Ergonomic control of endoscopes

Abstract

To solve problems with conventional medical devices, i.e., the difficulty of operating both a duodenoscope and a cholangioscope at the same time, and the difficulty of incorporating various features into small-diameter devices.SOLUTION: A controller for an auxiliary endoscope comprises a coupling piece to attach to a main endoscope, a handpiece connected to the coupling piece, a working shaft extending from the handpiece and extending into the coupler, and a first control feature located on the handpiece for operating a pull wire extending through the working shaft, the pull wire configured to steer the auxiliary endoscope, where the handpiece can be moved relative to the coupling piece to adjust a position of the auxiliary scope relative to the main scope.SELECTED DRAWING: Figure 8A

Description

Technical Field

[0001] Claims of Priority This application claims the benefit of priority of U.S. Provisional Patent Application No. 63 / 378,425, filed Oct. 5, 2022, the entire content of which is incorporated herein by reference.

[0002] The present disclosure generally relates to medical devices comprising an elongate body configured to be inserted into an incision or opening of a patient's anatomical structure to provide diagnostic or treatment operations, such as an endoscope.

[0003] More particularly, the present disclosure relates to a control device that can be attached to the proximal portion of the elongate body to control or position a diagnostic or treatment device attached to or extending from the distal portion of the elongate body.

Background Art

[0004] Endoscopes can be used for 1) providing access to various anatomical parts of other devices, such as treatment or tissue collection devices, and 2) imaging one or more of those anatomical parts. Such anatomical parts can include the gastrointestinal tract (such as the esophagus, stomach, duodenum, pancreaticobiliary ducts, intestine, and colon), the renal region (such as the kidneys, ureters, bladder, urethra), and other internal organs (such as the genital system, sinus cavities, submucosal regions, airways), among others.

[0005] Conventional endoscopes can be required for various clinical procedures, such as providing illumination, imaging, detection, and diagnosis of one or more medical conditions, providing fluid delivery to anatomical regions (such as delivery via a fluid channel of saline or other agents), providing access for one or more treatment devices to collect or treat anatomical regions (such as via a working channel), and providing a suction channel for collecting fluids (such as saline or other agents), among others.

[0006] In conventional endoscopic examinations, the distal portion of the endoscope can be configured to support and orient treatment devices, for example, by using an elevator. In some systems, two endoscopes can be configured to cooperate, with the first endoscope using an elevator to guide the second endoscope inserted into it. Such systems may be useful for guiding the endoscope to anatomical locations within the body that are difficult to reach. For example, some anatomical locations cannot be accessed by the endoscope until it has been inserted through a winding path. For example, in duodenal endoscopy procedures (e.g., endoscopic retrograde cholangiopancreatography, hereafter referred to as "ERCP"), an auxiliary scope (also called a daughter scope or cholangioscope) can be advanced through the working channel of the main scope (also called a mother scope or duodenoscopy). Furthermore, other devices (e.g., treatment devices), such as tissue retrieval devices used for biopsies, can also be inserted into the auxiliary scope. Therefore, the treatment device can be controlled and guided by pushing and pulling the shafts of the main and auxiliary scopes, for example, by using pull wires that extend within the shafts of the main and auxiliary scopes. The pull wires are typically fixed to the distal end of the shaft and connected to a control device at the proximal end of the shaft, allowing them to slide freely within the shaft between them. By operating a knob or lever on the control device, the pull wires can be pulled, thereby inducing bending of the shaft. Typically, the pull wires are arranged in pairs to produce bending of the shaft in opposite directions. [Prior art documents] [Patent Documents]

[0007] [Patent Document 1] WO2011 / 140118 A1 [Overview of the project] [Problems that the invention aims to solve]

[0008] This disclosure recognizes that the problems to be solved with conventional medical devices, particularly cholangioscopies and duodenoscopes, include, in particular, 1) the difficulty of operating both the duodenoscope and cholangioscopy simultaneously, and 2) the difficulty of incorporating various features (e.g., maneuverability, working channels, and tissue collection mechanisms) into small-diameter devices. For example, 1) it can be difficult to easily and ergonomically operate both the cholangioscopy and duodenoscope when both hands are occupied and sometimes held in an unnatural posture, and 2) it can be difficult to achieve four-directional control by including two sets of two pull wires in the cholangioscopy due to spatial constraints. [Means for solving the problem]

[0009] This disclosure can provide solutions to the above and other problems by providing systems, apparatus, and methods for the ergonomic control of endoscopes, such as cholangioscopies or other auxiliary scopes, which can be mounted on a duodenal endoscope and operated in a comfortable position. For example, the duodenal endoscope can be held and its function controlled using a first hand, and the cholangioscopies can be held and its function controlled using a second hand. By moving the second hand relative to the first hand, various movements of the cholangioscopies can be controlled. For example, moving the second hand up and down can control the retraction and advancement of the cholangioscopies within the duodenal endoscope, and rotating the second hand can cause rotation of the cholangioscopies shaft. The rotatable operability of the cholangioscopies can reduce or eliminate the need for a four-pull wire system, thereby freeing up space within the cholangioscopies and obtaining a larger working channel. This disclosure describes several examples of control devices for endoscopes having two pull wires and rotational capability arranged in an ergonomically advantageous manner to reduce fatigue, improve controllability, and reduce the number of pull wires compared to a four-pull wire system.

[0010] In this example, the control device for the auxiliary endoscope comprises a coupling device attached to the main endoscope, a handpiece connected to the coupling device, an operating shaft extending from the handpiece and into the coupling device, and a pull wire extending through the operating shaft, and a first control mechanism located on the handpiece for operating the pull wire, which is configured to control the auxiliary endoscope, and the handpiece can be moved relative to the coupling device to adjust the position of the auxiliary endoscope relative to the main endoscope.

[0011] In this example, the endoscope system comprises a main control unit, a main scope having an elongated shaft extending from the main control unit having a working channel, and an access port located on the main control unit for accessing the working channel, and an auxiliary scope having a slide post configured to be coupled to the access port, an auxiliary control unit slidably mounted on the slide post, an auxiliary shaft configured to extend from the auxiliary control unit through the slide post into the working channel of the main scope, and a control input extending into the auxiliary control unit and connecting to the auxiliary shaft. [Brief explanation of the drawing]

[0012] [Figure 1] This is a schematic diagram of an endoscopic system comprising an imaging and control system and an endoscope such as a duodenal endoscope, which can be used with the ergonomic control device of this disclosure. [Figure 2] Figure 1 is a schematic diagram of the imaging and control system, showing an imaging and control system connected to an endoscope. [Figure 3A] Figures 1 and 2 are schematic top views of the distal portion of the endoscope, which includes a camera module containing optical components for a side-viewing endoscope and a lifting mechanism. [Figure 3B] This is an enlarged cross-sectional view taken along the line 3B-3B in the plane of Figure 3A, showing the optical components. [Figure 3C] This is an enlarged cross-sectional view taken along the line 3C-3C in the plane of Figure 3A, showing the elevator mechanism. [Figure 4A] This is an end view of a camera module, including optical and functional components, suitable for use as an auxiliary scope that can be used with the endoscopes shown in Figures 1 and 2. [Figure 4B] This is a cross-sectional view taken along section 4B-4B in Figure 4A, showing the components of a camera module arranged using terminal-shaped steel. [Figure 5] This is a schematic diagram of the distal portion of a duodenal endoscope, which is used to position the cholangioscope close to the duodenum. [Figure 6] This is a schematic diagram of the distal end of an endoscope with two pull wires and rotational capability, showing two directions of bending and rotation relative to the central axis. [Figure 7] This is a schematic diagram of the distal end of an endoscope with four pull wires, showing four directions of bending relative to the central axis. [Figure 8A] This is a perspective view of a control device for an endoscope according to the present disclosure, having a handpiece pivotably attached to an attachment piece. [Figure 8B] Figure 8A is a schematic cross-sectional view of the control device, showing the shaft of the endoscope extending from the handpiece through the attachment piece. [Figure 9] Figure 8A is a perspective view of the control device, illustrating various control movements of the control device. [Figure 10] Figures 8A and 9 show perspective views of the control device as it is held by the operator when connected to a duodenal endoscope. [Figure 11] This figure shows the control device of Figure 10, which demonstrates various controlled movements. [Figure 12A] This is a schematic diagram of the distal tip of the endoscope attached to the control device shown in Figure 11, in the first state showing the bending of the distal tip. [Figure 12B] This is a schematic diagram of the distal tip of the endoscope attached to the control device shown in Figure 11, in the second state, which indicates rotation of the distal tip. [Figure 12C] This is a schematic diagram of the distal tip of the endoscope attached to the control device shown in Figure 11, in the third state, which shows the extension of the distal tip. [Figure 13] It is a schematic diagram of a control device for an endoscope in which a handpiece is rotatable within an attachment piece to facilitate 360-degree rotation. [Figure 14] It is a schematic diagram of a control device for an endoscope having a pistol grip and a top-loading treatment device. [Figure 15A] It is a schematic diagram of a control device for an endoscope having a rotatable knob connected to an attachment piece via a pivot coupler. [Figure 15B] It is a schematic cross-sectional view of the pivot coupler of FIG. 15A. [Figure 16A] It is a schematic diagram of a control device for an endoscope having a plurality of thumb wheels on a handpiece placed on an attachment piece. [Figure 16B] It is a schematic cross-sectional view of the thumb wheel of FIG. 16A configured to induce rotation and articulation of a shaft. [Figure 17] It is a flowchart showing a reprocessing method for the systems, treatment devices, and components disclosed in the present application.

Best Mode for Carrying Out the Invention

[0013] FIG. 1 is a schematic diagram of an endoscope system 10 including an imaging and control system 12 and an endoscope 14. The system of FIG. 1 is an exemplary example of an endoscope system suitable for use with the systems, devices, and methods described herein, such as an ergonomic control device. According to some examples, the endoscope 14 can be inserted into an anatomical region for imaging and / or to provide a passage for other devices such as an auxiliary scope and one or more treatment devices for the treatment of medical conditions related to a biopsy device or anatomical region. The endoscope 14 can, in an advantageous aspect, interface with and be connected to the imaging and control system 12. In the illustrated example, the endoscope 14 includes an upper gastrointestinal endoscope, although other types of endoscopes can also be used with the features and teachings of the present disclosure.

[0014] The imaging and control system 12 may include a control unit 16, an output unit 18, an input unit 20, a light source unit 22, a fluid source 24, and a suction pump 26.

[0015] The imaging and control system 12 may include various ports for coupling with the endoscope system 10. For example, the control unit 16 may include data input / output ports for receiving data from the endoscope 14 and communicating data to the endoscope 14. The light source unit 22 may include output ports for transmitting light to the endoscope 14, such as via an optical fiber link. The fluid source 24 may include ports for transmitting fluid to the endoscope 14. The fluid source 24 may comprise a pump and a fluid tank, or it may be connected to an external tank, container, or storage unit. The suction pump 26 may include ports used to generate suction force by vacuuming the endoscope 14, such as for drawing fluid from the anatomical region in which the endoscope 14 is inserted. The output unit 18 and input unit 20 can be used by an operator of the endoscope system 10, such as a surgeon or technician, to control the functions of the endoscope system 10 and to view the output of the endoscope 14. The control unit 16 may also be used to generate signals or other outputs from procedures in the anatomical region in which the endoscope 14 is inserted. In this example, the control unit 16 can generate electrical, acoustic, and fluid outputs for treating anatomical regions, such as by cauterization, incision, and cryotherapy.

[0016] The endoscope 14 may include an insertion section 28, a functional section 30, and a handle section 32 that can be coupled to a cable section 34 and a coupling section 36. By connecting the coupling section 36 to the control unit 16, the endoscope 14 can be connected to several mechanisms of the control unit 16, such as an input unit 20, a light source unit 22, a fluid source 24, and a suction pump 26.

[0017] The insertion section 28 may extend distally from the handle section 32, and the cable section 34 may extend proximal to the handle section 32. The insertion section 28 may be elongated and may include a bend section and a distal end to which the functional section 30 can be attached. The bend section may be controllable (e.g., by a control knob 38 on the handle section 32) to maneuver the distal end through a meandering anatomical passage (e.g., stomach, duodenum, kidney, ureter, etc.). The insertion section 28 may be elongated and may also include one or more working channels (e.g., internal lumens, etc.) that can support the insertion of one or more therapeutic instruments into the functional section 30, such as the auxiliary scope 134 in Figure 5. The working channels may extend between the handle section 32 and the functional section 30. Additional functions such as fluid passages, guidewires, and pull wires may also be provided by the insertion section 28 (e.g., via suction or irrigation passages, and wire passages, etc.).

[0018] The handle section 32 may be equipped with a control knob 38 and a port 40A. The control knob 38 can be coupled to a pull wire or other operating mechanism extending through the insertion section 28. Port 40A, and other ports such as port 40B (Figure 2), can be configured to connect to the handle section 32 for coupling various electrical cables, guidewires, auxiliary scopes, tissue collection devices, and fluid tubes, etc., to the insertion section 28. In the example, port 40A can be used to deliver an auxiliary scope or cholangioscope into the insertion section 28.

[0019] The imaging and control system 12, as illustrated in the example, can be mounted on a mobile platform (e.g., a cart 41) equipped with shelves for housing or supporting the light source unit 22, suction pump 26, image processing unit 42 (Figure 2), etc. Alternatively, some components of the imaging and control system 12 shown in Figures 1 and 2 can be mounted directly on the endoscope 14 to make the endoscope "self-supporting".

[0020] The functional section 30 may include components for treating and diagnosing the anatomical structures of a patient. The functional section 30 may include an imaging device, an illumination device, and an elevator, as further described with reference to the elevator 54 in Figures 3A to 3C.

[0021] Figure 2 is a schematic diagram of the endoscopic system 10 of Figure 1, comprising an imaging and control system 12 and an endoscope 14. Figure 2 schematically shows the components of the imaging and control system 12 coupled to the endoscope 14, which in the illustrated example includes a duodenal endoscope. The imaging and control system 12 may comprise a control unit 16, which may include, or be coupled to, an image processing unit 42, a treatment generator 44, and a drive unit 46, as well as a light source unit 22, an input unit 20, and an output unit 18. The coupling section 36 is connected to the control unit 16 via a cable 49 (Schematicically shown in Figure 2) to connect the endoscope 14 to several mechanisms of the control unit 16, such as the image processing unit 42 and the treatment generator 44. In the example, a port 40A may be used to insert another instrument or device, such as a dotascope or auxiliary scope, into the endoscope 14. As described herein, the port 40A may be configured to be coupled to various mounting fixtures capable of supporting the weight of the dotascope's control device. Such devices and equipment can be independently connected to the control unit 16 via cable 47. For example, cable 47 may have control input 314 as shown in Figures 8A to 89. In this example, port 40B can be used to connect the coupling section 36 to various inputs and outputs such as video, air, light, and electricity. The control unit 16 may be configured to activate a camera to view target tissue distal to the endoscope 14. Similarly, the control unit 16 may be configured to activate a light source unit 22 to illuminate the endoscope 14 or other devices extending from it.

[0022] The image processing unit 42 and the light source unit 22 can interface with the endoscope 14 (e.g., located in the functional section 30) by wired or wireless electrical connections, respectively. The imaging and control system 12 can thereby illuminate anatomical regions, collect signals representing anatomical regions, process signals representing anatomical regions, and display images representing anatomical regions on the output unit 18. The imaging and control system 12 may include the light source unit 22 to illuminate anatomical regions using light of a desired spectrum (e.g., broadband white light and narrowband imaging using preferred electromagnetic wavelengths). The imaging and control system 12 can be connected to the endoscope 14 (e.g., via an endoscope connector) for signal transmission (e.g., light output from the light source, video signals from the imaging system in the distal end, and diagnostic and sensor signals from the diagnostic device).

[0023] The fluid source 24 (Figure 1) can communicate with the control unit 16 and may comprise one or more sources of air, saline, or other fluids, as well as associated fluid passages (e.g., air channels, irrigation channels, suction channels) and connectors (barb fittings, fluid seals, and valves, etc.). The fluid source 24 can be used as activation energy for the biasing or pressure application device of this disclosure. The imaging and control system 12 may also include a drive unit 46, which may be an optional component. The drive unit 46 may comprise an electric drive for advancing the distal section of the endoscope 14, as described at least in PCT publication number WO2011 / 140118 A1 by Frassica et al., entitled "Rotate-to-Advance Catheterization System," which is incorporated herein by reference in its entirety.

[0024] Figures 3A to 3C show a first example of the functional section 30 of the endoscope 14 in Figure 2. Figure 3A is a top view of the functional section 30. Figure 3B is a cross-sectional view of the functional section 30 taken along the cross-section 3B-3B of Figure 3A. Figure 3C is a cross-sectional view of the functional section 30 taken along the cross-section 3C-3C of Figure 3A. Figures 3A to 3C show a side-viewing endoscope camera module 50 used as a duodenal endoscope, etc. Within the side-viewing endoscope camera module 50, the illumination and imaging systems are positioned so that the viewing angle of the imaging system corresponds to the anatomical structure of the target located laterally to the central longitudinal axis A1 of the endoscope 14.

[0025] In the examples of Figures 3A and 3B, the side-view endoscope camera module 50 may comprise a housing 52, a lifter 54, a fluid outlet 56, an illumination lens 58, and an objective lens 60. The housing 52 can form a fluid tight coupling with the insertion section 28. The housing 52 may have an opening for the lifter 54. The lifter 54 may include a mechanism for moving devices inserted through the insertion section 28, such as the auxiliary scope 134 in Figure 5. In particular, the lifter 54 may include a device that can bend an elongated device extending through the insertion section 28 along axis A1, as will be described in more detail with reference to Figure 3C. By using the lifter 54 to bend the elongated device to an angle with respect to axis A1, an anatomical region adjacent to the side-view endoscope camera module 50 can be treated or accessed. The lifter 54 is located, for example, radially outward of axis A1, alongside the illumination lens 58 and the objective lens 60.

[0026] As can be seen in Figure 3B, the insertion section 28 may have a central lumen 62 through which various components (e.g., the auxiliary scope 134 in Figure 5) can extend to connect the functional section 30 to the handle section 32 (Figure 2). For example, the illumination lens 58 may be connected to the optical transmitter 64, which may have an optical fiber cable or cable bundle extending to the light source unit 22 (Figure 1). Similarly, the objective lens 60 may be coupled to the prism 66 and the imaging unit 67, which may be coupled to the wiring 68. In addition, the fluid outlet 56A may be coupled to the fluid line 56B, which may have a tube extending to the fluid source 24 (Figure 1). Other slender elements, such as tubes, wires, and cables, may also extend through the central lumen 62 to connect the functional section 30 to components of the endoscopic system 10, such as the suction pump 26 (Figure 1) and the treatment generator 44 (Figure 2).

[0027] Figure 3C is a schematic cross-sectional view taken along the cross-section 3C-3C of Figure 3A, showing the elevator 54. The elevator 54 may be equipped with a deflector 55 which can be located within the housing space 53 of the housing 52. The deflector 55 may be connected to a wire 57 which extends through a tube 59 and connects to a handle section 32. The wire 57 can be actuated by turning a knob, pulling a lever, or pressing a button on the handle section 32. The movement of the wire 57 can cause a rotation of the deflector 55 around a pin 61, for example, clockwise, from a first position to a second position of the deflector 55 indicated by 55'. The deflector 55 can be actuated by the wire 57 to move the distal portion of the equipment 63 extending through a window 65 of the housing 52.

[0028] The housing 52 may have a housing space 53 for housing the deflector 55. The instrument 63, which is not necessarily depicted to the exact scale in Figure 3C, may include forceps, guidewires, or catheters extending through the central lumen 62. The instrument 63 may further include tissue collection or retrieval devices, such as the auxiliary scope 134 in Figure 5, the auxiliary shaft 303 of the endoscope 301 shown in Figure 8B, or those used to perform biopsies. The proximal end of the deflector 55 can be attached to the housing 52 at a pin 61 provided on the side-view endoscope camera module 50. The distal end of the deflector 55 may be located below the window 65 within the housing 52 when the deflector 55 is lowered or inactive. The distal end of the deflector 55 may extend at least partially outside the window 65 when the deflector 55 is raised or activated by the wire 57. The instrument 63 slides on the angled inclined surface 51 of the deflector 55, initially deflecting the distal end of the instrument 63 toward the window 65. The angled inclined surface 51 facilitates extending the distal portion of the instrument 63 from the window 65 at a first angle with respect to the axis of the central lumen 62. The angled inclined surface 51 includes grooves 69, such as V-shaped notches, which can receive and guide the instrument 63. When the deflector 55 is activated, the instrument 63 can be bent at a second angle, closer to a right angle than the first angle with respect to the axis of the central lumen 62. When the wire 57 is released, the deflector 55 can be rotated, for example counterclockwise, by pushing or releasing the wire 57 to return it to its lowered position. In this example, the instrument 63 may be equipped with a cholangioscope or an auxiliary scope 134 (Figure 5).

[0029] The side-view endoscope camera module 50 shown in Figures 3A to 3C may include optical components for acquiring image signals (e.g., objective lens 60, prism 66, imaging unit 67, wiring 68) and illumination components for transmitting or generating light (e.g., illumination lens 58, optical transmitter 64). The side-view endoscope camera module 50 may also include a photosensitive element such as a charge-coupled device ("CCD" sensor) or a complementary metal-oxide-semiconductor ("CMOS") sensor. In any example, the imaging unit 67 may be coupled to an image processing unit 42 (Figure 2) (e.g., via a wired or wireless connection) to transmit signals from the photosensitive element representing an image (e.g., video signals) to the image processing unit 42 for display on a display such as an output unit 18. In various examples, the imaging and control system 12 and the imaging unit 67 may be configured to provide output at a desired resolution suitable for endoscopic procedures (e.g., at least 480p, at least 720p, at least 1080p, at least 4K UHD, etc.).

[0030] Therefore, as the endoscope 14 is inserted further into the anatomical structure, the complexity of maneuvering and bending the endoscope 14 increases, as described with reference to Figure 5. Furthermore, additional devices can be used to reach even deeper locations within the anatomical structure, such as the instrument 63 in the form of an auxiliary scope 134. Thus, the cross-sectional area, e.g., diameter, of the subsequently nested devices decreases, thereby requiring even smaller devices that may be difficult to manufacture and operate, or that may require repeated interventions (e.g., patient interaction) to produce satisfactory results. As described herein, the present application describes an auxiliary scope that can have full 360-degree bending capability by incorporating only a pair of pull wires and rotational capability, thereby eliminating another pair of pull wires and freeing up space for other mechanisms.

[0031] Figure 4A is an end view of the end-viewing endoscope camera module 70, and Figure 4B is a cross-sectional view of the end-viewing endoscope camera module 70 taken along the cross section 4B-4B of Figure 4A. Figures 4A and 4B show end-viewing endoscope camera modules 70 used as gastroscopes, colonoscopes, and cholangioscopies, respectively. Within the end-viewing endoscope camera module 70, the illumination and imaging systems are positioned so that the viewing angle of the imaging system is aligned with the central longitudinal axis A1 of the endoscope 14 and corresponds to the anatomical structure of a target located adjacent to the end of the endoscope 14 (for example, distally).

[0032] The end-view endoscope camera module 70 shown in Figures 4A and 4B can be used as an alternative to the functional section 30 of the endoscope 14 in Figures 1 and 2. Furthermore, the end-view endoscope camera module 70 can be used in the cholangioscope, auxiliary scope 134 in Figure 5, and with the scope of the ergonomic control device shown in Figures 6 to 11. For example, the end-view endoscope camera module 70 can be located at the distal end of the auxiliary shaft 303 of the endoscope 301 shown in Figure 8B or the shaft 509 in Figure 14.

[0033] In the examples shown in Figures 4A and 4B, the end-view endoscope camera module 70 may comprise a housing 72, a treatment unit 74, a fluid outlet 76, an illumination lens 78, and an objective lens 80. The housing 72 can provide a seal to the lumen 82 by providing an end cap for the insertion section 28.

[0034] As can be seen in Figure 4B, the insertion section 28 may have a lumen 82 through which various components can be extended to connect, for example, the end-view endoscope camera module 70 to the handle section 32 (Figure 2). For example, the illumination lens 78 may be connected to an optical transmitter 84, which may have an optical fiber cable or cable bundle extending to the light source unit 22 (Figure 1). Similarly, the objective lens 80 may be connected to an imaging unit 87 which can be coupled to wiring 88. Also, the fluid outlet 76 may be connected to a fluid line 89, which may have a tube extending to a fluid source 24 (Figure 1). In this example, one of the fluid outlets 76 may have an inlet connected to a fluid line 89 configured to perform suction, such as being connected to a vacuum for the recovery of cleaning and irrigation fluids. Other slender elements, such as tubes, wires, and cables, may also extend through the lumen 82 to connect the functional section 30 to components of the endoscope system 10, such as the suction pump 26 (Figure 1) and the treatment generator 44 (Figure 2). For example, the treatment unit 74 may be equipped with a large-diameter lumen for receiving other treatment components, such as cutting devices and treatment devices, including tissue separation devices.

[0035] The end-view endoscope camera module 70 may also include a photosensitive element such as a charge-coupled device ("CCD" sensor) or a complementary metal-oxide-semiconductor ("CMOS") sensor. In either example, the imaging unit 87 can be coupled to an image processing unit 42 (Figure 2) (e.g., via a wired or wireless connection) to transmit signals from the photosensitive element representing the image (e.g., video signals) to the image processing unit 42 for display on a display such as an output unit 18. In various examples, the imaging and control system 12 and the imaging unit 87 may be configured to provide output at a desired resolution suitable for endoscopic procedures (e.g., at least 480p, at least 720p, at least 1080p, at least 4K UHD, etc.).

[0036] Figure 5 is a schematic diagram of the distal portion of the endoscope 100 according to this disclosure, positioned within the duodenum D. The endoscope 100 may comprise a functional module 102, an insertion section module 104, and a control module 106. The control module 106 may include a control device 108. The control module 106 may also include other components, such as those described with reference to the control unit 16 (Figure 2). Furthermore, the control module 106 may also comprise components that control the camera and light source connected to the auxiliary scope 134, such as an imaging unit 110, an illumination unit 112, and a power supply unit 114. The endoscope 100 may be configured similarly to the endoscope 14 in Figures 1 and 2.

[0037] The duodenum D may comprise a ductal wall 120, the sphincter of Oddi 122, the common bile duct 124, and the main pancreatic duct 126. The duodenum D constitutes the upper part of the small intestine. The common bile duct 124 carries bile from the gallbladder and liver (not shown) and pours this bile into the duodenum D through the sphincter of Oddi 122. The main pancreatic duct 126 carries pancreatic juice from the exocrine part of the pancreas (not shown) to the common bile duct 124. Sometimes, for example, to diagnose a patient's disease or illness, such as cancer, it may be desirable to remove biological material, such as tissue, from the common bile duct 124 or the main pancreatic duct 126 and analyze the tissue.

[0038] The functional module 102 may include a lifting section 130. The endoscope 100 may further include a lumen 132 and an auxiliary scope 134. The auxiliary scope 134 may include a lumen 136. The auxiliary scope 134 includes functional components such as a camera lens 137 and an optical lens (not shown) which are themselves coupled to the control module 106, to facilitate the navigation of the auxiliary scope 134 from the endoscope 100 through anatomical structures and to facilitate viewing of components extending from the lumen 132. In the example, the auxiliary scope 134 may include a pull wire for guiding the auxiliary scope 134 into the sphincter of Oddi 122. In the example, the auxiliary scope 134 may include an auxiliary shaft 303 of the endoscope 301 shown in Figure 8B.

[0039] In certain duodenal endoscopy procedures (e.g., endoscopic retrograde cholangiopancreatography, hereafter referred to as "ERCP"), an auxiliary scope (also called a duodenoscope or cholangioscope), such as an auxiliary scope 134, can be attached and advanced through the lumen 132 (or the central lumen 62 of the insertion section 28 of the endoscope 14 in Figure 3B) of the main scope (also called a motherscope or duodenoscope), such as the endoscope 100. The auxiliary scope 134 can be guided into the sphincter of Oddi 122. From there, the surgeon operating the auxiliary scope 134 can navigate it through the lumen 132 toward the gallbladder, liver, or other locations within the gastrointestinal tract to perform various procedures. The surgeon can navigate the auxiliary scope 134 through the entrance 128 of the main pancreatic duct 126 into the passage 129 of the common bile duct 124, or into the entrance 128. The auxiliary scope 134 can be used to guide additional devices into anatomical structures, pass them through the lumen 136, or attach them to the lumen 136 to obtain biomaterials. These additional devices may have their own functional components for the treatment procedure, such as a light source, camera, tissue separator, accessories, and biopsy channels. Therefore, it may be desirable to increase the available space within the auxiliary scope 134 to allow for the passage of additional devices with appropriate capabilities. See, for example, the intervention device 305 in Figure 8B. In some examples, the endoscope 100 can be used for the removal of cancerous or precancerous materials (e.g., carcinomas, sarcomas, osteosarcomas, leukemias, and lymphomas), the evaluation of endometriosis, and bile duct biopsies, etc.

[0040] However, as mentioned above, the sizes of the endoscope 100, the auxiliary scope 134, and the additional devices decrease in stages, so the size of the additional devices is usually small. For example, the lumen 132 of the endoscope 100 can usually be about 4.0 mm (about 0.157 inches) in diameter, and the lumen 136 of the auxiliary scope 134 can usually be about 1.2 mm (about 0.05 inches). Therefore, with conventional equipment, it may be difficult to obtain a sufficiently large tissue sample to ensure an accurate diagnosis without repeatedly removing and reinserting the additional devices.

[0041] In some conventional auxiliary scopes, four pull wires are used to maneuver or navigate the distal tip of the auxiliary scope 134 through the lumen 132, into the sphincter of Oddi 122, and through the entrance 128. As described above, the four pull wires can be manipulated to pull the shaft of the auxiliary scope 134 in four different directions, as shown in Figure 6, and bending in the intermediate direction is achieved by pulling two pull wires simultaneously. However, having four pull wires occupies a large portion of the available space within the shaft of the auxiliary scope. In this disclosure, the endoscope shaft may include two pull wires that have the ability to rotate the endoscope shaft to position the distal tip at any radial position relative to the central axis of the endoscope shaft, thereby facilitating the manipulation and navigation of the shaft. Thus, the endoscope shaft can still be navigated into and through the passage 129 and the main pancreatic duct 126, while providing further working channel space for, for example, accepting larger instruments or obtaining larger biopsy samples.

[0042] In the example, the length of the auxiliary scope 134 can be such that it provides the ability to reach the common bile duct 124, the main pancreatic duct 126, the ostium 128, and any desired location beyond it. In the example, the desired length of the auxiliary scope 134 to extend beyond the exit of the lumen 132 to reach the common bile duct 124, the main pancreatic duct 126, and the ostium 128 can be about 10 inches (about 25.4 cm) to provide sufficient reach. In the exemplary anatomical structure, the distance from the sphincter of Oddi 122 (ampulla of Fater) to the branch of the ostium 128 can be about 8 cm (about 3.15 inches), and it is usually desirable to advance the tip of the shaft 252 further about 4 cm (about 1.6 inches) into each of the common bile duct 124 and the main pancreatic duct 126. Therefore, it may be desirable that the tip of the auxiliary scope 134 be able to extend a total of about 12 centimeters (about 4.7 inches) from the exit of the lumen 132. Furthermore, as described below, the length of the slide post 320 can be approximately 10 inches (approximately 25.4 cm), approximately 6 to approximately 8 inches (approximately 15.2 cm to approximately 20.3 cm), or approximately 4 inches (approximately 10.2 cm).

[0043] Figure 6 is a schematic diagram of the distal end of an endoscope 200 having two pull wires and rotational capability, showing two directions of bending and rotation with respect to the central axis CA1. In an example, the endoscope 200 may include the auxiliary scope 134 example in Figure 5. Furthermore, the endoscope 200 may include the auxiliary shaft 303 of the endoscope 301 in Figure 8B, the shaft 509 of the endoscope 501 in Figure 14, and the shaft 709 of the endoscope 701 in Figure 16A. The endoscope 200 may include a shaft 202 in which a pull wire can be located. Pulling the pull wire can cause upward movement, for example, indicated by arrow 204U, and downward movement, indicated by arrow 204D. The shaft 202 can also be rotated 360 degrees, as indicated by arrow 206. Thus, the distal tip of the shaft 202 can be configured to reach various positions with respect to the central axis CA1, including allowing 360-degree rotation as described below. The pull wires of shaft 202 can be connected to one or more control mechanisms, such as the lever 350 in Figure 9. In this example, the control mechanism may be configured to pull one pull wire while simultaneously pushing the other pull wire.

[0044] Figure 7 is a schematic diagram of the distal end of an endoscope 250 having four pull wires, showing four-way bending relative to the central axis CA2. In an example, the endoscope 250 may include the auxiliary scope 134 shown in Figure 5. Furthermore, the endoscope 250 may include the auxiliary shaft 303 of the endoscope 301 in Figure 8B, the shaft 509 of the endoscope 501 in Figure 14, the shaft 609 of the endoscope 601 in Figure 15, and the shaft 709 of the endoscope 701 in Figure 16A. The endoscope 250 may also include a shaft 252 in which pull wires can be located. Pulling the pull wires can cause upward movement indicated by arrow 254U, downward movement indicated by arrow 254D, leftward movement indicated by arrow 254L, and rightward movement indicated by arrow 254R. The pull wires of the shaft 252 can be connected to one or more control mechanisms, such as the lever 350 in Figure 9. In the example, the first control mechanism can be configured to pull the first pull wire while simultaneously pushing the second pull wire on the opposite side, and the second control mechanism can be configured to pull the third pull wire while simultaneously pushing the fourth pull wire. By operating the two control mechanisms simultaneously, a bend in the intermediate direction can be caused.

[0045] Both the endoscope 200 in Figure 6 and the endoscope 250 in Figure 7 can achieve any radial orientation of the distal tip of each shaft relative to the central axis of the shaft. However, the endoscope 200 in Figure 6 can achieve this function with fewer than two pull wires, thereby freeing up space within the endoscope as described herein. The rotational capability of the endoscope 200 can be achieved in various ways, such as by using a control device as described with reference to Figures 8A to 16.

[0046] Figure 8A is a perspective view of a control device 300 for an endoscope 301 according to this disclosure, comprising a handpiece 302 and an attachment piece 304. Figure 8B is a schematic cross-sectional view of the control device 300 of Figure 8A, showing an auxiliary shaft 303 of the endoscope 301 extending from the handpiece 302 through the attachment piece 304, and an intervention device 305 extending into the control device 300. Figures 8A and 8B will be described together.

[0047] The control device 300 may comprise a handpiece 302 and an attachment piece 304. The handpiece 302 may comprise a control body 306, a handle body 308, a swivel body 310, an access opening 312, and a control input 314. The attachment piece 304 may comprise a receiver 316, a slide body 318, a slide post 320, and a coupler 322. In this example, the control device 300 may be connected to the proximal end of the shaft 202 in Figure 6 or the shaft 252 in Figure 7. The endoscope 301 may comprise an auxiliary shaft 303 and a control input 314, which can be connected by the control device 300.

[0048] The attachment piece 304 may comprise a coupling for attaching the handpiece 302 to the endoscope 14, the main endoscope, another scope, or a duodenal endoscope. The attachment piece 304 may comprise one or more of the following: a receiver 316, a slide body 318, a slide post 320, and a coupling 322. The coupling 322 can be attached to the endoscope 14, such as a duodenal endoscope. In this example, the coupling 322 can be attached to port 40A of the endoscope 14 (Figure 2). The slide post 320 may comprise a cannula-shaped body having a slot 324 into which the flexible elongated shaft of the control device 300 can be inserted. The slide post 320 may extend along the central axis CA3, or along the coupling axis or slide axis.

[0049] The coupling device 322 can be attached to the duodenal endoscope using various means such as coupling devices, fixators, Velcro® material, threaded collars, set screws, and adhesives. For example, the coupling device 322 may comprise a housing 326 having an opening 328. The housing 326 can be positioned to cover the port 40A of the handle section 312 (Figure 2). The housing 326 may have a shape that matches the shape of the port so that it can be fitted onto the port on the handle of the duodenal endoscope in a crimp fit, and can be fitted to cover the port and fixed using a fixator or other means. For example, the inner circumference of the opening 328 may be slightly larger than the outer circumference of the port on the duodenal endoscope. For example, the opening 328 may have a linear profile such as a square or rectangle, or a curved profile such as a circle or ellipse.

[0050] The slide post 320 may extend from the coupling 322 along the central axis CA3. The slide post 320 may have an elongated rigid body that can be maintained in a fixed position relative to the coupling 322. In an example, the slide post 320 may be made of rigid plastic or metal. In a further example, the slide post 320 may be made of a flexible tube, such as a gooseneck tube. The slide post may have sufficient strength to support the handpiece 302, for example, depending on its thickness and material properties. The slide post 320 may include an internal passage or lumen through which components, such as the shaft of a cholangioscope extending from the control device 300, can pass. The slot 324 may extend along the entire or partial length of the slide post 320 and may extend into the internal passage or lumen. In an example, the slot 324 may extend from the coupling 322 at the distal end to a position near the proximal end on the opposite side. In an example, the slot 324 may extend along the entire length of the slide post 320. The housing 326 may include an opening 330 into which the slide post 320 can be joined.

[0051] The slide body 318 may comprise an annular body configured to slide along the axis CA3 on the slide post 320. In this example, the slide body 318 can be held in place on the slide post 320 by friction. In this example, the slide body 318 may include a lock button 331. The lock button 331 may be configured to prevent the slide body 318 from moving relative to the slide post 320. For example, the lock button 331 may be configured to have an internal surface that presses against the slide post 320 to prevent movement by friction. In this example, the lock button 331 may be configured to have internal teeth that engage with a notch or groove (not visible in the drawing) positioned along the entire length of the slide post 320. In this example, the lock button 331 can be biased to the unlocked position by a spring load. An operator can press the lock button 331 to exceed the spring force and temporarily prevent the slide body 318 from moving relative to the slide post 320. In this example, the slide body 318 and slide post 320 may include opposing rails and grooves (not shown in the figure) extending parallel to the axis CA3 to prevent the slide body 318 from rotating around the axis CA3, allowing only linear translation. For example, the slide body 318 may include a tab or flange that enters into a slot 324 to prevent relative rotation between the slide body 318 and the slide post 320.

[0052] The receiver 316 can receive the swivel body 310. The receiver 316 and the swivel body 310 can extend along the axis CA4, or the axis of the handpiece or the axis of the swivel, as is best seen in Figure 8B. In this example, the internal surface 334 may have a circular surface that receives the opposing circular surface of the swivel body 310. The swivel body 310 may have components of the handpiece 302 that transport or transfer the internal components of the control body 306 and the handle body 308 to the attachment piece 304 via the internal passage 338. The swivel body 310 may be configured to rotate within the receiver 316. In this example, the swivel body 310 may be held in place within the receiver 316 by friction. In this example, the receiver 316 may include a lock button 340. Similar to the lock button 331, the lock button 340 may be spring-activated and configured to apply a frictional force to the swivel body 310 to prevent relative rotation. The lock button 340 may have additional calibration, for example, by being configured to have a stopper that engages with a notch or groove within the swivel body 310.

[0053] The slide body 318 may include an internal surface 332 (Figure 8B) that engages with the slide post 320. The slide body 318 can be connected to a receiver 316, which may comprise an annular body configured to receive the swivel body 310. The receiver 316 may comprise an internal surface 334 (Figure 8B) that engages with the swivel body 310. The slide body 318 may include an aperture 336 (Figure 8B) that connects a slot 324 to the lumen of the receiver 316, which is formed by the internal surface 334. The swivel body 310 may further comprise an internal passage 338 (Figure 8B) that allows passage between the receiver 316 and the handle body 308. Thus, the internal surface 334, aperture 336, slot 324, opening 330, and housing 326 can form a continuous opening. Such a passage can allow the auxiliary shaft 303 of the control device 300 to be inserted into the attachment piece 304.

[0054] The auxiliary shaft 303 may be a flexible, elongated shaft, such as the shaft 202 in Figure 6, and may be connected to the handpiece 302 and extend into the coupling 322 through the swivel body 310, the receiver 316, and the slide post 320. As described above, the coupling 322 may be connected to the access opening to the working channel of the duodenal endoscope. The pull wires 342A and 342B may extend into the auxiliary shaft 303 and through it to the distal end of the auxiliary shaft 303. The pull wires 342A and 342B may be connected to the actuator 344 in the handle body 308. The actuator 344 may be equipped with a drum or barrel that can be attached to the pull wires 342A and 342B. The actuator 344 may be connected to the lever 350 (Figure 9), for example, via a rod or shaft extending through the aperture 352 (Figure 8A) in the control body 306.

[0055] The control input 314 extends into the auxiliary shaft 303 and can provide functionality to the distal end of the auxiliary shaft 303. The control input 314 may comprise a tube, hose, or cable that can be connected to a control device such as the control unit 16 (Figures 1 and 2). The control input 314 may include passages for transporting fluids such as water or air, electrical signals for activating the illumination and imaging capabilities of the endoscope 301, and procedural energy such as electricity, ultrasound, excision, and cryotherapy. In this example, the control input 314 may comprise a fluid tube 315A and a power cable 315B. The control input 314 can be connected to buttons 354A and 354B (Figure 8B) for activating the capabilities of the endoscope 301. Buttons 354A and 354B can be connected to the control input 314 via appropriate wiring or cables (not shown) extending through apertures 356A and 356B in the control body 306. Buttons 354A and 354B can be configured to operate a valve or switch, allowing fluid or electricity to flow from the control input 314 to the auxiliary shaft 303.

[0056] Intervention devices 305, such as catheters, needles, biopsy devices, or tissue retrieval devices, can be inserted into the access opening 312 and extended into a flexible, elongated shaft to reach the working channel of the duodenal endoscope to which the control device 300 is attached. In this example, the access opening 312 may be located on the upper part of the control device 300, such as on the proximal surface of the swivel body 310. However, the access opening 312 may also be located in other positions, such as on the handle body 308. Once inserted into the access opening 312, the intervention device 305 can remain in a fixed axial position relative to the auxiliary shaft 303 of the control device 300. For example, the auxiliary shaft 303 can be attached to or fixed to the swivel body 310 via a brace 358. In this example, the brace 358 may comprise a flexible disc having a central aperture into which the auxiliary shaft 303 can be positioned, and an outer circumference attached to the swivel body 310, such as via adhesive or a fixator. Therefore, the rotational motion of the swivel body 310 relative to the receiver 316 can further result in the rotation of the auxiliary shaft 303 relative to the receiver 316. Similarly, the motion of the swivel body 310 relative to the slide post 320 can further result in the movement of the auxiliary shaft 303 relative to the axis CA3. In addition to this, or as an alternative, the auxiliary shaft 303 can be fixed to the swivel body 310 by other means such as a fastener, adhesive, and Velcro® material.

[0057] With this configuration, the handle body 308 can be supported by the receiver 316 and the swivel body 310 against the slide post 320. Therefore, with the slide post 320 attached to the motherscope or duodenoscope via the coupling 322, as shown in Figures 10 and 11, an operator who can hold the handle body 308 in an ergonomic position relative to the motherscope can move the handle body 308 with one hand, such as the right hand, to advance and retract the auxiliary shaft 303 axially, rotate it, and bend it. As described below, rotating the handle body 308 along axis CA4 can cause rotation of the auxiliary shaft 303 within the motherscope, raising and lowering the handle body 308 along the slide post 320 can cause retraction and advancement of the auxiliary shaft 303 within the motherscope, and activating the actuator 344 (Figure 9) can cause bending of the distal tip of the auxiliary shaft 303 relative to the motherscope.

[0058] Figure 9 is a perspective view of the control device 300 of Figure 8A, showing various control movements of the control device 300. The lever 350 can be attached to the handle body 308 of the handpiece 302 with aperture 352 (Figure 8A), and can also be attached to pull wires 342A and 342B (Figure 8B). Furthermore, buttons 354A and 354B can be attached to the handle body 308 with apertures 356A and 356B (Figure 8A), respectively, to operate the mechanism of the control input 314.

[0059] The operator can activate the lever 350 to move the pull wire within the auxiliary shaft 303. The lever 350 can be connected to an actuator 344 to produce its rotation. For example, the lever 350 can be moved up and down as indicated by arrow 360. In this example, moving the lever 350 upward can produce an upward movement of the auxiliary shaft 303, similar to the movement relative to the shaft 202 shown by arrow 204U in Figure 6, and moving the lever 350 downward can produce a downward movement of the auxiliary shaft 303, similar to the movement relative to the shaft 202 shown by arrow 204D in Figure 6. In this example, the lever 350 may be equipped with a lock button 359. The lock button 359 can be configured to fix the lever 350 to the handle body 308, similar to other lock buttons described herein. In this example, the lever 350 can be motorized. A button to control the motor of the lever 350 can be included on the handpiece 302, on the clip-type device of the duodenal endoscope, or on a foot pedal. For example, the motor can be positioned on or within the handle body 308 along the rotation axis of the lever 350, and the motor can be powered from the imaging and control system 12 (Figure 1), and another button or switch on the handle body 308, or from a mooring device that can be attached to the duodenal endoscope or foot pedal. In an example, the drive unit 46 (Figure 2) may include a motor that can provide power input to any of the control mechanisms described herein, such as by rotating a flexible drive shaft that can be extended to the lever 350 through a control input 314 to provide operation of a pull wire or rotation of an operating shaft. Thus, the control device for the lever 350 may be positioned remotely from the handpiece 302, in a position that is more convenient or ergonomic for the operator to use, such as by operating it with the foot. Thus, other operations of the handpiece 302 can be performed more freely by the operator without having to keep their hand in the position to operate the lever 350.

[0060] As indicated by arrow 362, rotation can be applied to the handpiece 302 at the handle body 308. The movement of the handpiece 302, indicated by arrow 362, allows the swivel body 310 to rotate around axis CA4 within the receiver 316. In this example, moving the handle body 308 upward can cause rotation of the auxiliary shaft 303, similar to the clockwise movement of the shaft 202 around the central axis CA1, indicated by arrow 206 in Figure 6. Moving the handle body 308 downward can cause rotation of the auxiliary shaft 303, similar to the counterclockwise movement of the shaft 202 around the central axis CA1, indicated by arrow 206 in Figure 6.

[0061] As indicated by arrow 364, linear motion can be applied to the handpiece 302 at the handle body 308. The movement of the handpiece 302 indicated by arrow 364 causes the swivel body 310 to push and pull the receiver 316 along the slide post 320. In the example, as will be described in more detail with reference to Figures 10 to 12C, moving the handle body 308 upward can cause a parallel movement of the auxiliary shaft 303 backward relative to the distal tip of the endoscope 14, and moving the handle body 308 downward can cause a parallel movement of the auxiliary shaft 303 forward relative to the distal tip of the endoscope 14.

[0062] Figure 10 is a perspective view of the control device 300 of Figures 8A and 9, held by the operator. In the example of Figure 10, the operator's left hand LH can grasp the handle section 32 of the endoscope 14, and the operator's right hand RH can grasp the handle body 308 of the endoscope 301. In this example, as can be seen from Figure 10, the slide post 320, receiver 316, and swivel body 310 can be configured to hold the handle body 308 approximately parallel to the endoscope 14. That is, the axis extending along the larger dimension of the handle body 308 can extend approximately parallel to the axis extending along the larger dimension of the handle section 32. This posture provides an ergonomically comfortable position for the right hand RH relative to the left hand LH, allowing for instinctive operation of the control device 300 relative to the handle section 32.

[0063] The weight of both the endoscope 14 and the endoscope 301 can be supported by both the left hand LH and the right hand RH. The endoscope 14 can be operated in a conventional manner using the left hand LH. Holding the left hand LH firmly provides resistance to the operation of the endoscope 301 by the right hand RH. That is, the left hand LH supports the endoscope 14 and can resist the twisting of the handle body 308 in the receiver 316 and the parallel movement of the handle body 308 along the slide post 320.

[0064] When the right hand RH is moved downward in Figure 10, the receiver 316 can be slid downward along the slide post 320 toward the endoscope 14. When the right hand RH is moved upward in Figure 10, the receiver 316 can be slid upward along the slide post 320 toward the endoscope 14. See arrow 364 in Figure 11.

[0065] By bending the wrist of the right hand (RH), the handle body 308 can be twisted relative to the receiver 316. For example, bending the wrist of the right hand (RH) forward with ulnar deviation in Figure 10 (viewing the length of the slide post 320 downward toward the endoscope 14) can produce a clockwise rotation of the auxiliary shaft 303, and bending the wrist of the right hand (RH) backward with radial deviation in Figure 10 (viewing the length of the slide post 320 downward toward the endoscope 14) can produce a counterclockwise rotation of the auxiliary shaft 303. See arrow 362 in Figure 11.

[0066] Moving the right thumb (RH) upward in Figure 10 will push lever 350 (Figure 12) upward, and moving the right thumb (RH) downward in Figure 10 will push lever 350 (Figure 12) downward. See arrow 360 in Figure 11.

[0067] As described with reference to Figures 11 to 12C, moving the right hand RH can generate a controlled movement of the control device 300 that brings about the movement of the distal tip 366 of the auxiliary shaft 303 (Figures 12A to 12C).

[0068] Figure 11 shows the control device 300 of Figure 10 along with various control movements that induce the movement of the distal tip 366, indicated by arrows 360, 362, and 364, respectively, indicated by arrows 370 (Figure 12A), 372 (Figure 12B), and 374 (Figure 12C).

[0069] Moving lever 350 in the direction of arrow 360 can cause movement of the distal end of auxiliary shaft 303 in the direction of arrow 370, such as radial bending. Lever 350 can also bend the distal end of auxiliary shaft 303 by pulling pull wires 342A and 342B that extend through the auxiliary shaft 303.

[0070] Moving the handle body 308 in the direction of arrow 362 can cause movement of the distal end of the auxiliary shaft 303 in the direction of arrow 372, such as rotation. Rotating the handle body 308 can cause the auxiliary shaft 303 to twist within the slide post 320 and the endoscope 14.

[0071] Moving the handle body 308 in the direction of arrow 364 can cause movement of the distal tip of the auxiliary shaft 303 in the direction of arrow 374, such as axial translation. By pushing and pulling the handle body 308, the auxiliary shaft 303 can be pushed and pulled within the slide post 320 and the endoscope 14.

[0072] As described herein, the attachment piece 304 shown in Figures 8A to 12C can provide support for the control device handpiece 302 on another scope, such as a duodenal endoscope. Therefore, the operator can maintain the control device 300 in a position convenient for use without having to constantly keep their hand on the control device 300. The slide post 320, receiver 316, and swivel body 310 can position the handpiece 302 relative to other scopes to ensure operator comfort and reduce fatigue and repetitive stress injuries. Furthermore, the handpiece 302 can be coupled to the attachment piece 304 to simplify the operation of the endoscope 301, such as by controlling the movement of the auxiliary shaft 303, allowing the handpiece 302 to move relative to the attachment piece 304. Additionally, control mechanisms for operating the endoscope 301, such as pull wires and procedural movements, can be positioned ergonomically on the handpiece 302. In this example, the hand placed on the handpiece 302 can control all movements of the auxiliary shaft 303 (i.e., axial movement, radial bending, and rotation) and all operations of the endoscope 301 (irrigation, treatment energy, imaging, etc.) without having to reposition the hand.

[0073] Figure 13 is a schematic diagram of the control device 400 for the auxiliary scope 401. In this example, the auxiliary scope 401 may include the auxiliary scope 134 shown in Figure 5. The control device 400 may include a handpiece 402 and an attachment piece 404. In this example, the control device 400 may be connected to the proximal end of the shaft 202 shown in Figure 6 or the shaft 252 shown in Figure 7.

[0074] The handpiece 402 may comprise a control body 406, a handle body 408, a swivel body 410, and an access opening 412. The handpiece 402 can be connected to a shaft 403 and a control input 414. The attachment piece 404 may comprise a receiver 416, a slide body 418, a slide post 420, and a coupler 422 having an opening 430. The attachment piece 404 can be configured similarly to the attachment piece 304 shown in Figures 8A to 11.

[0075] The control body 406 and the handle body 408 can be configured similarly to the control body 306 and the handle body 308 in Figures 8A to 11. However, the swivel body 310 of the control device 300 can be replaced with a swivel body 410, which can be configured to allow the control body 406 and the handle body 408 to rotate 360 ​​degrees more easily around axis CA6. That is, the axis of the handle body 408 can be aligned with the axis of the receiver 416. Similar to the example in Figures 8A to 12C, the axis of the handle body 408 can be tilted with respect to axis CA6. Thus, the operation of the control device 400 can be similar to that of the control device 300, except that it includes the ergonomic alignment of the handle body 408 with respect to the receiver 416 and the swivel ring 417.

[0076] In this example, the slide body 418 can be held in place on the slide post 420 by friction. In this example, the slide body 418 may include a lock button similar to the lock button 331 in Figure 8A. In this example, the receiver 416 may include a lock button similar to the lock button 340 in Figure 8A.

[0077] The control input 414 may comprise a fluid tube 415A and a power cable 415B, which can be attached to the control device 400 through a swivel ring 417. The swivel ring 417 can allow the control input 414 to remain stationary while the control body 406 and handle body 408 rotate around the axis CA6. In this example, the handle body 408 and swivel body 410 can be rigidly connected and extend through the swivel ring 417. Thus, rotating the handle body 408 can cause rotation of the swivel body 410 within both the swivel ring 417 and the receiver 416. However, since the swivel ring 417 remains stationary, the need for the control input 414 to rotate around the axis CA6 can be avoided. The interior of the swivel ring 417 may include fluid and electrical couplers, such as rotary unions, to provide the outputs of the fluid tube 415A and power cable 415B to the shaft 403.

[0078] The control unit 406 may include apertures 456A and 456B for receiving buttons to operate the control input 414. The control unit 406 may also include an aperture 452 for receiving an actuator to operate a pull wire extending into the shaft 403. An access opening 412 can be used to bring another device, such as an intervention device 305 (Figure 8A), into the shaft 403.

[0079] The example in Figure 13 allows the operator to provide multiple rotational inputs to the handle body 408 along axis CA6 without interference from the control input 415, and, if desired, to rotate the handle body 408 and shaft 403 a full 360 degrees around axis CA6. Thus, by activating the pull wire to facilitate the shaft 403 reaching a desired position within the anatomical structure, the distal end of the shaft 403 can be easily positioned in any orientation relative to axis CA6.

[0080] Figure 14 is a schematic diagram of a control device 500 for an endoscope 501 having a pistol grip 502 and a top-loading treatment device 504. The control device 500 may comprise a handpiece 506, a control input 507, an attachment piece 508, and a shaft 509. The handpiece 506 may comprise a slide body 510 from which the pistol grip 502 extends. The attachment piece 508 may comprise a slide post 512 and a coupling device 514. The treatment device 504 may be configured similarly to the intervention device 305 (Figure 8A) or the device 63 (Figure 3C). In this example, the control device 500 may be connected to the proximal end of the shaft 202 in Figure 6 or the shaft 252 in Figure 7.

[0081] Attachment piece 508 can be configured similarly to attachment piece 304 in Figures 8A to 11. Slide post 512 can extend from coupling 514 along the central axis CA7. Slide post 512 may have an elongated rigid body that can be maintained in a fixed position relative to coupling 514. In this example, slide post 512 may be made of rigid plastic or metal. In a further example, slide post 512 may be made of a flexible tube such as a gooseneck tube. Slide post 512 may include an internal passage 516 or lumen through which components such as a shaft 509 extending from the slide body 510 can pass.

[0082] The slide body 510 may include a platform for mounting other components of the control device 500. For example, an actuator 518 for operating a pull wire within the shaft 509, and buttons 520A and 520B for operating the control input 507. For example, button 520A may be configured to operate a fluid tube 522A, and button 520B may be configured to operate a power cable 522B.

[0083] The slide body 510 may comprise a body having an internal passage 524 configured to fit around the slide post 512. The slide body 510 may also include a passage 526 for receiving a shaft 509. The shaft 509 can be fixed to the slide body 510 to facilitate pushing, pulling, and rotating of the shaft 509 by the slide body 510. The slide body 510 may extend along a handle axis coaxial with the axis CA7 of the slide post 512. The slide body 510 may move relative to the slide post 512, and the slide post 512 may extend further outward from the upper or proximal surface of the slide body 510 as the slide body 510 is advanced further downward along the slide post 512 toward the coupling 514. As with other examples described herein, the slide body 510 may frictionally engage with the slide post 512 and may be locked in place by various locking mechanisms actuated by an operator.

[0084] The shaft 509 can be attached to the slide body 510 so that when the slide body 510 is advanced further downward along the slide post 512 toward the coupling 514, the shaft 509 can be pushed further away from the slide post 512 and the coupling 514. Furthermore, when the slide body 510 is rotated around the slide post 512, the shaft 509 can be rotated within the slide post 512. The shaft 509 can be fixed or attached to the slide body 510 in various ways that facilitate coordinated or equivalent axial and rotational motion with the slide body 510.

[0085] The pistol grip 502 can be attached to the slide body 510 to provide an ergonomic grip. Buttons 520A and 520B can be positioned on the slide body 510 so that they are easily accessible to the thumb of the hand gripping the pistol grip 502. Similarly, the actuator 518 can be positioned on the slide body 510 so that it is easily accessible to the thumb of the hand gripping the pistol grip 502.

[0086] Figure 15A is a schematic diagram of a control device 600 for an endoscope 601 having a knob 602 connected to a handpiece 606 via a pivot coupling 603 (Figure 15B). Figure 15B is a schematic cross-sectional view of the pivot coupling 603 of Figure 15A. Figures 15A and 15B will be described together.

[0087] The control device 600 may further include a control input 607, an attachment piece 608, and a shaft 609. The handpiece 606 may include a slide body 610 to which a knob 602 can be attached. The attachment piece 608 may include a slide post 612 and a coupler 614. In this example, the control device 600 may be connected to the proximal end of the shaft 202 in Figure 6 or the shaft 252 in Figure 7.

[0088] Attachment piece 608 can be configured similarly to attachment piece 304 in Figures 8A to 11. Slide post 612 can extend from coupling 614 along the central axis CA8. Slide post 612 may have an elongated rigid body that can be maintained in a fixed position relative to coupling 614. In this example, slide post 612 may be made of rigid plastic or metal. In a further example, slide post 612 may be made of a flexible tube such as a gooseneck tube. Slide post 612 may include an internal passage 616 or lumen through which components such as a shaft 609 extending from slide body 610 can pass.

[0089] The slide body 610 may include a platform for mounting other components of the control device 600. For example, a knob 602 for operating a pull wire in the shaft 609, and buttons 620A and 620B for operating the control input 607. For example, button 620A may be configured to operate a fluid tube 622A, and button 620B may be configured to operate a power cable 622B.

[0090] The slide body 610 may comprise a body having an internal passage 624 configured to fit around the slide post 612. The slide body 610 may also include an internal passage for receiving the shaft 609. An access opening 618 may be included in the slide body 610 to allow a therapeutic device, such as the intervention device 305 (Figure 8A) or instrument 63 (Figure 3C), to be inserted into the shaft 609. The slide body 610 may extend along a handle axis coaxial with the axis CA8 of the slide post 612. The slide body 610 may move relative to the slide post 612, and as the slide post 612 advances the slide body 610 further downward toward the coupling 614 along the slide post 612, the slide body 610 may extend further outward from its upper or proximal surface.

[0091] The shaft 609 can be attached to the slide body 610 so that when the slide body 610 is advanced further downward along the slide post 612 toward the coupling 614, the shaft 609 can be pushed further away from the slide post 612 and the coupling 614. However, the shaft 609 can be rotated by rotating the knob 602 around the axis CA9, rather than by rotating the slide body 610 around the slide post 612 and axis CA8 to induce rotation of the shaft 609. As with other examples described herein, the slide body 610 can frictionally engage with the slide post 612 and can be locked in place by various locking mechanisms that can be operated by an operator.

[0092] As can be seen in Figure 15B, the pivot coupler 603 can connect the knob 602 to the shaft 609. The pivot coupler 603 can function as a joystick, allowing rotation and bending of the shaft 609. The pivot coupler 603 may comprise a bracket 650 extending from the shaft 609 and a post 652 extending from the knob 602. The post 652 may include a plate 654 that can be attached to the bracket 650 by a pivot pin 656. Pull wires 658A and 658B can extend from the shaft 609 and connect to the knob 602. The shaft 609 can be supported within the slide body 610 via a bracket 660. The bracket 660 may be configured to hold the shaft 609 in place along axis CA9 such that movement of the slide body 610 along axis CA8 produces movement of the shaft 609. However, the bracket 660 may be configured to allow the shaft 609 to rotate within the slide body 610. Therefore, the knob 602 can be configured to induce rotation along the axis CA9 of the shaft 609. For example, the rotation of the knob 602 can induce rotation of the pivot pin 656 and the plate 654, which in turn can induce rotation of the bracket 650 and the shaft 609. The plate 654 and the bracket 650 may have a flat or planar plate that allows the rotation of the knob 602 to be transmitted to the shaft 609, but allows relative rotation between the plate 654 and the bracket 650 on the pivot pin 656. However, the pivot pin 656 may be configured to allow the knob 602 to pivot on the pivot pin 656 relative to the bracket 650. The pivot of the knob 602 on the pivot pin 656 can actuate the pull wires 658A and 658B.

[0093] The configurations in Figures 15A and 15B allow the operator to apply rotational input to the shaft 609 and flexion motion to the shaft 609 with one hand using wrist movements. For example, inward and outward movements of the wrist can cause rotation of the knob 602 and shaft 609, and flexion and extension movements of the wrist can cause tension on one of the pull wires 658A and 658B. Buttons 620A and 620B can be accessed on the slide body 610 by the thumb of a hand placed on the knob 602.

[0094] Figure 16A is a schematic diagram of the control device 700 for an endoscope 701 having thumbwheels 702A and 702B connected to a handpiece 704. Figure 16B is a schematic cross-sectional view of the thumbwheels 702A and 702B of Figure 16A, configured to induce rotation and articulation of the shaft 709. Figures 16A and 16B will be described together.

[0095] The control device 700 may further comprise a control input 707, an attachment piece 708, and a shaft 709. The handpiece 706 may comprise a slide body 710 to which thumbwheels 702A and 702B can be attached. The attachment piece 708 may comprise a slide post 712 and a coupler 714. In this example, the control device 700 may be connected to the proximal end of the shaft 202 in Figure 6 or the shaft 252 in Figure 7.

[0096] Attachment piece 708 can be configured similarly to attachment piece 304 in Figures 8A to 11. Slide post 712 can extend from coupling 714 along the central axis CA10. Slide post 712 may have an elongated rigid body that can be maintained in a fixed position relative to coupling 714. In examples, slide post 712 may be made of rigid plastic or metal. In further examples, slide post 712 may also be made of a flexible tube such as a gooseneck tube. Slide post 712 may include an internal passage 716 or lumen through which components such as a shaft 709 extending from slide body 710 can pass. The internal passage 716 may also include an access opening on the outside of slide body 710, allowing insertion into the shaft 709 of a therapeutic device such as intervention device 305 (Figure 8A) or device 63 (Figure 3C).

[0097] The slide body 710 may include a platform for mounting other components of the control device 700. For example, a thumbwheel 702A for rotating the shaft 709, and a thumbwheel 702B for operating the pull wires 750A and 750B within the shaft 709, can be mounted on the slide body 710. Additionally, button 720A may be configured to operate the fluid tube 722A, and button 720B may be configured to operate the power cable 722B.

[0098] The slide body 710 may comprise a body having an internal passage 624 configured to fit around the slide post 712. The slide body 710 may extend along a handle axis coaxial with the axis CA10 of the slide post 712. The slide body 710 may move relative to the slide post 712, and as the slide post 712 advances the slide body 710 further downward toward the coupling 714 along the slide post 712, the slide body 710 may extend further outward from its upper or proximal surface. As with other examples described herein, the slide body 710 may frictionally engage with the slide post 712 and may be locked in place by various locking mechanisms actuated by an operator.

[0099] The shaft 709 can be attached to the slide body 710 so that when the slide body 710 is advanced further downward along the slide post 712 toward the coupling 714, the shaft 709 can be pushed further away from the slide post 712 and the coupling 714. However, instead of rotating the slide body 710 around the slide post 712 and axis CA10 to induce rotation of the shaft 709, the shaft 709 can be rotated by rotating the thumbwheel 702A.

[0100] As can be seen in Figure 16B, the thumbwheel 702A can be mounted on the axle 752A within the slide body 710, and the thumbwheel 702B can be mounted on the axle 752B within the slide body 710. Figure 16B may include a cross-sectional view of the slide body 710 viewed downward toward the slide post 712. In this example, the axle 752A may be equipped with a worm gear engaged with a drive gear 754. The drive gear 754 may engage with an output gear 756, which may be coupled to a drive wheel 758.

[0101] The shaft 709 can be supported within the slide body 710 via a bracket 760. The bracket 760 can be configured to hold the shaft 709 in place along axis CA10 such that the movement of the slide body 710 along axis CA10 causes the movement of the shaft 709. However, the bracket 760 can be configured to allow the shaft 709 to rotate within the slide body 710. Thus, the thumbwheel 702A can be configured to induce rotation of the shaft 709 along axis CA10. For example, the rotation of the thumbwheel 702A can induce the rotation of the drive gear 754, which in turn can induce the rotation of the output gear 756. The output gear 756 can rotate a drive wheel 758 that can frictionally engage with the shaft 709. The drive wheel 758 may include a rubber disc that can push the shaft 709 when the thumbwheel 702A is pressed. Other rotatable rubber discs can also be included within the slide body 710 to allow rotation of the shaft 709 while holding it in an axial position. In this example, the rubber disc can be configured to ride in a groove within the shaft 709, allowing rotation while maintaining axial fixation. Rotating the thumbwheel 702B on the axle 752B can actuate the pull wires 750A and 750B. A drum or barrel can also be mounted on the axle 752B to provide the tensile capacity of the thumbwheel 702B (e.g., an increased lever ratio).

[0102] The configurations in Figures 16A and 16B allow the operator to apply rotational input to the shaft 709 and flexion motion to the shaft 709 with one hand using the movement of the thumb. For example, moving the thumb wheel 702B upward can induce flexion of the shaft 709 in a first direction, and moving the thumb wheel 702B downward can induce flexion of the shaft 709 in a second direction opposite to the first direction. For example, moving the thumb wheel 702A upward can induce rotation of the shaft 709 around the axis CA10 in a first direction, and moving the thumb wheel 702A downward can induce rotation of the shaft 709 in a second direction opposite to the first direction. Buttons 720A and 720B can be accessed on the slide body 710 by the thumb of a hand placed on the slide body 710.

[0103] Figure 17 is a flowchart showing a reprocessing method 800 for a treatment device disclosed herein. The treatment devices described above, such as the control device 300 in Figure 8A, the control device 400 in Figure 13, the control device 500 in Figure 14, the control device 600 in Figure 15A, and the control device 700 in Figure 16A, as well as insertion sections and operating shafts that can be attached thereto, may be discarded after a single use or may be used repeatedly multiple times. In the case of a configuration that is used repeatedly multiple times, for example, the reprocessing method of Figure 17 may be required or usable. An operator collects the used treatment device after it has been used for a treatment and transports it to a factory or other location (Step S1). Next, the operator cleans and sterilizes the collected and transported used treatment device (Step S2). Next, the operator performs an acceptance inspection of the used treatment device (Step S3). After that, the operator disassembles the used treatment device (Step S4) and replaces some of the used parts of the used treatment device with new parts (Step S5). Following step S5, the operator assembles the new or reprocessed treatment device (step S6). In some examples, step S6 may include adding an identifier indicating that the device has been modified from its original state, such as adding a label or other mark indicating that the device has been reprocessed, modified, or refurbished. Following step S6, the operator sequentially performs inspection of the new treatment device (step S7), sterilization and storage (step S8), and transport (step S9). The treatment device according to this embodiment has an ergonomic control device that can be reprocessed and used multiple times. Thus, the ergonomic control device of this disclosure has the advantage of being able to reduce the cost of medical procedures.

[0104] (Examples) Embodiment 1 is a control device for an auxiliary endoscope, comprising: a coupling device attached to a main endoscope; a handpiece connected to the coupling device; an operating shaft extending from the handpiece and into the coupling device; and a pull wire extending through the operating shaft, the control device being configured to operate the pull wire, and the control device being able to move the handpiece relative to the coupling device to adjust the position of the auxiliary endoscope relative to the main endoscope.

[0105] In Example 2, the subject matter of Example 1 is optionally extended to include the ability to move the handpiece to adjust the amount of the working shaft extending through the coupling.

[0106] In Example 3, the subject matter of Example 2 is optionally extended to include the fact that the handpiece is axially translatable relative to the coupling along the slide axis.

[0107] In Example 4, the subject of Example 3 optionally includes a coupling device comprising a slide post extending along the slide axis, configured to be coupled to the main endoscope, and a handpiece configured to slide along the slide post.

[0108] In Example 5, the subject of Example 4 is optionally extended to include the connection of the handpiece to the slide post via a receiver that facilitates the rotation of the handpiece relative to the coupling.

[0109] In Example 6, the subject of Example 5 optionally includes the handpiece extending along a handpiece axis that is inclined with respect to the axis of the receiver.

[0110] In Example 7, one or more of the themes from Examples 5 to 6 optionally include the handpiece extending along a handpiece axis aligned with the axis of the receiver.

[0111] In Example 8, one or more of the themes from Examples 4 to 7 optionally include a handpiece extending along a handpiece axis coaxial with the slide post.

[0112] In Example 9, one or more of the themes from Examples 4 to 8 are optionally included, where the rotation of the handpiece results in the rotation of the operating shaft.

[0113] In Example 10, the subject of Example 9 optionally includes a first control mechanism which, when pivoted, can actuate a pull wire and when rotated, can rotate an actuation shaft.

[0114] In Example 11, one or more of the themes from Examples 9-10 optionally include the ability to rotate the working shaft by directly rotating the handpiece around the slide post.

[0115] In Example 12, the subject of Example 11 optionally includes a first control mechanism comprising a first thumbwheel attached to the handpiece.

[0116] In Example 13, the subject of Example 12 optionally includes a second control mechanism configured to provide rotation of the working shaft relative to the handpiece.

[0117] In Example 14, the subject of Example 13 is optionally further configured such that the second control mechanism comprises a second thumbwheel connected to the drive wheel by a gear system, and the drive wheel is configured to rotate the actuation shaft.

[0118] In Example 15, one or more subjects from Examples 11 to 14 optionally include a handpiece comprising a main body configured to slide along a slide post, and a pistol grip extending from the main body.

[0119] In Example 16, one or more themes from Examples 1 to 15 optionally include a first control mechanism comprising a lever attached to the handpiece.

[0120] In Example 17, one or more subjects from Examples 1 to 16 optionally further include an aperture located in the handpiece that communicates with an opening in the working shaft connected to the working channel of the working shaft.

[0121] In Example 18, one or more subjects from Examples 1 to 17 optionally further include a control input connected to the working shaft to provide an intervention function at the distal end of the working shaft, and a button positioned on the handpiece for operating the control input.

[0122] In Example 19, one or more subjects from Examples 1 to 18 optionally further include a locking mechanism to prevent movement of the handpiece relative to the connector.

[0123] In Example 20, one or more subjects from Examples 1 to 19 optionally include a coupling housing configured such that the coupling is attached to the main endoscope so as to cover a port for receiving an auxiliary endoscope.

[0124] Embodiment 21 is an endoscopic system comprising a main control unit, an elongated shaft extending from the main control unit having a working channel extending therein, and a main scope having an access port located on the main control unit for accessing the working channel, and an auxiliary scope having a slide post configured to be coupled to the access port, an auxiliary control unit slidably mounted on the slide post, an auxiliary shaft configured to extend from the auxiliary control unit through the slide post into the working channel of the main scope, and a control input extending into the auxiliary control unit and connecting to the auxiliary shaft.

[0125] In Example 22, the subject of Example 21 is optionally extended to include an auxiliary control device comprising: a handpiece including a first control mechanism for operating a pull wire in an auxiliary shaft; a swivel body extending from the handpiece; a receiver slidably mounted on a slide post to receive the swivel body, such that when the handpiece rotates in the swivel body, the auxiliary shaft can be rotated in the slide post; and an access opening in the swivel body for receiving an intervention device in the auxiliary shaft.

[0126] In Example 23, the subject matter of Example 22 is optionally extended to include positioning the handpiece by a swivel body and receiver so that it is substantially parallel to the main control device.

[0127] In Example 24, one or more subjects from Examples 21 to 23 optionally include an auxiliary control device comprising: a handpiece including a first control mechanism for operating a pull wire in an auxiliary shaft; a receiver slidably mounted on a slide post to receive the handpiece, such that when the handpiece rotates in the receiver, the auxiliary shaft can be rotated in the slide post; and an access opening for the handpiece to receive an intervention device in the auxiliary shaft.

[0128] In Example 25, the subject of Example 24 optionally includes a swivel ring that connects the control input to the handpiece, allowing the control input to rotate relative to the handpiece.

[0129] In Example 26, one or more subjects from Examples 21 to 25 optionally include an auxiliary control device comprising a slide body comprising a first control mechanism for operating a pull wire in an auxiliary shaft, the slide body configured to slide on and rotate around a slide post, and a pistol grip extending from the slide body.

[0130] In Example 27, the subject of Example 26 optionally includes the inclusion of one or more buttons for operating the control inputs on the slide body.

[0131] In Example 28, one or more subjects from Examples 21 to 27 optionally include an auxiliary control device comprising: a slide body configured to slide on a slide post; a knob connected to the slide body, configured to operate a pull wire within an auxiliary shaft and rotate the auxiliary shaft relative to the slide post; and an access opening in the slide body for receiving an intervention device within the auxiliary shaft.

[0132] In Example 29, the subject matter of Example 28 is optionally extended to include the connection of the knob to the auxiliary shaft via a pivot coupling configured to provide lateral movement of the knob relative to the auxiliary shaft and to drive rotation of the auxiliary shaft via a pin connection between flat plates.

[0133] In Example 30, one or more themes from Examples 21 to 29 optionally include an auxiliary control device comprising a slide body configured to slide on a slide post, a first thumbwheel for operating a pull wire in an auxiliary shaft, and a second thumbwheel for rotating the auxiliary shaft in the slide post.

[0134] In Example 31, the subject matter of Example 30 is optionally extended to include a second thumbwheel connected to an auxiliary shaft via a worm gear system configured to rotate a drive wheel.

[0135] Each of these non-limiting embodiments may exist independently or in combination with one or more of the other embodiments in various orders or combinations.

[0136] annotation The above detailed description includes references to the accompanying drawings, which constitute part of the detailed description. These drawings illustrate specific embodiments that can be used to carry out the invention. These embodiments are also referred to herein as “examples.” These examples may include elements other than those shown or described. However, the inventors also intend examples in which only the shown or described elements are provided. Furthermore, the inventors also intend examples (or one or more embodiments thereof) using any combination or order of the shown or described elements with respect to a particular example (or one or more embodiments thereof) or to other examples (or one or more embodiments thereof) shown or described herein.

[0137] In the event of any conflicting usage between this document and any document incorporated by reference, the usage in this document shall prevail.

[0138] In this document, the terms "a" or "an" are used to mean one or more, separate from other instances where "at least one" or "one or more" are described or used, as is common in patent documents. In this document, the term "or" is used to indicate non-exclusiveness; that is, unless otherwise specified, "A or B" means "A but not B," "B but not A," and "A and B." In this document, the terms "include" and "in which" are used as plain English equivalents of the terms "equip" and "wherein," respectively. Furthermore, in the following claims, the terms "include" and "equip" are open-ended; that is, any system, apparatus, article, composition, preparation, or process that includes elements other than those listed after these terms in the claim is considered to be included within the scope of that claim. In addition, in the following claims, terms such as "first," "second," and "third" are used simply as labels and are not intended to impose numerical requirements on their subjects.

[0139] The above description is intended to be illustrative and not restrictive. For example, the above examples (or one or more of them) may be used in combination with each other. Other embodiments may also be used, for example, by those skilled in the art, by considering the above description. To allow readers to quickly ascertain the nature of this technical disclosure, an abstract is provided in accordance with 37, 1.72(b) of the Code of Federal Rules. This is submitted with the understanding that it will not be used to interpret or limit the scope or meaning of the claims. Also, in the above detailed description, various features may be grouped together to simplify the disclosure. This should not be interpreted as meaning that any disclosed feature that is not claimed is essential to any claim. Inventive subject matter may be found in some of the features of a particular disclosed embodiment. Accordingly, the following claims are incorporated into the detailed description as examples or embodiments, and each claim exists as a separate embodiment on its own, and such embodiments are intended to be able to be combined with each other in various combinations or orders. The scope of the invention shall be determined by reference to the appended claims and the equivalents of the entire scope given thereto. [Explanation of Symbols]

[0140] 10 Endoscopy Systems 12. Imaging and control systems 14 Endoscopy 16 Control Unit 18 Output Units 20 Input Units 22 Light source units 24 Fluid source 26 Suction pump 42 Image Processing Unit 44 Treatment Generator 46 Drive Unit 50 Side-view Endoscope Camera Module 70 End-View Endoscope Camera Module 134 Auxiliary Scope 108, 300, 400, 500, 600, 700 control devices 100, 301, 501, 601, 701 Endoscopes 302, 402, 506, 606, 704, 706 Handpieces 304, 404, 508, 608, 708 Attachment Pieces 306, 406 Control Unit 308, 408 Handle body 310, 410 Swivel Body 312, 412 Access openings 314, 414, 507, 607, 707 control inputs 316, 416 receiver 318, 418, 510, 610, 710 Slide Body 320, 420, 512, 612, 712 slide posts 322, 422, 514, 614, 714 combiner 350 Lever 401 Auxiliary Scope 403, 509, 609, 709 shafts 417 Swivel Ring 502 Pistol Grip 504 Top-loading treatment device 602 Knob 603 Pivotal coupler 702A, 702B Thumbwheel

Claims

1. A control device for an auxiliary endoscope, A coupling device that can be attached to the main endoscope, The handpiece connected to the aforementioned connector, The swivel body extending from the aforementioned handpiece, The operating shaft of the auxiliary endoscope extends from the handpiece and into the coupling, A pull wire extending through the actuation shaft, comprising a first control mechanism located on the handpiece for operating the pull wire configured to control the actuation shaft, The handpiece can be moved relative to the coupling to adjust the position of the handpiece relative to the main endoscope. The coupling device comprises a slide post extending along the slide axis, configured to be coupled to the main endoscope, The handpiece is slidably mounted on the slide post and connected to the slide post via a receiver that rotatably receives the swivel body. As a result, the coupling extends along the first main shaft, the handpiece extends along the second main shaft, and the first and second main shafts are different from each other so that the handpiece can rotate with the swivel body relative to the receiver. The operating shaft passes through the swivel body, the receiver, and the slide post, When the handpiece rotates relative to the receiver in the swivel body, the operating shaft can be rotated within the slide post. Control device.

2. The control device according to claim 1, wherein the handpiece can be moved to adjust the amount of the operating shaft extending through the coupling.

3. The control device according to claim 1, wherein the handpiece is configured to slide along the slide post.

4. The control device according to claim 3, wherein the connection of the handpiece to the slide post via the receiver facilitates the rotation of the handpiece relative to the coupling.

5. The control device according to claim 4, wherein the handpiece extends along a handpiece axis that is inclined with respect to the axis of the receiver.

6. The control device according to claim 4, wherein the handpiece extends along a handpiece axis aligned with the axis of the receiver.

7. The control device according to claim 3, wherein the rotation of the handpiece causes the rotation of the operating shaft.

8. The control device according to claim 7, wherein the first control mechanism includes a joystick that can actuate the pull wire when pivoted and rotate the actuation shaft when rotated.

9. The control device according to claim 1, wherein the first control mechanism comprises a lever attached to the handpiece.

10. The control device according to claim 1, further comprising an aperture located in the handpiece that communicates with an opening in the operating shaft connected to the working channel of the operating shaft.

11. A control input connected to the operating shaft is provided at the distal end of the operating shaft to provide an intervention function, A button positioned on the handpiece for operating the aforementioned control input, The control device according to claim 1, further comprising:

12. The control device according to claim 1, further comprising a locking mechanism for preventing movement of the handpiece relative to the coupling.

13. The control device according to claim 1, wherein the coupling device comprises a coupling housing configured to be attached to the main endoscope so as to cover a port for receiving the auxiliary endoscope.

14. Main scope, Main control unit, An elongated shaft extending from the main control device, having a working channel extending therein, and Access port located on the main control unit for accessing the working channel A main scope equipped with, It is an auxiliary scope, A slide post configured to be connected to the aforementioned access port, An auxiliary control device slidably mounted on the aforementioned slide post, An auxiliary shaft configured to extend from the auxiliary control device through the slide post into the working channel of the main scope, and An auxiliary scope having a control input extending into the auxiliary control device and connected to the auxiliary shaft, Equipped with, The auxiliary control device is A handpiece including a first control mechanism for operating a pull wire within the auxiliary shaft, The swivel body extending from the aforementioned handpiece, A receiver slidably mounted on the slide post to receive the swivel body, wherein when the handpiece rotates relative to the receiver on the swivel body, the auxiliary shaft can be rotated within the slide post; Equipped with, The auxiliary shaft passes through the swivel body, the receiver, and the slide post, The aforementioned slide post is configured to extend along the slide axis, The handpiece is connected to the slide post via the receiver, As a result, the slide post extends along the first spindle, the auxiliary control device extends along the second spindle, and the first and second spindles are different from each other so that the handpiece can rotate with the swivel body relative to the receiver. Endoscopic system.

15. The auxiliary control device is The endoscopic system according to claim 14, further comprising an access opening in the swivel body for receiving an intervention device within the auxiliary shaft.

16. The endoscope system according to claim 14, wherein the handpiece is positioned by the swivel body and the receiver so as to be substantially parallel to the main control device.

17. The auxiliary control device is The endoscopic system according to claim 14, further comprising an access opening in the handpiece for receiving an intervention device within the auxiliary shaft.

18. The endoscopic system according to claim 17, further comprising a swivel ring that connects the control input to the handpiece so that the control input can rotate relative to the handpiece.

19. The auxiliary control device is A slide body configured to slide on the aforementioned slide post, A knob connected to the slide body, configured to operate a pull wire within the auxiliary shaft and rotate the auxiliary shaft relative to the slide post, An access opening in the slide body for receiving the intervention device inside the auxiliary shaft, The endoscopic system according to claim 14, comprising:

20. The endoscope system according to claim 19, wherein the knob is connected to the auxiliary shaft via a pivot coupling configured to provide lateral movement of the knob relative to the auxiliary shaft and to drive rotation of the auxiliary shaft via a pin connection between flat plates.

21. The auxiliary control device is A slide body configured to slide on the aforementioned slide post, A first thumbwheel for operating the pull wire within the auxiliary shaft, A second thumbwheel for rotating the auxiliary shaft within the slide post, The endoscopic system according to claim 14, comprising:

22. The endoscope system according to claim 21, wherein the second thumbwheel is connected to the auxiliary shaft via a worm gear system configured to rotate a drive wheel.

Images