Endoscope with integrated stabilizer and cannulation elements

Abstract

An endoscope system can include an arm and a scope defining a working channel extending along a longitudinal axis of the scope. The working channel can define an opening of the working channel at a distal tip of the scope. The arm can be connected to the distal tip of the scope and can be movable with respect to the scope and the working channel to engage and clear tissue from the opening of the working channel.

Description

ENDOSCOPE WITH INTEGRATED STABILIZER AND CANNULATION ELEMENTSCLAIM OF PRIORITY

[0001] This patent application claims the benefit of priority to Jake Terravecchia, U.S. Patent Application Serial Number 63 / 557,865, entitled “ENDOSCOPE WITH INTEGRATED STABILIZER AND CANNULATION ELEMENTS,” filed on February 26, 2024, which is hereby incorporated by reference herein in its entirety.TECHNICAL FIELD

[0002] The present disclosure relates generally to medical devices and instruments configured to provide diagnostic and treatment operations. More specifically, the present disclosure relates to medical device systems comprising elongate bodies, such as endoscopes, that can be inserted into incisions or openings in anatomy of a patient and advanced to reach locations deep within anatomic passageways of the patient where the diagnostic and treatment operations can be performed.BACKGROUND

[0003] Endoscopes can be used to provide passage of other devices, e.g., therapeutic devices or tissue collection devices, toward various anatomical portions, or for imaging of such anatomical portions. Such anatomical portions can include gastrointestinal tract (e.g., esophagus, stomach, duodenum, pancreaticobiliary duct, intestines, colon, and the like), renal area (e.g., kidney(s), ureter, bladder, urethra) and other internal organs (e.g., reproductive systems, sinus cavities, submucosal regions, respiratory tract), and the like.SUMMARY

[0004] In an endoscopy, a distal portion of the endoscope can be configured for supporting and orienting a therapeutic device. A distal portion of some current ureteroscopes can provide irrigation to the surgical site through a working channel during a lithotripsy procedure. Kidney stone fragments generated during the procedure can be removed using baskets, and dust (e.g., smaller fragments) canremain in the kidney to pass naturally during urination. A next generation of ureteroscopes can have separate channels to allow irrigation of saline and aspiration of stone dust. Aspiration of stone dust can be achieved through the working channel. One issue that arises during dust aspiration is a fragment getting stuck or lodged in the working channel at its opening at the distal tip of the scope, which can limit or preventing further aspiration of fluid and dust. This situation can delay the procedure and cause user dissatisfaction.

[0005] The present disclosure can help to address these issues by including a clearing device connected to a distal tip of the endoscope. When the working channel becomes clogged or stuck with a stone fragment, the clearing device can be operated (either manually or automatically) to clear the stone fragment from the working channel, allowing for the procedure to proceed, helping to save time and reduce patient complications.

[0006] For example, an endoscope system can include an arm and a scope defining a working channel extending along a longitudinal axis of the scope. The working channel can define an opening of the working channel at a distal tip of the scope. The arm can be connected to the distal tip of the scope and can be movable with respect to the scope and the working channel to engage and clear tissue from the opening of the working channel.

[0007] The above discussion is intended to provide an overview of subject matter of the present patent application. It is not intended to provide an exclusive or exhaustive explanation of the invention. The description below is included to provide further information about the present patent application.BRIEF DESCRIPTION OF THE DRAWINGS

[0008] In the drawings, which are not necessarily drawn to scale, like numerals may describe similar components in different views. Like numerals having different letter suffixes may represent different instances of similar components. The drawings illustrate generally, by way of example, but not by way of limitation, various embodiments discussed in the present document.

[0009] FIG. 1 illustrates a schematic diagram of an endoscopy system.

[0010] FIG. 2 illustrates a schematic diagram of the imaging and control system of FIG. 1 showing the imaging and control system connected to the endoscope.

[0011] FIG. 3 illustrates a schematic view of a distal portion of an endoscope and a control system.

[0012] FIG. 4 illustrates a side view of a portion of an endoscope in a first condition.

[0013] FIG. 5 illustrates a side view of a portion of an endoscope in a second condition.

[0014] FIG. 6 illustrates end view of a portion of an endoscope in a second condition.

[0015] FIG. 7A illustrates an end view of a portion of an endoscope in a first condition.

[0016] FIG. 7B illustrates an end view of a portion of an endoscope in a second condition.

[0017] FIG. 8A illustrates a side cross-sectional view of a portion of an endoscope.

[0018] FIG. 8B illustrates a side cross-sectional view of a portion of an endoscope.

[0019] FIG. 8C illustrates a side cross-sectional view of a portion of an endoscope.

[0020] FIG. 8D illustrates a side cross-sectional view of a portion of an endoscope.

[0021] FIG. 9A illustrates an end view of a portion of an endoscope in a first condition.

[0022] FIG. 9B illustrates an end view of a portion of an endoscope in a second condition.

[0023] FIG. 10 illustrates a side cross-sectional view of a portion of an endoscope.

[0024] FIG. 11 illustrates a schematic view of a portion of an endoscope.

[0025] FIG. 12 illustrates a block diagram illustrating an example of a machine upon which one or more embodiments may be implemented.DETAILED DESCRIPTION

[0026] FIG. 1 is a schematic diagram of an endoscopy system 10 that can include an imaging and control system 12 and an endoscope 14. The system of FIG. 1 is an illustrative example of an endoscopy system suitable for use with the systems, devicesand methods described herein, such as an endoscope with an integrated guide and arm for guiding extension of an auxiliary scope.

[0027] The endoscope 14 can be insertable into an anatomical region for imaging or to provide passage of or attachment to (e.g., via tethering) one or more sampling devices for biopsies, or one or more therapeutic devices for treatment of a disease state associated with the anatomical region. The endoscope 14 can interface with and connect to an imaging and control system 12. The endoscope 14 can also include a ureteroscope, though other types of endoscopes can be used with the features and teachings of the present disclosure. The imaging and control system 12 can include a control unit 16, an output unit 18, an input unit 20, a light source 22, a fluid source 24, and a suction pump 26.

[0028] The imaging and control system 12 can include various ports for coupling with the endoscopy system 10. For example, the control unit 16 can include a data input / output port for receiving data from and communicating data to the endoscope 14. The light source 22 can include an output port for transmitting light to the endoscope 14, such as via a fiber optic link. The fluid source 24 can include a port for transmitting fluid to the endoscope 14. The fluid source 24 can include, for example, a pump and a tank of fluid or can be connected to an external tank, vessel or storage unit. The suction pump 26 can include a port used to draw a vacuum from the endoscope 14 to generate suction, such as for withdrawing fluid from the anatomical region into which the endoscope 14 is inserted. The output unit 18 and the input unit 20 can be used by an operator of the endoscopy system 10 to control functions of the endoscopy system 10 and view output of the endoscope 14. The control unit 16 can additionally be used to generate signals or other outputs from treating the anatomical region into which the endoscope 14 is inserted. In some examples, the control unit 16 can generate electrical output, acoustic output, a fluid output and the like for treating the anatomical region with, for example, cauterizing, cutting, freezing and the like.

[0029] The endoscope 14 can include an insertion section 28, a functional section 30 and a handle section 32, which can be coupled to a cable section 34 and a coupler section 36. The coupler section 36 can be connected to the control unit 16 to connect the endoscope 14 to multiple features of the control unit 16, such as the input unit 20, the light source unit 22, the fluid source 24, and the suction pump 26.

[0030] The insertion section 28 can extend distally from the handle section 32 and the cable section 34 can extend proximally from the handle section 32. The insertion section 28 can be elongate and include a bending section, and a distal end to which the functional section 30 can be attached. The bending section can be controllable (e.g., by a control knob 38 on the handle section 32) to maneuver the distal end through tortuous anatomical passageways (e.g., stomach, duodenum, kidney, ureter, etc.). The insertion section 28 can also include one or more working channels (e.g., an internal lumen) that can be elongate and can support insertion of one or more therapeutic tools of the functional section 30, such as an auxiliary scope 134 (of FIG. 4). The working channel can extend between the handle section 32 and the functional section 30. Additional functionalities, such as fluid passages, guide wires, and pull wires can also be provided by the insertion section 28 (e.g., via suction or irrigation passageways, or the like).

[0031] The handle section 32 can include the knob 38 as well as a port 40a. The knob 38 can be connected to a pull wire, or other actuation mechanisms, extending through insertion the section 28. Port 40a, as well as other ports, such as the port 40B (of FIG. 2) can be configured to couple various electrical cables, guide wires, auxiliary scopes, tissue collection devices of the present disclosure, fluid tubes and the like to the handle section 32, such as for coupling with the insertion section 28.

[0032] The imaging and control system 12 can be provided on a mobile platform (e.g., a cart 41) with shelves for housing the light source 22, the suction pump 26, an image processing unit 42 (FIG. 2), etc. Alternatively, several components of imaging and the control system 12 shown in FIGS. 1 and 2 can be provided directly on the endoscope 14 so as to make the endoscope self-contained.

[0033] The functional section 30 can include components for treating and diagnosing anatomy of a patient. The functional section 30 can include an imaging device, an illumination device and a guide, as discussed in further detail below. The functional section 30 can further include optically enhanced biological matter and tissue collection and retrieval devices as are described herein. For example, the functional section 30 can include one or more electrodes conductively connected to the handle section 32 and functionally connected to the imaging and control system12 to analyze biological matter in contact with the electrodes based on comparative biological data stored in the imaging and control system 12.

[0034] FIG. 2 is a schematic diagram of the endoscopy system 10 of FIG. 1 including the imaging and control system 12 and the endoscope 14. FIG. 2 schematically illustrates components of the imaging and the control system 12 coupled to the endoscope 14, which in the illustrated example includes a ureteroscope. The imaging and control system 12 can include the control unit 16, which can include or be coupled to an image processing unit 42, a treatment generator 44 and a drive unit 46, as well as the light source 22, the input unit 20, and the output unit 18. The control unit 16 can include, or can be in communication with, an endoscope 100, a surgical instrument and an endoscopy system, which can include a device configured to engage tissue and collect and store a portion of that tissue and through which imaging equipment (e.g., a camera) can view target tissue via inclusion of optically enhanced materials and components. The control unit 16 can be configured to activate a camera to view target tissue distal of a surgical instrument and the endoscopy system. Likewise, the control unit 16 can be configured to activate the light source unit 22 to shine light on the surgical instrument, which can include select components that are configured to reflect light in a particular manner, such as tissue cutters being enhanced with reflective particles.

[0035] The image processing unit 42 and light source 22 can each interface with the endoscope 14 (e.g., at the functional unit 30) by wired or wireless electrical connections. The imaging and control system 12 can accordingly illuminate an anatomical region, collect signals representing the anatomical region, process signals representing the anatomical region, and display images representing the anatomical region on the display unit 18. The imaging and control system 12 can include light the source 22 to illuminate the anatomical region using light of desired spectrum (e.g., broadband white light, narrow-band imaging using preferred electromagnetic wavelengths, and the like). The imaging and control system 12 can connect (e.g., via an endoscope connector) to the endoscope 14 for signal transmission (e.g., light output from light source, video signals from imaging system in the distal end, diagnostic and sensor signals from a diagnostic device, and the like).

[0036] The fluid source 24 (shown in FIG. 1) can be in communication with control unit 16 and can include one or more sources of air, saline or other fluids, as well as associated fluid pathways (e.g., air channels, irrigation channels, suction channels) and connectors (barb fittings, fluid seals, valves and the like). The fluid source 24 can be utilized as an activation energy for a biasing device or a pressureapplying device of the present disclosure. The imaging and control system 12 can also include the drive unit 46, which can include a motorized drive for advancing a distal section of endoscope 14.

[0037] The coupler section 36 can be connected to the control unit 16 to connect to the endoscope 14 to multiple features of the control unit 16, such as the image processing unit 42 and the treatment generator 44. In examples, the port 40a can be used to insert another instrument or device, such as a daughter scope or auxiliary scope, into the endoscope 14. Such instruments and devices can be independently connected to the control unit 16 via the cable 47. In some examples, the port 40B can be used to connect coupler section 36 to various inputs and outputs, such as video, air, light and electric.

[0038] FIG. 3 is a schematic illustration of a distal portion of an endoscope 100, which can be a portion of the endoscopy system 10 such as the endoscope 14. The endoscope 100 can include a distal portion 102 and a control module 104. The control module 104 can include a controller 106. The control module 104 can include other components, such as those described with reference to the endoscopy system 10 of FIG. 1 and the control unit 16 of FIG. 2. Additionally, the control module 104 can include components for controlling a camera and a light source connected to an auxiliary scope (or daughter scope), such as an imaging unit 108, lighting 110, and a power unit 112. The endoscope 100 can be configured similarly as the endoscope 14 of FIGS. 1 and 2. The control module 104 can also include an actuator 114 (e.g., a motor or the like) for operating an arm of the endoscope 100 (discussed in further detail below).

[0039] The endoscope 100 can further include a working channel 116 including a distal opening 118. The working channel 116 can be a bore, passage, channel, lumen, or the like, extending through the endoscope 100, such as through the insertion section 28. The working channel 116 can be configured to support one or moreinstrument therein or therethrough and can be configured to receive fluid flow therethrough, such as suction pressure during remove of stone fragments or dust. The endoscope 100 can also include an irrigation channel 120 that can be a bore, passage, channel, lumen, or the like, extending through the endoscope 100, such as through the insertion section 28. The irrigation channel 120 can be configured to receive and discharge fluid into a cavity of the body such as a ureter during, for example, a lithotripsy procedure. The irrigation channel 120 can be isolated from the working channel 116, but the irrigation channel 120 can be connected to the working channel 116 as discussed in further detail below.

[0040] The endoscope 100 can also include a sensor 122. The sensor 122 can be one of several types of sensors such as a pressure sensor, temperature sensor, optical sensor, or the like. For example the sensor 122 can be an image capture sensor and can include a lens, an image capture sensor, and a chip or processor. Optionally, one or more of these components can be located in the image processing unit 42 or can be connected to the image processing unit 42. The sensor 122 can be connected to an outer portion of the endoscope 100 or a distal face of the endoscope 100. Optionally, the sensor 122 can be angled with respect to the outer surface of the endoscope 100 or angled with respect to a longitudinal axis of the endoscope 100.

[0041] The endoscope 100 can also include an arm 124 connected to the distal portion 102 of the endoscope 100. The arm 124 can be an arm, rod, blade, armature, or like that can be movable with respect to the scope and the working channel 116 to engage and clear tissue from the opening 118 of the working channel 116. The arm 124 can optionally be in communication with the control module 104. The control module 104 can control operation of the arm 124, such as to clear a stone fragment or tissue when it is determined that the distal opening 118 is clogged. For example, the arm 124 can be connected to the actuator 114 such that the control module 104 can operate the actuator 114 to move the arm 124 with respect to the distal portion 102 and the working channel 116. Optionally, one or more components of the control module 104 can be connected to the handle section 32 to allow a user to operate one or more components of the control module 104 using the handle section 32. For example, a user can operate the actuator 114 to control the arm 124 via the scope handle.

[0042] In operation of some examples, the sensor 122 can be configured to transmit a signal to the control module 104 (e.g., to the controller 106). The control module 104 can be configured to determine or detect whether there is a clog of the distal opening 118 of the working channel 116 based on the signal. When the controller 106 determines or detects a clog, the controller 106 can operate the actuator 114 to move the arm 124 to clear the clog, as discussed in further detail below.

[0043] FIG. 4 illustrates a side view of a portion of an endoscope 100 in a first condition. FIG. 5 illustrates a side view of a portion of the endoscope 100 in a second condition. FIG. 6 illustrates end view of a portion of the endoscope 100 in the second condition. FIGS. 4-6 are discussed together below. The endoscope 100 can be consistent with the endoscope 100 discussed above. FIGS. 4-6 show additional details of the endoscope 100. For example, FIGS. 4-6 show how the endoscope 100 can operate to clear a stone or tissue 50.

[0044] FIGS. 4-6 also show that the endoscope 100 can include a wire or shaft 126 extending at least partially through an actuator lumen 128 of the scope to connect the actuator 114 to the arm 124. The shaft 126 and the actuator lumen 128 (as well as the working channel 116 and the irrigation channel 120) can extend along a longitudinal axis A of the endoscope 100. The actuator lumen 128 can be separate or isolated from the working channel 116. The arm 124 can be located at least partially within the actuator lumen 128 and can be movable along the actuator lumen 128. The shaft 126 can be rigid or semi-rigid and made of one or more of foams, metals, polymers, or the like. The shaft can be operated by the actuator 114 to push, pull, rotate, pivot, or otherwise move the arm 124 with respect to the actuator lumen 128, the working channel 116, and the distal opening 118.

[0045] FIGS. 4-6 also show how the endoscope 100 can be operated to clear the working channel 116. For example, as shown in FIG. 4, the arm 124 can be in a retracted condition or state within the actuator lumen 128 during normal operation of the endoscope 100 (e.g., aspiration or suction of stone dust or fragments through the working channel 116). When the distal opening 118 is clogged by a stone fragment or tissue 50, as shown in FIG. 5, the control module 104 (such as upon detection of the clog) can operate the actuator 114 to move the shaft 126 to move the arm 124. During such an operation, the arm 124 can move proximally to distally to engage the tissue50 and force the tissue 50 from the distal opening 118 and the working channel 116, as shown in FIG. 5, to clear the distal opening 118, allowing for suction to resume normally.

[0046] As shown in FIGS. 5 and 6, when the arm 124 is moved distally, the arm 124 can move upward (from the perspective of FIGS. 5 and 6) or laterally inward (e.g., towards a center of the endoscope 100 or towards an opposite side of the endoscope 100). Such movement can be guided by the actuator lumen 128 (which can be optionally curved or shaped to cause the arm 124 to move in such a direction). This movement can also be caused at least in part by a shape of the arm 124. For example, the arm 124 can be curved or bent biasing movement of the arm 124. Optionally, the arm 124 can be made of a resilient material such as spring steel (or a similar alloy) configured to flex once the arm 124 extends at least partially beyond the actuator lumen 128 and is free to flex or bend. As also shown in FIG. 6, the arm 124 can move entirely across the distal opening 118 which can help to ensure the arm 124 can clear a stone of any size from the distal opening 118. Though the arm 124 is shown as having a width smaller than a diameter of the working channel 116, the width of the arm 124 can be as large as the diameter of the working channel 116.

[0047] FIG. 7A illustrates an end view of a portion of an endoscope 700 in a first condition. FIG. 7B illustrates an end view of a portion of the endoscope 700 in a second condition. FIGS. 7A-7B are discussed together below. The endoscope 700 can be similar to the endoscope 100 discussed above. For example, the endoscope 700 can be the endoscope 14 or a part of the endoscopy system 10. The endoscope 700 can include a distal portion 702 including working channel 716 having a distal opening 718. The endoscope 700 can also include an irrigation channel 720 and an actuator lumen. The endoscope 700 can also include an arm 724 that can be connected to a shaft 726.

[0048] The arm 724 can be a rigid or semi-rigid arm, blade, rod, armature, or the like configured to rotate about a distal face 730 of the distal portion 702 such as to engage tissue. The arm 724 can be curved complementary to a shape of the distal opening 718 (or the working channel 716) such that when the arm 724 is in a first condition (as shown in FIG. 7A) the arm 724 is clear of the distal opening 718 thereby limiting obstruction of the working channel 716 during suction or other (e.g.,lithotripsy) operations. The arm 724 can be straight or can have other shapes in other examples. The shaft 726 can be connected to the arm 724 and connected to an actuator (e.g., the actuator 114) such that the actuator can cause the shaft 726 to rotate the arm 724 about the shaft 726 to move the arm 724 from first condition to the second condition (shown in FIG. 7B). The arm 724 can be configured to rotate between 5 degrees and 360 degrees or more. In some examples, the actuator 114 can be operable to rotate the arm such that the arm 724 does not extend beyond a width of the endoscope 100.

[0049] In operation of some examples, a sensor (e.g., the sensor 122) can be configured to transmit a signal to the control module 104 (e.g., to the controller 106). The control module 104 can be configured to determine or detect whether there is a clog of the distal opening 718 of the working channel 716 based on the signal. When the controller 106 determines or detects a clog, the controller 106 can operate the actuator 114 to move the arm 724 to clear the clog or tissue that is stuck in the working channel 716 or the distal opening 718. In some examples the arm 724 can have one or more sharp edges, serrations, or other profiles or shapes to promote clearing of tissue from the distal opening 718. The arm 724 can also be configured to engage the tissue using both sides of the arm 724 (e.g., in both rotational directions of the arm 724).

[0050] FIG. 8A illustrates a side cross-sectional view of a portion of an endoscope 800A. FIG. 8B illustrates a side cross-sectional view of a portion of an endoscope 800B. FIG. 8C illustrates a side cross-sectional view of a portion of an endoscope 800C. FIG. 8D illustrates a side cross-sectional view of a portion of an endoscope 800D. FIGS. 8A-8D are discussed together below. The endoscopes 800A-800D (endoscopes 800) can be similar to the endoscope 700 discussed above. FIGS. 8A-8D shows different arrangements of the arm 824. Each of the endoscopes 800 can include a distal portion 802, a working channel 816 (having a distal opening 818), an irrigation channel 820, and an actuator lumen 818. A shaft 826 can extend at least partially through the face 830 to connect to an arm 824 that can be located at or near the distal opening 818.

[0051] The arm 824 of the endoscope 800A can be distally offset from a face 830 of the distal portion 802. The arm 824 of the endoscope 800B can be located at adistal side of the face 830 of the distal portion 802 or can be near or minimally distally offset from the face 830. The arm 824 of the endoscope 800C can be proximally offset from a face 830 of the distal portion 802. The arm 824 of the endoscope 800D can be located at a proximal side of the face 830 of the distal portion 802 or can be near or minimally proximally offset from the face 830.

[0052] FIG. 9A illustrates an end view of a portion of an endoscope 900 in a first condition. FIG. 9B illustrates an end view of a portion of the endoscope 900 in a second condition. FIGS. 9A-9B are discussed together below. The endoscope 900 can be similar to the endoscopes discussed above; the endoscope 900 can include an arm that pivots. Any of the endoscopes discussed above or below can include the features of the endoscope 900.

[0053] The endoscope 900 can include a distal portion 902, a working channel 916 (having a distal opening 918), and an irrigation channel 920. A portion of an actuator or shaft 926 can extend at least partially through a face 930 of the distal portion 902 to connect to an arm 924 that can be located at or near the distal opening 918. The arm can be relatively flat or planar and can be configured to mate with the face 930 when the arm 924 is in a first condition (as shown in FIG. 9A) and can be configured to extend (e.g., pivot or rotate) away from the face 930 (as shown in FIG. 9B). The arm 924 can include an opening 932 that extends at least partially through the arm 924 and can be configured to align with the distal opening 918. The opening 932 can be the same size as the distal opening 918 or can be slightly larger or slightly smaller. For example, if the opening 932 is the same size as the distal opening 918 or smaller than the distal opening 918, tissue or debris can become first or partially stuck in the arm 924 before becoming stuck in the distal opening 918, which can be easier to clear the distal opening 918. Optionally, the opening 932 can be larger than the distal opening 918 such as to limit obstruction of (for example) flow into the working channel 916.

[0054] In operation of some examples, a sensor (e.g., the sensor 122) can be configured to transmit a signal to the control module 104 (e.g., to the controller 106). The control module 104 can be configured to determine or detect whether there is a clog of the distal opening 918 of the working channel 916 based on the signal. When the controller 106 determines or detects a clog, the controller 106 can operate the actuator 114 to pivot or rotate the arm 924 (e.g., using the shaft 926) to clear the clogor tissue that is stuck in the working channel 916, the distal opening 918, or the opening 932.

[0055] FIG. 10 illustrates a side cross-sectional view of a portion of an endoscope 1000. The endoscope 1000 can be similar to the endoscopes discussed above; the endoscope 1000 can include fluid clearing mechanism. Any of the endoscopes discussed above or below can include the features of the endoscope 1000.

[0056] The endoscope 1000 can include a distal portion 1002, a working channel 1016 (having a distal opening 1018), and an irrigation channel 1020. The endoscope 1000 can also include a bypass channel 1034 connecting the irrigation channel 1020 to the working channel 1016 and can include a valve 1036 located at least partially within the bypass channel 1034 or between the irrigation channel 1020 and the working channel 1016. The valve 1036 can be a stop valve, such as a ball valve, butterfly valve, gate valve, globe valve, solenoid valve, diaphragm valve, or the like. The valve 1036 can be manually (e.g., user) operated such as through a remote button or lever (e.g., located on the handle section 32) or the valve 1036 can include an actuator that can be connected to the control module 104, such as to the controller 106.

[0057] The irrigation channel 1020 can be connected to the fluid source 24, such as to the fluid pump, so that the fluid pump can be operable to generate a fluid flow through the irrigation channel 1020. Similarly, the vacuum pump 26 can be in fluid communication with the working channel 1016 and the vacuum pump 26 can be operable to generate a vacuum flow through the working channel 1016 to aspirate or extract debris (e.g., stone dust or fragments) from a cavity of the body.

[0058] In operation of some examples, a sensor (e.g., the sensor 122) can be configured to transmit a signal to the control module 104 (e.g., to the controller 106). The control module 104 can be configured to determine or detect whether there is a clog of the distal opening 1018 of the working channel 1016 based on the signal. When the controller 106 determines or detects a clog, the controller 106 can disable the suction flow through the working channel 1016 such as by disabling the suction pump 26. The controller 106 can then operate the valve 1036 to divert fluid flow from the irrigation channel 1020 to the working channel 1016 to engage tissue located at or near the opening 1018 such as to clear tissue or stone portions from the distal opening1018. Once it is determined that the distal opening 1018 is clear (e.g., using the sensor 122 and the controller 106), the valve 1036 can be operated to close, preventing flow of fluid from the irrigation channel 1020 into the working channel 1016. The suction pump 26 can then be enabled to resume normal operation.

[0059] FIG. 11 illustrates a schematic view of the valve 1036 in the 1034. FIG. 11 shows that the valve 1036 can include a body 1038 and a movable portion 1040 movable relative to the body 1038. The valve 1036 can also include an opening 1042 extending at least partially through one or more of the movable portion 1040 and the body 1038. The movable portion 1040 can be connected to the actuator 114 such as via a cable or shaft 1026. This can allow the controller 106 to operate the valve 1036 to open allowing fluid to flow through the bypass channel 1034. The valve 1036 can optionally be normally closed such that when the controller 106 does not send an signal to operate the actuator, the movable portion 1040 can be biased to close the opening 1042 to prevent or limit flow through the bypass channel 1034 and the valve 1036.

[0060] FIG. 12 illustrates a block diagram of an example machine 1200 upon which any one or more of the techniques (e.g., methodologies) discussed herein may perform. Examples, as described herein, may include, or may operate by, logic or a number of components, or mechanisms in the machine 1200. Circuitry (e.g., processing circuitry) is a collection of circuits implemented in tangible entities of the machine 1200 that include hardware (e.g., simple circuits, gates, logic, etc.). Circuitry membership may be flexible over time. Circuitries include members that may, alone or in combination, perform specified operations when operating. In an example, hardware of the circuitry may be immutably designed to carry out a specific operation (e.g., hardwired). In an example, the hardware of the circuitry may include variably connected physical components (e.g., execution units, transistors, simple circuits, etc.) including a machine readable medium physically modified (e.g., magnetically, electrically, moveable placement of invariant massed particles, etc.) to encode instructions of the specific operation. In connecting the physical components, the underlying electrical properties of a hardware constituent are changed, for example, from an insulator to a conductor or vice versa. The instructions enable embedded hardware (e.g., the execution units or a loading mechanism) to create members of thecircuitry in hardware via the variable connections to carry out portions of the specific operation when in operation. Accordingly, in an example, the machine readable medium elements are part of the circuitry or are communicatively coupled to the other components of the circuitry when the device is operating. In an example, any of the physical components may be used in more than one member of more than one circuitry. For example, under operation, execution units may be used in a first circuit of a first circuitry at one point in time and reused by a second circuit in the first circuitry, or by a third circuit in a second circuitry at a different time. Additional examples of these components with respect to the machine 1200 follow.

[0061] In alternative embodiments, the machine 1200 may operate as a standalone device or may be connected (e.g., networked) to other machines. In a networked deployment, the machine 1200 may operate in the capacity of a server machine, a client machine, or both in server-client network environments. In an example, the machine 1200 may act as a peer machine in peer-to-peer (P2P) (or other distributed) network environment. The machine 1200 may be a personal computer (PC), a tablet PC, a set-top box (STB), a personal digital assistant (PDA), a mobile telephone, a web appliance, a network router, switch or bridge, or any machine capable of executing instructions (sequential or otherwise) that specify actions to be taken by that machine. Further, while only a single machine is illustrated, the term “machine” shall also be taken to include any collection of machines that individually or jointly execute a set (or multiple sets) of instructions to perform any one or more of the methodologies discussed herein, such as cloud computing, software as a service (SaaS), other computer cluster configurations.

[0062] The machine (e.g., computer system) 1200 may include a hardware processor 1202 (e.g., a central processing unit (CPU), a graphics processing unit (GPU), a hardware processor core, or any combination thereof), a main memory 1204, a static memory (e.g., memory or storage for firmware, microcode, a basic-input- output (BIOS), unified extensible firmware interface (UEFI), etc.) 1206, and mass storage 1208 (e.g., hard drive, tape drive, flash storage, or other block devices) some or all of which may communicate with each other via an interlink (e.g., bus) 1230. The machine 1200 may further include a display unit 1210, an alphanumeric input device 1212 (e.g., a keyboard), and a user interface (UI) navigation device 1214 (e.g.,a mouse). In an example, the display unit 1210, input device 1212 and UI navigation device 1214 may be a touch screen display. The machine 1200 may additionally include a storage device (e.g., drive unit) 1208, a signal generation device 1218 (e.g., a speaker), a network interface device 1220, and one or more sensors 1216, such as a global positioning system (GPS) sensor, compass, accelerometer, or other sensor. The machine 1200 may include an output controller 1228, such as a serial (e.g., universal serial bus (USB), parallel, or other wired or wireless (e.g., infrared (IR), near field communication (NFC), etc.) connection to communicate or control one or more peripheral devices (e.g., a printer, card reader, etc.).

[0063] Registers of the processor 1202, the main memory 1204, the static memory 1206, or the mass storage 1208 may be, or include, a machine readable medium 1222 on which is stored one or more sets of data structures or instructions 1224 (e.g., software) embodying or utilized by any one or more of the techniques or functions described herein. The instructions 1224 may also reside, completely or at least partially, within any of registers of the processor 1202, the main memory 1204, the static memory 1206, or the mass storage 1208 during execution thereof by the machine 1200. In an example, one or any combination of the hardware processor 1202, the main memory 1204, the static memory 1206, or the mass storage 1208 may constitute the machine readable media 1222. While the machine readable medium 1222 is illustrated as a single medium, the term "machine readable medium" may include a single medium or multiple media (e.g., a centralized or distributed database, and / or associated caches and servers) configured to store the one or more instructions 1224.

[0064] The term “machine readable medium” may include any medium that is capable of storing, encoding, or carrying instructions for execution by the machine 1200 and that cause the machine 1200 to perform any one or more of the techniques of the present disclosure, or that is capable of storing, encoding or carrying data structures used by or associated with such instructions. Non-limiting machine readable medium examples may include solid-state memories, optical media, magnetic media, and signals (e.g., radio frequency signals, other photon based signals, sound signals, etc.). In an example, a non-transitory machine readable medium comprises a machine readable medium with a plurality of particles having invariant(e.g., rest) mass, and thus are compositions of matter. Accordingly, non-transitory machine-readable media are machine readable media that do not include transitory propagating signals. Specific examples of non-transitory machine readable media may include: non-volatile memory, such as semiconductor memory devices (e.g., Electrically Programmable Read-Only Memory (EPROM), Electrically Erasable Programmable Read-Only Memory (EEPROM)) and flash memory devices; magnetic disks, such as internal hard disks and removable disks; magneto-optical disks; and CD-ROM and DVD-ROM disks.

[0065] The instructions 1224 may be further transmitted or received over a communications network 1226 using a transmission medium via the network interface device 1220 utilizing any one of a number of transfer protocols (e.g., frame relay, internet protocol (IP), transmission control protocol (TCP), user datagram protocol (UDP), hypertext transfer protocol (HTTP), etc.). Example communication networks may include a local area network (LAN), a wide area network (WAN), a packet data network (e.g., the Internet), mobile telephone networks (e.g., cellular networks), Plain Old Telephone (POTS) networks, and wireless data networks (e.g., Institute of Electrical and Electronics Engineers (IEEE) 802.11 family of standards known as WiFi®, IEEE 802.16 family of standards known as WiMax®), IEEE 802.15.4 family of standards, peer-to-peer (P2P) networks, among others. In an example, the network interface device 1220 may include one or more physical jacks (e.g., Ethernet, coaxial, or phonejacks) or one or more antennas to connect to the communications network 1226. In an example, the network interface device 1220 may include a plurality of antennas to wirelessly communicate using at least one of single-input multiple-output (SIMO), multiple-input multiple-output (MIMO), or multiple-input single-output (MISO) techniques. The term “transmission medium” shall be taken to include any intangible medium that is capable of storing, encoding or carrying instructions for execution by the machine 1200, and includes digital or analog communications signals or other intangible medium to facilitate communication of such software. A transmission medium is a machine readable medium.NOTES AND EXAMPLES

[0066] The following, non-limiting examples, detail certain aspects of the present subject matter to solve the challenges and provide the benefits discussed herein, among others.

[0067] Example 1 is an endoscope system comprising: a scope defining a working channel extending along a longitudinal axis of the scope, the working channel defining an opening of the working channel at a distal tip of the scope; and an arm connected to the distal tip of the scope and movable with respect to the scope and the working channel to engage and clear tissue from the opening of the working channel.

[0068] In Example 2, the subject matter of Example 1 optionally includes an actuator connected to the arm and operable to cause the arm to move with respect to the scope and the working channel.

[0069] In Example 3, the subject matter of Example 2 optionally includes a scope handle connected to a proximal portion of the scope, the actuator connected to the scope handle, and the actuator user-operable via the scope handle.

[0070] In Example 4, the subject matter of any one or more of Examples 2-3 optionally include a controller connected to the scope and configured to transmit a signal to the actuator to operate the actuator.

[0071] In Example 5, the subject matter of Example 4 optionally includes a sensor configured to transmit a signal to the controller, the controller configured to detect a clog of the distal tip based on the signal, and the controller configured to operate the actuator when a clog is detected.

[0072] In Example 6, the subject matter of any one or more of Examples 2-5 optionally include a wire or shaft extending at least partially through the scope to connect the actuator to the arm.

[0073] In Example 7, the subject matter of Example 6 optionally includes wherein the scope includes an actuator lumen extending along the longitudinal axis of the scope and separate from the working channel, the arm or the wire or the shaft located at least partially within the actuator lumen and movable along the actuator lumen.

[0074] In Example 8, the subject matter of any one or more of Examples 6-7 optionally include wherein the scope includes an actuator lumen extending along the longitudinal axis of the scope and separate from the working channel, the arm or thewire or the shaft located at least partially within the actuator lumen and movable from the actuator lumen toward the opening to engage tissue located at or near the opening.

[0075] In Example 9, the subject matter of any one or more of Examples 1-8 optionally include wherein the arm is rotatably connected to the distal tip and configured to rotate across at least a portion of a distal face of the distal tip to engage tissue located at or near the opening.

[0076] In Example 10, the subject matter of any one or more of Examples 1-9 optionally include wherein the arm is pivotably or rotatably connected to the distal tip and configured to extend distally from a distal face of the distal tip to engage tissue located at or near the opening.

[0077] Example 11 is an endoscope system comprising: a scope defining a working channel extending along a longitudinal axis of the scope, the working channel defining an opening of the working channel at a distal tip of the scope; an arm connected to the distal tip of the scope and movable with respect to the scope and the working channel to engage and clear tissue from the opening of the working channel; and an actuator connected to the arm and operable to cause the arm to move with respect to the scope and the working channel.

[0078] In Example 12, the subject matter of Example 11 optionally includes a scope handle connected to a proximal portion of the scope, the actuator connected to the scope handle, and the actuator user-operable via the scope handle.

[0079] In Example 13, the subject matter of any one or more of Examples 11-12 optionally include a controller connected to the scope and configured to transmit a signal to the actuator to operate the actuator.

[0080] In Example 14, the subject matter of Example 13 optionally includes a sensor configured to transmit a signal to the controller, the controller configured to detect a clog of the distal tip based on the signal, and the controller configured to operate the actuator when a clog is detected.

[0081] In Example 15, the subject matter of any one or more of Examples 11-14 optionally include wherein the scope includes an actuator lumen extending along the longitudinal axis of the scope and separate from the working channel, an arm, wire, or shaft of the actuator located at least partially within the actuator lumen and movablefrom the actuator lumen toward the opening to engage tissue located at or near the opening.

[0082] Example 16 is an endoscope system comprising: a scope defining a working channel extending along a longitudinal axis of the scope and defining an irrigation channel extending along the longitudinal axis, the working channel defining an opening of the working channel at a distal tip of the scope; a fluid pump in fluid communication with the irrigation channel, the fluid pump operable to generate a fluid flow through the irrigation channel; and a valve connected to the irrigation channel and the working channel, the valve operable to divert fluid flow from the irrigation channel to the working channel to engage tissue located at or near the opening.

[0083] In Example 17, the subject matter of Example 16 optionally includes a vacuum pump in fluid communication with the working channel, the vacuum pump operable to generate a vacuum flow through the working channel.

[0084] In Example 18, the subject matter of Example 17 optionally includes a controller connected to the fluid pump, the vacuum pump, and the valve, the controller configured to control operation of the fluid pump, the vacuum pump, and the valve.

[0085] In Example 19, the subject matter of Example 18 optionally includes a sensor configured to transmit a signal to the controller, the controller configured to detect a clog of the distal tip based on the signal, and the controller configured to operate the valve, when a clog is detected, to divert fluid flow from the irrigation channel to the working channel to engage tissue located at or near the opening.

[0086] In Example 20, the subject matter of Example 19 optionally includes wherein the controller is configured to: disable the vacuum pump before operating the valve to divert fluid flow from the irrigation channel to the working channel.

[0087] In Example 21, the apparatuses or method of any one or any combination of Examples 1 - 20 can optionally be configured such that all elements or options recited are available to use or select from.

[0088] The above detailed description includes references to the accompanying drawings, which form a part of the detailed description. The drawings show, by way of illustration, specific embodiments in which the invention can be practiced. Theseembodiments are also referred to herein as “examples.” Such examples can include elements in addition to those shown or described. However, the present inventors also contemplate examples in which only those elements shown or described are provided. Moreover, the present inventors also contemplate examples using any combination or permutation of those elements shown or described (or one or more aspects thereof), either with respect to a particular example (or one or more aspects thereof), or with respect to other examples (or one or more aspects thereof) shown or described herein.

[0089] In the event of inconsistent usages between this document and any documents so incorporated by reference, the usage in this document controls. In this document, the terms “including” and “in which” are used as the plain-English equivalents of the respective terms “comprising” and “wherein.” Also, in the following claims, the terms “including” and “comprising” are open-ended, that is, a system, device, article, composition, formulation, or process that includes elements in addition to those listed after such a term in a claim are still deemed to fall within the scope of that claim.

[0090] In this document, the terms “a” or “an” are used, as is common in patent documents, to include one or more than one, independent of any other instances or usages of “at least one” or “one or more.” In this document, the term “or” is used to refer to a nonexclusive or, such that “A or B” includes “A but not B,” “B but not A,” and “A and B,” unless otherwise indicated. In this document, the terms “including” and “in which” are used as the plain-English equivalents of the respective terms “comprising” and “wherein.” Also, in the following claims, the terms “including” and “comprising” are open-ended, that is, a system, device, article, composition, formulation, or process that includes elements in addition to those listed after such a term in a claim are still deemed to fall within the scope of that claim. Moreover, in the following claims, the terms “first,” “second,” and “third,” etc. are used merely as labels, and are not intended to impose numerical requirements on their objects.

[0091] The above description is intended to be illustrative, and not restrictive. For example, the above-described examples (or one or more aspects thereof) may be used in combination with each other. Other embodiments can be used, such as by one of ordinary skill in the art upon reviewing the above description. The Abstract is provided to allow the reader to quickly ascertain the nature of the technical disclosure.It is submitted with the understanding that it will not be used to interpret or limit the scope or meaning of the claims. Also, in the above Detailed Description, various features may be grouped together to streamline the disclosure. This should not be interpreted as intending that an unclaimed disclosed feature is essential to any claim. Rather, inventive subject matter may lie in less than all features of a particular disclosed embodiment. Thus, the following claims are hereby incorporated into the Detailed Description as examples or embodiments, with each claim standing on its own as a separate embodiment, and it is contemplated that such embodiments can be combined with each other in various combinations or permutations. The scope of the invention should be determined with reference to the appended claims, along with the full scope of equivalents to which such claims are entitled.

Claims

CLAIMS:

1. An endoscope system comprising: a scope defining a working channel extending along a longitudinal axis of the scope, the working channel defining an opening of the working channel at a distal tip of the scope; and an arm connected to the distal tip of the scope and movable with respect to the scope and the working channel to engage and clear tissue from the opening of the working channel.

2. The endoscope system of claim 1, comprising: an actuator connected to the arm and operable to cause the arm to move with respect to the scope and the working channel.

3. The endoscope system of claim 2, comprising: a scope handle connected to a proximal portion of the scope, the actuator connected to the scope handle, and the actuator user-operable via the scope handle.

4. The endoscope system of any of claim 2, comprising: a controller connected to the scope and configured to transmit a signal to the actuator to operate the actuator.

5. The endoscope system of claim 4, comprising: a sensor configured to transmit a signal to the controller, the controller configured to detect a clog of the distal tip based on the signal, and the controller configured to operate the actuator when a clog is detected.

6. The endoscope system of any of claims 2-5, further comprising: a wire or shaft extending at least partially through the scope to connect the actuator to the arm.

7. The endoscope system of claim 6, wherein the scope includes an actuator lumen extending along the longitudinal axis of the scope and separate from the working channel, the arm or the wire or the shaft located at least partially within the actuator lumen and movable along the actuator lumen.

8. The endoscope system of claim 6, wherein the scope includes an actuator lumen extending along the longitudinal axis of the scope and separate from the working channel, the arm or the wire or the shaft located at least partially within the actuator lumen and movable from the actuator lumen toward the opening to engage tissue located at or near the opening.

9. The endoscope system of any of claims 1-8, wherein the arm is rotatably connected to the distal tip and configured to rotate across at least a portion of a distal face of the distal tip to engage tissue located at or near the opening.

10. The endoscope system of any of claims 1-9, wherein the arm is pivotably or rotatably connected to the distal tip and configured to extend distally from a distal face of the distal tip to engage tissue located at or near the opening.

11. An endoscope system comprising: a scope defining a working channel extending along a longitudinal axis of the scope, the working channel defining an opening of the working channel at a distal tip of the scope; an arm connected to the distal tip of the scope and movable with respect to the scope and the working channel to engage and clear tissue from the opening of the working channel; and an actuator connected to the arm and operable to cause the arm to move with respect to the scope and the working channel.

12. The endoscope system of claim 11, comprising:a scope handle connected to a proximal portion of the scope, the actuator connected to the scope handle, and the actuator user-operable via the scope handle.

13. The endoscope system of claim 11, comprising: a controller connected to the scope and configured to transmit a signal to the actuator to operate the actuator.

14. The endoscope system of claim 13, comprising: a sensor configured to transmit a signal to the controller, the controller configured to detect a clog of the distal tip based on the signal, and the controller configured to operate the actuator when a clog is detected.

15. The endoscope system of any of claims 11-14, wherein the scope includes an actuator lumen extending along the longitudinal axis of the scope and separate from the working channel, an arm, wire, or shaft of the actuator located at least partially within the actuator lumen and movable from the actuator lumen toward the opening to engage tissue located at or near the opening.

16. An endoscope system comprising: a scope defining a working channel extending along a longitudinal axis of the scope and defining an irrigation channel extending along the longitudinal axis, the working channel defining an opening of the working channel at a distal tip of the scope; a fluid pump in fluid communication with the irrigation channel, the fluid pump operable to generate a fluid flow through the irrigation channel; and a valve connected to the irrigation channel and the working channel, the valve operable to divert fluid flow from the irrigation channel to the working channel to engage tissue located at or near the opening.

17. The endoscope system of claim 16, comprising:a vacuum pump in fluid communication with the working channel, the vacuum pump operable to generate a vacuum flow through the working channel.

18. The endoscope system of claim 17, comprising: a controller connected to the fluid pump, the vacuum pump, and the valve, the controller configured to control operation of the fluid pump, the vacuum pump, and the valve.

19. The endoscope system of claim 18, comprising: a sensor configured to transmit a signal to the controller, the controller configured to detect a clog of the distal tip based on the signal, and the controller configured to operate the valve, when a clog is detected, to divert fluid flow from the irrigation channel to the working channel to engage tissue located at or near the opening.

20. The endoscope system of claim 19, wherein the controller is configured to: disable the vacuum pump before operating the valve to divert fluid flow from the irrigation channel to the working channel.

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