from the open position to the closed position. The jaws of the tool can be opened by removing the user's foot from the actuator 40a. As another example, the tool may include a laser fiber, thereby allowing laser energy to be emitted by pressing the actuator 40a and the emission of laser energy to be stopped by releasing the actuator 40a. In some examples, pressing the actuator 40a can cause an electrode to extend into the tissue and / or energize the electrode. Actuator 40b may be operated similarly to actuator 40a, moving the plunger of the handle 152a to actuate the tool at the distal end of the second medical device 152. The tool may be any medical tool, and it will be understood that the handles 150a and 152a are not limited to plunger-type handles. For example, the handles 150a and 150b may include knobs or other known actuaries or actuaries or end effectors of the first and second medical devices 150 and 152.

[0044] Next, a method for operating the medical system 10 will be described. The shaft 120 may be inserted into the body, for example, the body of patient 1000 in Figure 1, through a natural orifice, an incision, or any other orifice in the body, and advanced to a target site. A medical professional may visualize the target site using one or more light-emitting elements 184 and / or visualization devices 182 at the distal end of the shaft 120, for example, the visualization device 182 being coupled to a user interface or display via an umbilicus. The first medical instrument 150 may be introduced at its proximal end into the lumen 166 of the first tube 160 through the opening of the locking member 139a of port 136a, and the medical instrument 152 may be introduced at its proximal end into the lumen 168 of the second tube 162 through the opening of the locking member of the corresponding control device 130b. The first medical device 150 and the second medical device 152 may be introduced into lumens 166 and 168, respectively, at any point during the medical procedure, for example, before or after the shaft 120 is inserted into the patient's body. The locking member 139a can be locked or unlocked by rotating the locking member clockwise or counterclockwise. The locking member 139a may be locked or unlocked at any point during the procedure to allow the first medical device 150 and the second medical device 152 to move within lumens 166 and 168, respectively.

[0045] After positioning the distal end of the shaft 120 at the target site, the user may advance one or both of the first tube 160 and the second tube 162 distally so that the distal end of the first tube 160 and / or the distal end of the second tube 162 extend distal to the most distal end of the shaft 120, as indicated by arrow C in Figure 5B. As described herein, this distal movement of the first tube 160 and the second tube 162 relative to the shaft 120 is caused by the user moving the control devices 130a, 130b distally, as indicated by arrow B in Figure 5A. For example, the user may use their thumb and index finger to grasp one or both of the control devices 130a, 130b and move the control devices distally within the slot 114. In this way, the user may move the distal ends of the first tube 160 and / or the second tube 162 distal to the most distal end of the shaft 120.

[0046] If the first tube 160 or the second tube 162 extends distal to the most distal end of the shaft 120, the user may articulate the first tube 160 or the second tube 162, respectively, using the joystick 132a or joystick 132b. For example, the user may grasp the joystick 132a in Figure 5A with their thumb and index finger (or any other fingers if desired) and move the joystick 132a in any direction indicated by arrow D in Figure 5A. For example, the user's first hand may grasp the handle 110 while the user's second hand operates the joystick 132a or joystick 132b. Alternatively, the handle 110 may be fixed by, for example, a support device 40, thereby allowing the user to operate the joystick 130a with their first hand and the joystick 130b with their second hand. As shown in Figures 5C, 5E, and 5F, movement of the joystick 132a in any 360-degree direction can cause a corresponding movement of the distal end of the first tube 160. Movement of the joystick 132a or joystick 132b can give a similar movement to the distal end of the first tube 160 or the second tube 162. For example, if the joystick 132a is moved 30 degrees in one direction, the distal end of the first tube 160 may be bent 30 degrees in the corresponding direction. It will be understood that the bending angle of the distal ends of the first tube 160 and the second tube 162 is not limited to the degree of movement of the joystick 132a or joystick 132b. Before, during, or after the articular movement of the joystick 132a, the first medical instrument 150 may be advanced distally so that the distal end of the sheath 170 and the corresponding tool extend distal to the most distal end of the first tube 160. The user may move the joystick 132a and / or continue to move the sheath 170 within the first tube 160 so that a tool at the distal end of the sheath 170, such as a gripper, is aligned with the target tissue.It will be understood that the user may visualize the target tissue on a monitor displaying images transmitted via the visualization device 182, for example, on a user interface or display.

[0047] Once the tissue is properly positioned relative to the tool, the user may activate the actuator 40a by pressing it with their foot. If the tool is a gripper, the activation of the actuator 40a may move the plunger in the handle of the first medical instrument 150 in a first direction, causing the jaws of the gripper to close around the tissue. The user may lift their foot away from the actuator 40a, thereby moving the plunger (or other movable element) in the handle of the first medical instrument 150 in the opposite direction, thereby opening the jaws of the tool.

[0048] It will be understood that similar joint movements of the distal end of tube 162 can be performed using joystick 132b. In addition, the user may move the sheath 172 of the second medical device 152 within the second tube 162 in a manner similar to that described herein (e.g., Figure 5F). The user may actuate the handle of the medical device 152 by pressing or releasing actuator 40b. This may actuate a tool located at the distal end of sheath 172 (e.g., opening and closing a cutting tool, opening and closing another gripping element, deploying the device using a tool, or any similar action).

[0049] Once the user has completed the work at the target site, the user may remove the shaft 120 from the body. In some examples, one or both of the first tube 160 and the second tube 162, and / or one or both of the first medical instrument 150 and the second medical instrument 152 may extend distal to the most distal end of the shaft 120. In one example, the first medical instrument 150 may include a gripping element for grasping tissue, and the second medical instrument 152 may include a cutting element for cutting or incising tissue from the body. For example, it may be desirable to remove a portion of tissue from the target site. In this case, one or more of the tools may grasp the tissue distal to the most distal end of the shaft 120, and this tissue may be removed from the body by removing the shaft 120 from the body. The user may also use knobs 42, 43 to bend or articulate the shaft 120, thereby causing the first tube 160 and the second tube 162, as well as any tools extending therein, to bend in the same direction as the shaft 120.

[0050] While various medical systems have been described, it will be understood that the specific arrangement of elements in these medical systems is not limited. Furthermore, the size and shape of the catheter or shaft of the medical system, or the medical instruments used with the medical system, and / or the method of deploying the system are not limited. As illustrated in the examples herein, the tube within the lumen of the endoscope sheath may extend distal to the most distal end of the endoscope sheath, and may be independently flexed or articulated to provide independent articulation for medical instruments extending within the lumen of the tube, thereby improving visualization and / or access to the target site. For example, in certain procedures, accessing the target site from multiple different directions may improve the outcome of the medical procedure, reduce the time of the medical procedure, and improve the patient's recovery time after the medical procedure. In addition, the individual first and second tubes 160, 162 may provide high maneuverability, high lifting force, shorter articulation radius, and high dissociation force. Furthermore, providing a control unit (e.g., control devices 130a, 130b) on the handle 110 may enable a single user to operate the medical system 10. For example, a user can hold the handle 110 using one handle and use the other hand (along with one or both feet) to provide independent and / or simultaneous joint movements, translations, and / or actions of the medical tool. It will be understood that more than one operator may use the medical system 10, for example, with an assistant assisting in guiding, positioning, and / or manipulating the medical system 10 within the body.

[0051] 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 this disclosure. For example, the maximum bending angle, the location of the bend in the longitudinal direction of the tube, and the number of tubes extending and moving within the endoscope sheath can be modified based on the desired medical treatment. Other embodiments of this disclosure will be apparent to those skilled in the art from the consideration herein and the practice of the invention disclosed herein. This specification and the examples are for illustrative purposes only, and the true scope and spirit of the invention are intended to be shown by the following claims.

Claims

1. A handle including the first slot, A first control device configured to move in the proximal and distal directions within the first slot, wherein the first control device defines a lumen extending from a first opening to a second opening, the first opening being the distal opening and the second opening being the proximal opening, A sheath extending from the handle and having a longitudinal axis, defining a first lumen extending from the handle to the distal end of the sheath, A first tube extending into the first lumen of the sheath, the proximal end of the first tube extending through the first opening of the first control device, the first tube connected to the first control device, and configured to move between a first position where the distal end of the first tube is coplanar with the distal end of the sheath or proximal to the distal end of the sheath, and a second position where the distal end of the first tube is positioned distal to the distal end of the sheath. The first slot is a medical device that extends parallel to the longitudinal direction of the sheath.

2. The medical device according to claim 1, wherein the first tube is configured to move between the first position and the second position when the first control device moves distally from the proximal end of the first slot.

3. The medical device according to claim 1, wherein the first control device includes a locking mechanism configured to prevent the first control device from moving and to maintain the position of the first control device relative to the handle in the proximal and distal directions.

4. The medical device according to claim 3, wherein the locking mechanism includes an annular ring extending radially outward from the first tube, the annular ring contacting a portion of the handle and increasing the frictional force between the handle and the first tube, and the first control device is configured to move within the first slot when a force sufficient to overcome the frictional force of the annular ring is applied to the first control device.

5. A handle including a first slot, A first control device configured to move in the proximal and distal directions within the first slot, A sheath extending from the handle and having a longitudinal axis, defining a first lumen extending from the handle to the distal end of the sheath, A first tube extending within the first lumen, connected to the first control device, and configured to move between a first position where the distal end of the first tube is coplanar with the distal end of the sheath or proximal to the distal end of the sheath, and a second position where the distal end of the first tube is positioned distal to the distal end of the sheath, The first slot extends parallel to the longitudinal direction of the sheath, The first control device includes a joystick, the movement of which is configured to bend the distal end of the first tube at an angle with respect to the longitudinal axis of the sheath, in a medical device.

6. The medical device according to claim 5, further comprising at least three articular movement wires extending from the joystick to the distal end of the first tube, the distal end of each of the at least three articular movement wires being attached to the first tube.

7. The medical device according to claim 6, wherein the first tube includes an articular movement wire lumen corresponding to each of the at least three articular movement wires, and each of the at least three articular movement wires extends within the corresponding articular movement wire lumen.

8. A handle including a first slot, A first control device configured to move in the proximal and distal directions within the first slot, A sheath extending from the handle and having a longitudinal axis, defining a first lumen extending from the handle to the distal end of the sheath, A first tube extending within the first lumen and including a tubular lumen, connected to the first control device, and configured to move between a first position where the distal end of the first tube is coplanar with the distal end of the sheath or proximal to the distal end of the sheath, and a second position where the distal end of the first tube is positioned distal to the distal end of the sheath, A medical device configured to be inserted into the tube lumen, wherein the distal end of the medical device is configured to extend distal to the distal end of the sheath, A rotatable locking mechanism at the proximal end of the tube lumen, wherein the rotatable locking mechanism is configured to fluidly seal the medical device within the tube lumen when the rotatable locking mechanism is in the locked position, and the medical device is configured to move within the tube lumen when the rotatable locking mechanism is in the unlocked position, The first slot is a medical device that extends parallel to the longitudinal direction of the sheath.

9. A handle including a first slot, A first control device configured to move in the proximal and distal directions within the first slot, A sheath extending from the handle and having a longitudinal axis, defining a first lumen extending from the handle to the distal end of the sheath, A first tube extending within the first lumen and including a tubular lumen, connected to the first control device, and configured to move between a first position where the distal end of the first tube is coplanar with the distal end of the sheath or proximal to the distal end of the sheath, and a second position where the distal end of the first tube is positioned distal to the distal end of the sheath, A medical device configured to be inserted into the tube lumen, wherein the distal end of the medical device is configured to extend distal to the distal end of the sheath, and the distal end of the medical device includes a tool. The system comprises an actuator configured to operate the aforementioned medical device, The tool includes a plurality of jaws connected by a hinge, the actuator includes a foot pedal, the plurality of jaws are configured to move from an open position to a closed position when the foot pedal is pressed, and the plurality of jaws are configured to move from the closed position to the open position when the foot pedal is released. The first slot is a medical device that extends parallel to the longitudinal direction of the sheath.

10. A handle including a first slot, A first control device configured to move in the proximal and distal directions within the first slot, A sheath extending from the handle and having a longitudinal axis, defining a first lumen extending from the handle to the distal end of the sheath, A first tube extending within the first lumen, connected to the first control device, and configured to move between a first position where the distal end of the first tube is coplanar with the distal end of the sheath or proximal to the distal end of the sheath, and a second position where the distal end of the first tube is positioned distal to the distal end of the sheath. A second lumen located within the sheath and extending from the handle to the distal end of the sheath, A second tube extending within the second lumen, configured to move between a first position where the distal end of the second tube is coplane with the distal end of the sheath or proximal to the distal end of the sheath, and a second position where the distal end of the second tube is located distal to the distal end of the sheath. The second slot, A second control device configured to move within the second slot, the second control device includes a second joystick configured to bend the distal end of the second tube, The first slot is a medical device that extends parallel to the longitudinal direction of the sheath.

11. The medical device according to claim 10, wherein the first control device and the second control device are configured to move independently of each other, and the first tube and the second tube are configured to bend independently of each other.

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