Endoscope

Abstract

An example ureteroscope includes a handpiece having a catheter end and a control end. The ureteroscope also includes a catheter extending from the catheter end of the handpiece. The ureteroscope is configured to selectively vary the stiffness of a distal end region of the catheter. For example, the ureteroscope is configured to increase the stiffness of the distal end of the catheter.

Description

Background Art

[0001] Small endoscopes are desired for many industrial and medical applications. For example, even if the natural openings and lumens of the human body are small, small endoscopes can be used to insert them into the target locations in the body through those openings and lumens. In single-incision laparoscopy, especially when the incision itself is of the minimum size, it is desirable to use a smaller endoscope to provide an in-body view of the surgical site. Often, patients tend to feel stimulation when an endoscope is inserted into their body, and a smaller endoscope can reduce such unpleasant experiences and minimize the trauma suffered by the patient. Furthermore, doctors can improve diagnostic and treatment protocols with smaller endoscopes. For example, transnasal endoscopy can sometimes be replaced by transoral endoscopy.

Prior Art Documents

Patent Documents

[0002]

Patent Document 1

Patent Document 2

Patent Document 3

Summary of the Invention

Means for Solving the Problems

[0003] The embodiments are directed toward ureteroscopes, endoscopic systems having the same, and methods of using the same. In one embodiment, a ureteroscope is disclosed. The ureteroscope has a handpiece. The handpiece has a catheter end, a control end, a working assembly configured to receive one or more surgical instruments, and a steering controller configured to bend at least a portion of the catheter. The ureteroscope also has a catheter extending from the catheter end of the handpiece. The catheter has a proximal end region and a distal end region spaced further from the handpiece than the proximal end region. The working assembly has at least one of two parts: a first movable part configured to move relative to the catheter end of the handpiece, or the steering controller has at least one of two parts: a second movable part configured to move relative to the catheter end of the handpiece. The movement of the first movable part relative to the catheter end of the handpiece changes the stiffness of at least a portion of the catheter. The movement of the second movable part relative to the catheter end of the handpiece changes the stiffness of at least a portion of the catheter.

[0004] In one embodiment, a method using a ureteroscope is disclosed. In this method, a ureteroscope is prepared. The ureteroscope has a handpiece. The handpiece has a catheter end, a control end, a working assembly configured to receive one or more surgical instruments, and a steering controller configured to bend at least a portion of the catheter. The ureteroscope also has a catheter extending from the catheter end of the handpiece. The catheter has a proximal end region and a distal end region spaced further from the handpiece than the proximal end region. The working assembly has at least one of a first movable part configured to move relative to the catheter end of the handpiece, or the steering controller has at least one of a second movable part configured to move relative to the catheter end of the handpiece. In this method, the stiffness of at least a portion of the catheter is also adjusted by moving at least one of at least a portion of the first movable part and at least a portion of the second movable part relative to the catheter end of the ureteroscope handpiece.

[0005] Features derived from any of the disclosed embodiments can be used in combination with each other without limitation. In addition, other features and advantages of the present disclosure will become clear to those skilled in the art through examination of the detailed description and accompanying drawings provided below.

[0006] The drawings depict several embodiments of the present disclosure, and the same reference numerals in the drawings refer to the same or similar elements or features in the various views and embodiments shown in the drawings. [Brief explanation of the drawing]

[0007] [Figure 1A] This is an isoangle schematic diagram of an endoscope system according to one embodiment. [Figure 1B] This is a cross-sectional view of a portion of a ureteroscope, taken along plane 1B-1B. [Figure 1C] This is a side elevation view of the terminal end of the distal end region of a catheter according to one embodiment. [Figure 1D] This is a magnified view of a ureteroscope illustrating one embodiment of a method for selectively changing the rigidity of at least a portion of a catheter using an actuator. [Figure 1E] This is a magnified view of a ureteroscope illustrating one embodiment of a method for selectively changing the rigidity of at least a portion of a catheter using an actuator. [Figure 2A] This is a side elevation view of a ureteroscope according to one embodiment, configured to change the rigidity of at least a portion of the catheter using a control device. [Figure 2B] This is a side elevation view of a ureteroscope according to one embodiment, configured to change the rigidity of at least a portion of the catheter using a control device. [Figure 3] This is a side elevation view of a catheter shaft relating to one embodiment, which can be used with any of the catheters disclosed in this application. [Modes for carrying out the invention]

[0008] The embodiments are directed toward ureteroscopes, endoscopic systems having the same, and methods of use thereof. One example of a ureteroscope comprises a handpiece having a catheter end and a control end. The ureteroscope also has a catheter extending from the catheter end of the handpiece. The handpiece also has a working assembly configured to retract one or more surgical instruments, and a steering controller configured to selectively bend at least a portion of the catheter. The ureteroscope is configured to selectively change the stiffness of at least a portion of the catheter. In one example, the working channel port has a first movable part, or the steering controller has a second movable part, or at least one of the two. The first movable part and / or the second movable part are configured to move relative to a portion of the handpiece (e.g., the catheter end). By moving the first movable part and / or the second movable part relative to a portion of the handpiece, the stiffness of at least a portion of the catheter can be selectively changed.

[0009] Some ureteroscopes are equipped with catheters that have a flexible distal end region (i.e., the region of the catheter distal to the handpiece). The flexible distal end region of such catheters allows the catheter to be moved within the intricate passages of the human or animal body. The flexible distal end region of such catheters also allows for selective changes in the shape of the catheter (e.g., curvature), enabling it to be manipulated through bends in the intricate passages and allowing selection of the passage through which the catheter moves. However, the flexible distal end of such ureteroscope catheters can twist, and due to their flexibility, they may be immobile in tight passages or passages that are at least partially blocked.

[0010] Unlike the ureteroscopes discussed in the previous paragraph, the ureteroscope disclosed herein allows for the selective modification of the stiffness of at least a portion of the catheter. For example, the ureteroscope disclosed herein may be equipped with a catheter having a flexible distal end region during normal use. However, when the internal passage is narrowed, at least partially obstructed, or for any other reason, the stiffness of the distal end region of the catheter can be selectively increased (i.e., the flexibility of the distal end region can be selectively decreased). Increasing the stiffness of the distal end region of the catheter allows it to push into the narrowed passage or displace obstacles. After moving the distal end region of the catheter within the narrowed passage or displacing obstacles, the stiffness of the distal end region of the catheter can be selectively decreased (i.e., the flexibility of the distal end region can be selectively increased).

[0011] Figure 1A is an isometric schematic view of an endoscope system 100 according to one embodiment. This endoscope system 100 has a ureteroscope 102. Figure 1B is a cross-sectional view of a portion of the ureteroscope 102 taken along the plane 1B-1B. The ureteroscope 102 has a handpiece 104 and a catheter 106 extending from the handpiece 104. The catheter 106 has a proximal end region 108 adjacent to or embedded in the handpiece 104 and a distal end region 110 on the opposite side of the proximal end region 108. The ureteroscope 102 is configured to selectively change the rigidity of at least a portion of the catheter 106 (e.g., the distal end region 110 of the catheter 106).

[0012] The handpiece 104 can be elongated and has a catheter end 112 and a control end 114. The catheter end 112 is near the catheter 106, and the control end 114 is on the opposite side, i.e., farther away from the catheter end 112. Because the control end 114 is on the opposite side from the catheter end 112, the control end 114 and the catheter end 112 are at separate ends of the handpiece 104 and can be oriented in different directions from each other. The control end 114 can have a generally spherical shape, and the handpiece 104 can be tapered between the control end 114 and the catheter end 112.

[0013] When the control end 114 is on the opposite side or far from the catheter end 112, the handpiece 104 has an intermediate or central portion 116 located between the catheter end 112 and the control end 114. This central portion 116 has a first or upper surface 118, a second or lower surface 120, and two opposing sides 122 located between the upper surface 118 and the lower surface 120. In some embodiments, the upper and lower surfaces 118,120 of the central portion 116 are rounded, and the sides 122 are made substantially flat.

[0014] In one embodiment, both the catheter 106 and the handpiece 104 are disposable. In certain embodiments, the catheter 106 and the handpiece 104 are manufactured as a single unit, or the catheter 106 is fixed to the handpiece 104 via a handpiece-to-catheter connector 124. Alternatively, only the catheter 106 can be disposable, and the handpiece 104 can be sterilized and reused multiple times. In this case, the catheter 106 is detachably connected to the handpiece 104 and the catheter end 112 via the handpiece-to-catheter connector 124.

[0015] As previously discussed, the catheter 106 has a proximal end region 108 and a distal end region 110 spaced apart from the proximal end region 108. The proximal end region 108 is attached to the catheter end 112 (e.g., handpiece-to-catheter connector 124), is integrally formed with it, or is disposed inside it. The distal end region 110 can be configured to be positioned within each person's urethral orifice. Figure 1C is a side elevation view of the end of the distal end region 110 of the catheter 106 according to one embodiment.

[0016] The ureteroscope 102 has a working assembly 125. The working assembly 125 has a working channel port 126 contoured by the handpiece 104 and a working channel 127 contoured by or disposed within the catheter 106. The working channel 127 extends from the proximal end region 108 to the distal end region 110 of the catheter 106. The working channel port 126 and the working channel 127 are integrally connected (directly or indirectly). The working channel port 126 and the working channel 127 are configured to allow various surgical instruments and cleaning devices to be drawn in as needed for procedures such as lithotripsy and removal. For example, various surgical instruments can be inserted into the working channel port 126 and the working channel 127, and these various surgical instruments can then be used in the distal end region 110 of the catheter 106. The working assembly 125 may also have at least one of the following: a working channel connector 128 connected to or attached to the working channel port 126, or at least one conduit 130 that indirectly connects the working channel port 126 to the catheter 106. In one embodiment, as shown in the figure, the conduit 130 can be extended into the catheter 106, thereby forming the contour of at least a portion of the working channel 127. In such an embodiment, the conduit 130 can be extended into the catheter 106 and firmly (e.g., immobilely) attached to at least the distal end region 110 of the catheter 106. In one embodiment, instead of the conduit 130 being extended into the catheter 106, the catheter 106 forms the contour of the working channel 127.

[0017] The working channel port 126 can be arranged near the catheter end 112 of the handpiece 104. For example, the working channel port 126 can be arranged at a position less than 1 / 2 of the distance from the catheter end 112 to the control end 114, less than 1 / 3 of the distance from the catheter end 112 to the control end 114, less than 1 / 4 of the distance from the catheter end 112 to the control end 114, or less than 1 / 5 of the distance from the catheter end 112 to the control end 114. By arranging the working channel port 126 near the catheter end 112, it is less likely that the working channel port 126 and any surgical instrument extending therefrom will interfere with the use of the ureteroscope 102, so the ergonomics of the handpiece 104 can be improved.

[0018] The ureteroscope 102 has a steering controller 132 configured to control one or more steering wires 134, and the wires 134 are connected to the effective bending portion (e.g., the distal end region 110) of the catheter 106, so the effective bending portion of the catheter 106 can be bent to a desired position. Therefore, the user can bend or deflect the catheter 106 (e.g., bend or deflect the distal end region 110) using the steering controller 132.

[0019] The steering controller 132 can be configured to have a driver 136 connected to the steering wire 134. The driver 136 is configured to bend the catheter 106 by moving the steering wire 134. For example, the driver 136 is configured to be rotatable around a rotation axis. The rotation axis can extend substantially perpendicular to the long axis of the handpiece 104. The steering wire 134 is preferably attached to both sides of the driver 136. In this way, by rotating the driver 136 around the rotation axis, at least one of the steering wires 134 can be brought closer to or moved away from the catheter end 112 of the handpiece 104. As an example, in the case where the steering wire 134 includes two steering wires 134, as shown in the figure, by rotating the driver 136, one of the steering wires 134 can be brought closer to the catheter end 112 while the other steering wire 134 is moved away from the catheter end 112. In such an example, the steering wire 134 approaching the catheter end 112 is in a non-tensioned state, and the steering wire 134 moving away from the catheter end 112 is in a tensioned state. By selectively tensioning one of the two steering wires 134, at least a part of the catheter 106 will be selectively bent. It should be noted that the principle of selectively tensioning one or more of the steering wires 134 is by selectively bending or warping the catheter 106, and the ureteroscope 102 may have one or three or more steering wires 134.

[0020] According to an example, by making the driver 136 generally cylindrical, the driver 136 can be fitted into the generally spherical control end 114. However, it should be noted that the driver 136 may have other shapes.

[0021] In one example, as shown in the figure, the driver 136 is disposed inside the handpiece 104. In one example, the driver 136 is at least partially disposed on the outer surface of the handpiece 104 or is accessible from outside the handpiece 104 in other ways.

[0022] It should be noted that the control controller 132 may have one or more elements configured to selectively move the control wire 134 relative to the catheter end 112, instead of the driver 136. For example, the control controller 132 may have one or more elements configured to move along a trajectory, each element attached to a corresponding control wire 134. By moving these elements along the trajectory, the control wire 134 is moved relative to the catheter end 112, thereby selectively bending the catheter. For simplicity and clarity, this application will discuss only the driver 136. However, it should be noted that (as will be discussed in more detail in relation to Figures 2A and 2B) the mechanism for moving the driver 136 may be applied to any other element configured to move the control wire 134 relative to the catheter end 112.

[0023] When the driver 136 is located inside the handpiece 104, the control controller 132 may be provided with a mechanism located on the outer surface of the handpiece 104 that can be operated by the user, causing the driver 136 to rotate. In one example, as shown in the figure, the control controller 132 has a lever 138 attached to the driver 136. The lever 138 extends along the outer surface of the handpiece 104. The lever 138 is configured such that moving the lever 138 relative to the control end 114 causes the driver 136 to rotate, thereby selectively bending at least a portion of the catheter 106. In another example, the control controller 132 may have one or more gears attached to the driver 136 and configured to rotate the driver 136, in place of or in addition to the lever 138. A disc-shaped device may be exposed at least partially on the outer surface of the handpiece 104, and the gears may be attached to the disc-shaped device. The user can rotate the disc-shaped device to turn the driver 136. In one example, the control unit 132 replaces or adds a motor, which is attached to the driver 136 and configured to rotate the driver 136, to the lever 138. This motor can be controlled by the host machine 146, computer 150, controller 154, or other devices.

[0024] The catheter 106 of the ureteroscope 102 can be used to image the inner surface of tubular structures, such as the lumen of a human or animal body. For example, the catheter 106 can be inserted through the subject's urethra to access various parts of the urinary tract. However, it should be noted that the ureteroscope 102 may also be used as an industrial endoscope, in which case the tubular structure would be part of industrial equipment, instruments, products, machinery, production lines, etc. In certain embodiments, the catheter 106 can be used as a tether, and by having multiple scale markings or fiducials, a physician can measure the distance the photoelectric module 140 has advanced into the tubular structure, such as the lumen of the body. Other structures(s) can also be incorporated into the ureteroscope 102 as desired.

[0025] The ureteroscope 102 may have a photoelectric module 140 (e.g., a camera or other imager) for imaging the subject of interest. For example, the photoelectric module 140 and at least one light source 1142 may be located in the distal end region 110 of the catheter 106 or elsewhere on the catheter 106. The photoelectric module 140 may comprise a microcamera module having an image sensor microchip, a set of microlenses, and a microillumination module. A suitable photoelectric module is disclosed in Patent Document 1, and its entirety will be incorporated into this application by reference. According to certain embodiments, the photoelectric module 140 may be placed in a rigid or semi-rigid shell-like housing located in the distal end region 110, which is configured to be inserted into the tubular structure when imaging the inner surface of the tubular structure. For example, the photoelectric module 140 may be inserted into the patient's body through an innate bodily opening such as the mouth, nose, urethra, bladder, vagina, or anus. The ureteroscope 102 may therefore have different configurations to accommodate its use as a gastrointestinal endoscope, colonoscope, endoscopic ultrasound (EUS), endoscopic retrograde cholangiopancreatography, and other appropriate application devices. Applications of the ureteroscope 102 include diagnostic observation related to endometrial polyps, infertility, abnormal bleeding, and pelvic pain, as well as surgical procedures for embryonic growth arrest and uterine malformations.

[0026] The ureteroscope 102 may have a communication interface 144, generally located outside the catheter 106, to receive signals from an image sensor in the photoelectric module 140. This communication interface 144 can be located inside or near the handpiece 104. At least the photoelectric module 140 can be coupled to the communication interface 144.

[0027] The endoscope system 100 may have one or more electronic devices that process and display image data received from the photoelectric module 140 of the ureteroscope 102. For example, the endoscope system 100 may include one or more of the following: a host machine 146 having a microprocessor, a computer 150 having a microprocessor, and a display 148. The host machine 146 can be connected to one or more terminals of the computer 150 and the display 148, thereby reprocessing and displaying the image data from the photoelectric module 140. The host machine 146 and the computer 150 can be programmed with image processing software that takes image data output from the photoelectric module 140 of the ureteroscope 102 as input and generates two- or three-dimensional reconstructed images of the body cavity that can be displayed on the display 148. Therefore, a processor in at least one of the host machine 146, computer 150, and display 148 can be programmed to receive multiple still images of a subject generated by the photoelectric module 140 as input, and then output software to display a three-dimensional rendered image of that subject based on those multiple still images. The display 148 can include any suitable display, as long as it is configured to display moving images (movies) or still images collected by the image sensor of the photoelectric module 140. Although shown as separate blocks in Figure 1A, the host machine 146, computer 150, and display 148 may include a single device, two devices, three devices, or more than three devices.

[0028] The endoscope system 100 may also have a cable 152 configured to operably couple the ureteroscope 102 to at least one of the host machine 146, computer 150, and display 148. The cable 152 allows the communication interface 144 of the ureteroscope 102 to be electrically coupled to at least one of the host machine 146, computer 150, and display 148. The cable 152 can also allow the communication interface 144 to communicate with and receive power from the host machine 146 or other power sources. The cable 152 can also be configured so that the communication interface 144 can send image data captured by the photoelectric module 140 to the host machine 146 for processing, storage, and display.

[0029] The communication interface 144 can incorporate one or more of the following: a processor board, a camera board, a frame grabber, and a power supply. The processor board can be connected to the host machine 146 via cable 152 for storing and playing back images generated by the ureteroscope 102. The communication interface 144 can also be configured to communicate with and receive power from the host machine 146 and other power supplies via cable 152. The communication interface 144 can also send image data captured in the distal end region 110 to the host machine 146 for processing, storage, and display.

[0030] The ureteroscope 102 may have one or more controllers 154 located at or near the control end 114 of the handpiece 104. These one or more controllers 154 may include one or more switches, buttons, rotatable knobs, movable tables, etc. In certain embodiments, the one or more controllers 154 may be configured to adjust the view presented on the display 148. For example, the one or more controllers 154 may be configured to adjust at least one of the brightness, zoom, focus, and contrast of one or more images displayed on the display 148. Thus, the one or more controllers 154 allow the user to adjust the view presented on the display 148 and / or computer 150 according to their preferences and as needed while using the ureteroscope 102. In certain embodiments, at least one of the one or more controllers 154 is configured to activate (e.g., turn on) or deactivate (e.g., turn off) at least one light source 1142 (Figure 1C) located in the distal end region 110 of the catheter 106. In certain embodiments, at least one of the one or more controllers 154 is configured to activate and deactivate the photoelectric module 140.

[0031] By operating the ureteroscope 102, selected tasks can be performed or completed manually, automatically, or in combination thereof. Several ureteroscopy functions can be realized by using components comprising hardware, software, firmware, or a combination thereof. General-purpose components, such as a general-purpose computer or oscilloscope, can be used in the ureteroscope 102, while dedicated or custom components, such as circuits, integrated circuits, or software, can also be used. For example, several functions can be realized by executing several software instructions using one or more data processors that are components of a general-purpose or custom computer. These one or more data processors can be embedded in at least one of the communication interface 144, host machine 146, computer 150, and display 148. In certain embodiments, the data processor or computer 150 includes volatile memory for storing instructions and / or data, and / or non-volatile storage, such as a magnetic hard disk and / or removable media, for storing instructions and / or data. In certain embodiments, network connectivity is incorporated into the implement. In certain embodiments, the implement may incorporate a user interface, typically comprising one or more input devices (e.g., one that allows input of commands and / or parameters) and output devices (e.g., one that allows notification of operational parameters and results).

[0032] Alternatively, the handpiece 104 may further include a compact battery module that supplies power to the photoelectric module 140 and at least one light source 1142. The power source within the handpiece 104 may be, for example, one or more conventional disposable dry cell batteries or lithium-ion rechargeable batteries.

[0033] Endoscopic systems and other examples of endoscopes are disclosed in Patent Document 2, published on June 18, 2020, and Patent Document 3, submitted on February 9, 2022. Therefore, the entirety of the disclosures in each document will be incorporated into this application by reference.

[0034] As previously discussed, the ureteroscope 102 is configured to selectively change the rigidity of at least a portion of the catheter 106. For example, the ureteroscope 102 is configured to selectively change the rigidity of the distal end region 110 of the catheter 106. In the illustrated embodiment, the ureteroscope 102 is configured to increase the rigidity of at least a portion of the catheter 106 using a working assembly 125. As will be discussed in more detail later, the working assembly 125 has a first movable part. In the use of this application, the "first movable part" refers to a part of the working assembly 125 that can be moved relative to the handpiece 104, for example, relative to the catheter end 112 of the handpiece 104. The first movable part may include the entire working assembly 125 or only a portion of it. The first movable part of the working assembly 125 is configured to be movable relative to at least the catheter end 112 of the handpiece 104. By moving the first movable part of the working assembly 125 relative to the catheter end 112, at least a portion of the working assembly 125 can be made taut. When at least a portion of the working assembly 125 is taut, a compressive force is applied to the catheter 106 in the working channel 127 (e.g., the distal end region 110 of the catheter 106 is directly pulled back towards the handpiece 104). The compressive force applied to the catheter 106 increases the rigidity of at least a portion of the catheter 106. For example, the compressive force applied to the catheter 106 causes at least the distal end region 110 or its vicinity to exhibit greater rigidity.

[0035] The handpiece 104 has an actuator 156 coupled (e.g., attached) to a part of the working assembly 125. The actuator 156 is configured to move relative to the rest of the handpiece 104 (e.g., relative to the catheter end 112) in response to user operation. The movement of the actuator 156 relative to the catheter end 112 causes at least a part of the working assembly 125 to also move relative to the handpiece 104. For example, the movement of the actuator 156 can move at least one of the following relative to at least a part of the handpiece 104: at least a part of the working channel port 126, at least a part of the working channel 127, at least a part of the working channel connector 128, and at least a part of the conduit 130. The first movable part of the working assembly 125 includes the actuator 156 and other parts of the working assembly 125 that are moved by the movement of the actuator 156.

[0036] The actuator 156 can assume a first (i.e., initial) position relative to the rest of the handpiece 104. By manipulating the actuator 156 (e.g., turning, pushing, pulling), each person can move the actuator 156 to a second position, different from the first position, relative to a part of the handpiece 104 (e.g., the catheter end 112). The second position may be further or closer to the components of the handpiece 104 than the first position (e.g., further or closer to the catheter end 112). After moving the actuator 156 to the second position, the user can further manipulate the actuator 156 at will to return it to the first position or to one or more additional positions separate from the first and second positions.

[0037] In one example, the first moving part of the work assembly 125 can be in a first (i.e., initial) state when the actuator 156 is in a first position. When the first moving part is in the first state, a tensile force may be applied to at least a portion of the work assembly 125, or it may be applied to that portion. Moving the actuator 156 from the first position to the second position switches the first moving part to a second state, which is different from the first state. If a tensile force is to be applied to at least a portion of the work assembly 125 when the first moving part is in the first state, then a tensile force may be applied to at least a portion of the work assembly 125 when the first moving part is in the second state. If a tensile force is to be applied to at least a portion of the work assembly 125 when the first moving part is in the first state, then a different tensile force (e.g., a larger or smaller tensile force) may be applied to at least a portion of the work assembly 125, or there may be virtually no tensile force applied to it, when the first moving part is in the second state. The actuator 156 may be moved to one or more additional positions so that the first moving part exhibits one or more different states. Note that, as used in this application, the first state, the second state, and one or more additional states can indicate different positions of the first moving part relative to the components of the handpiece 104 (e.g., relative to the catheter end 112) and / or the tensile force applied thereto.

[0038] In one embodiment, at least a portion of the actuator 156 is made easily accessible to the user of the ureteroscope 102. At least a portion of the actuator 156 can be easily accessible, for example, if at least a portion of the actuator 156 is located on or extends from the outer surface of the handpiece 104. If at least a portion of the actuator 156 is easily accessible, the user can directly operate the actuator 156 (e.g., rotate, push, pull, etc.). The user's operation of the actuator 156 allows the actuator 156 to move relative to the rest of the handpiece 104. In one example, as shown, at least a portion of the actuator 156 can be mounted, embedded in, or otherwise coupled to the work channel port 126. Since the work channel port 126 is located on the outer surface of the handpiece 104, at least a portion of the actuator 156 can be easily accessible by positioning the actuator 156 to be mounted, embedded in, or otherwise coupled to the work channel port 126.

[0039] In one embodiment, the actuator 156 is not easily accessible. The actuator 156 is not easily accessible if, for example, it is located within the handpiece 104 (e.g., at least a portion of the actuator 156 is attached to, embedded in, or otherwise connected to the working channel 127 or an optional conduit 130). Even if the actuator 156 is not easily accessible, it can be operated indirectly by the user. One possible indirect operation of the actuator 156 is control of the actuator 156 by using one or more components of the endoscope system 100 (e.g., the host machine 146, the computer 150, or the controller 154). For example, the actuator 156 can be indirectly moved relative to the rest of the handpiece 104 by operating a component of the endoscope system 100 (e.g., pressing a key on the computer 150, pressing the controller 154, or driving it in any other way).

[0040] The actuator 156 may have some kind of actuator configured to move relative to a portion of the handpiece 104. In one example, as shown in the figure, the actuator 156 is a threaded element that is attached to a portion of the handpiece 104. In such an example, operation of the actuator 156 involves rotating the easily accessible portion of the actuator 156 relative to the handpiece 104. Rotating the actuator 156 in a first direction (e.g., counterclockwise) can move the actuator 156 away from the rest of the handpiece 104, while rotating the actuator 156 in a second direction (e.g., clockwise) can move the actuator toward the rest of the handpiece 104. In one example (not shown), the actuator 156 may have a plunger that can be pulled outward from or pushed into a portion of the handpiece 104. In another example, the actuator 156 may have an element mounted on a track, and when the actuator 156 is moved relative to a portion of the handpiece 104, the element moves along the track. In one example, the actuator 156 is said to have a motor, a pneumatic press, a hydraulic press, or other actuator.

[0041] Figures 1D and 1E are enlarged views of a ureteroscope 102 illustrating an embodiment of a method for selectively changing the rigidity of at least a portion of a catheter 106 using an actuator 156. According to Figure 1D, the actuator 156 can be initially prepared in a first position. In this first position, the actuator 156 can be brought as close as possible to the catheter end 112 by screwing it completely into the working channel port 126. The actuator 156 is attached to at least one or more of the working channel connector 128 and optional conduits 130, as depicted in Figure 1B. According to Figure 1E, the actuator 156 can be moved to a second position, which in this embodiment is located away from a portion of the handpiece 104 (e.g., away from the catheter end 112), by rotating it (e.g., counterclockwise). Moving the actuator 156 to the second position causes the first moving part of the work assembly 125 (e.g., the work channel connector 128, at least a portion of the optional conduit 130, and optionally at least a portion of the work channel 127) to transition from the first state to the second state. In the illustrated embodiment, when the first moving part transitions to the second state, the tensile force applied to the work assembly 125 increases. Consequently, a compressive force is applied from the work channel 127 to the catheter 106, thereby increasing the stiffness of at least a portion of the catheter 106. By returning the actuator 156 to the first position, the first moving part of the work assembly 125 can be reversed back to the first state, and consequently, the stiffness of at least a portion of the catheter 106 can be reduced.

[0042] The rigidity of the catheter can also be changed using parts other than the working assembly 125 or additional parts of the ureteroscope disclosed herein. For example, Figures 2A and 2B are side elevation views of a ureteroscope 202 according to one embodiment, configured to change the rigidity of at least a portion of the catheter 206 using a control controller 232. Except as otherwise disclosed herein, the ureteroscope 202 is the same as or very similar to any of the ureteroscopes disclosed herein. For example, the ureteroscope 202 may have a handpiece 204, a catheter 206, a working assembly 225 (e.g., at least a working channel port 226 and a working channel), and a control controller 232. The ureteroscope 202 can be used with any of the endoscopic systems disclosed herein.

[0043] As previously discussed, the ureteroscope 202 is configured to selectively change the rigidity of at least a portion of the catheter 206 (e.g., the distal end region of the catheter 206). For example, the ureteroscope 202 is configured to increase the rigidity of at least a portion of the catheter 206 using at least a portion of the control unit 232. As will be discussed in more detail later, the control unit 232 has a second movable part. In the use of this application, the "second movable part" refers to the part of the control unit 232 that can move relative to the handpiece 204. The second movable part may include the entirety of the control unit 232 or only a portion of it. The first movable part of the control unit 232 is configured to move relative to the catheter end 212 of the handpiece 204. When the second movable part of the control unit 232 is moved relative to the catheter end 212, at least a portion of the control unit 232 moves, thereby tensing at least a portion of the control wire (shown in Figure 1B). The control wire is firmly (i.e., immovably) attached to the distal end region of the catheter 206. Therefore, tensing at least a portion of the control wire applies a compressive force from the control wire to the catheter 206 (e.g., the distal end region of the catheter 206 is pulled directly back towards the handpiece 204). The compressive force applied to the catheter 206 increases its rigidity.

[0044] The handpiece 204 has an actuator 256, which is the same as or very similar to the actuator 256 in Figures 1A to 1E, except as otherwise disclosed herein. For example, the actuator 256 is coupled (e.g., attached) to a part of the control unit 232. The actuator 256 is configured to move relative to the rest of the handpiece 204 (e.g., relative to the catheter end 212) in response to user operation. The movement of the actuator 256 also moves at least a part of the control unit 232. For example, the movement of actuator 156 can move at least one of the following: at least a part of the control wire, at least a part of the driver, at least a part of the lever 238, and any other component of the control unit 232. The second movable part of the control unit 232 includes the actuator 256 and the parts of the control unit 232 that are moved by the movement of the actuator 256.

[0045] Actuator 256 can assume a first (i.e., initial) position relative to the rest of the handpiece 204, as shown in Figure 2A. By manipulating actuator 256, each user can move it to a second position, different from the first position, relative to the rest of the handpiece 204, as shown in Figure 2B. The second position may be further or closer to a portion of the handpiece 204 than the first position (e.g., further or closer to the catheter end 212). After moving actuator 256 to the second position, the user can further manipulate actuator 256 to return it to the first position or to one or more additional positions separate from the first and second positions.

[0046] When the actuator 256 is moved relative to the catheter end 212, at least a portion of the control unit 232 moves. In other words, moving the actuator 256 moves the second movable part of the control unit 232 relative to the handpiece 204. The second moving part of the control unit 232 can be in a first (i.e., initial) state when the actuator 256 is in the first position, and can be in a second state different from the first state when the actuator 256 is in the second position. The second moving part can also exhibit one or more additional states when the actuator 256 is in one or more additional positions, as discussed earlier.

[0047] In one embodiment, at least a portion of the actuator 256 is easily accessible to the user of the ureteroscope 202. At least a portion of the actuator 256 may be easily accessible if, for example, at least a portion of the actuator 256 is located on or extends from the outer surface of the handpiece 204. In one example, as shown in the figure, the actuator 256 may have a knob 258 located on the outer surface of the handpiece 204, and the knob 258 may be easily accessible. In another embodiment, the actuator 256 is not easily accessible. The actuator 256 may not be easily accessible if, for example, the actuator 256 is located within the handpiece 204 (e.g., at least a portion of the actuator 256 is mounted on, embedded in, or otherwise connected to a driver). When the actuator 256 is not easily accessible, it may be operated indirectly by the user.

[0048] As previously discussed, in one embodiment, the actuator 256 has a knob 258. This knob 258 can be directly attached to the second moving part and may have at least one additional element extending from the knob 258 to the control controller 232. The parts of the actuator 256 that are attached to the control controller 232 can be rotatably mounted on the control controller 232, thereby enabling the rotation of a driver (not shown). A slot 260 can be formed in the handpiece 204, thereby enabling the knob 258 to move laterally. By moving the knob 258 laterally along the slot 260, the actuator 256 can move at least a portion of the control controller 232. According to one embodiment, the actuator 256 may include any of the other actuators disclosed herein, such as a threaded attachment, a plunger that can be pulled outward from or pushed into a portion of the handpiece 204, a motor, a pneumatic press, a hydraulic press, or other actuators.

[0049] According to Figure 2A, the actuator 256 can be initially prepared in a first position. According to Figure 2B, the actuator 256 can be moved to a second position, which is away from the catheter end 212, in this embodiment. When the actuator 256 is moved to the second position, the second moving part of the control unit 232 transitions from the first state to the second state. By transitioning the second moving part to the second state, the tensile force applied to the control wire increases. A compressive force is applied to the catheter 206 from the control wire, increasing the rigidity of at least a portion of the catheter 206. By returning the actuator 256 to the first position, the second moving part of the control unit 232 can be reversed back to the first state, and consequently, the rigidity of at least a portion of the catheter 206 can be reduced.

[0050] It should be noted that the rigidity of at least a portion of the catheter can also be changed using other components of the ureteroscope disclosed herein. In one example, the ureteroscope disclosed herein may have one or more actuators configured to apply tensile force directly to the control wire by moving or without moving the control controller. In another example, the ureteroscope disclosed herein may have one or more actuators configured to apply compressive force to the catheter by applying tensile force to the wires extending from the photoelectric module 140 and / or light source 142 in Figure 1C. In another example, the ureteroscope disclosed herein may have a laser fiber and / or a laser fiber channel configured to receive the laser fiber, as disclosed in Patent Document 3, whose disclosure was previously incorporated into this application and filed on February 9, 2022. In such an example, one or more actuators can be configured to apply compressive force to the catheter by applying tensile force to the laser fiber and / or laser fiber channel.

[0051] A catheter shaft is often provided at least in the distal end region of a catheter. Providing a catheter shaft to the catheter allows for support of that region of the catheter and better control of the catheter's bending. According to one embodiment, the catheter disclosed may have a catheter shaft configured to facilitate changes in its rigidity. For example, Figure 3 is a side elevation view of a catheter shaft 370 according to one embodiment, which may be used in any of the catheters disclosed. This catheter shaft 370 has a plurality of links 372. These links 372 can be practically hollow (e.g., generally annular) so that a working channel, maneuvering wire, and other catheter components can be positioned to pass through them. By pivotally attaching the links 372 to adjacent links 372, the catheter shaft 370 can pivot as the catheter bends. For example, each link 372 may have a body 374. At least some of the links 372 also have attachment portions 376 extending from their bodies 374. These attachment portions 376 can be attached to adjacent bodies 374 in such a manner that they can move (e.g., pivot) relative to each other. In one example, as shown in the figure, the attachment portion 376 can be attached to the adjacent body 374 using a hinge 377. In another example, the attachment portion 376 is integrally formed with or firmly attached to the body 374 of the adjacent link 372. In such an example, the attachment portion 376 can be made elastic so that the adjacent bodies 374 pivot relative to each other as the attachment portion 376 deforms.

[0052] At least a portion of each adjacent link 372 is separated from each other by a gap 378. For example, the gap 378 can be located between adjacent bodies 374. The catheter shaft 370 can be configured to allow the size of the gap 378 between adjacent links 372 (i.e., the distance between adjacent links 372) to be changed. In one example, as shown in the figure, an elongated slot 380 is formed in the attachment portion 376, configured to allow the size of the gap 378 to be changed. Specifically, a hinge 377 is placed in the slot 380 and can be moved back and forth within the slot 380, thereby increasing or decreasing the size of the gap 378. In one example, the attachment portion 376 can be configured to deform to change the size of the gap 378.

[0053] The catheter shaft 370 can be made somewhat more rigid by changing the size of the gap 378. For example, the movement between links 372 can be restricted by the mutual contact of adjacent bodies 374. Increasing the size of the gap 378 increases the amount of movement between adjacent bodies 374 before they come into contact. In other words, increasing the size of the gap 378 increases the allowable movement between adjacent bodies 374, thus decreasing the rigidity (i.e., increasing the flexibility) of the catheter shaft 370. Conversely, decreasing the size of the gap 378 decreases the amount of movement between adjacent bodies 374 before they come into contact. In other words, decreasing the size of the gap 378 increases the allowable movement between adjacent bodies 374, thus increasing the rigidity (i.e., decreasing the flexibility) of the catheter shaft 370.

[0054] The size of the gap 378 may depend on whether or not a compressive force is applied to the catheter. For example, when a compressive force is applied to the catheter, the size of the gap 378 decreases, thus increasing the rigidity of the catheter shaft 370. When the rigidity of the catheter shaft 370 increases, the rigidity of the portion of the catheter that contains the catheter shaft 370 also increases. By reducing or eliminating the compressive force applied to the catheter, the size of the gap 378 can be increased, thereby lowering the rigidity of the catheter shaft 370 and the portion of the catheter that contains the catheter shaft 370.

[0055] The catheter shaft 370 can be configured such that the size of the gap 378 increases when the compressive force applied to the catheter decreases or disappears. In one example, the catheter shaft 370 may have a spring 382 (as schematically shown in Figure 3) connected to one or more of the links 372 (e.g., connected to the link 372 at the end of the catheter shaft 370). When the compressive force applied to the catheter decreases or disappears, the spring 382 can apply a biasing force to push the links 372 apart. In another example, the catheter shaft 370 is springless. In such an example, the size of the gap 378 increases without a spring due to the resilience (i.e., tendency to return to its original shape) of the catheter shaft 370 and / or the catheter to which the catheter shaft 370 is provided.

[0056] It should be noted that the ureteroscope disclosed herein can also be used in endoscopic examinations that do not involve the urinary tract (e.g., at least one of the urethra, bladder, ureters, and kidneys). For example, the ureteroscope can be used in endoscopic examinations involving the digestive tract, airway, ear, reproductive system, abdominal or pelvic cavity, inside a joint, thoracic organs, fetus, hand, or any other part of the body, in place of or in addition to the urinary tract.

[0057] While this application has disclosed various aspects and embodiments, other aspects and embodiments are also taken into consideration. The various aspects and embodiments disclosed herein are for illustrative purposes only and should not be considered as limitations.

[0058] Degree demonstratives (e.g., "almost," "substantially," "generally," etc.) indicate structurally or functionally insignificant variations. When a degree demonstrative is accompanied by a quantity demonstrative, the degree demonstrative is understood to mean ±10%, ±5%, or +2% of the quantity demonstrative. When a degree demonstrative is used to modify a shape, it indicates that the shape modified by the degree demonstrative has the appearance of the disclosed shape. For example, a degree demonstrative can be used to indicate that the shape may have rounded corners instead of sharp corners, curved edges instead of straight edges, one or more protrusions extending from them, be oval-shaped, or be the same as the disclosed shape.

Claims

1. It is an endoscope, catheter end, Control terminal, A work assembly configured to accommodate one or more devices, A control device configured to bend at least a portion of the catheter, and In a handpiece having movable parts, The movable part is configured to move relative to the catheter end of the handpiece, and the handpiece is configured The catheter extends from the catheter end of the handpiece, and has a proximal end region and a distal end region that is further away from the handpiece than the proximal end region. Equipped with, The movement of the movable part of the handpiece relative to the catheter end compresses the catheter, or compresses the catheter shaft provided in the distal end region of the catheter, thereby adjusting the rigidity of a part of the catheter. An endoscope in which at least one of the work assembly and the control unit includes the movable part.

2. The endoscope according to claim 1, An endoscope in which the rigidity of the distal end region of the catheter increases when at least a portion of the movable part moves away from the catheter end.

3. The endoscope according to claim 1, An endoscope having the aforementioned working assembly and the aforementioned movable part.

4. The endoscope according to claim 3, An endoscope in which the movable part has a threaded actuator screwed into the handpiece, and by rotating the threaded actuator, the distance from the threaded actuator to the catheter end of the handpiece increases or decreases.

5. The endoscope according to claim 1, An endoscope having the aforementioned control unit and the aforementioned movable part.

6. The endoscope according to claim 5, An endoscope in which the movable part has a knob extending from at least a portion of the control unit.

7. The endoscope according to claim 1, An endoscope wherein the catheter has a catheter shaft, the catheter shaft has a plurality of links, each of the plurality of links is pivotally attached to an adjacent link, at least a portion of the adjacent links is separated by a gap, and the movement of the movable part of the handpiece relative to the catheter end compresses the catheter shaft, thereby increasing the rigidity of a portion of the catheter.

8. The endoscope according to claim 7, An endoscope in which the plurality of links are configured such that when at least one part of the movable portion moves away from the catheter end, the gap between adjacent links becomes smaller.

9. The endoscope according to claim 7, An endoscope in which the catheter shaft has at least one spring attached to at least some of the plurality of links.

10. The endoscope according to claim 1, The aforementioned work assembly Work channel port and, The system includes a work channel connector connected to the work channel port, and either the work channel port or a conduit connecting the work channel connector to the work channel of the catheter, The movable part is connected to at least one of the work channel port, the work channel connector, and the conduit. An endoscope in which the movement of the movable part of the handpiece relative to the catheter end moves at least a portion of at least one of the working channel port, the working channel connector, and the conduit, thereby compressing the catheter or compressing the catheter shaft, and thereby changing the rigidity of the portion of the catheter.

11. The endoscope according to claim 3, An endoscope in which a channel is formed in the movable part, configured to receive one or more instruments.

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