Medical joint movement devices and methods for using them

Abstract

To provide a system, a device, and a method for treating a target treated region by using articulation movement device bringing an advanced-level of maneuverability.SOLUTION: A first actuator is configured to (1) articulate a shaft in response to translating the first actuator in a first direction relative to a handle and a second actuator and (2) actuate an end effector in response to translating the first actuator in a second direction relative to the handle and the second actuator. The second actuator is configured to (1) articulate the shaft in response to translating the second actuator in the first direction relative to the handle and the first actuator and (2) actuate the end effector in response to translating the second actuator in the second direction relative to the handle and the first actuator.SELECTED DRAWING: Figure 1B

Description

Technical Field

[0001] Various aspects of the present disclosure generally relate to medical joint movement systems, devices, and related methods. Examples of the present disclosure relate, among other things, to systems, devices, and related methods for causing a medical tool to perform joint movement on a subject.

Background Art

[0002] Endoscopic and surgical procedures of the gastrointestinal (GI) tract include, among others, submucosal dissection, colectomy, obesity surgery, esophagectomy, gastric bypass, and sleeve gastrectomy. These procedures may involve lifting and / or removing tissue from the patient's body. Accessory devices for performing such procedures may include complex interfaces for operating the devices. Additionally, the interface may impose limitations on the ability to perform joint movement to maneuver the device within the patient's body, thereby requiring the use of additional devices or multiple hands to operate the device.

Summary of the Invention

[0003] Among other things, aspects of the present disclosure relate to systems, devices, and methods for treating a target treatment site using a joint movement device that provides, among other things, a high degree of maneuverability. Each of the aspects disclosed herein can include one or more of the features described in relation to any of the other disclosed aspects.

[0004] For example, a medical device includes a handle, a shaft extending distally from the handle, an end effector extending distally from the shaft, a first actuator movably coupled to the handle, and a second actuator movably coupled to the handle. The first actuator is configured to (1) articulate the shaft in response to (1) translating the first actuator relative to the handle and the second actuator in a first direction, and (2) actuate the end effector in response to (2) translating the first actuator relative to the handle and the second actuator in a second direction. The second actuator is configured to (1) articulate the shaft in response to (1) translating the second actuator relative to the handle and the first actuator in a first direction, and (2) actuate the end effector in response to (2) translating the second actuator relative to the handle and the first actuator in a second direction.

[0005] Any of the medical devices described herein may include any of the following features: A handle includes a first track extending along the body of the handle. A first actuator is received within the first track and configured to translate along the first track. The first track has a longitudinal length corresponding to (1) a first degree of joint movement of the shaft and (2) a first range of motion of the end effector. A handle includes a second track extending along the body of the handle. A second actuator is received within the second track and configured to translate along the second track. The second track has a longitudinal length corresponding to (1) a second degree of joint movement of the shaft and (2) a second range of motion of the end effector. Further includes a first wire and a second wire disposed within the handle and shaft. The first wire is coupled to the first actuator and a first part of the end effector. The second wire is coupled to the second actuator and a second part of the end effector. The first actuator is configured to move a first wire in a first direction in order to articulate the shaft and move the first and second parts in a first direction. The second actuator is configured to move a second wire in a second direction in order to move the second part relative to the first part. The second actuator is configured to move a second wire in a first direction in order to articulate the shaft and move the first and second parts in a first direction. The first actuator is configured to move a first wire in a second direction in order to move the second part relative to the first part. The first actuator is configured to move the first part relative to the second part, and the second actuator is configured to move the second part relative to the first part. The first actuator is configured to articulate the shaft toward the first actuator in a first direction in response to translating the first actuator toward the handle and the second actuator in a first direction.The second actuator is configured to articulate the shaft toward the second actuator in the first direction in response to translating the second actuator relative to the handle and the first actuator in the first direction. The first and second actuators are arranged around the circumference of the handle. The first and second actuators are at least partially arranged within the handle. The first actuator includes a first finger ring, the second actuator includes a second finger ring, and the handle includes a third finger ring. The third finger ring is fixed relative to the first and second finger rings, and the first and second finger rings move relative to each other and relative to the third finger ring. The first actuator has a proximal position corresponding to the articulated position of the shaft, a distal position corresponding to the operating position of the end effector, and a neutral position between the proximal and distal positions, corresponding to the non-articulated position of the shaft and the non-operating position of the end effector.

[0006] In another example, the medical device includes a handle having a first movable actuator and a second movable actuator; a shaft extending distally from the handle and having an end effector at the distal end of the shaft; a first wire disposed within the shaft and coupled to the first movable actuator and the end effector; and a second wire disposed within the shaft and coupled to the second movable actuator and the end effector. The first movable actuator is configured to (1) articulate the shaft in response to (1) translating the first wire proximal to the shaft and the second movable actuator; and (2) actuate the end effector in response to (2) translating the first wire distal to the shaft and the second movable actuator. The second movable actuator is configured to (1) articulate the shaft in response to (1) translating the second wire proximal to the shaft and the first movable actuator, and (2) actuate the end effector in response to (2) translating the second wire distal to the shaft and the first movable actuator.

[0007] Any of the medical devices described herein may include any of the following features: A handle includes a first track and a second track extending along both sides of the handle. A first movable actuator is received in the first track and configured to translate along the first track, and a second movable actuator is received in the second track and configured to translate along the second track. The first track has a first longitudinal length corresponding to (1) a first degree of articular movement of the shaft and (2) a first range of motion of the end effector. The second track has a second longitudinal length corresponding to (1) a second degree of articular movement of the shaft and (2) a second range of motion of the end effector. The first movable actuator is configured to articularize the shaft toward the first movable actuator in a first direction in response to translating the first actuator toward the handle and the second actuator in a first direction. The second movable actuator is configured to articulate its shaft toward the second movable actuator in the first direction in response to translating the second actuator toward the handle and the first actuator in the first direction.

[0008] In a further example, a medical device includes a handle having a first longitudinal track and a second longitudinal track, a shaft extending distally from the handle, an end effector at the distal end of the shaft, and a first actuator coupled to a first wire disposed within the shaft. The first actuator translates along the first longitudinal track. The medical device includes a second actuator coupled to a second wire disposed within the shaft. The second actuator translates along a second longitudinal track. The first actuator is configured to retract the first wire proximally relative to the shaft to articulate the shaft in a first direction when the first actuator moves proximally within the first longitudinal track and the second actuator is fixed relative to the second longitudinal track. The second actuator is configured to retract a second wire proximally relative to the shaft in order to articulate the shaft in a second direction when the second actuator moves proximally within the second longitudinal track and the first actuator is fixed relative to the first longitudinal track. The second direction is the opposite of the first direction.

[0009] It should be understood that both the general description above and the detailed description below are illustrative and explanatory only and do not limit the claimed invention. The accompanying figures incorporated herein and constituting part of this specification illustrate exemplary embodiments of the disclosure and, together with the description, serve to illustrate the principles of the disclosure. [Brief explanation of the drawing]

[0010] [Figure 1A] A side view of an exemplary medical device according to an aspect of the present disclosure, including a pair of actuators, a handle, and an effector in an operated (closed) state and an in-articulation position. [Figure 1B] A side view of the medical device of Figure 1A, according to an aspect of the present disclosure, in which the end effector is in a non-operating (open) state and in a joint movement position. [Figure 2]A side view of the end effector of the medical device of Figure 1A, including a pair of wires, according to an aspect of this disclosure. [Figure 3] A perspective view of the end effector of the medical device of Figure 1A in the operating (closed) state, according to an aspect of the present disclosure. [Figure 4] A perspective view of the end effector of the medical device of Figure 1A in a non-operating (open) state, according to an aspect of the present disclosure, in which each pair of wires is disposed within the shaft of the medical device. [Figure 5] A cross-sectional perspective view of the proximal shaft of the medical device shown in Figure 1A, according to an aspect of this disclosure. [Figure 6] A cross-sectional perspective view of the distal joint movement joint of the medical device shown in Figure 1A, according to an aspect of this disclosure. [Figure 7] A perspective view of the handle of another exemplary medical device according to an aspect of this disclosure. [Modes for carrying out the invention]

[0011] In ESD, objects within the GI tube, such as tumors, are targeted for removal. A medical device capable of removing the target object is received within a medical instrument (e.g., an endoscope) that is positioned at the target treatment site via the GI tube under endoscopy. Ancillary devices for manipulating the tissue surrounding the target object may be positioned at the target treatment site under endoscopy. However, ancillary devices and systems suitable for ESD are limited. However, this disclosure is not limited to ESD procedures and can instead be used for any appropriate medical procedure.

[0012] Examples of the present disclosure include systems, devices, and methods for manipulating materials and / or objects (e.g., tissue) at a targeted therapeutic site within a subject (e.g., a patient) with high maneuverability. In an example, ESD includes endoscopic placement of an end-effector, e.g., a jaw assembly or other similar tool, at a targeted therapeutic site. Placement of the end-effector may be via a catheter, scope (such as an endoscope, bronchoscope, or colonoscope), tube, or sheath, inserted into the GI tube through a natural orifice. The natural orifice may be, for example, the nose, mouth, or anus, and placement may be within any part of the GI tube, including the esophagus, stomach, duodenum, large intestine, or small intestine. Placement may also be within the GI tube, other body lumens, or other organs or body spaces accessible through an opening in the body.

[0013] Next, aspects of this disclosure are referenced in detail, examples of which are shown in the accompanying figures. Where possible, the same or similar reference numbers are used throughout the figures to refer to the same or similar parts. The term “distal” refers to the part of the device that is furthest from the user when the device is introduced into a patient. In contrast, the term “proximal” refers to the part of the device that is closest to the user when the device is placed within the subject. When used herein, the terms “equipped,” “equipped,” or any other variation thereof are intended to cover non-restrictive inclusion, thereby meaning that a process, method, article, or apparatus comprising a list of elements does not necessarily include only those elements, but may include other elements not expressly listed or that are specific to such process, method, article, or apparatus. The term “exemplary” is used in the sense of “example” rather than “ideal.” When used herein, the terms “about,” “substantial,” and “approximate” indicate a range of values ​​within + / - 10% of the stated value.

[0014] Examples of the present disclosure may include devices and methods for performing various medical procedures and / or treating any other part of the large intestine (colon), small intestine, cecum, esophagus, gastrointestinal tract, and / or any other appropriate anatomical structure of a patient (collectively referred to herein as “target therapeutic site”). As mentioned above, the present disclosure is not limited to any specific medical device or method, and aspects of the present disclosure may be used in connection with any appropriate medical tool and / or medical method in any appropriate site in the body. Various examples described herein include single-use or disposable medical devices.

[0015] Figures 1A and 1B show an exemplary medical device 100 according to an example of the present disclosure. The medical device 100 may include a handle 102 having a longitudinal length defined by a proximal end 104 and a distal end 106. The proximal end 104 may include a gripping feature configured to facilitate manual control of the handle 102. For example, the gripping feature may include a ring sized and molded to receive the fingers of a user of the medical device 100. The handle 102 may further include a pair of tracks 108, 109 positioned along both sides of the handle 102 and extending between the proximal end 104 and the distal end 106. As further described herein, the tracks 108, 109 may define the paths of one or more actuators 110, 112, and the longitudinal length of the tracks 108, 109 may define the range of joint movement and operation of the medical device 100.

[0016] The medical device 100 may further include a pair of actuators 110, 112 movably coupled to a handle 102 on tracks 108, 109. For example, the medical device 100 may include a first actuator 110 slidably coupled to a first track 108 and a second actuator 112 slidably coupled to a second track 109. In one or more directions A, B, the first actuator 110 may be configured to translate along the first track 108, and the second actuator 112 may be configured to translate along the second track 109. That is, each of the first actuator 110 and the second actuator 112 can move in the first direction A or the second direction B. The first actuator 110 and the second actuator 112 may be configured to move independently of each other and relative to each other. The actuators 110, 112 may be operated in various suitable ways and in various sequences, for example, simultaneously and / or separately from each other. In some embodiments, the first actuator 110 and the second actuator 112 are arranged around the circumference of the handle 102 and together can surround at least a portion of the handle 102 between them.

[0017] Although not shown, it should be understood that the first actuator 110 may be coupled to a first wire 170 received within the handle 102, and the second actuator 112 may be coupled to a second wire 172 received within the handle 102 (see Figures 2-4). The wires 170 and 172 can be coupled to the actuators 110 and 112 by various suitable mechanisms, including, for example, crimping, adhesive, or ultrasonic curling. Thus, each actuator 110 and 112 may be configured to move the corresponding wires 170 and 172 relative to the handle 102 in response to translation along their respective tracks 108 and 109.

[0018] Referring still to Figures 1A and 1B, the first actuator 110 may include a body having a gripping feature 114 extending laterally outward from the body of the first actuator 110. The second actuator 112 may include a body having a gripping feature 116 extending laterally outward from the body of the second actuator 112. Each gripping feature 114, 116 may be configured to facilitate the movement of the respective actuators 110, 112 relative to the corresponding tracks 108, 109. In this example, each gripping feature 114, 116 may include a ring sized and molded to receive the corresponding finger of the user of the medical device 100. It should be understood that the gripping features 114, 116 may have a variety of other suitable sizes, shapes, and / or configurations without departing from the scope of this disclosure.

[0019] The medical device 100 may include a shaft 120 fixed to a handle 102 and extending distally from the handle 102, specifically from a distal end 106. The shaft 120 may include a proximal shaft 122 and a distal articular movement joint 130. The proximal end of the proximal shaft 122 may extend to connect to the distal end 106, and the proximal end of the distal articular movement joint 130 may connect to the distal end of the proximal shaft 122. The medical device 100 may further include an end effector 140 connected to the distal end of the distal articular movement joint 130. The end effector 140 may include one or more parts such as a clevis 142, a first jaw 148A, and a second jaw 148B. The clevis 142 may be firmly attached to the distal end of the distal articular movement joint 130, and the jaws 148A and 148B may be pivotably connected to the clevis 142. As further described herein, each jaw 148A, 148B may be movable in response to the translation of actuators 110, 112. In this embodiment, the end effector 140 can exclude one or more links coupled to the pair of jaws 148A, 148B. As further described herein, the medical device 100 may be configured to increase the gripping force between jaws 148A, 148B by excluding the links within the end effector 140.

[0020] Referring next to Figures 2 and 3, each jaw 148A, 148B may be coupled to at least one of the actuators 110, 112 via corresponding wires 170, 172. For example, the first jaw 148A may be coupled to the second actuator 112 via the second wire 172, and the second jaw 148B may be coupled to the first actuator 110 via the first wire 170. In this example, the first jaw 148A may include a proximal arm 144A that accepts the second wire 172, and the second jaw 148B may include a proximal arm 144B that accepts the first wire 170. Therefore, it should be understood that the end effector 140 eliminates the link (or any other structure) between the jaws 148A, 148B and the wires 170, 172, thereby allowing the wires 170, 172 to be directly coupled to the jaws 148A, 148B in the corresponding proximal arms 144A, 144B. The medical device 100 may be able to operate in such a way as to minimize the mechanical loss of force transmission between the actuators 110, 112 and the jaws 148A, 148B by eliminating one or more links (or any other structure) between the wires 170, 172 and the jaws 148A, 148B.

[0021] For illustrative purposes only, it is to be understood that end effector 140 is shown in FIG. 2 in a condition where clevis 142 is omitted. End effector 140 can comprise pins 146 that define pivot points for jaws 148A, 148B, i.e., the jaws 148A, 148B can be movably coupled to each other around the pins 146. Further, first jaw 148A and second jaw 148B can be movably coupled to clevis 142 at pins 146. Each of jaws 148A, 148B can include a plurality of teeth along an inner surface for gripping an object, such as tissue, disposed between jaws 148A, 148B. It is to be understood that end effector 140 can include various suitable configurations including, but not limited to, one or more clamps, shears, forceps, tweezers, suturing devices, illumination devices, imaging systems, gripping assemblies, and various other suitable tools and / or devices. Thus, the end effector 140 shown and described herein is merely exemplary, whereby medical device 100 can include various other end effectors without departing from the scope of the present disclosure.

[0022] Referring now to Figure 4, the first wire 170 and the second wire 172 are arranged within the shaft 120 and extend distally from the distal joint movement joint 130 to connect to the proximal arms 144B and 144A, respectively. In this example, the shaft 120 may include a first lumen 128A configured to receive the first wire 170 and a second lumen 128B configured to receive the second wire 172. It should be understood that movement of the first actuator 110 along the handle 102 can result in movement of the first wire 170 in the first lumen 128A and corresponding movement of the second jaw 148B. Furthermore, movement of the second actuator 112 along the handle 102 can result in movement of the second wire 172 in the second lumen 128B and corresponding movement of the first jaw 148A. As described in detail herein, each of the first actuator 110 and the second actuator 112 may be configured to actuate the end effector 140 and articulate the distal articular joint 130. Additionally, as described in further detail below, the shaft 120 (e.g., proximal shaft 122, distal articular joint 130) may include one or more inner layers, including a first inner layer 134 having a braided structure and a second inner layer 136 (e.g., a multi-lumen shaft) defining a first lumen 128A and a second lumen 128B.

[0023] Next, referring to FIG. 5, the proximal shaft 122 is shown as having a plurality of layers. In this example, the proximal shaft 122 can include an outer layer 123, a first inner layer 124, a second inner layer 126, and a third inner layer 128. The outer layer 123 can be disposed around the first inner layer 124 and can be configured to insulate the first inner layer 124 from, for example, a tool (such as an electric scalpel) positioned adjacent to the medical device 100. In some examples, the outer layer 123 can be formed from an insulating material such as a reflow including, for example, Pebax® resin. The outer layer 123 can further be formed of a material having a predetermined hardness in the range of about 10 D (Durometer) to about 100 D, more specifically 30 D to 75 D. In other embodiments, the outer layer 123 can be completely omitted.

[0024] The first inner layer 124 can be disposed around the second inner layer 126 and can include a braid formed of a plurality of wires (such as flat, round, etc.) braided together. In some examples, the first inner layer 124 can include a plurality of wires in the range of about 10 wires to about 100 wires, more specifically 16 wires to 32 wires. In some embodiments, the braid of the first inner layer 124 can be inclined at an angle in the range of about 10 degrees to about 100 degrees, more specifically 30 degrees to 50 degrees. The braid of the first inner layer 124 can be in various suitable patterns including, for example, a diamond braid, a Hercules braid, etc. The first inner layer 124 can be configured to increase the torque and / or hardness of the proximal shaft 122. In other embodiments, the first inner layer 124 can be completely omitted.

[0025] Still referring to FIG. 5, the second inner layer 126 can be disposed around the third inner layer 128 and can include a coil wound around the third inner layer 128 (such as in a clockwise direction, counterclockwise direction, etc.). In some embodiments, the coil pitch of the second inner layer 126 can be substantially the same as the wire diameter of the coil. The second inner layer 126 can be configured to provide rigidity to the proximal shaft 122.

[0026] The third inner layer 128 is formed of polytetrafluoroethylene (PTFE) and may include a first lumen 128A and a second lumen 128B for receiving the first wire 170 and the second wire 172, respectively. In this example, the lumens of the third inner layer 128 may have similar and / or different diameters relative to each other. The third inner layer 128 may include a diameter in the range of about 0.5 mm to about 1.0 mm, specifically 0.8 mm. The first lumen 128A may include a diameter in the range of about 0.2 mm to about 0.8 mm, specifically 0.4 mm, and the second lumen 128B may include a diameter in the range of about 0.1 mm to about 0.7 mm, specifically 0.3 mm. In other embodiments, the third inner layer 128 may be omitted entirely, or instead of a pair of sheaths each defining a lumen for receiving at least one of the wires 170, 172.

[0027] Referring still to Figure 5, the first wire 170 and the second wire 172 can be formed from a variety of materials, including, for example, stainless steel, nitinol, plastic, and aluminum. In some examples, the first wire 170 and / or the second wire 172 can be coated with PTFE and / or other suitable materials. Additionally, the first wire 170 and / or the second wire 172 can each consist of a single wire or a multi-strand wire assembly. As will be described in more detail herein, each of the first wire 170 and the second wire 172 can be configured to produce articulation of the shaft 120 and operation of the end effector 140.

[0028] Referring next to Figure 6, the distal articular movement joint 130 is shown having multiple layers. In this example, the distal articular movement joint 130 may include an outer layer 132, a first inner layer 134, and a second inner layer 136. The outer layer 132 may be arranged around the first inner layer 134 and may be configured to insulate the first inner layer 134. For example, the outer layer 132 may be formed of an insulating material such as reflow containing Pebax® resin. The outer layer 132 may be formed of a material having a predetermined stiffness that is relatively less than that of the outer layer 122 of the proximal shaft 122. For example, the outer layer 132 may have a predetermined stiffness in the range of about 5D to about 100D, more specifically from 30D to about 50D. As described in detail herein, the distal articular movement joint 130 may be configured to bend relative to the proximal shaft 122 in response to the action of at least one of the wires 170, 172.

[0029] The first inner layer 134 may be arranged around the second inner layer 136 and may include a braid formed of multiple wires (e.g., flat, round, etc.) braided together. The first inner layer 134 may be substantially similar to the first inner layer 124. For example, the first inner layer 134 may include multiple wires ranging from about 10 to about 100 wires, more specifically from 16 to 32 wires. In other examples, the first inner layer 134 may include fewer wires than the first inner layer 124. The first inner layer 134 may be configured to increase the torque and / or stiffness of the distal articular movement joint 130. In some embodiments, the braid of the first inner layer 134 may be inclined at angles ranging from about 10 to about 100 degrees, more specifically from 30 to 50 degrees, etc. The braid of the first inner layer 134 may be various suitable patterns, including, for example, a diamond braid, a Hercules braid, etc.

[0030] Referring still to Figure 6, the second inner layer 136 is formed of polytetrafluoroethylene (PTFE) and may include a first lumen 128A and a second lumen 128B for receiving the first wire 170 and the second wire 172, respectively. In this example, the first lumen 128A and the second lumen 128B of the second inner layer 136 may have similar and / or different diameters relative to each other. In other embodiments, the second inner layer 136 may be omitted entirely, or instead of a pair of sheaths each defining a lumen for receiving at least one of the wires 170, 172. The second inner layer 136 may be formed of a material having a predetermined stiffness in the range of about 15D to about 95D, more specifically 33D to 50D. The first wire 170 can extend distally from the second inner layer 136 through the clevis 162 for engagement with the proximal arm 144B (see Figures 2-3). The first wire 170 can be securely fastened to the proximal arm 144B by adhesive, welding, crimping, ultraviolet (UV) curing, etc. The second wire 172 can extend distally from the second inner layer 136 through the clevis 162 for engagement with the proximal arm 144A (see Figures 2-3). The second wire 172 can be securely fastened to the proximal arm 144A by adhesive, welding, crimping, ultraviolet (UV) curing, etc.

[0031] According to an exemplary method of using the medical device 100, the medical instrument (e.g., an endoscope) is first navigated through the patient's body so that the distal end of the medical instrument can be positioned at the target treatment site. The medical device 100 may be received within the medical instrument, and the end effector 140 may extend outward from the distal end of the medical instrument. In this case, the end effector 140 may be positioned at the target treatment site within the patient, while the handle 102 is positioned outside the patient at the proximal end of the medical instrument. It should be understood that the end effector 140 is kept in an activated (closed) state during delivery through the medical instrument.

[0032] Referring to Figure 1A, the first actuator 110 and the second actuator 112 can each be positioned in a first position relative to the handle 102, thereby maintaining the distal articulated joint 130 in an unarticulated state (for example, the longitudinal axis of the distal articulated joint 130 is aligned with the longitudinal axis of the shaft 120), and the end effector 140 in an operational state. Alternatively, the actuators 110 and 112 can be positioned along the intermediate portions of the tracks 108 and 109, thereby maintaining the wires 170 and 172 in a neutral position relative to the shaft 120 and the end effector 140. In this case, the first wire 170 does not apply tension to the second jaw 144B, and the second wire 172 does not apply tension to the first jaw 144A, thereby maintaining the end effector 140 in operation and the distal articular movement joint 130 in an articular movement state (for example, parallel to the shaft 120 and / or handle 102).

[0033] Referring next to Figure 1B, the first actuator 110 is translated along the first track 108 in a first direction A (for example, proximal) to pull the first wire 170 proximal to the shaft 120 and handle 102. In this case, the first actuator 110 is moved to its most proximal position and configured to articulate the distal articular joint 130 toward the side of the handle 102 containing the first actuator 110, thereby moving the end effector 140 radially outward in the first direction A. For example, a user of the medical device 100 can move the first actuator 110 relative to the handle 102 by pulling the first actuator 110 proximal toward the proximal end 104. The first actuator 110 can slide relative to the handle 102 in response to a proximal force applied to the gripping feature 114. In this case, the first wire 170 (securely fastened to the body of the first actuator 110 along a portion of the handle 102) can move relative to the handle 102 in the first direction A, together with the gripping feature 114. With the first wire 170 securely fastened to the proximal arm 144B, the first actuator 110 may be configured to move the first wire 170 relative to the handle 102 and the shaft 120.

[0034] The first actuator 110 applies a proximal (tensile) force to the proximal arm 148B by pulling the first wire 170 proximal, thereby bending the distal articular movement joint 130. In this case, the connection point between the wire 170 and the arm 148B is off-center and radially outward along the longitudinal axis of the distal articular movement joint 130 toward the same side of the medical device 100 as the first actuator 110, so that the end effector 140 can be deflected in the first direction A, i.e., in the same direction of movement as the first actuator 110 relative to the handle 102. The user of the medical device 100 can selectively adjust the degree of articular movement of the distal articular movement joint 130 and the corresponding range of deflection of the end effector 140 in response to the degree of movement of the first actuator 110 relative to the handle 102. Furthermore, the handle 102 can be rotated to rotate the shaft 120, moving the end effector 140 relative to the target treatment site, facilitating further movement of the medical device 100 toward the target object within the target treatment site. In some embodiments, the second actuator 112 may remain stationary while the first actuator 110 is translating relative to the handle 102.

[0035] Referring still to Figure 1B, the second actuator 112 can be translated along the second track 109 in the second direction B opposite to the first direction A, thereby pushing the second wire 172 distally toward the shaft 120 and handle 102. In this case, with the distal articular movement joint 130 already articulated by the first actuator 110, the second actuator 112 can be moved to its most distal position, thereby transitioning the end effector 140 from the actuated state (Figure 1A) to the deacted state. For example, a user of the medical device 100 can move the second actuator 112 relative to the handle 120 by sliding the second actuator 112 distally toward the distal end 106 to its most distal position. The second actuator 112 can slide relative to the handle 120 in response to a distal force being applied to the gripping feature 116. In this case, the second wire 172 (securely fastened to the body of the second actuator 112 along a portion of the handle 102) can move relative to the handle 102 together with the gripping feature 116. With the second wire 170 securely fastened to the proximal arm 144A, the second actuator 112 may be configured to move the second wire 172 relative to the handle 102 and the shaft 120.

[0036] The second actuator 112 can push the second wire 172 distally, applying a distal (extrusion) force on the proximal arm 144A, thereby moving the first jaw 148A around the pin 146 away from the second jaw 148B. In this case, the end effector 140 can transition to a non-operating state in which the jaws 148A and 148B are disengaged from each other. The user of the medical device 100 can selectively adjust the degree of disengagement between the jaws 148A and 148B in response to the range of translation of the second actuator 112 relative to the second track 109. Conversely, the gap formed between the jaws 148A and 148B can correspond to the longitudinal translation of the second actuator 112 along the handle 102. In some embodiments, the first actuator 110 may remain stationary during the translation of the second actuator 112 relative to the handle 102.

[0037] The end effector 140 is maneuvered around the target treatment site by manipulating the position, orientation, and / or configuration of the handle 102 by a gripping feature located at the proximal end 104, allowing the end effector 140 to be positioned adjacent to the target object. With the target object positioned between the openings formed between the jaws 148A and 148B, the second actuator 112 is translated proximal in the first direction A (e.g., to the neutral and / or most proximal position) to move the first jaw 148A toward the second jaw 148B, allowing the target object (e.g., tissue) to be clamped between them.

[0038] It should be understood that actuators 110 and 112 can provide multifunctional capabilities depending on the order in which each actuator 110 and 112 operates relative to each other. For example, in another embodiment, the second actuator 112 may be moved in a first direction A (e.g., to the most proximal position) instead of the first actuator 110, thereby allowing the distal articular movement joint 130 to bend in the first direction A toward the second actuator 112. In this case, the next operation of the first actuator 110 in a second direction B (e.g., to the most distal position) would result in the movement of the second jaw 148B relative to the first jaw 148A, allowing the end effector to transition from a closed configuration to an open configuration. Since both actuators 110 and 112 can articulate the shaft 120 and actuate the end effector 140, the medical device 100 can provide an ergonomic interface for manipulating a target object (e.g., tissue) during a one-handed procedure by the user. Furthermore, the medical device 100 can provide multiple degrees and / or directions of joint movement through actuators 110, 112.

[0039] Referring next to Figure 7, another exemplary medical device 200 is shown by example in this disclosure. Unless otherwise described herein, medical device 200 may be configured and operate similarly to medical device 100. Thus, the same reference numerals are used to identify the same components.

[0040] The medical device 200 may include a handle 202 having a defined longitudinal length between a proximal end 204 and a distal end 206. The handle 202 may be sized, molded, and configured to be grasped by a user of the medical device 200. That is, the handle 202 can provide an ergonomic interface for grasping the medical device 200 and maneuvering the handle 202 with one hand. The handle 202 may further include a pair of tracks positioned along both sides of the handle 202 and extending between the proximal end 204 and the distal end 206. For example, the handle 202 may include a first track 208 along the upper wall of the handle 202 and a second track (not shown) positioned along the bottom wall of the handle 202. Each track may define a path for one or more actuators 210, 212, and the longitudinal length of the tracks may define the range of joint movement and operation of the medical device 200.

[0041] The medical device 200 may further include a pair of actuators 210, 212 movably coupled to the handle 202 on a track. For example, the medical device 200 may include a first actuator 210 slidably coupled to a first track 208 and a second actuator 212 slidably coupled to a second track. In this example, the first track 208 and the second track may include openings formed along the outside of the handle 202, thereby allowing the actuators 210, 212 to be at least partially disposed within the openings and seated inside the handle 202. In one or more directions (e.g., proximal, distal, etc.), the first actuator 210 may be configured to translate along the first track 208, and the second actuator 212 may be configured to translate along the second track. Although not shown, it should be understood that a first actuator 210 may be coupled to a first wire 170 in the handle 202, and a second actuator 212 may be coupled to a second wire 172 in the handle 202. Thus, each actuator 210, 212 may be configured to move the corresponding wires 170, 172 relative to the handle 202 in response to translation along their respective tracks.

[0042] Referring still to Figure 7, the first actuator 210 may include a body having a gripping feature 214, and the second actuator 212 may include a body having a gripping feature 216. Each gripping feature 214, 216 may be configured to facilitate the movement of the respective actuators 210, 212 relative to the corresponding track. In this example, the gripping features 214, 216 may include slidable buttons and / or knobs sized and molded to receive a user's fingers into the gripping features 214, 216. It should be understood that the gripping features 214, 216 may have a variety of other suitable sizes, shapes, and / or configurations without departing from the scope of this disclosure.

[0043] The medical device 200 may further include a shaft 120 extending distally from the handle 202, specifically from the distal end 206. Although not shown, the medical device 200 may include a proximal shaft 122 and a distal articular joint 130, with an end effector 140 coupled to the distal end of the articular joint 130. The medical device 200 may be configured and operable in the same manner as the medical device 100 described above, so that the movement of actuators 210, 212 relative to the handle 202 can result in similar articular movements and actions of the shaft 120 and end effector 140 as described in detail above with respect to the medical device 100.

[0044] Each of the systems, devices, assemblies, and methods described above can be used to manipulate target tissue with a high degree of maneuverability. By providing a medical device with an intuitive handle that allows for one-handed control of the joint movement and operation of the end-effector, the user can use the other hand to control other devices and / or tools during a procedure for treating a target site. In this case, the user can reduce overall procedure time, increase the efficiency of the procedure, and / or avoid unnecessary harm to the subject's body caused by limited control of other tools / devices.

[0045] It will be apparent to those skilled in the art that various modifications and variations may be made to the disclosed devices and methods without departing from the scope of this disclosure. Other aspects of this disclosure will be apparent to those skilled in the art from the considerations herein and the practice of the features disclosed herein. This specification and examples are intended to be considered illustrative only. The technical concepts included in this disclosure are described below. (Note 1) It is a medical device, The handlebars and A shaft extending distally from the handle, An end effector extending distally from the aforementioned shaft, A first actuator movably coupled to the handle and The device comprises a second actuator movably coupled to the handle, The first actuator is configured to (1) articulate the shaft in response to (1) translating the first actuator in a first direction relative to the handle and the second actuator, and (2) actuate the end effector in response to (2) translating the first actuator in a second direction relative to the handle and the second actuator. A medical device wherein the second actuator is configured to (1) articulate the shaft in response to (1) translating the second actuator in a first direction relative to the handle and the first actuator, and (2) actuate the end effector in response to (2) translating the second actuator in a second direction relative to the handle and the first actuator. (Note 2) The handle includes a first track extending along the body of the handle, The medical device according to Appendix 1, wherein the first actuator is configured to be received within the first track and to translate along the first track. (Note 3) The medical device according to Appendix 2, wherein the first track has a longitudinal length corresponding to (1) the degree of first joint movement of the shaft and (2) the first operating range of the end effector. (Note 4) The handle includes a second track extending along the body of the handle, The medical device according to Appendix 3, wherein the second actuator is configured to be received within the second track and to translate along the second track. (Note 5) The medical device according to Appendix 4, wherein the second track has a longitudinal length corresponding to (1) the degree of second joint movement of the shaft and (2) the second operating range of the end effector. (Note 6) The device further includes a first wire and a second wire disposed within the handle and the shaft, The first wire is coupled to the first actuator and the first part of the end effector. The medical device according to any one of appendices 1 to 5, wherein the second wire is coupled to the second actuator and the second part of the end effector. (Note 7) The first actuator is configured to move the first wire in the first direction in order to articulate the shaft and move the first portion and the second portion in the first direction. The medical device according to Appendix 6, wherein the second actuator is configured to move the second wire in a second direction in order to move the second part relative to the first part. (Note 8) The second actuator is configured to move the second wire in the first direction in order to articulate the shaft and move the first and second parts in the first direction. The medical device according to Appendix 7, wherein the first actuator is configured to move the first wire in the second direction in order to move the second part relative to the first part. (Note 9) The medical device according to any one of appendices 6 to 8, wherein the first actuator is configured to move the first part relative to the second part, and the second actuator is configured to move the second part relative to the first part. (Note 10) A medical device according to any one of appendices 1 to 9, wherein the first actuator is configured to articulate the shaft toward the first actuator in a first direction in response to the first actuator translating the first actuator in a first direction relative to the handle and the second actuator. (Note 11) The medical device according to Appendix 10, wherein the second actuator is configured to articulate the shaft toward the second actuator in the first direction in response to the second actuator translating the second actuator in the first direction relative to the handle and the first actuator. (Note 12) The medical device according to any one of appendices 1 to 11, wherein the first actuator and the second actuator are arranged around the circumference of the handle. (Note 13) The medical device according to any one of appendices 1 to 12, wherein the first actuator and the second actuator are at least partially disposed within the handle. (Note 14) The first actuator includes a first finger ring, the second actuator includes a second finger ring, and the handle includes a third finger ring. The medical device according to any one of appendices 1 to 13, wherein the third finger ring is fixed to the first and second finger rings, and the first and second finger rings move relative to each other and relative to the third finger ring. (Note 15) The medical device according to any one of appendices 1 to 14, wherein the first actuator has a proximal position corresponding to the articular movement position of the shaft, a distal position corresponding to the operating position of the end effector, and a neutral position located between the proximal and distal positions, corresponding to the non-articular movement position of the shaft and the non-operating position of the end effector.

Claims

1. It is a medical device, The handlebars and A shaft extending distally from the handle, An end effector extending distally from the aforementioned shaft, A first actuator movably coupled to the handle and The system comprises a second actuator movably coupled to the handle, A medical device wherein the first actuator is configured to (1) articulate the shaft in response to (1) translating the first actuator in a first direction relative to the handle and the second actuator, and (2) actuate the end effector in response to (2) translating the first actuator in a second direction relative to the handle and the second actuator.

2. The medical device according to claim 1, wherein the second actuator is configured to articulate the shaft in response to translating the second actuator in the first direction relative to the handle and the first actuator.

3. The medical device according to claim 1, wherein the second actuator is configured to actuate the end effector in response to translating the second actuator in a second direction relative to the handle and the first actuator.

4. The medical device according to claim 1, wherein the handle comprises a body and a first track extending longitudinally along the body, and the first actuator is configured to translate along the first track.

5. The medical device according to claim 4, wherein the longitudinal length of the first track corresponds to the degree of first joint movement of the shaft.

6. The medical device according to claim 4, wherein the longitudinal length of the first track corresponds to the first operating range of the end effector.

7. The medical device according to claim 4, wherein the handle further includes a second track extending longitudinally along the body, and the second actuator is configured to translate along the second track.

8. The medical device according to claim 7, wherein the longitudinal length of the second track corresponds to the degree of second joint movement of the shaft.

9. The medical device according to claim 7, wherein the longitudinal length of the second track corresponds to the second operating range of the end effector.

10. The device further includes a first wire disposed within the handle and the shaft, wherein the first wire is coupled to the first actuator and the first portion of the end effector. The medical device according to claim 1, wherein the first actuator is configured to move the first wire in the first direction in order to articulate the shaft and move the first portion in the first direction.

11. The medical device according to claim 10, wherein the first actuator is configured to move the first wire in the second direction in order to move the second portion of the end effector relative to the first portion.

12. The medical device according to claim 1, wherein the first actuator is arranged around the circumference of the handle.

13. The medical device according to claim 1, wherein the first actuator is at least partially disposed within the handle.

14. The medical device according to claim 1, wherein the first actuator includes a finger ring movable relative to the handle.

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