Medical devices and related methods

Abstract

The medical device includes a handle including an axis, a device shaft extending from the handle to a distal end, and a control device. The control device is coupled to the handle, the control device including a knob. The knob is rotatable relative to the handle. The control device also includes a control shaft extending from the knob, at least one spring clutch including two legs, and a spool. The spool is rotatable relative to the axis. The control device also includes one or more wires coupled to the spool. Rotation of the knob is configured to rotate the control shaft, loosening the at least one spring clutch, rotating the spool, and moving the one or more wires.

Description

Technical Field

[0001] Various aspects of the present disclosure generally relate to medical devices and methods for accessing, visualizing, manipulating, or otherwise treating tissues or other substances within the body. In particular, aspects of the present disclosure relate to medical devices and methods for controlling locking and unlocking of deflection or other movement of a portion of a delivery shaft of a medical device.

Background Art

[0002] In certain medical procedures, a physician, technician, or other user needs to control an endoscope (or other endoscope or medical device) within the duodenum and other medical accessory devices. Depending on the position of the patient relative to the position of the user, the user controlling the device may need to twist and / or turn their wrist and / or body so that the medical device is adjusted and positioned to face the intended target site. As a result, the user may be at increased risk of ergonomic injury to their hands, wrists, and back. Further, the distal end of a medical device may be deflectable in one or more directions. The deflection may be locked, for example, via a proximal lock element, but smaller or more controlled movement may require the lock element to be disengaged and then re-engaged. Alternatively, the user may attempt to deflect or otherwise manipulate the medical device with the lock element engaged. These movements can further increase the risk to the user of suffering ergonomic injury. These concerns can increase the duration, cost, and risk of the medical procedure. The devices and methods of the present disclosure may correct some of the deficiencies described above or address other aspects of the art.

Summary of the Invention

[0003] Embodiments of the present disclosure relate particularly to devices and methods for controlling locking and unlocking of deflection or other movement of a portion of a shaft. Each of the examples disclosed herein may include one or more of the features described in relation to any of the other disclosed examples.

[0004] In one embodiment, the medical device may include a handle including an axis, a device shaft extending distally from the handle, and a control device. The control device may be connected to the handle, and the control device may include a knob. The knob may be rotatable relative to the handle. The control device may also include a control shaft extending from the knob, at least one spring clutch including two legs, and a spool. The spool may be rotatable relative to the axis. The control device may also include one or more wires connected to the spool. Rotation of the knob may be configured to rotate the control shaft, release at least one spring clutch, rotate the spool, and move one or more wires.

[0005] The medical device may include one or more of the following features: The shaft may include a radially extending portion, and the shaft may include a first projection and a second projection extending from the radially extending portion. The spool may define a first gap and a second gap, and the first projection and the second projection may be configured to be located within the first gap and the second gap. At least one spring clutch may include a first spring clutch and a second spring clutch, each of which may include a first leg and a second leg. The first spring clutch may be released by rotating the knob in a first direction, bringing the first projection into contact with the first leg of the first spring clutch, and the second spring clutch may be released by rotating the knob in a first direction, bringing the second projection into contact with the first leg of the second spring clutch. Further rotation of the knob in the first direction may cause (1) the first leg of the first spring clutch to contact the first stop surface of the spool adjacent to the first gap, (2) the first leg of the second spring clutch to contact the second stop surface of the spool adjacent to the second gap, and (3) the spool to rotate in the first direction. Rotation of the knob in the second direction may cause the first projection to contact the second leg of the second spring clutch, thereby loosening the second spring clutch, or rotation of the knob in the second direction may cause the second projection to contact the second leg of the first spring clutch, thereby loosening the first spring clutch. Further rotation of the knob in the second direction may cause (1) the second leg of the second spring clutch to contact the third stop surface of the spool adjacent to the second gap, (2) the second leg of the first spring clutch to contact the fourth stop surface of the spool adjacent to the second gap, and (3) the spool to rotate in the second direction.

[0006] At least one spring clutch may include at least one spring formed of a coil having two radially outward-extending legs. At least one spring clutch may include at least one spring having a ring-shaped form including a partially cylindrical portion and an interacting portion. The interacting portion may include a first end and a second end. The first end may include a first radially outward-extending leg, and the second end may include two radially outward-extending legs. The spring clutch may include at least one spring having a partially ring-shaped form including a partially cylindrical portion and an open portion. The partially cylindrical portion may include two radially outward-extending legs on both sides of the open portion. The spring clutch may include at least one spring formed of a coil having two radially inward-extending legs.

[0007] The control device may be a first control device. The medical device may further include a second control device coaxial with the first control device. The second control device may include a second knob, the second knob may be rotatable relative to a handle. The second control device may also include a second control shaft extending from the second knob, at least one second spring clutch including two legs, and a second spool. The second spool may be rotatable relative to an axis. The second control device may further include one or more second wires connected to the second spool. Rotation of the second knob may be configured to rotate the second control shaft, release at least one second spring clutch, rotate the second spool, and move one or more second wires. A portion of the control shaft of the first control device may be nested within the second control shaft of the second control device. The medical device may further include a hollow shaft separating a portion of the control shaft from the second control shaft. The hollow shaft may be connected to the handle, and the hollow shaft may include a radially extending portion that separates the spool of the first control device from the second spool of the second control device. The distal end of the delivery shaft may be deflectable via the control device. The handle may include at least one port configured to receive a medical device. The port may be connected to a lumen extending through the handle and the delivery shaft. The control device may be configured to control an elevator located adjacent to the lumen at the distal end of the delivery shaft. The control device may be located on the proximal portion of the handle, and the medical device does not have to include a brake outside the body of the handle to lock the knob position.

[0008] In another embodiment, the medical device may include a handle including an axis. The medical device may also include a device shaft extending distal to the handle and a control device. The control device may be connected to the handle and may include a first knob. The first knob may be rotatable relative to the handle. The control device may also include a first control shaft extending from the first knob, at least one first spring clutch including two legs, a first spool which may be rotatable relative to the axis, and one or more first wires connected to the first spool. The control device may also include a second knob. The second knob may be rotatable relative to the handle. The control device may include a second control shaft extending from the second knob, at least one second spring clutch including two legs, a second spool which may be rotatable relative to the axis, and one or more second wires connected to the second spool. The rotation of the first knob may be configured to rotate the first control shaft, release at least one first spring clutch, rotate the first spool, move one or more first wires, and deflect the distal end of the delivery shaft in a first plane. The rotation of the second knob may be configured to rotate the second control shaft, release at least one second spring clutch, rotate the second spool, move one or more second wires, and deflect the distal end of the delivery shaft in a second plane different from the first plane.

[0009] The medical device may include one or more of the following features: The first shaft may include at least one first projection, and the second shaft may include at least one second projection. The first spool may define at least one first gap, and the second spool may define at least one second gap. At least one first projection may be located within at least one first gap, and at least one second projection may be located within at least one second gap. Multiple legs of at least one first spring clutch may be located between at least one first projection and multiple edges of at least one first gap. Multiple legs of at least one second spring clutch may be located between at least one second projection and multiple edges of at least one second gap. The first plane and the second plane may be perpendicular.

[0010] In yet another embodiment, the medical device handle may include a shaft and a control device. The shaft may be fixed to the handle. The control device may include a first knob which may be rotatable relative to the handle, a first control shaft extending from the first knob, at least one first spring clutch including two legs, a first spool which may be rotatable relative to the shaft, and one or more first wires connected to the first spool. The control device may also include a second knob which may be rotatable relative to the handle, a second control shaft extending from the second knob, at least one second spring clutch including two legs, a second spool which may be rotatable relative to the shaft, and one or more second wires connected to the second spool. Rotation of the first knob may be configured to rotate the first control shaft, release at least one first spring clutch, rotate the first spool, and move one or more first wires. The rotation of the second knob may be configured to rotate the second control shaft, release at least one second spring clutch, rotate the second spool, and move one or more second wires.

[0011] A medical device handle may include one or more of the following features: A portion of the first control shaft may be nested within the second control shaft. The medical device handle may further include a hollow shaft that separates a portion of the first control shaft from the second control shaft. The hollow shaft may be connected to the handle and may include a radially extending portion that separates the first spool from the second spool.

[0012] Please understand that both the general description above and the detailed description below are illustrative and explanatory only and do not limit the claimed disclosure. [Brief explanation of the drawing]

[0013] The accompanying drawings incorporated herein and constituting part of herein illustrate exemplary embodiments of this disclosure and serve to illustrate the principles of this disclosure together with the description. [Figure 1A] Different diagrams of exemplary medical devices according to aspects of this disclosure are shown. [Figure 1B] Different diagrams of exemplary medical devices according to aspects of this disclosure are shown. [Figure 1C] Different diagrams of exemplary medical devices according to aspects of this disclosure are shown. [Figure 2A] Figures 1A to 1C show different diagrams of the control devices for the medical devices according to the aspects of this disclosure. [Figure 2B] Figures 1A to 1C show different diagrams of the control devices for the medical devices according to the aspects of this disclosure. [Figure 2C] Figures 1A to 1C show different diagrams of the control devices for the medical devices according to the aspects of this disclosure. [Figure 3] An exploded view of a control device according to an aspect of this disclosure is shown. [Figure 4A] Figures 1A-1C, 2A-2C, and 3 illustrate different exemplary spring clutches that may be incorporated into the control device according to aspects of this disclosure. [Figure 4B]Figures 1A-1C, 2A-2C, and 3 illustrate different exemplary spring clutches that may be incorporated into the control device according to aspects of this disclosure. [Figure 4C] Figures 1A-1C, 2A-2C, and 3 illustrate different exemplary spring clutches that may be incorporated into the control device according to aspects of this disclosure. [Figure 4D] Figures 1A-1C, 2A-2C, and 3 illustrate different exemplary spring clutches that may be incorporated into the control device according to aspects of this disclosure. [Figure 5A] Different diagrams of other exemplary medical devices according to aspects of this disclosure are shown. [Figure 5B] Different diagrams of other exemplary medical devices according to aspects of this disclosure are shown. [Figure 5C] Different diagrams of other exemplary medical devices according to aspects of this disclosure are shown. [Figure 6A] A different diagram of another control device according to an aspect of this disclosure is shown. [Figure 6B] A different diagram of another control device according to an aspect of this disclosure is shown. [Figure 7] An exploded view of another control device according to an aspect of this disclosure is shown. [Modes for carrying out the invention]

[0014] As used herein, the terms "proximal" and "distal" are used to indicate the relative positions of components of an exemplary medical system and an exemplary medical device. As used herein, "proximal" indicates a position that is relatively close to the exterior of the body, or close to a medical professional using the medical system or medical device. In contrast, "distal" indicates a position that is relatively far from a medical professional using the medical system or medical device, or closer to the interior of the body. As used herein, the terms "comprises," "comprising," "having," "including," or other variations thereof are intended to cover non-exclusive inclusion, such that a system, device, or method that comprises a list of elements does not include only those elements but may include other elements not expressly listed or inherent to them. Unless otherwise specified, the term "exemplary" is used in the sense of "example" rather than "ideal." As used herein, the terms "about," "substantially," and "approximately" indicate a range of values within + / - 10% of the stated value.

[0015] Examples of the present disclosure include devices and methods for promoting and / or improving the effectiveness, efficiency, and / or safety of medical procedures. Embodiments of the present disclosure may relate to devices and methods for performing various medical procedures and / or treatment portions of the large intestine (colon), small intestine, cecum, esophagus, stomach, any other part of the gastrointestinal tract, the kidneys or other parts of the urinary tract, the heart, the lungs, and / or any other suitable patient anatomical structure. The various embodiments described herein include single-use or disposable medical devices. Some aspects of the present disclosure may be used in endoscopes, arthroscopes, bronchoscopes, ureteroscopes, colonoscopes, or other types of procedures. For example, the disclosed aspects may be used with duodenoscopes, bronchoscopes, ureteroscopes, colonoscopes, catheters, diagnostic or therapeutic tools or devices, or other types of medical devices. One or more of the elements discussed herein may be metal, plastic, or may include any combination of shape memory metals (e.g., nitinol), shape memory polymers, polymers, or biocompatible materials.

[0016] Here, reference is made in detail to the examples of the present disclosure described above and shown in the accompanying drawings. Throughout the drawings, the same reference numbers are used to indicate the same or similar parts as much as possible. It should be noted that one or more aspects of the medical devices discussed herein may be combined with and / or used with one or more aspects of other medical devices discussed herein.

[0017] Figures 1A - 1C show different views of an exemplary medical device 10. Figure 1A is a front view of the medical device 10, Figure 1B is a perspective view of the medical device 10, and Figure 1C is a side view of the proximal portion of the medical device 10. The medical device 10 includes a handle 12 that includes a handle body and a device shaft or delivery shaft 14 that extends from the handle 12 to a distal end 16. The medical device 10 may be a duodenoscope, an endoscope, a colonoscope, a ureteroscope, a bronchoscope, etc., or any other similar medical device having a handle and a shaft. Additionally, the medical device 10 includes a control device 30. The control device 30 is movable (e.g., rotatable) relative to the handle 12 and can control the movement of a portion (e.g., the distal end 16) of the delivery shaft 14.

[0018] The handle 12 may include, for example, one or more openings 18A and 18B on the proximal portion of the handle 12. One or more of the openings 18A and 18B may be connectable to or may receive one or more valves to control, for example, the delivery of air or water or the application of suction through the handle 12 and the delivery shaft 14.

[0019] In addition, the handle 12 may have one or more lumens (not shown) that extend, for example, to the distal end 16 and communicate with one or more lumens of the delivery shaft 14. In this embodiment, the handle 12 may include at least one port 20 in, for example, an intermediate portion of the handle 12 (e.g., between the proximal and distal portions). The port 20 may open into one or more working channels or lumens within the handle 12. The port 20 may receive one or more tools or end effectors, which can be delivered, for example, outside the distal end 16 through the handle 12 and the delivery shaft 14. In this embodiment, the port 20 may be sized and / or shaped to receive one or more medical devices (e.g., forceps, grippers, scissors, clips, staplers, needles, knives, electrodes, cauterization loops, etc.) and deliver one or more medical devices to an area close to the distal end 16 of the delivery shaft 14. In addition, the port 20 may be configured to help form a seal around the proximal portion of the medical device, for example, by including a valve, threads for screwing onto a cap, etc.

[0020] The handle 12 may be connected to a conduit 22. The conduit 22 may connect the handle 12 to an external power supply, processing software, one or more displays, one or more memory or storage devices, etc. In this embodiment, the medical device 10 may include one or more illumination devices and / or cameras at the distal end 16, which can be powered and / or connected to processing software, one or more displays, memory, etc. via one or more communication wires (not shown) within the medical device 10 and via the conduit 22. Furthermore, the conduit 22 may connect the handle 12 to one or more fluid sources (e.g., an air source, a water source, etc.). The conduit 22 may also connect the handle 12 to a suction source. In these embodiments, one or more valves connected to or received in the openings 18A and 18B may control the application of air or water delivery and / or suction through the medical device 10 to an area adjacent to the distal end 16 of the delivery shaft 14.

[0021] The control device 30 is connected to the handle 12, for example, at the proximal portion of the handle 12. As described above, the control device 30 is movable (e.g., rotatable) relative to the handle 12 and can control the movement (e.g., deflection) of the distal end 16 of the delivery shaft 14. Alternatively, the control device 30 may actuate or move an elevator within the delivery shaft 14, or otherwise actuate the cable drive function of the medical device 10.

[0022] The control device 30 may include a dial, wheel, lever, knob 32, or other rotational control element, which may be rotatable to deflect the distal end 16 of the delivery shaft 14 in a first or second direction. As shown in Figure 1C, the knob 32 may extend away from the handle 12 (for example, perpendicularly in a side view of the handle 12). Furthermore, as will be discussed in detail below, the control device 30 may include one or more clutch devices to help lock and / or unlock the position of the knob 32, and thereby lock and / or unlock the position of the distal end 16 of the delivery shaft 14 or other features of the delivery shaft 14.

[0023] Furthermore, the distal end 16 of the delivery shaft 14 may include at least one distal opening 24 through which, for example, a medical device may extend, fluid may be delivered, suction may be applied, or the medical device 10 may treat the treatment site. Not shown, the distal end 16 may include one or more instruments for illumination (e.g., LEDs) and imaging (e.g., cameras), an elevator for directing instruments or medical devices exiting the distal opening 24, and / or openings for irrigation and / or suction. Furthermore, the medical device 10 may include one or more additional components (e.g., a processor, memory, etc.) for controlling various functions in the distal end 16 and / or other parts of the medical device 10.

[0024] Figures 2A to 2C show various views of the control device 30. Figure 2A is a front view of the control device 30. Figure 2B is a cross-sectional view of the control device 30 along section 2B-2B of Figure 2A, for example. Figure 2C is a rear view of the control device 30 as seen from, for example, an internal position (not shown) of the handle 12 when the control device 30 is connected to the handle 12. As described above, the control device 30 includes a knob 32. The knob 32 may include, for example, one or more projections 34 extending radially away from the rotation center 38 of the knob 32, and one or more recesses 36 extending radially toward the rotation center 38 of the knob 32. The projections 34 and recesses 36 may help the user grip and / or rotate the knob 32. In addition, the knob 32 may include one or more indicators, for example, a right-bias indicator 40A and a left-bias indicator 40B. In this embodiment, the distal end 16 of the delivery shaft 14 can be deflected to the right by rotating the knob 32 in the direction of the rightward deflection indicator 40A (for example, clockwise), and the distal end 16 of the delivery shaft 14 can be deflected to the left by rotating the knob 32 in the direction of the leftward deflection indicator 40B (for example, counterclockwise). Alternatively, in other embodiments, the elevator may be raised by rotating the knob 32 in one direction, and the elevator may be lowered by rotating the knob 32 in the other direction.

[0025] As shown in Figures 2A-2C, the control device 30 includes one or more indicator or control elements (e.g., linkages, chains, belts, wires, etc.), such as a first control wire 42A and a second control wire 42B. In at least one embodiment, the first control wire 42A and the second control wire 42B may extend from the knob 32 through the handle 12 and the delivery shaft 14 to the distal portion of the delivery shaft 14 (e.g., the distal end 16). In another embodiment, the first control wire 42A and the second control wire 42B may extend via the handle 12 and be connected to one or more deflection wires or other control elements in the delivery shaft 14. In any of these embodiments, rotation of the knob 32 controls the movement of the control wires 42A and 42B, and consequently, rotation of the knob 32 may control the deflection of the distal end 16 of the delivery shaft 14, the operation of the elevator, or otherwise activate the cable drive function of the medical device 10.

[0026] As shown in Figure 2B, the control device 30 includes a control shaft 44. The shaft 44 may be formed integrally with the knob 32, or it may be fixedly connected to the knob 32. The shaft 44 may extend into the proximal portion of the handle 12. The proximal portions of the first control wire 42A and the second control wire 42B may be indirectly connected to the shaft 44, for example, by being tightly wound around and fixed to an element that can be rotatably connected to the shaft 44 (e.g., a spool 50, Figures 2B, 2C, and 3). For example, as shown in Figures 2C and 3, the spool 50 has a connecting portion 51 (which may include, for example, a slot, gap, opening, etc.) that receives one or more proximal portions of the first control wire 42A and the second control wire 42B in order to secure the control wire(s) to the spool 50. Note that since wire 42B is outside the cross section 2B-2B (Figure 1), wire 42B is not shown in Figure 2B. Nevertheless, both control wires 42A and 42B can be connected to the spool 50 so that the rotation of the spool 50 can control the movement of both control wires 42A and 42B. In this embodiment, the shaft 44 is rotated by rotating the knob 32, which rotates the spool 50, and then the spool Rotation of the spool 50 may pull one of the first control wires 42A and the second control wire 42B proximally, deflecting the distal portion of the delivery shaft 14 in a certain direction. Alternatively, the shaft 44 may be rotated by rotating the knob 32, which then pulls one of the first control wires 42A and the second control wire 42B proximally via the spool 50 to operate or move the elevator in the delivery shaft 14, or otherwise activate the cable drive function of the medical device 10. Furthermore, although not shown, the control device 30 may include one or more gears, sprockets, pulleys, cranks, etc. The control device 30 may also include one or more racks, chains, belts, linkages, etc.

[0027] Furthermore, as shown in Figures 2B and 2C, the control device 30 includes at least one biasing device, for example, at least one spring clutch 46. The spring clutch 46 may be at least partially circular and surround a rod or shaft 48. The shaft 48 may be fixed to the handle 12. In addition, as shown in Figure 2C, the spring clutch 46 may be positioned around the shaft 48, for example, between the shaft 48 and the spool 50. When no force is acting on the control device 30, the spring clutch 46 is firmly positioned or pressed around the shaft 48, helping to fix the spool 50, and consequently the first control wire 42A and the second control wire 42B, to the shaft 48, and consequently to the handle 12 and the delivery shaft 14. In one or more embodiments, the spring clutch 46 may help to lock, hold, or otherwise restrain the movement of the shaft 48, and consequently the first control wire 42A and the second control wire 42B, for example, via a frictional connection between the spring clutch 46 and the shaft 48.

[0028] The spring clutch 46 may include one or more legs 52. By rotating the knob 32 and the shaft 44, interaction with one or more legs 52 of the spring clutch 46 may occur. For example, by rotating the knob 32 and the shaft 44, a portion of the shaft 44 can be brought into contact with one or more legs 52, and by pushing one or more legs 52 in one direction, the spring clutch 46 can be released, extended, or loosened. By loosening the spring clutch 46, frictional connection between the spool 50 and the shaft 48 can be reduced. Furthermore, rotating the knob 32 and the shaft 44 can also bring a portion of the shaft 44 or a portion of one or more legs 52 into contact with a portion of the spool 50, thereby allowing the spool 50 to rotate. By rotating the spool 50, one or more of the control wires 42A and 42B can be retracted proximally to control a portion of the delivery shaft 14, for example, to deflect the distal end 16.

[0029] As described in detail below, when no force is applied to the knob 32, the spring clutch 46 contracts, helping to fix the spool 50 relative to the shaft 48. When the spool 50 is rotated, the spring clutch 46 is in a relaxed position, so the spring clutch 46 does not provide a spring-back force that biases the spool 50 back to its original position before rotation. Thus, the spring clutch 46 helps to lock the spool 50 in the rotated position. In this embodiment, the spring clutch 46 helps to fix the spool 50, and by extension the first control wire 42A and the second control wire 42B, in a position selected by the user acting on the knob 32. For example, fixing the spool 50 in a selected position may help to fix the distal end 16 in a deflected or articulated position. In this embodiment, fixing the spool 50 in a selected position can help lock or otherwise hold the distal end 16 in a selected configuration (e.g., an operated position) relative to, for example, the other part of the delivery shaft 14 and / or the treatment site. As will be described later, when the first control wire 42A or the second control wire 42B is pulled distally (e.g., by an inherent force resulting from the bending or deflection of a portion of the delivery shaft 14, or by a portion of the delivery shaft 14 coming into contact with tissue or other material), the first control wire 42A or the second control wire 42B can thus apply force(s) to the spool 50. The force(s) may cause the spool 50 to interact with one or more legs 52 of the spring clutch 46, or to tighten the spring clutch 46, thereby helping to securely fix the spool 50 by the shaft 48 and prevent relative rotation.

[0030] Figure 3 is an exploded view of a control device 30, which includes a knob 32, a shaft 44, at least one spring clutch (i.e., two spring clutches 46A and 46B), a shaft 48, and a spool 50. Although not shown, control wires 42A and 42B may be coupled to the spool 50. In this embodiment, the spool 50 can be rotated by rotating the knob 32 and the shaft 44, which can control the movement of the control wires 42A and 42B (Figures 2A-2C) to deflect or otherwise control the distal portion of the delivery shaft (not shown).

[0031] As shown, a portion of the shaft 44 inside the handle 12 includes at least one projection. As shown in Figure 3, the shaft 44 may include two projections 54A and 54B, for example, each projection 54A, 54B being on both sides of the shaft 44, for example, on both sides with respect to the longitudinal axis of the shaft 44. The shaft 44 may also include a radially extending portion 56 that extends radially outward from, for example, a longitudinal portion of the shaft 44 (for example, the end of the shaft 44 opposite the knob 32). In this embodiment, the projections 54A, 54B can extend longitudinally from the radially extending portion 56. Furthermore, the spring clutches 46A and 46B are each formed by a wire coil having openings 58A and 58B, and each spring clutch 46A and 46B includes two legs 52A and 52B, and 52C and 52D, which project radially away from at least partially cylindrical spring clutches 46A and 46B, respectively. In this embodiment, the spring clutch 46A includes the two legs 52A and 52B, and the spring clutch 46B includes the two legs 52C and 52D.

[0032] The spool 50 may include a substantially cylindrical outer portion 58. Furthermore, the spool 50 may include, for example, a substantially cylindrical inner opening 60 for receiving the shaft 48, and the inner opening 60 may include two enlarged portions or gaps 62A and 62B. For example, gap 62A may include a first stop surface 64A and a second stop surface 64B on the opposing ends of gap 62A. In this embodiment, as the knob 32 and shaft 44 rotate, as discussed below, the protrusions 54A, 54B can interact with the legs 52A-52D and gaps 62A, 62B. Furthermore, although not shown, the control device 30 may include additional spring clutches to correct, for example, the frictional force generated between one or more spools 50 and the shaft 48. Furthermore, the control device 30 may include additional protrusions from the shaft 44, gaps within the spool 50, etc., to accommodate and operate the legs of the additional spring clutches.

[0033] Referring to Figures 2B, 2C, and 3, when the control device 30 is assembled, the shaft 48 is fixedly connected to a portion of the handle 12. The spring clutches 46A and 46B and the spool 50 may be positioned around a portion of the shaft 48. For example, the shaft 48 may include an enlarged portion 66. The openings 58A and 58B of the spring clutches 46A and 46B may be positioned on the enlarged portion 66, and may be spaced laterally apart along the enlarged portion 66, for example. When the spring clutches 46A and 46B are positioned on the enlarged portion 66, they may be positioned tightly around the enlarged portion 66. For example, the spring clutches 46A and 46B may be loosened in order to be positioned around the enlarged portion 66 (for example, by pinching or moving one or more of the legs 52A to 52D of each spring clutch 46A and 46B toward each other). The spool 50 may be positioned on top of the spring clutches 46A and 46B, or around the enlarged portion 66 of the shaft 48.

[0034] Next, the shaft 44 can be positioned on the axis 48. For example, as shown in Figure 2B, the shaft 44 includes an inner lumen that receives the axis 48. The axis 48 may include a connecting portion 68, and the knob 32 may include an opening 70 that connects to the lumen in the shaft 44, for example. In this embodiment, the axis 48 can be connected to the knob 32 using a connecting element (e.g., a screw, bolt, etc.) that allows relative rotation between them.

[0035] When the shaft 44 is positioned on the axis 48, the radially extending portion 56 may abut against or be adjacent to the enlarged portion 66 of the axis 48. Furthermore, the protrusions 54A and 54B may be positioned within the gaps 62A and 62B between the pairs of legs 52A to 52D of the spring clutches 46A and 46B. For example, the protrusion 54A may be positioned between the leg 52B of the spring clutch 46A and the leg 52D of the spring clutch 46B, and within the gap 62A. In addition, the protrusion 54B may be positioned between the leg 54A of the spring clutch 46A and the leg 52C of the spring clutch 46B, and within the gap 62B.

[0036] Once the control device 30 is assembled, the knob 32 and, by extension, the shaft 44 can be rotated in a first direction, for example, clockwise, to bring the projection 54A into contact with the leg 52B of the spring clutch 46A and push the leg 52B clockwise. This contact may also rotate the entire spring clutch 46A, for example, to bring the leg 52B of the spring clutch 46A into contact with the stop surface 64B of the gap 62A. Further rotation of the knob 32 may loosen the spring clutch 46A so that the spool 50 is fixed non-rotatably with respect to the shaft 48 by the spring clutch 46A. In addition, rotating the knob 32 and the shaft 44 in the first direction may also bring the projection 54B into contact with the leg 52C of the spring clutch 46B and push the leg 52C clockwise. This contact may also rotate the entire spring clutch 46B, for example, by bringing the legs 52C of the spring clutch 46B into contact with the stop surface of the gap 62B. Further rotation of the knob 32 may loosen the spring clutch 46B so that the spool 50 is fixed non-rotatably to the shaft 48 by the spring clutch 46B.

[0037] Conversely, rotating the knob 32, and by extension the shaft 44, in a second direction, for example counterclockwise, can bring the projection 54A into contact with the leg 52D of the spring clutch 46B and push the leg 52D counterclockwise. This contact may also rotate the entire spring clutch 46B, for example, bringing the leg 52D of the spring clutch 46D into contact with the stop surface 64A of the gap 62A. Further rotation of the knob 32 may loosen the spring clutch 46B so that the spool 50 is fixed non-rotatably relative to the shaft 48 by the spring clutch 46B. In addition, rotating the knob 32 and the shaft 44 in a second direction can also bring the projection 54B into contact with the leg 52A of the spring clutch 46A and push the leg 52A counterclockwise. This contact may also rotate the entire spring clutch 46A, for example, by bringing the legs 52A of the spring clutch 46A into contact with the stop surface of the gap 62B. Further rotation of the knob 32 may loosen the spring clutch 46A so that the spool 50 is fixed non-rotatably to the shaft 48 by the spring clutch 46A.

[0038] When both spring clutches 46A and 46B are loosened, the rotation of the knob 32 and shaft 44 can rotate the spool 50, thereby controlling the movement of at least one of the first control wire 42A and / or the second control wire 42B (Figures 2A-2C). Furthermore, as described above, an external force, such as a force applied to the spool 50 by a control wire, can cause the spool 50 to rotate and come into contact with one or more of the clutch springs 46A and 46B in such a way that it tightens one or more of the clutch springs 46A and 46B. For example, if a force from one of the control wires acts on the spool 50 and rotates it clockwise, the stop surface 64A can come into contact with the leg portion 52D and push the leg portion 52D clockwise, thereby tightening the spring clutch 48B. Similarly, a clockwise force acting on the spool 50 can also bring the stopping surface of the gap 62B into contact with the leg 52A, pushing the leg 52A clockwise, thereby tightening the spring clutch 48A. Thus, the control device 30 can also help hold a portion of the delivery shaft 14 in the operated position.

[0039] Figures 4A to 4D show various spring clutches that may be incorporated into a control device 30, for example, that selectively rotatably connect and disconnect the spool 50 to and from the shaft 48 based on the rotation of a knob 32 and a shaft 44. As shown in Figure 4A, the spring clutch 146 includes a winding coil 168. Furthermore, as described above, the spring clutch 146 includes two legs 152A and 152B that extend radially away from the coil 168. The legs 152A and 152B may be coupled to the coil 168 by bends 170A and 170B. As shown, the coil 168 may include about three wire loops. However, although not shown, the coil 168 may include fewer or more wire loops, which may affect the amount of force required to compress the spring clutch 146 and also affect the retaining force applied by the spring clutch 146 to hold the spool relative to the shaft. As described above, the protrusions from the shaft may interact with the legs 152A and 152B to loosen the spring clutch 146.

[0040] Figure 4B shows another exemplary spring clutch 246. As shown, the spring clutch 246 may include, for example, a ring-shaped form including at least partially cylindrical portion 272A and an interacting portion 272B. The interacting portion 272B includes a first end 274A and a second end 274B, which at least partially overlap along, for example, a portion of the circumference of the spring clutch 246. The first end 274A may include a leg portion 252A extending radially outward. The second end 274B may include two legs 252C and 252D, which are spaced apart to form an opening that movably receives the first end 274A. Thus, the first end 274A and the second end 274B are movable relative to each other. For example, there may be a gap 276A between the leg portion 252A and one end of the cylindrical portion 272A. Furthermore, there may be gaps 276B and 276C between the legs 252B and 252C and the other end of the cylindrical portion 272A. In this embodiment, the leg 252A can move within the gap 276A. Furthermore, the legs 252B and 252C can move within the gaps 276B and 276C. As described above, the projection from the shaft may interact with one or more of the legs 252A, 252B, or 252C to release the spring clutch 246. The spring clutch 246 may be formed of sheet metal. Alternatively, the spring clutch 246 may be formed of a plastic material, for example, by an injection molding process.

[0041] Figure 4C shows yet another exemplary spring clutch 346. As shown, the spring clutch 346 may include, for example, a partially ring-shaped form including at least a partially cylindrical portion 372A and an open portion 372B. The open portion 372B may extend between a first leg 352A and a second leg 352B. As described above, the projection from the shaft may interact with one or more of the legs 352A or 352B to loosen the spring clutch 346. Similar to the spring clutch 246, the spring clutch 346 may be formed from sheet metal, or instead, the spring clutch 346 may be formed from a plastic material, for example, via an injection molding process.

[0042] Figure 4D shows a further exemplary spring clutch 446. As shown, the spring 446 may also be formed from a wound coil 468. The spring clutch 446 also includes two legs 452A and 452B extending radially inward from the coil 468. The legs 452A and 452B may be coupled to the coil 468 by bends 470A and 470B. In this embodiment, although not shown, the spring 446 may be used for a control device including an outer cylinder (similar to a shaft 48) fixed to the housing of a handle and a spool positioned within an opening in the outer cylinder. Rotation of the knob and shaft can interact with the legs 452A and 452B to selectively release the spring 346 and rotate the inner spool. Furthermore, one or more of the spring clutches 46, 46A, 46B, 146, 246, and 346 may be modified to include their respective radially inwardly extending legs.

[0043] In these embodiments, one or more of the spring clutches 46, 46A, 46B, 146, 246, 346, and 446 can be incorporated into the control device 30. For example, when selecting one or more spring clutches for the control device 30, the desired spring compression force, manufacturing cost, and other factors can be considered. In addition, the compression force of the control device 30 may be changed by adding or removing one or more spring clutches to the assembly connecting the spool 50 to the shaft 48 (or by modifying one or more spring clutches, for example, by adding a coil loop). Furthermore, the compression force of the control device 30 can be changed by changing the diameter of the shaft 48 located within the spring clutch(s). The compression force of the control device 30 can also be changed by changing the material and / or frictional properties of the control device 30. For example, the shaft 48 may be formed of a Teflon® coated shaft. Alternatively or in addition, the spring clutch may be formed of a Teflon® coated wire or a Teflon®-containing plastic. Furthermore, in one or more embodiments, one or more friction-reducing agents (e.g., grease) may be applied to one or more surfaces within the control device 30.

[0044] Furthermore, as will be discussed below, three or more control devices 30 may be used together, for example, with nesting knobs and hollow tubes or shafts. Furthermore, although two control wires 42A and 42B are shown connected to each spool 50, the disclosure is not limited thereto. For example, one control wire may be connected to each spool 50, or three or more control wires may be connected to each spool 50 to provide additional proximal retraction force to, for example, one or more portions of the delivery shaft 14. Furthermore, although two spring clutches 46 connecting each spool 50 to the shaft 48 are shown, the disclosure is not limited thereto. For example, to control the frictional force selectively connecting the spool 50 to the shaft 48, one spring clutch 46 may be used with each spool 50, or three or more spring clutches 46 may be used with each spool 50. The size, material, stiffness, elasticity, etc. of the spring clutches 46, along with the number of spring clutches 46, may be modified as desired to control the frictional connection between the spool 50 and the shaft 48.

[0045] Figures 5A–5C show different diagrams of an alternative exemplary medical device 510 as provided in this disclosure. Figures 5A–5C show elements similar to those of medical device 10, which is referred to by reference numeral 500. Figure 5A is a front view of medical device 510, and Figure 5B is a perspective view of medical device 510. Figure 5C is a side view of the proximal portion of medical device 510. Medical device 510 includes a handle 512 including a handle body, and a delivery shaft 514 extending from the handle 512 to a distal end (not shown). In addition, medical device 510 includes a control device 530.

[0046] The control device 530 includes a first knob 532 and a second knob 580. The second knob 580 may be positioned between the first knob 532 and the handle 512. In this embodiment, the first knob 532 may be rotatable relative to the handle 512 to actuate or control the distal portion of the delivery shaft 514 in the first embodiment, and the second knob 580 may be rotatable relative to the handle 512 to actuate or control the distal portion of the delivery shaft 514 in the second embodiment. The first knob 532, the second knob 580, and their respective couplings may be substantially coaxial. In one embodiment, the first knob 532 can control a first elevator in the delivery shaft 514, and the second knob 580 can control a second elevator in the delivery shaft 514. In another embodiment, the first knob 532 may be rotatable to deflect the distal end of the delivery shaft 514 in a first plane, and the second knob 580 may be rotatable to deflect the distal end of the delivery shaft 514 in a second plane. The second plane may be substantially perpendicular to the first plane. In this embodiment, the control device 530 comprising the first knob 532 and the second knob 580 can enable deflection of the distal end of the delivery shaft 514 to any position or direction within a hemispherical range extending from the distal end. Furthermore, the control device 530 comprising the first knob 532 and the second knob 580 may enable deflection of the distal end of the delivery shaft 514 to any position or direction within a range extending from the distal end of the delivery shaft 514 by a large deflection angle, and this range is larger than the hemispherical range. In yet another embodiment, the first knob 532 may control the deflection of the distal end of the delivery shaft 514, and the second knob 580 may control the elevator, or vice versa. In these embodiments, the control device 530 includes an internal braking device and, consequently, does not require an external braking device that the user can operate and / or release from outside the handle 512.

[0047] Figures 6A and 6B show diagrams of the control device 530. Figure 6A is a cross-sectional view of the control device 530 along a cross-section similar to, for example, cross-section 2B-2B in Figure 2A. Figure 6B is a rear view of the control device 530 when the control device 530 is connected to the handle 512, for example, as seen from an internal position in the handle 512 (Figures 5A-5C). The control device 530 includes two or more indicator wires or control wires (e.g., 542A, 542B, 542C, and 542D) which can control one or more components of the delivery shaft 514 as described above.

[0048] As described above, the knob 532 may be connected to the control shaft 544 or may be formed integrally with the control shaft 544. The shaft 544 may include an internal lumen for receiving a portion of the shaft 548 and may interact with the spool 550 to control the movement of one or more control wires, for example, a first control wire 542A. Furthermore, one or more spring clutches 546A may be positioned between the spool 550 and a portion of the shaft 548 to selectively rotate the spool 550 and fix or lock it to the shaft 548.

[0049] In addition, the knob 580 may be connected to or integrally formed with the control shaft 582. The shaft 582 may include an internal lumen for receiving a portion of the shaft 544, and consequently, the shaft 548. In one embodiment, a hollow shaft 578 can be positioned between the shaft 544 and the shaft 582. The shaft 582 may also interact with the spool 584 to control the movement of one or more control wires, for example, a second control wire 542B. In addition, one or more spring clutches 546C may be positioned between the spool 584 and a portion of the hollow shaft 578 to selectively rotate the spool 584 and fix or lock it to the hollow shaft 578. Furthermore, the hollow shaft 578 may include an extension 586. The extension 586 may be positioned between the spool 550 and the spool 584 and may help to allow the spool 550 and the spool 584 to operate and rotate independently of each other.

[0050] The shaft 544, spring clutch 546A, shaft 548, and spool 550 operate to selectively lock and unlock the rotation of the shaft 544 and spool 550 relative to the shaft 548, as discussed with respect to the corresponding structures in Figures 2A-2C and Figure 3. As shown in Figure 6B, the spring clutch 546A may be positioned around the shaft 548, for example, between the shaft 548 and the spool 550. When no force is acting on the control device 530, the spring clutch 546A is firmly positioned or pressed around the shaft 548, helping to secure the spool 550, and consequently the first control wire 542A, to the shaft 548, and consequently to the handle 512 and the delivery shaft 514. The spring clutch 546A may include one or more legs 552. The knob 532 and shaft 544 may interact with one or more legs 552 of the spring clutch 546A by rotating them. For example, by rotating the knob 532 and shaft 544, a portion of the shaft 544 can be brought into contact with one or more legs 552, and by pushing one or more legs 552 in a certain direction, the spring clutch 546A can be released or loosened. By loosening the spring clutch 546A, the frictional connection between the spool 550 and the shaft 548 can be reduced. Furthermore, by rotating the knob 532 and shaft 544, a portion of the shaft 544, or a portion of one or more legs 552, may also be brought into contact with a portion of the spool 550, which can cause the spool 550 to rotate. Then, by rotating the spool 550, the control wire 542A can be retracted to a proximal position, thereby controlling a portion of the delivery shaft 514.

[0051] Similarly, although not shown in Figures 6A and 6B, the shaft 582 may interact with one or more legs of the spring clutch 546C, for example, so that the rotating knob 580 loosens the spring clutch 546C and thereby reduces the frictional connection between the spool 584 and the hollow shaft 578.

[0052] Figure 7 is an exploded view of a control device 530, which includes a knob 532, a shaft 544, at least one spring clutch (i.e., two spring clutches 546A and 546B), a shaft 548, and a spool 550. Although not shown, one or more control wires (e.g., control wires 542A and 542B) may be connected to the spool 550. In this embodiment, the spool 550 can be rotated by rotating the knob 532 and the shaft 544, similar to the interaction of the knob 32, shaft 44, spring clutch 46, shaft 48, spool 50, and control wires 42A, 42B shown in Figures 2A-2C and 3, which can control the movement of one or more control wires to deflect or otherwise control the distal portion of the delivery shaft (not shown). As described above, one or more of the spring clutches 546A or 546B can be released by rotating the knob 530 and the shaft 544. For example, the shaft 544 includes one or more projections, such as a first projection 554A and a second projection 554B connected to the shaft 544 via a radially extending portion 556. The projections 554A and 554B interact with a plurality of legs of the spring clutches 546A and 546B, as described above, to loosen the spring clutches 546A and 546B and loosen the connection between the spool 550 and the extended portion 566 of the shaft 548. Furthermore, as described above, the plurality of legs may interact with one or more stop surfaces (e.g., stop surfaces 564A and 564B) to rotate the spool 550 and control one or more control wires (not shown).

[0053] Furthermore, as shown in Figure 7, the control device 530 includes a knob 580, a shaft 582, at least one additional spring clutch (i.e., two spring clutches 546C and 546D), and a spool 584. Although not shown, one or more control wires (e.g., control wires 542C and 542D) may be connected to the spool 584. This assembly operates in substantially the same manner as the interaction of the knob 32, shaft 44, spring clutch 46, shaft 48, spool 50, and control wires 42A and 42B shown in Figures 2A, 2C, and 3. Specifically, by rotating the knob 580 and shaft 582, the spring clutches 546C and 546D can be interacted with and released, as described above, thereby rotating the spool 584. By rotating the spool 584, the movement of one or more control wires can be controlled to deflect or otherwise control the distal portion of the delivery shaft (not shown). Furthermore, the hollow shaft 578 may be fixed to the handle 512, which may help to allow shafts 544 and 582 to rotate independently. Additionally, the hollow shaft 578 may include an extension 586, which separates spools 550 and 584, allowing spools 550 and 584 to rotate independently.

[0054] Furthermore, rotating the knob 580 and the shaft 582 may loosen one or more of the spring clutches 546C or 546D. For example, the shaft 582 includes one or more projections connected to the shaft 582 via a radially extending portion 590, e.g., a first projection 588A and a second projection 588B. The projections 588A and 588B interact with the multiple legs of the spring clutches 546C, 546D as described above, to loosen the spring clutches 546C, 546D and loosen the connection between the spool 584 and the hollow shaft 578. Furthermore, as described above, the multiple legs may interact with one or more stop surfaces (e.g., stop surfaces 592A or 592B) to rotate the spool 584 and control one or more control wires (not shown).

[0055] Furthermore, as described above, external forces, such as forces applied to the spool 550 or spool 584 by control wires, can cause the spool 550 or spool 584 to rotate and come into contact with one or more of the clutch springs 546A, 546B, 546C, and 546D, thereby tightening one or more of the clutch springs 546A, 546B, 546C, and 546D. For example, multiple control wires may apply forces from inherent forces on the delivery shaft 514 to bias the delivery shaft 514 back to an unbent or undefended position, or from forces caused by the distal end of the delivery shaft 514 coming into contact with tissue or other material at the treatment site. These forces can tighten the spools 550 and 584 into contact with one or more of the clutch springs 546A, 546B, 546C, and 546D. Thus, the control device 530 can also help hold a portion of the delivery shaft 514 in an operated position.

[0056] One or more spring clutches, and any combination thereof, can be incorporated into the control device 530. In addition, three or more knobs, shafts, etc., may be included on the handle 512 to control, for example, three or more aspects of the delivery shaft. For example, three knobs can be incorporated into the control device on the handle 512. The first and second knobs may be configured to deflect the delivery shaft 514 in two different planes, and the third knob may be configured to actuate, for example, an elevator located adjacent to the distal opening 24 in Figures 1A and 1B.

[0057] Various embodiments discussed herein may help reduce the duration, cost, and / or risk of medical procedures. For example, a control device allows a user to selectively operate one or more control wires. Multiple control devices also help lock multiple control wires in selected positions and prevent unintended movement of multiple control wires from forces acting on the delivery shaft, for example. In this embodiment, multiple control devices may help provide a brake with a small number of inexpensive components. The brake provided by the multiple control device is automatically disengaged when the knob and shaft are rotated by user operation due to the spring force provided by the spring clutch(s) and the brake provided by the multiple control device is automatically engaged after the user operation is completed. For example, a user may rotate a knob to deflect the distal end of the delivery shaft. The user may release their hand from the knob in the rotated position, and one or more spring clutches may automatically return to the retracted position, locking the spool on the shaft. In this embodiment, the force applied to the spool by multiple control wires, or the back pressure from multiple control wires, tightens one or more spring clutches, which helps prevent the force applied by the multiple control wires from rotating the spool.

[0058] In addition, one or more spring clutches may be formed from commonly available spring or wire materials. Alternatively, one or more spring clutches may be formed from stamped sheet metal, plastic materials, injection-molded clips, etc. The size, number, material, etc., of one or more spring clutches may also be tailored to a particular medical device or a particular application of a medical device. The amount of friction that each spring clutch can withstand before slipping may vary based on the characteristics of each spring clutch. However, the amount of friction that each spring clutch can withstand before slipping also depends on the number of wraps or coils (or longitudinal width) constituting one or more spring clutches, the material properties of the wire, and the amount of preload friction (e.g., how "tight" the springs are on the shaft in the neutral or non-operating position), due to interference between the inner diameter of one or more spring clutches and the outer diameter of the shaft, etc. The frictional force supplied to the spool may also be controlled (e.g., increased or decreased) based on the number of spring clutches included around the shaft. Next, the frictional force can provide sufficient holding force to prevent the delivery shaft from spontaneously returning to a straight or non-operating position, while also minimizing the driving force required for the knob and shaft to release one or more spring clutches, rotate the spool, and actuate a portion of the delivery shaft.

[0059] Multiple control devices may be placed anywhere on the handle, for example, in a convenient location during medical procedures. Furthermore, multiple control devices do not require an external braking system (multiple braking components outside the handle body), which can help reduce the overall size and utility of the multiple control devices and multiple medical devices. Not requiring an external braking system may also help allow the knobs(s) of the multiple control devices to be placed adjacent to or close to the multiple handles, which can improve the ergonomics and / or utility of the medical devices, especially for users with smaller hands. In addition, not requiring an external braking system can reduce the overall size of the handle, for example, reducing the risk of the handle tipping and / or falling from the table (for example, during sterilization), reducing the size and / or amount of packaging required to package the medical devices, and reducing the space required to store the medical devices.

[0060] As described above, multiple control devices can automatically lock multiple control wires, and consequently, multiple delivery shafts, into selected positions. Therefore, there is no need for the user to operate external braking elements, which can stress internal components and worsen user hand fatigue, or to lock one or more components in place and then operate components of the locking configuration for final or smaller operations. Furthermore, multiple control devices may be incorporated onto a single handle, as described above, to perform cable drive functions for multiple medical devices, such as deflecting the distal end of a delivery shaft in multiple directions, operating or moving one or more elevators within a delivery shaft, and / or otherwise.

[0061] Accordingly, the various embodiments discussed herein may help improve the effectiveness of treatment and / or recovery from a procedure, such as a procedure to treat a treatment site. The various embodiments discussed herein may help reduce and / or minimize the duration of a procedure, reduce the risk of unintended operation by the user, and / or reduce the risk of unintended contact with tissue or other substances during the delivery, repositioning, or use of a medical device in a procedure.

[0062] The principles of this disclosure are discussed herein with reference to exemplary embodiments for various uses, but it should be understood that this disclosure is not limited thereto. Those skilled in the art and those with access to the teachings provided herein will recognize that additional modifications, applications, embodiments, and substitutions of equivalents all fall within the scope of the embodiments described herein. Therefore, this disclosure should not be considered limited by the foregoing description.

Claims

1. The handle including the shaft, A device shaft extending from the handle to the distal end, A control device connected to the handle, A knob rotatable relative to the handle, A control shaft extending from the knob, A spring clutch including two legs, A spool that is rotatable with respect to the aforementioned shaft, The control device includes one or more wires connected to the spool. A medical device including, The medical device is configured such that, by rotating the knob, the control shaft is rotated, the at least one spring clutch is released, the spool is rotated, and one or more wires are moved.

2. The medical device according to claim 1, wherein the control shaft includes a radially extending portion, and the control shaft includes a first projection and a second projection extending from the radially extending portion.

3. The medical device according to claim 2, wherein the spool defines a first gap and a second gap, and the first protrusion and the second protrusion are configured to be positioned within the first gap and the second gap.

4. The medical device according to claim 3, wherein the at least one spring clutch includes a first spring clutch and a second spring clutch, and the first spring clutch and the second spring clutch each include a first leg and a second leg.

5. By rotating the knob in the first direction, the first projection is brought into contact with the first leg of the first spring clutch, thereby loosening the first spring clutch; by rotating the knob in the first direction, the second projection is brought into contact with the first leg of the second spring clutch, thereby loosening the second spring clutch; Further rotation of the knob in the first direction causes (1) the first leg of the first spring clutch to contact the first stop surface of the spool adjacent to the first gap, (2) the first leg of the second spring clutch to contact the second stop surface of the spool adjacent to the second gap, and (3) the spool to rotate in the first direction, as described in claim 4.

6. By rotating the knob in the second direction, the first projection is brought into contact with the second leg of the second spring clutch, and the second spring clutch is released; By rotating the knob in the second direction, the second projection is brought into contact with the second leg of the first spring clutch, and the first spring clutch is released; Further rotation of the knob in the second direction causes (1) the second leg of the second spring clutch to contact the third stop surface of the spool adjacent to the second gap, (2) the second leg of the first spring clutch to contact the fourth stop surface of the spool adjacent to the second gap, and (3) the spool to rotate in the second direction, as described in claim 4.

7. The medical device according to any one of claims 1 to 6, wherein the at least one spring clutch includes at least one spring formed of a coil having two radially outward-extending legs.

8. The medical device according to any one of claims 1 to 6, wherein the at least one spring clutch includes at least one spring having a ring shape including a partially cylindrical portion and an interacting portion, the interacting portion including a first end and a second end, the first end including a first radially outward-extending leg, and the second end including two radially outward-extending legs.

9. The medical device according to any one of claims 1 to 6, wherein the spring clutch includes at least one spring having a partially ring shape including a partially cylindrical portion and an open portion, and the partially cylindrical portion includes two radially outwardly extending legs on both sides of the open portion.

10. The medical device according to any one of claims 1 to 6, wherein the spring clutch includes at least one spring formed of a coil having two radially inwardly extending legs.

11. The control device is a first control device, and the medical device further comprises a second control device coaxial with the first control device, and the second control device is A second knob rotatable relative to the handle, A second control shaft extending from the second knob, A second spring clutch comprising at least one leg portion, A second spool that is rotatable with respect to the aforementioned shaft, Includes one or more second wires connected to the second spool, The medical device according to any one of claims 1 to 6, wherein the rotation of the second knob is configured to rotate the second control shaft, loosen the at least one second spring clutch, rotate the second spool, and move one or more second wires.

12. A portion of the control shaft of the first control device is nested inside the second control shaft of the second control device, and the medical device is further, The medical device according to claim 11, comprising a hollow shaft that separates a part of the control shaft from the second control shaft, wherein the hollow shaft is connected to the handle and includes a radially extending portion that separates the spool of the first control device from the second spool of the second control device.

13. The medical device according to any one of claims 1 to 6, wherein the distal end of the device shaft is deflectable via the control device.

14. The medical device according to any one of claims 1 to 6, wherein the handle includes at least one port configured to receive a medical device, the port being connected to a lumen extending through the handle and the device shaft, and the control device being configured to control an elevator (lifting platform) positioned adjacent to the lumen at the distal end of the device shaft.

15. The medical device according to any one of claims 1 to 6, wherein the control device is located on the proximal portion of the handle, and the medical device does not include a brake outside the body of the handle to lock the position of the knob.

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