Endoscope with disposable operating channel

Abstract

An endoscope which comprises a flexible inspection duct having a proximal end, connected to a control device, a closed distal end, an access door formed at said proximal end, and an outlet door formed at said distal end, the endoscope further comprises a suction device and a suction channel arranged inside the inspection duct and connectable to said suction device to induce suction at the distal end, the endoscope being characterized in that it comprises a disposable operating channel, arranged inside the inspection duct and in communication with said suction channel.

Description

[0001] Endoscope with disposable operating channel

[0002] DESCRIPTION

[0003] The present invention relates to an endoscope comprising a disposable operating channel capable of obviating the contaminations of pathogens among patients; the invention further relates to a kit to transform a conventional endoscope into an endoscope according to the present invention.

[0004] The endoscope is a medical instrument which allows to perform diagnostic and therapeutic procedures at level of the hollow organs of the body. Then, a digestive endoscopy (in which gastroscope, colonoscope, duodenoscope, etc., are used) , urological endoscopy (cystoscope etc.) , gynecological endoscopy (hysteroscope, etc.) , pneumological endoscopy (bronchoscope, etc.) and so on, can be distinguished.

[0005] The endoscope is inserted in the body through a natural orifice such as the mouth, the nose or anu, and it has a camera and a light source to illuminate the internal area that the physician wants to observe, which is then displayed on a monitor.

[0006] Most endoscopes have an operating (or biopsy) channel, that is a channel running through the endoscope in all its length and in which one or more devices (forceps, clips, baskets, cannulotomes , dilation balloons etc.) can be inserted, hereinafter called surgical instruments, to perform a medical treatment to a patient (biopsies, removal of tumours, coagulation of bleeding, extraction of stones etc.) .

[0007] Some types of endoscopes are stiff, but most endoscopes, particularly those used for the digestive system, are flexible.

[0008] The flexible endoscope comprises two fundamental sections: the control device and the inspection duct.

[0009] The inspection duct is substantially a flexible tubular probe which is inserted in the body during the endoscopy. The length and the diameter of the duct can vary considerably based upon model and use . The channels it contains are generally protected, by way of example , by a spiral metal sheath, a steel mesh and an outer layer, made of plastics . The duct is hollow and, as said, it provides protection for the internal components , including the angulation system, the optical fibres and the video signal cables of the biopsy channel .

[0010] The inspection duct comprises an end distal to the operator, thereat an angulation section is positioned which, in turns , includes an optical sensor, systems o f optical lenses made of glass (not exhaustively : an obj ective lens for close-up and undistorted vision, a proj ection lens for illuminating near and far areas ) , optical fibres and a noz zle of the air / water system . In the context of digestive endoscope , the length of the inspection duct generally varies with the model , but usually it is comprised between 100 cm and 160 cm . The angulation section usually is about 10 cm long, whereas the external diameter of most gastroscopes , duodenoscopes and colonoscopes can vary between 5 . 4 mm and 13 . 2 mm .

[0011] On the contrary, the control device includes the commands useable by the physician : knobs for controlling the angulation section (high / low, right / left , block of angulations ) , valve for controlling air / water ( the pressure thereof involves the water supply for washing the lenses and the hole closing thereof causes the insuf flation of air ) , suction valve , remote switch videos , focusing mechanism for the optical fibre endoscopes , voltage regulator and handle to keep the endoscope ( ergonomic design for ease of use ) , input of the operating channel (used for inserting the surgical instruments for the endoscopic therapy) . A rubber valve i s usually applied on the input of the operating channel which is useful to prevent liquids and blown air from coming out from the surgery field, however allowing to insert the surgical instruments .

[0012] Some endoscopes can comprise : - a channel therefrom water is to be irrigated, the command thereof usually i s not present on the control device , but through a pedal ;

[0013] - an elevator consisting of a lever mechanism situated at the distal end of the inspection channel , preferably 5 mm long, the tilting thereof is regulated by the control device to allow to vary the angulation of the surgical instruments depending upon the operating needs .

[0014] In the context of endoscopy, it is required that , further to the correct execution of the procedure in itsel f , close attention has to be paid to all processes for the preparation and subsequent management of the endoscopes and accessories . In particular, it is necessary to pay attention to the high- level decontamination, cleansing and disinfection treatment of endoscopic instruments and their accessories , to guarantee a safe health care , from the infective point of view, for the subsequent user .

[0015] Unfortunately, several scienti fic studies have detected that sometimes the sterili zation processes , however accurate , do not completely el iminate the pathogens that have nested in the instrument , by causing contamination between di f ferent patients .

[0016] This aspect is particularly relevant and signi ficant for the duodenoscopes since , unlike gastroscopes and colonoscopes , the duodenoscopes allow the access to the common bile duct and to the bile ducts of the liver . These structures are substantially sterile environments , di f ferently from the remaining sections of the digestive tract . For this reason, the fact of vehiculating inside thereof bacteria coming from another patient can cause potentially fatal infections ( cholangitis ) .

[0017] The endoscopic procedure for which the duodenoscopes are used is called Endoscopic Retrograde Cholangiopancreatography (ERCP ) , a potentially li fe-saving procedure to treat the problems of pancreas and biliary tract . The ERCP-correlated nosocomial infections are a problem recogni zed at world level . They occur since , when performing procedures on infected patients ( especially in case of mul ti - drugs-resi stant bacteria or biofilm producers ) , the duodenoscopes become contaminated and it may happen that , despite the sterili zation processes , some bacteria survive and therefore can then infect the subsequent patient subj ected to ERCP . Duodenoscope manufacturing companies have tried to partially reduce this problem by introducing on the market disposable caps ( or distal tips ) , since it is exactly in the cap, and in particular behind the elevator, that there was the most di f ficult area to be cleaned up in the sterili zation processes .

[0018] However, this has not allowed to solve completely the problem and several studies , by performing swabs o f duodenoscopes and by analysing the components thereof with optical and electronic microscopy, have highlighted that some bacteria can survive to the sterili zation processes by nesting in the micro-recesses and in the microfractures which form in the operating channel of the duodenoscope . These microfractures are caused by the inevitable repeated passage of the surgical instruments ( cannulotomes , guiding wires , biopsy forceps , Dormia baskets , etc . ) required to carry out the treatment .

[0019] In order to solve this problem definitively, wholly disposable duodenoscopes have been introduced on the market , but to date they have not become established widely for various reasons . Firstly, the quality of the procedures suf fers because the technical performance of the disposable duodenoscopes , considering the materials used to reali ze the disposable duodenoscopes , cannot be compared to that of the reprocessable duodenoscopes . Secondly, the cost for the single procedure is much higher, as well as the cost-ef fectiveness ratio , while considering the savings in economic terms for treating the avoided infections , results to be disadvantageous . Thirdly, from a sustainability point of view, the disposal of a whole endoscope after each single procedure can result to be much more burdensome. For all these reasons, the disposable duodenoscopes are reserved for rare cases, the reprocessable duodenoscopes being still used in most of the procedures.

[0020] Some examples of endoscopes with disposable components are described by the International patent application Nr. WO 2022 / 055199 Al, by the European patent Nr. EP 2007270 Bl, and by the US patent application Nr. US 2020 / 0367730 Al: in these documents disposable covers, external to the flexible inspection duct, are described. The problem of this type of invention is given by the increase in section of the endoscopes, which in some cases could prevent the use thereof.

[0021] The US patent application Nr. US 2022 / 0125283 Al relates to an endoscope with a groove along the whole operating channel. The groove allows to insert removably a tube for the insertion of the surgical instruments. The present technical solution involves a greater exposure of the operating channel to the atmosphere and the body fluids, not being a closed channel; moreover, some embodiments of the invention could not guarantee a stable positioning of the tube which subjected to the pressure of the surgical instruments could come out, even only partially, from the operating channel. Other embodiments of the invention which could prevent a possible outcome have complex designs, potentially difficult to be inserted.

[0022] Other examples of wholly disposable endoscope are described by the European patent Nr. EP 256, 656,4 Bl and by the Chinese patent application Nr. ON 110,833,385 A.

[0023] The technical problem underlying the present invention is to implement an endoscope comprising a disposable operating channel allowing to obviate the drawbacks mentioned with reference to the known art.

[0024] Such problem is solved by an endoscope comprising a disposable operating channel which avoids the contamination with pathogens among patients, as defined according to claim 1.

[0025] The present invention allows to obviate the problem of the contamination of pathogens among patients, and at the same time it provides some relevant advantages . In particular, the shape of a standard endoscope remains unchanged, without increases in diameter which could prevent the use thereof in determined applications and the standard operating channel , which is the one which is more in direct contact with fluids or organic parts of the patient , is made disposable , by avoiding the contamination between patients , without increasing excessively the costs of the endoscopic procedures .

[0026] Other advantages , features and use modes of the present invention will be made evident by the following detailed description of some embodiments thereof , given by way of not limiting example . The figures of the enclosed drawings will be referred to , wherein :

[0027] • figure 1 is a sectional side view of a schematic representation of an endoscope and of a pre ferred embodiment of disposable operating channel with a relative guiding wire according to the present invention;

[0028] • figure 2 is a sectional side view of a schematic representation of an endoscope and of another preferred embodiment of disposable operating channel with relative guiding wire . The disposable operating channel comprises a branch setting it in communication with a suction channel , said disposable operating channel can be inserted in said endoscope through an openable access portion;

[0029] • figure 3 is a schematic view of an endoscope according to the invention with a distal end of said endoscope and with said openable access portion;

[0030] • figure 4 is a sectional side view of a schematic representation of an endoscope in which said disposable operating channel is being inserted by using said guiding wire of figure 1 ;

[0031] • figure 5 is a sectional side view of a schematic representation of an endoscope in which said disposable operating channel of figure 1 has been inserted in a use position; • figure 6 is a schematic view of a trans formation kit of the endoscope according to figure 1 showing an endoscope , a perspective view of said disposable operating channel of figure 1 and of the respective guiding wire ; and

[0032] • figure 7 is a schematic view of a trans formation kit of the endoscope according to figure 2 comprising an endoscope , a perspective view of said disposable operating channel of figure 2 and of the respective guiding wire .

[0033] According to a first aspect of the invention, with reference to figures 1 and 2 , an endoscope , designated as a whole with 1 , is described .

[0034] It comprises a closed and flexible inspection duct 2 having a proximal end 2A, connected to a control device 3 , a closed distal end 2B, an access door 2C formed at said proximal end 2A, and an outlet door 2D formed at said distal end 2B .

[0035] Advantageously, the inspection duct 2 is closed to reduce the contamination due to the bacterial and / or viral exposure in the pre-operating phase . Said inspection duct 2 is the part of the endoscope 1 which inserts inside a patient to perform the endoscopic procedures and which can have a length comprised between 10 cm and 160 cm, preferably 125 cm, and a diameter comprised between 3 . 5 mm and 16 mm, preferably 11 . 6 mm .

[0036] The control device 3 allows to move said inspection duct 2 through a moving mechanism comprised in said endoscope 1 in order to address the inspection duct 2 ins ide the bowels .

[0037] According to some preferred embodiments , said endoscope 1 , e . g . duodenoscopes , can comprise an elevator placed at the distal end 2B . Said elevator consists in a lever mechanism, preferably 5 mm long, whose angulation is regulated by said control device 3 to allow the variation of the angulation of the surgical instruments depending upon the operating needs . The endoscope 1 further comprises a light source 4 and an optical channel 5 , arranged inside the inspection duct 2 , to transmit a light beam from the proximal end 2A, which can be connected to said light source 4 , to the distal end 2B of the inspection duct 2 .

[0038] According to some preferred embodiments of the invention, said optical channel 5 is implemented by using the optical fibre , being flexible and suitable to transmit the light from the proximal end 2A to the distal end 2B . The light source 4 upstream of the optical channel 5 can be a simple incandescent light bulb, with LED or neon technology, constituting a light source 4 which provides the light , which is transmitted to the distal end 2B, in order to be able to illuminate a surgery field ( internal organs of the patient ) .

[0039] In fact , to be able to display the surgery field, the endoscope 1 , moreover, comprises a display device 6 and an image sensor 7 positioned inside the inspection duct 2 at the distal end 2B, said display device 6 being associated to the image sensor 7 .

[0040] Said image sensor 7 can be substantially a microcamera arranged at the distal end 2B, said image sensor 7 allows to display the surgery field only i f suitably illuminated; therefore , the use of both the light source 4 and of the image sensor 7 , allows performing endoscopic procedures .

[0041] According to some preferred embodiments , said display device 6 is a monitor, alternatively it can be a wearable visor .

[0042] During the endoscopic procedures it i s necessary to clean the surgery field, preferably with air and water .

[0043] Therefore , said endoscope comprises a water tank 8 , an air tank 9 under pressure , a system 9B for pumping water and a blowing channel 10 which is arranged inside the inspection duct 2 and can be connected alternatively to the pumping system 9B or to the air tank 9 , to blow air or water at said distal end 2B . Preferably, said water tank 8 and said air tank 9 are under pressure and they can be connected to said control device 3 through a tubular connection, commonly cal led umbilical cord .

[0044] Even in this case , the presence of the blowing channel 10 is synergic to that of the light source 4 with relative optical channel 5 , of the image sensor 7 with relative display device 6 , since both the image sensor 7 and the optical channel 5 tend to get dirty during the endoscopic procedures and in order to clean them it is required to blow water ; on the contrary, from a same noz zle placed at the distal end 2B , air can be blown when the bowels have to be stretched for adequate display .

[0045] According to other embodiments , said endoscope 1 also comprises a washing channel (not shown in figures ) arranged inside the inspection duct 2 . The washing channel can be used to irrorate , with abundant water amounts , the surgery field, i f it is foreseen in an operating procedure . Preferably, said washing channel can be connected to the water tank 8 .

[0046] During the endoscopic procedures , further to blow fluids and air, it is necessary to suck them . In fact , it could be necessary to suck blood, visceral fluids , the sprayed water or the blown air, etc .

[0047] Therefore , the endoscope also comprises a suction device 11 and a suction channel 12 arranged inside the inspection duct 2 and connectable to said suction device 11 to induce suction at the distal end 2B . Such suction channel 12 in its more distal part consi sts of the same operating channel , whereas in its more proximal part separates therefrom with a Y-l ike intersection .

[0048] Said suction device 11 being for example a vacuum pump .

[0049] In order to control the light source 4 , the image sensor 7 , the blowing channel 10 and the suction device 12 , the control device 3 comprises a plurality of actuating mechani sms which allow an operator to activate or deactivate all mentioned components so as to use them according to the needs dictated by the endoscopic procedure .

[0050] At last , the endoscope 1 , the invention relates to , is characteri zed in that it comprises a disposable operating channel 13 , arranged inside the inspection duct 2 and in communication with said suction channel 12 .

[0051] Preferably, said disposable operating channel 13 is wholly arranged inside the inspection duct 2 and in communication with said suction channel 12 .

[0052] Advantageously, with the disposable operating channel 13 , which is then used for one single patient , the contagion among patients , on whom endoscopic procedures are performed with the same endoscope 1 , is avoided .

[0053] It will be appreciated that even in the disposable operating channel 13 it is possible to insert the surgical instruments , indeed said disposable operating channel 13 performs even the role of biopsy channel .

[0054] An additional advantage lies in that a closed inspection duct 2 prevents the disposable operating channel 13 from possibly coming out from the inspection duct 2 , in particular, from the lateral walls of the inspection duct 2 .

[0055] Thus , it is possible that due to the force exerted by the surgical instruments , i f the inspection channel 2 does not have continuous walls , the disposable operating channel 13 can partially come out from its seat or in any case can have a greater clearance which causes unwished motions in the operating room .

[0056] Preferably, said disposable operating channel 13 is made of flexible plastic material for healthcare use , for example silicone .

[0057] More preferably, said disposable operating channel 13 is made of polyethylene terephthalate ( PET ) .

[0058] According to some embodiments , said disposable operating channel 13 can include a spiral made of medical metallic material , for example copper or aluminium. The spiral made of metallic material provides better sti f fness to the flexible plastic material , by simpli fying, for example , the procedures for inserting the disposable operating channel 13 in the inspection duct 2 .

[0059] Therefore , the synergic ef fect o f the light source 4 with the relative optical channel 5 , of the display device 6 with the relative image sensor 7 , of the blowing channel 10 , of the suction device 11 with the relative suction channel 12 and of the disposable operating channel 13 allows to perform a wide range of endoscopic procedures ef fectively, economically and by reducing the risk of infections transmitted among patients .

[0060] According to the embodiments shown in figures 1 , 4 , 5 , 6 the disposable operating channel 13 comprises a hole 14 on a wall thereof 15 , setting it in communication with the proximal part of said suction channel 12 .

[0061] Preferably, said disposable operating channel 13 comprises a stopping end 16 comprising an marker 17 at the proj ection of the hole 14 thereon .

[0062] According to these embodiments , said disposable operating channel 13 can be inserted, removably, in a pre-existing standard operating channel .

[0063] In this way, the pre-existing operating channel is coated inside by the disposable operating channel 13 ; then, the disposable operating channel 13 cannot cause transportation of infections among patients , since between one patient and another one , further to the sterili zation procedures , the disposable operating channel 13 used on a first patient is replaced with a new and sterile disposable operating channel 13 to be used on a second patient .

[0064] Advantageously, the presence of the marker is useful to position the disposable operating channel 13 with the hole 14 towards the suction channel 12 , which enters the standard operating channel . Preferably, said hole 14 is at a distance from the stopping end 16 comprised between 3 cm and 7 cm, more preferably at 5 cm .

[0065] The main advantage of this preferred embodiment is that the standard endoscopes do not require any preliminary modi fication to allow the reversible insertion of the disposable operating channel 13 .

[0066] According to this preferred embodiment of the invention, when implementing an endoscope 1 , it is required to implement a disposable operating channel 13 with a diameter slightly smaller than the diameter of the pre-existing operating channel , to allow the insertion thereof without reducing too much the section of the disposable operating channel 13 , then allowing an easy insertion of the surgical instruments .

[0067] Therefore , said disposable operating channel 13 can have a diameter comprised between 3 mm and 5 mm, preferably 4 . 1 mm and a length comprised between 10 cm and 160 cm, preferably 130 cm .

[0068] More preferably, said disposable operating channel 13 can have a length comprised between 120 cm and 130 cm, in particular i f arranged to be inserted in duodenoscopes .

[0069] According to other preferred embodiments of the invention shown in figure 2 and 7 , said disposable operating channel 13 comprises a branch 18 setting it in communication with said suction channel 12 .

[0070] In these embodiments , the disposable operating channel 13 can be set directly in connection with the suction channel 12 at the height of the control device 3 .

[0071] In this case , the endoscope instead of having a pre-existing operating channel in which the disposable operating channel 13 is to be inserted, can have a dedicated housing in the inspection channel 2 (not shown in figures ) , which can be a guiding channel or a portion of the inspection duct 2 separated with a septum, in which the disposable operating channel 13 can slide . In order insert the disposable operating channel 13 according to this embodiment , the endoscope 1 comprises an openable access portion 19 , at said proximal end 2A, wherein it is possible to reversibly insert said disposable operating channel 13 and to connect it to the proximal part of the suction channel 12 .

[0072] Preferably, said openable access portion 19 , is positioned only at said proximal end 2A, in particular, at said access door 2C .

[0073] The openable access portion can have quadrangular shape , wherein a first si ze is preferably comprised between 2 cm and 5 cm, more preferably 4 cm, and a second si ze is preferably comprised between 2 cm and 5 cm, more preferably 2 . 5 cm .

[0074] Advantageously, the fact of limiting the si zes of the openable access portion 19 allows to guarantee an easy insertion of the disposable operating channel 13 and to avoid the prolonged exposure of the disposable operating channel 13 to the external environment , by limiting the contamination thereof with pathogens .

[0075] Moreover, the reduced si zes of the openable access portion 19 allow a good stability of the di sposable operating channel 13 inside the inspection duct 2 while still allowing an easy insertion thereof .

[0076] According to other embodiments , the openable access portion 19 can have an irregular shape and can extend as far as the access door 2C allowing the insertion of the disposable operating channel 13 in the inspection duct 2 and allowing to place an initial portion 13A of the disposable operating channel 13 at the access door 2C and to place the branch 18 in connection with the suction channel 12 . Once positioned the disposable operating channel 13 in the use position, the openable access portion 19 is arranged to be re-closed and contain inside thereof the disposable operating channel 13 .

[0077] The disposable operating channel according to these last embodiments can have a diameter comprised between 3 mm and 5 mm, preferably 4 . 2 mm and a length comprised between 10 cm and 160 cm, preferably 130 cm .

[0078] The main advantage of this embodiment of disposable operating channel 13 is the fact of not producing a reduction in the section of the operating channel .

[0079] According to some embodiments , the disposable operating channel 13 , preferably with the metallic spiral , can be inserted in the access door 2C and pushed as far as the outlet door 2D of the endoscope 1 .

[0080] According to a second aspect of the invention, with reference to figures 1 , 2 , 5 and 6 a trans formation kit , designated as a whole with 20 , is described .

[0081] Said trans formation kit 20 has the purpose of modi fying an endoscope 1 according to the described embodiments ; said kit

[0082] 20 which comprises one or more disposable operating channels 13 , each one being set in communication with said suction channel 12 , once inserted in said endoscope 1 , one or more guiding wires 21 for the insertion of the disposable operating channel 13 in the endoscope . Each guiding wire 21 with a length preferably greater than the length of the inspection duct 2 and with a diameter which allows to insert said guiding wire

[0083] 21 in said disposable operating channel 13 . Each guiding wire 21 of the plurality of guiding wires 21 can be inserted in a respective disposable operating channel 13 of the plurality of disposable operating channels 13 .

[0084] Each disposable operating channel 13 comprises a proximal end 16A and a distal end 16B .

[0085] Said guiding wires 21 comprise a proximal end 21A, a distal end 21B and a possible exceeding portion 23 which, once the guiding wire 21 has been inserted in the disposable operating channel 13 , by making it to enter from the inlet end 16A and by making it to exit from the outlet end 16B, comes out from the latter . Preferably, the exceeding portion 23 has a length greater than the length of the inspection duct 2 . Once the guiding wire 21 is inserted in the disposable operating channel 13 , they both can be inserted in the endoscope 1 , by making the possible exceeding portion to come out from the outlet door 2D .

[0086] According to the preferred embodiment example shown in figures 1 , 4 , 5 , 6 , said disposable operating channel 13 and said guiding wire 21 , being inserted inside the disposable operating channel 13 , are suitable to be inserted in said inspection duct 2 , in particular in a pre-existing operating channel , through said access door 2C .

[0087] While inserting said disposable operating channel 13 , having inside said guiding wire 21 , it is necessary to position, i f present , the marker 17 on the stopping end 16 toward the origin of the suction channel 12 , so that , once the disposable operating channel 13 is inserted, it is still possible to suck the fluids from the the distal end 2B to the proximal end 2A.

[0088] Once the disposable operating channel 13 is in a use position, with the outlet end 16B at said distal end 2B, the guiding wire 21 can be extracted by slipping it out of the outlet door 2D, alternatively it can be extracted by slipping it out of the access door 20.

[0089] I f the guiding wire 21 were pulled out of the access door 20, one would prevent the di sposable operating channel 13 from moving from its use position, by keeping said stopping end 16 in contact with said control device 3 . Such stopping end 16 would be preferably stabili zed by an application on the access door 2C of a rubber valve which can be present on the endoscope 1 to prevent liquids and blown air from coming out from the surgery field, however allowing the insertion of the surgical instruments .

[0090] It will be appreciated that under use position it is meant when the disposable operating channel 13 coats completely or replaces a pre-existing operating channel .

[0091] Preferably, in order to ease the extraction of the guiding wire 21 from the access door 2C and to make the guiding wire 21 dragging the disposable operating channel 13 , each one of said guiding wires 21 comprises a locking end 22 coming in contact with said stopping end 16 at least when the latter is in contact with said access door 2C .

[0092] The locking end 22 has the double purpose of preventing the proximal end 21A of the guiding wire 21 from slipping accidentally inside the disposable operating channel 13 and from providing a section to be able to be grasped, which is not fili form, in order to extract it easily from the disposable operating channel 13 .

[0093] This embodiment example is particularly advantageous since it allows to use an existing endoscope , already provided with standard operating channel , by covering the latter internally with the disposable operating channel 13 , thus avoiding the contamination thereof during an endoscopic procedure .

[0094] According to another preferred embodiment of the trans formation kit 20 of the endoscope 1 , the invention relates to , as shown in figures 2 and 7 , each disposable operating channel 13 comprises a branch 18 sets in communication with said suction channel 12 and wherein said control device 3 comprises an openable access portion 19 , wherein it is possible to reversibly insert said disposable operating channel 13 in which said guiding wire 21 is inserted .

[0095] Preferably, said openable access portion 19 , is positioned at said proximal end 2A, in particular near said access door 2C .

[0096] The openable access portion 19 can have quadrangular shape , wherein a first si ze is preferably comprised between 2 cm and 5 cm, more preferably 4 cm, and a second si ze is preferably comprised between 2 cm and 5 cm, more preferably 2 . 5 cm .

[0097] Alternatively, the openable access portion 19 can have ovoid shape , wherein a first axis is preferably comprised between 2 cm and 5 cm, more preferably 4 cm, and a second axis is preferably comprised between 2 cm and 5 cm, more preferably 2 . 5 cm . According to other embodiments , the openable access portion 19 can have an irregular shape and can extend as far as the access door 2C allowing the insertion of the disposable operating channel 13 in the inspection duct 2 and allowing to place an initial portion 13A of the disposable operating channel 13 at the access door 2C and to place the branch 18 in connection with the suction channel 12 . Once the disposable operating channel 13 is positioned in the use position, the openable access portion 19 is arranged to be re-closed and contain inside thereof the disposable operating channel 13 .

[0098] In fact , in order to insert said disposable operating channel 13 one may need a guiding wire 21 which al lows to arrange the disposable operating channel 13 in its use position by reducing the possibility that it gets stuck inside the inspection duct 2 .

[0099] Therefore , it results necessary to have a trans formation kit 20 comprising one or more disposable operating channels 13 according to this last embodiment and one or more guiding wires 21 .

[0100] Even in this embodiment , the disposable operating channel can have a stopping end 16 sets in contact with said control element 3 at least when said disposable operating channel 13 is in a use position and each one of said guiding wires 21 can comprise a locking end 22 sets in contact with said stopping end 16 at least when the latter is in contact with said access door 2C .

[0101] According to this embodiment , in order to insert said disposable operating channel 13 it is necessary to remove the openable access portion 19 , which for example is a shaped small door with a mechanical interlocking easily reversible from a closed position to an open position and vice versa ; then one can proceed with inserting one of the disposable operating channels 13 in case with said guiding wire 21 .

[0102] Once said disposable operating channel 13 is inserted, the branch 18 is connected with the suction channel 12 , then, i f the disposable operating channel 13 is in use position, said guiding wire 21 is extracted in the already described modes .

[0103] At last , the openable access portion 19 is re-closed .

[0104] The trans formation kit 20 to trans form the conventional endoscopes into endoscopes 1 with disposable operating channel 13 , deals with the risk of contamination among patients without facing the costs for purchasing and disposing entire disposable endoscopes .

[0105] Moreover, the trans formation kit 20 allows to have a stock of disposable operating channels 13 and possible corresponding guiding wires 21 to face the several dai ly endoscopic procedures .

[0106] It will be appreciated that i f one already has an endoscope , once a first trans formation kit 20 is used up, it i s suf ficient to stock up on a new trans formation kit 20 without having to change endoscope .

[0107] The present invention generally relates to an endoscope 1 , but preferably it relates to a duodenoscope .

[0108] It will be appreciated that the endoscopes 1 , the invention relates to , are mainly used within healthcare procedures , but they can be used even to inspect ravines , small cavities , archaeological areas , and so on .

[0109] The present invention has been so far described with reference to preferred embodiments . It is to be meant that other embodiments belonging to the same inventive concept may exist, all within the protective scope of the enclosed claims .

Claims

CLAIMS1. An endoscope (1) comprising:• a closed and flexible inspection duct (2) having a proximal end (2A) , connected to a control device (3) , a closed distal end (2B) , an access door (2C) formed at said proximal end (2A) , and an outlet door (2D) formed at said distal end (2B) ;• a light source (4) and an optical channel (5) arranged inside the inspection duct (2) , to transmit a light beam from the proximal end (2A) , which can be connected to said light source (4) , to the distal end (2B) of the inspection duct (2) ;• a display device (6) and an image sensor (7) positioned on the distal end (2B) of the inspection duct (2) , said display device (6) being associated to the image sensor (7) ;• a water tank (8) , an air tank (9) , a system (9B) for pumping air and water and a blowing channel (10) arranged inside the inspection duct (2) and alternatively connectable to said water tank (8) and to said air tank (9) to blow air or water at said distal end (2B) ; and• a suction device (11) and a suction channel (12) arranged inside the inspection duct (2) and connectable to said suction device (11) to induce suction at the distal end (2B) , characterized in that it further comprises a disposable operating channel (13) , arranged inside the inspection duct (2) and in communication with said suction channel (12) .

2. The endoscope (1) according to claim 1, wherein said disposable operating channel (13) comprises a hole (14) on a wall thereof (15) , that establishes communication with said suction channel (12) and a stopping end (16) which contacts said control element (3) when said disposable operating channel (13) is in a use position.

3. The endoscope (1) according to claim 2, wherein said stopping end (16) comprises an marker (17) at the projection of the hole (14) thereon.

4. The endoscope (1) according to claim 1, wherein said disposable operating channel (13) comprises a branch (18) that establishes communication with said suction channel (12) .

5. The endoscope (1) according to claim 4, which comprises an openable access portion (19) , at said proximal end (2A) , wherein it is possible to reversibly insert said disposable operating channel (13) .

6. A transformation kit (20) to modify an endoscope (1) , wherein the endoscope (1) comprises:• a flexible inspection duct (2) having a proximal end (2A) , connected to a control device (3) , a closed distal end (2B) , an access door (2C) formed at said proximal end (2A) , and an outlet door (2D) formed at said distal end (2B) ;• a light source (4) and an optical channel (5) arranged inside the inspection duct (2) , to transmit a light beam from the proximal end (2A) , which can be connected to said light source (4) , to the distal end (2B) of the inspection duct (2) ;• a display device (6) and an image sensor (7) positioned on the distal end (2B) of the inspection duct (2) , said display device (6) being associated to the image sensor (7) ;• a water tank (8) , an air tank (9) , a system (9B) for pumping air and water and a blowing channel (10) arranged inside the inspection duct (2) and alternatively connectable to said water tank (8) and to said air tank (9) to blow air or water at said distal end (2B) ;• a suction device (11) and a suction channel (12) arranged inside the inspection duct (2) and connectable to said suction device (11) to induce suction at the distal endsaid transformation kit (20) comprises:• one or more disposable operating channels (13) , each one can be inserted in the inspection duct (2) and in communication with said suction channel (12) ;• one or more guiding wires (21) each one having a diameter which allows to insert said guiding wire (21) in said disposable operating channel (13) .

7. The transformation kit (20) according to claim 6, wherein each disposable operating channel (13) comprises a hole (14) implemented on a wall thereof (15) , said disposable operating channel (13) and said guiding wire (21) , being inserted inside the disposable operating channel (13) , are suitable to be inserted in said inspection duct (2) through said access door (2C) .

8. The transformation kit (20) according to claim 6, wherein each disposable operating channel (13) comprises a branch (18) that establishes communication with said suction channel (12) e wherein said control device (3) comprises an openable access portion (19) wherein it is possible to reversibly insert said disposable operating channel (13) wherein said guiding wire (21) is inserted.

9. The transformation kit (20) according to claim 7 or 8, wherein each disposable operating channel (13) comprises a stopping end (16) which contacts said control element (3) when said disposable operating channel (13) is in a use position, preferably, said stopping end (16) comprises an marker (17) at the projection of said hole (14) or the projection of said branch (18) .

10. The transformation kit (20) according to claims 6 to 9, wherein each one of said guiding wires (21) comprises a locking end (22) which comes in contact with said stopping end (16) at least when the latter is in contact with said access door (2C) .

11. A disposable operating channel (13) for endoscope (1) comprising an inspection duct (2) and a suction channel (12) in communication to each other, an access door (2C) to saidinspection duct (2) , wherein said disposable operating channel (13) can be inserted in said inspection duct (2) through said access door (2C) and is in communication with said suction channel ( 12 ) .

12. The disposable operating channel (13) according to claim11 comprising a hole (14) implemented on a wall thereof (15) arranged to be placed at said suction channel (12) .

13. The disposable operating channel (13) according to claim12 wherein the endoscope (1) comprises a control device (3) connected to a proximal end (2A) of said inspection duct (2) and wherein said disposable operating channel (13) comprises a stopping end (16) which contacts said control device (3) when said disposable operating channel (13) is in a use position, preferably, said stopping end (16) comprises an marker (17) at the projection of the hole (14) thereon.

14. The disposable operating channel (13) according to claim 11 comprising a branch (18) that establishes communication with said suction channel (12) and wherein said endoscope (1) comprises a control device (3) connected to a proximal end (2A) of said inspection duct (2) and an openable access portion (19) wherein it is possible to reversibly insert said disposable operating channel (13) .

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