Instrument devices, functional sleeve and medical system

Abstract

The present invention relates to an instrument device (100, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1500, 1600), in particular an endoscope device (102), comprising an instrument shaft (104) having a proximal portion (106) and a distal portion (108), in particular for insertion into a patient, with the distal portion (108) comprising a reflector assembly (110) with a reflector (112) that can be moved between a stowed state and a deployed state, with the distal portion (108) defining a base circumference (114) in the stowed state of the reflector (112) and the reflector (112) being located radially outside the base circumference (114) at least in part in the deployed state. The present invention also relates to a further instrument device, a functional sleeve and a medical system.

Description

[0001] Instrument devices, functional sleeve and medical system

[0002] The present application relates to instrument devices, a functional sleeve and a medical system.

[0003] Endoscopes are known from the prior art. An endoscope is a device by means of which a hollow space such as a cavity and / or the like can be visually examined. Particularly in diagnostic and therapeutic medicine, endoscopes have become an indispensable tool for the minimally invasive visual examination and inspection of anatomical structures as well as intracorporeally inserted instruments into patient cavities. An endoscope usually comprises an endoscope shaft, which is partially guided into the cavity to perform the visual examination. Existing anatomical access points are often used to guide the endoscope shaft into the cavity. For example, an endoscope shaft can be guided through the oral cavity into the esophagus or trachea. When designing endoscopes, care is therefore always taken to ensure that the endoscope shaft has the smallest possible diameter.This reduces the strain on the patient, improves access to cavities and ensures the mobility of the endoscope within the cavity.

[0004] Most endoscopes include a camera that can be used to image the anatomical structures to be examined within the cavity. However, since the light available within the cavity for imaging the structures is limited, endoscopes usually also include an illumination device that can be used to provide illumination light to illuminate the structures and to couple it out of the endoscope. Traditionally, light guides are used to guide illumination light coupled in at the proximal end of the endoscope to an output point at the distal end. The illumination device often also includes a light source such as an LED on a distal end surface of the endoscope shaft. In this case, no or fewer light guides extending along the endoscope shaft are required, which is why structural simplicity can be achieved. This light source illuminates the structure to be imaged distally.

[0005] The inventors have recognized that, according to such an embodiment of an endoscope, the illumination of the structure, in terms of its homogeneity and illumination intensity in the peripheral regions, is insufficient to ensure good image quality. Particularly in the case of illumination for hyperspectral and / or multispectral imaging, where illumination light in different wavelength ranges is used, homogeneous illumination right up to the peripheral regions is difficult.

[0006] The inventors also recognized that the light source must have a high light intensity to ensure good illumination of the cavity. However, such a light source generates significant heat during operation and can therefore reach a high temperature. This could pose a risk to the patient, for example, if the distal end surface comes into contact with tissue, and therefore represents a fundamental limitation in the design of the lighting device.

[0007] Due to the limited diameter of the endoscope shaft, it is also only possible to position light sources on the distal end surface to a limited extent. This is especially true if, in addition to a light source and the camera, openings for working channels and / or suction channels are to be provided on the distal end surface.

[0008] The inventors also recognized that for performing hyperspectral and / or multispectral imaging, it is advantageous to provide a plurality of light sources on the distal end surface. However, due to limited space, this is difficult to implement.

[0009] In addition to endoscopes, there are other instrument devices that can be inserted into a patient's cavity to perform a diagnostic and / or therapeutic procedure. The inventors have recognized that these instrument devices face the same limitations regarding limited installation space, particularly at the distal end surface of an instrument shaft.

[0010] Based on the prior art, the invention is based on the object of efficiently utilizing the available installation space, in particular of an instrument shaft, and / or ensuring a high quality of illumination.

[0011] The object is achieved according to the invention by instrument devices, a functional sleeve, and a medical system, as described herein and defined in the claims. The present invention provides for the provision of an instrument device, in particular an endoscope device. The instrument device comprises a, in particular elongated, instrument shaft, in particular an endoscope shaft, with a proximal section and a distal section, in particular for insertion into a patient, wherein the distal section comprises a reflector assembly with a reflector that is movable between a stowed state and a deployed state, wherein in the stowed state of the reflector, the distal section defines a base circumference, and wherein in the deployed state the reflector is located at least partially radially outside the base circumference.

[0012] The present invention further provides for an instrument device, in particular an endoscope device. The instrument device comprises an instrument shaft, in particular an endoscope shaft, with a proximal section and a distal section, in particular for insertion into a patient, and a functional sleeve.The functional sleeve comprises a sleeve body into which the instrument shaft can be inserted, a reflector assembly attached to the sleeve body with a reflector which is movable between a stowed state and a deployed state, wherein in the stowed state of the reflector the functional sleeve defines a base circumference, and wherein in the deployed state the reflector is located at least partially radially outside the base circumference, and an actuating mechanism which can be actuated by a movement of the instrument shaft relative to the sleeve body, wherein by actuating the actuating mechanism the reflector can be transferred from the stowed state to the deployed state.

[0013] The present invention further provides for the provision of a functional sleeve, in particular for an instrument device according to the invention. The functional sleeve comprises a sleeve body into which an instrument shaft can be inserted, a reflector assembly attached to the sleeve body with a reflector that is movable between a stowed state and a deployed state, wherein in the stowed state of the reflector, the functional sleeve defines a base circumference, and wherein in the deployed state, the reflector is located at least partially radially outside the base circumference, and an actuating mechanism that can be actuated by moving the instrument shaft relative to the sleeve body, wherein actuating the actuating mechanism can transfer the reflector from the stowed state to the deployed state. The present invention further provides for the provision of a medical system.The medical system comprises a functional sleeve according to the invention and one of the instrument devices according to the invention with an instrument shaft that can be inserted into a sleeve body of the functional sleeve.

[0014] The features according to the invention allow the available installation space, in particular of the instrument shaft, to be efficiently utilized and / or a high quality of illumination to be ensured. For example, an anatomical structure within a cavity can be homogeneously illuminated right up to the edge of an area to be imaged. In general, a radiation surface can be enlarged while maintaining a compact design, in particular after the instrument device has been introduced into a cavity. Light can be emitted in one direction from the radiation surface, for example. This allows the installation space to be utilized effectively. This results in a great deal of design freedom and / or flexibility in the configuration of instrument devices. For example, individual components can be designed to be powerful. Alternatively or additionally, a low energy density of the components used can be achieved.

[0015] Furthermore, a larger number of components can be accommodated in the instrument shaft. The inventors have recognized that by using the reflector, a component can be arranged at a different location along the instrument shaft than is usually done. This allows efficient use of installation space that has previously remained more or less unused. By using the reflector, components do not necessarily have to be arranged on the distal end surface, but can, for example, be provided along the instrument shaft. This allows additional components to be provided alongside more powerful components, and the functionality of the instrument device can be expanded. The inventors have recognized that, for example, multifunctional instrument devices can be provided when a reflector is used.The reflector allows for the limited space available within the instrument shaft to be expanded. Furthermore, an instrument shaft with a smaller diameter can be provided to increase patient comfort and improve the usability of the instrument device. By providing a stowed and deployed state, the instrument device can be adapted to anatomical conditions as needed. During insertion, the instrument device has a smaller diameter because it is used in the stowed state. This allows the instrument shaft to be efficiently guided into a cavity. However, the available space within the cavity itself is larger. The instrument device can be used in the deployed state during use and has a larger diameter in this state.

[0016] The inventors have recognized that by using the functional sleeve, the instrument device with reflector assembly can be constructed simply and cost-effectively. By providing the reflector assembly on the sleeve body of the functional sleeve, one component of the instrument device can be provided that comprises moving parts, in particular the reflector assembly, and one component, in particular the instrument shaft, that does not comprise any moving parts, in particular the reflector assembly. In the event of a defect or maintenance, the functional sleeve comprising the reflector assembly and the moving parts can be easily repaired and / or replaced. Furthermore, the inventors have recognized that moving parts are more subject to wear and are more difficult to recondition. They are therefore provided on a component that can be manufactured cost-effectively.The instrument shaft, which is relatively more expensive to manufacture, does not include any of these parts, especially the reflector assembly, which would require more frequent replacement. Overall, this reduces operating costs and generates less waste, thus increasing environmental sustainability. Consequently, one wear part, the functional sleeve, and one part, the instrument shaft, can be provided that can be designed for frequent reuse. Furthermore, the instrument shaft can advantageously be used specifically to actuate the reflector assembly. A synergy can be created between the various parts.

[0017] The instrument device may be a medical instrument device. According to some embodiments, the instrument device may be an endoscope device. An instrument device may be a device comprising a tool, an assembly, and / or the like, which is configured to visually image, measure and / or determine properties of an object region, perform an intervention, support a therapeutic and / or diagnostic action, and / or the like. In particular, the instrument device may be a medical instrument device, in particular a medical endoscope device. This may be at least partially introduced into a cavity of a patient. The instrument device may be insertable within the cavity. The instrument device may be an assembly of an instrument, in particular a structurally and / or functionally independent one.In some embodiments, an instrument can be provided with an instrument device according to the invention. Alternatively or additionally, the instrument device can form an instrument, in particular a complete instrument.

[0018] According to some embodiments, the instrument device may comprise an endoscope and / or an endoscope system, be configured as such, and / or form at least a part and preferably at least a major part of an endoscope and / or an endoscope system. "At least a major part" may mean at least 55%, preferably at least 65%, more preferably at least 75%, particularly preferably at least 85%, and most preferably at least 95%, in particular with respect to a volume and / or mass of an object and / or with respect to a longitudinal extent of the endoscope and / or the endoscope system.

[0019] The instrument device can be configured to be insertable into a cavity for inspection, application, and / or observation, for example, into an artificial and / or natural cavity, such as the interior of a body, a body organ, tissue, or the like. The instrument device can also be configured to be insertable into a housing, casing, shaft, pipe, or other, particularly artificial, structure for inspection and / or observation.

[0020] In particular, an object region can be imaged and image data can be generated by means of the endoscope device and / or an image can be guided along the instrument shaft, in particular the endoscope shaft.

[0021] The instrument shaft, in particular the endoscope shaft, can in particular be an elongated instrument shaft. Elongated can refer to an aspect ratio of the instrument shaft. The aspect ratio can be, for example, at least 5:1, in particular at least 10:1, preferably at least 50:1, and particularly in the case of flexible endoscopes even more than 100:1, wherein the larger number refers to the length of the instrument shaft and the smaller number refers to a diameter and / or a side length of a cross-sectional area of ​​the shaft that is arranged perpendicular to the main extension direction of the instrument shaft. The main extension direction can mean the longest side of a smallest cuboid into which the instrument shaft can be completely arranged.The instrument shaft can extend in the main direction of extension over at least 5 cm, in particular at least 15 cm, preferably at least 40 cm, and especially in the case of flexible endoscopes, even over 100 cm. Furthermore, the instrument shaft can be made of a plastic and / or metal. In particular, the instrument shaft can be hollow-cylindrical and / or enclose and / or house additional components. The instrument shaft can be flexible and / or rigid. In principle, the instrument shaft can extend along a longitudinal axis, in particular in the main direction of extension.

[0022] The endoscope device can be designed for and / or form various types of endoscopes. For example, the endoscope can be a flexible and / or a rigid endoscope.

[0023] According to some embodiments, the instrument shaft can comprise at least one component for signal conduction, for example, an electrical cable, a light guide, and / or the like. Furthermore, the instrument shaft, in particular the endoscope shaft, can comprise optical elements configured to guide light, which is coupled into the instrument shaft at a distal portion of the instrument shaft, proximally and to transmit an image of an object region. In particular, the optical elements can at least partially jointly form a relay lens system, in particular comprising at least one rod lens.

[0024] In general, "distal" can mean that a first object is arranged further away from a reference point than a second object, where the reference point is a user of the instrument device. "Distal" can refer in particular to a longitudinal axis of the instrument shaft. In this context, "distal" can mean that, when following the longitudinal axis of the instrument shaft starting from the user, the distance to the "distal" arranged first object is greater than the distance to the second object. It can occur that the "distal" arranged object is arranged closer to the user in a spatial coordinate system if, for example, the instrument shaft has a bend. According to these embodiments, the second object is arranged "proximal" to the first object. An object arranged between the first object and the second object can be arranged "medially".

[0025] In addition to the proximal section and the distal section, the instrument shaft can have a medial section. The medial section can extend from the proximal section to the distal section. The sections do not have to have the same length. Preferably, the medial section is longer than the distal section and / or the proximal section. The proximal section and / or the distal section can each extend, in particular, over 1% to 50%, in particular over 1% to 30%, preferably over 1% to 10%, of the instrument shaft. In particular, the distal section can be configured to be introduced into a patient cavity, an artificial cavity, a body cavity, and / or the like, in some cases together with at least a section of the medial section.While the distal and, according to some embodiments, at least partially the medial portion is insertable into the patient's body and / or arranged in the body, the proximal portion can be arranged outside the body.

[0026] The reflector assembly comprises the reflector and can include further components, sections, and / or the like that are provided for movement, adjustment, deformation, and / or the like of the reflector. The reflector assembly can be arranged on the instrument shaft and / or on the functional sleeve. The reflector assembly can be designed in multiple parts. Furthermore, the reflector assembly can be specifically provided to expand the functionality of a prior art instrument device. This can mean that the reflector assembly is separated from a, in particular movable, surface, structure, and / or the like that merely randomly reflects a wave such as light and / or ultrasound. By means of the reflector assembly, a reflection can be specifically exploited. In particular, the reflector can be provided for the targeted exploitation of a reflection.In addition, the reflector assembly may include components that provide mobility of the reflector and / or secure the reflector to the functional sleeve and / or the instrument shaft, for example a shaft, a bearing, a joint, a spring, an anchor, an adhesive, a rivet, and / or the like.

[0027] The reflector can be provided for reflection, in particular in a targeted manner. Reflection can mean the reflection of an incident wave, incident radiation and / or the like. Reflection can comprise, for example, mirroring and / or diffuse scattering. The reflector can be provided to reflect, re-radiate and / or redirect waves and / or rays. The reflector can comprise a surface, a section, a component, a structure and / or the like that is designed to reflect waves and / or rays. The propagation of these waves and / or rays can be influenced by the reflector, in particular in a targeted and / or purposeful manner. This can comprise focusing, scattering, direction guidance, conversion, mirroring and / or the like. The reflector can define a / the radiation surface.The radiating surface can comprise a surface of the reflector from which waves and / or rays incident on the reflector are reflected. In principle, the reflector's function can be based on reflection.

[0028] The reflector assembly can be designed to be movable and / or assume different states. The term "state" can refer to a shape, fold, configuration, specific relative position of movable parts, and / or the like. "Being movable between the states" can in particular mean that the states can be adjusted by deformation, relative movement, and / or the like of individual parts to one another. The reflector can be convertible from one state to another by movement. This does not mean assembly. In particular, individual parts do not have to be disassembled and reassembled in a different orientation and / or arrangement. It can mean that a materially integral connection remains at least at one point.

[0029] The stowed state can refer to a state in which the reflector assembly and / or the reflector has a small appearance, shape, and / or the like with respect to a radial direction of the instrument shaft. In other words, the reflector assembly and / or the reflector can have a small extension in the radial direction in the stowed state. "Small" in this context is to be understood in relation to the diameter of the instrument shaft. In particular, in the stowed state, the reflector can assume a position and / or shape in which it is not configured for targeted reflection. "Targeted" can mean that a functional expansion of the instrument device can be achieved. It is understood that the reflector can in principle also reflect in the stowed state, but it can be arranged in such a way that the reflected wave and / or radiation cannot be used.In particular, it can be provided that the instrument device is inserted and / or can be inserted into the cavity and / or the like when the reflector is in the stowed state. The stowed state can be specifically adjustable to simplify insertion. In the deployed state, the reflector can have such a large radial extent that insertion may be difficult or even impossible. Due to the stowed state, the reflector can be arranged in such a way that insertion is possible.

[0030] In the deployed state, the reflector can have a greater radial extent than in the stowed state. As already described, the radial extent is to be understood in relation to the instrument shaft. The radial direction can extend, in particular, orthogonally to the main extension direction of the instrument shaft. In the deployed state, the reflective property of the reflector can be specifically exploited and / or a function based on the reflection can be produced. A wave can, for example, be specifically deflected and information can only be obtained based on the deflected wave. For example, light can be specifically deflected in one direction so that an object area, an anatomical structure and / or the like is illuminated. It can be provided that the instrument device is operated in the deployed state. Furthermore, it can be provided that the instrument device is fed to a cavity in the stowed state.

[0031] The base circumference of the distal section can be defined jointly by the reflector and the instrument shaft. In some embodiments, the reflector can protrude radially beyond the instrument shaft. In other embodiments, the reflector can not extend radially beyond the instrument shaft. In some embodiments, the base circumference can therefore at least substantially correspond to the circumference of the instrument shaft. In other embodiments, the base circumference is larger than the circumference of the instrument shaft due to a contribution from the reflector. The enlargement can be at least substantially up to 5%, 10%, 15%, or even up to 20%. In the stowed state, the reflector can protrude radially up to 1 mm, 10 mm, 20 mm, 50 mm, 1 cm, 2 cm, 3 cm, 4 cm, or even up to 5 cm and / or even further beyond the instrument shaft.

[0032] The base circumference can define a stowage area in a distal view of the distal section of the instrument shaft. The base circumference can be defined, for example, by an outer imaginary contour of this view, wherein the contour in particular includes all components and / or parts, in particular the reflector and / or the reflector assembly, of the distal section. Components and / or parts arranged further proximally can be excluded. In the deployed state, the reflector can protrude from the base circumference or the imaginary contour. This can define a deployment circumference. The deployment circumference can define an deployment area that is larger than the stowage area. In the deployed state, the reflector can extend away from the instrument shaft when viewed distally. Generally speaking, the reflector assembly can be radially smaller in the stowed state and radially larger in the deployed state.

[0033] The functional sleeve can comprise a standalone component that can be provided, moved, handled, and / or the like independently of the instrument shaft. For example, the functional sleeve and the instrument shaft can be delivered and / or stored in different outer packaging. It can be provided that the instrument shaft is inserted into the functional sleeve at least substantially immediately before use. The functional sleeve can also have a different nominal service life than the instrument shaft. This can mean that the functional sleeve is intended for single, double, or triple use and / or is not intended for reprocessing. The instrument shaft, on the other hand, can be intended for multiple, in particular multiple, uses and / or for reprocessing, for example comprising autoclaving and / or the like.The functional sleeve can be a disposable item.

[0034] A functional sleeve can be understood as a casing, a surrounding shell, an overshaft and / or the like. More precisely, the sleeve body can form the casing, the surrounding shell, the overshaft and / or the like. The functional sleeve, in particular the sleeve body, can be configured to at least partially accommodate the instrument shaft. The functional sleeve, in particular the sleeve body, can comprise an elongated, in particular hollow-cylindrical, tube into which the instrument shaft can be inserted. Elongated can have at least essentially the same meaning as in connection with the instrument shaft. "Insertion" can also be understood as meaning that the sleeve body can be slipped over the instrument shaft. In a configuration in which the instrument shaft is inserted into the sleeve body, both the deployed state and the stowed state can be assumed by the reflector.The instrument shaft can be movably received in the sleeve body. In particular, the instrument shaft can be displaceable within the sleeve body, in particular linearly. The functional sleeve, in particular the sleeve body, can be flexible and / or rigid, depending on the instrument shaft with which it is to be used. The functional sleeve can be made of a plastic and / or a metal. In particular, the functional sleeve can be characterized by inexpensive production. In the radial direction, the functional sleeve can have an extension that is at least essentially twice the wall thickness of the functional sleeve, in particular the sleeve body, and an air gap that is twice the size between the sleeve body and the functional sleeve. The wall thickness of the functional sleeve, in particular the sleeve body, can be up to 1 mm, 2 mm, 5 mm, 10 mm, 50 mm, 1 cm and / or up to 2 cm.

[0035] Analogous to the base circumference in conjunction with the instrument shaft, the sleeve body, together with the reflector assembly, can define the base circumference. The explanations are also applicable to the functional sleeve. In a preferred embodiment, the reflector does not protrude radially beyond the sleeve body in the stowed state.

[0036] In principle, the reflector can be moved, particularly in a targeted manner, by the actuating mechanism. Actuation of the actuating mechanism can have the purpose of moving the reflector, particularly transferring it from the stowed state to the deployed state and / or vice versa. Actuation of the actuating mechanism can involve a deliberate action to change the state of the reflector.

[0037] The actuating mechanism of the functional sleeve can be arranged on a distal portion, in particular in a region close to a distal end surface of the sleeve body. By means of the actuating mechanism, the reflector can be movably mounted relative to the sleeve body. In particular, the reflector can be rotatably mounted. In some embodiments, the reflector can extend distally beyond a distal end surface of the sleeve body. The movement for actuating the actuating mechanism can in particular comprise a relative movement, in particular a linear movement, between the sleeve body and / or the functional sleeve and the instrument shaft. For example, the instrument shaft can be pushed forward within the sleeve body and, by pushing forward, the reflector can be transferred into the deployed state. The actuation can be based on the instrument shaft contacting a portion of the actuating mechanism and moving it through the movement.The movement of the section can cause the reflector to rotate and / or the reflector to be brought into use by rotation. The actuation can be effected by the user, for example, by advancing the instrument shaft relative to the functional sleeve.

[0038] The medical system may be intended for use in a medical environment. It may be intended that medical professionals operate the medical system.

[0039] According to some embodiments of the instrument device, the reflector assembly can comprise an actuation mechanism, wherein actuation of the actuation mechanism can transfer the reflector from the stowed state to the deployed state and / or from the deployed state to the stowed state. A change of state can be specifically brought about by means of the actuation mechanism. The operability of the instrument device is improved.

[0040] In principle, the actuating mechanism can be formed by the reflector assembly. According to some embodiments, the actuating mechanism can be formed jointly by the instrument shaft and the reflector assembly.

[0041] A user-friendly instrument device can be provided if the actuation mechanism can be actuated by a user. The user can determine when a change of state should be triggered. The user can specifically cause the reflector to assume the stowed state upon insertion of the instrument shaft. Furthermore, the user can specifically transfer the reflector to the deployed state when the instrument shaft is positioned within a patient's cavity.

[0042] An easy-to-use and reliable instrument device can be provided if the actuating mechanism comprises a drive. The drive can be embodied as an electric drive unit and / or comprise an electrically driven motor. The drive can be actuated, for example, by means of a foot switch and / or a robotic remote control mechanism. A force for actuating the actuating mechanism can be generated by the drive. Alternatively or additionally, the actuating mechanism can be passive and / or passively actuable. This can mean that a force for actuating the actuating mechanism is applied by the user.

[0043] Furthermore, the actuating mechanism can be actuated by pushing, in particular, the instrument shaft and / or the actuating mechanism through a trocar. Advantageously, the actuating mechanism is actuated by insertion into the cavity itself. The actuation occurs automatically together with the insertion. No separate actuation by the user is required. The trocar is a medical instrument with which access to a cavity and / or body cavity such as the abdominal cavity and / or the thoracic cavity is created and / or kept open, using a sharp or blunt tool. The trocar can define a channel through which the instrument device, in particular the instrument shaft, can be passed and at least partially inserted into the patient. “Pushing through” can mean inserting the instrument shaft into the patient’s cavity through the trocar channel.The trocar channel can define an opening with a circumference larger than the base circumference. The instrument shaft can thus only be pushed through the trocar in the stowed position. During the passage, a force can be exerted on the reflector by the trocar, transferring it into the stowed position. In this context, the reflector can be transferred into the stowed position by pushing it through.

[0044] Furthermore, the actuating mechanism can comprise a passive return element configured to hold the reflector in the deployed state, and the return element can be configured to at least partially store energy applied to move the reflector into the stowed state in such a way that it returns the reflector to the deployed state when a force causing the movement into the stowed state is removed. Such an instrument device is characterized by high ease of use and reliability. The user does not have to perform any separate action to transfer the reflector to the deployed state. The use of the passive return element can ensure that the reflector reliably assumes the deployed state. The deployed state can be considered the normal state, while the stowed state is only assumed during insertion.If the reflector is compressed radially and / or moved radially inward by a radial force, a restoring force is generated. The restoring element can apply the restoring force to the reflector. The restoring force can cause the reflector to move into the deployed state. When subjected to an external force, the restoring element can store potential energy and convert the potential energy into kinetic energy. In particular, the passive restoring element can comprise a spring, in particular a torsion spring. The restoring element can be movably arranged and / or fastened to the endoscope shaft by means of the passive restoring element, in particular the spring. The spring can be deformable by the external force and / or the applied energy, wherein the deformation can generate the restoring force.

[0045] According to some embodiments, the reflector comprises a foldable reflector arm which rests against the instrument shaft in the stowed state and extends at an angle from the instrument shaft in the deployed state. The use of the reflector arm can provide a safe and reliable reflector assembly. The reflector arm can have a rigid shape or be designed to be rigid in itself. During operation, the reflector arm can be at least substantially unable to be converted into another state by elastic deformation of the reflector arm. The reflector arm can be rotatably mounted on the instrument shaft. The reflector arm can be convertible from the stowed state into the deployed state by folding it open. During conversion and operation, it can be provided that the reflector arm does not change its shape. The reflector arm can be designed to be dimensionally stable.The reflector can form the reflector arm and / or the reflector arm can form the reflector. “Contiguous” can mean that the reflector arm is folded in and / or a circumference of the instrument shaft is at least substantially not enlarged. However, there can be an air gap between the reflector arm and the instrument shaft. This can be as small as possible. An angle enclosed by a longitudinal axis of the reflector arm and the longitudinal axis of the instrument shaft can, for example, be a maximum of 10°, 5°, and / or 1° in the stowed state. The longitudinal axis of the reflector arm can extend along the main extension axis of the reflector arm. In the stowed state, the longitudinal axis of the reflector arm can be arranged at least substantially coaxially to the longitudinal axis of the instrument shaft. In the deployed state, the longitudinal axes can enclose an angle greater than, for example, 1°, 5°, and / or 10°.The angle may, for example, be at least substantially 45°.

[0046] Furthermore, the reflector arm can comprise an actuating portion that at least partially defines the actuating mechanism. The actuating mechanism can be formed at least partially by the reflector arm. For example, a portion of the reflector arm can be movable, displaceable, and / or displaceable by the instrument shaft.

[0047] Furthermore, the actuating section can comprise a proximal end section of the reflector arm, and a distal section of the reflector arm can comprise a reflection section. The reflection section can define the radiating surface. Waves can be deflected and / or modified by means of the reflection section. By folding out or converting it into the deployed state, the reflection section can be brought into a position in which it extends at an angle from the instrument shaft.

[0048] Furthermore, the reflector arm can be hinged to the instrument shaft and define a rotation axis. Such an instrument device can have a simple design and be manufactured cost-effectively. The reflector arm and the instrument shaft can jointly form a joint, in particular a rotary joint. This allows the reflector arm to be pivoted and / or unfolded to transfer it into the operational state. In particular, a proximal section, in particular the end section, of the reflector arm can be hinged to the instrument shaft.

[0049] A safe-to-use reflector arm can be provided if the rotation axis is spaced from a distal end of the instrument shaft. The reflector arm can be arranged such that it does not extend distally beyond the instrument shaft. The risk of breakage and / or damage to the reflector arm can be reduced. In some embodiments, the rotation axis can be spaced from the distal end of the instrument shaft by a length of the reflector arm. In yet other embodiments, the rotation axis can be spaced by a distance greater than the length of the reflector arm.

[0050] Furthermore, the reflector, in particular the reflector arm, can form an angle with the instrument shaft, in particular the endoscope shaft, in the deployed state. The reflector can open at least partially distally in the deployed state. This can mean that the angle can be less than 90°. The reflector can at least partially rest against the distal section in the stowed state.

[0051] A safe and reliable actuation mechanism can be provided if the actuation mechanism comprises a web. The web can be movably mounted on the instrument shaft and, at a distance from the axis of rotation, on the reflector arm. Actuation of the actuation mechanism can cause the web to move, and actuation of the actuation mechanism can enable the reflector, in particular the reflector arm, to be transferred from the stowed state to the deployed state. The web can be used to raise and / or support the reflector arm. The web can be provided as a force-transmitting element. By raising the web, the reflector arm can be folded out and / or pivoted out. The web can be used to convert a linear movement along the longitudinal axis of the instrument shaft into a rotary movement of the reflector arm about the pivot joint. The web can be rigid and / or dimensionally stable. The web can be elongated.The bar can be rod-shaped and / or strip-shaped. In the deployed state, the bar can extend from the instrument shaft in an opposite direction to the reflector arm. The bar can support the reflector arm relative to the instrument shaft.

[0052] Furthermore, the actuation mechanism can comprise a cable that extends from the proximal portion to the distal portion of the instrument shaft. The cable can be used to move the bridge and / or convert the reflector arm into the deployed state. The cable can be operated by the user, in particular to bring about the deployed state of the reflector.

[0053] Furthermore, the actuation, in particular of the actuating mechanism, can comprise an axial displacement of at least one articulation point of the web along the instrument shaft. Advantageously, this allows one movement to be efficiently converted into another. Efficient and space-saving action can be taken to effect a rotary movement of the reflector arm and / or the web through a linear movement, in particular at the articulation point of the web. The articulation point can comprise a bearing, a joint, a guide, and / or the like of the web on the instrument shaft. The axial displacement can comprise a displacement along the longitudinal axis of the instrument shaft. The web can be pivotally mounted on the reflector arm and the instrument shaft. An axial displacement of the articulation point, at which the web is pivotally mounted on the instrument shaft, causes the web to pivot, stand up, and / or unfold away from the instrument shaft.

[0054] In addition, the reflector arm can comprise a side facing the endoscope shaft, which has a width corresponding to up to 10%, up to 30%, up to 50% and / or up to 70% of a diameter of the base circumference. This makes it possible to achieve a large radiation surface and / or reflection surface. The side facing the endoscope shaft can, in particular, be planar and / or flat. The side can define a reflection surface. The diameter can correspond to the diameter of an imaginary circle encircling the base circumference. The diameter can mean the longest straight line that can be placed in an area defined by the base circumference.

[0055] A safe and easy-to-insert instrument device can be provided if a radial outer side of the reflector arm is formed in a circular arc. The outer side of the reflector arm, together with a portion of an outer side of the instrument shaft, can define a circular surface, an oval surface, and / or the like. In the stowed state, the instrument device can have at least substantially a circular and / or oval cross-section in the section in which the reflector is arranged. The reflector arm can be designed such that it adapts to an outer contour of the instrument shaft. An instrument device can be provided that has no sharp edges, steps, and / or the like. Good insertability in the stowed state can be achieved, and safe operation can be ensured.

[0056] A space-saving reflector assembly can be provided by a reflector arm that includes a filling chamber. Filling the filling chamber with a fluid and / or gas can transfer the reflector arm from the stowed state to the deployed state. The filling chamber can at least partially form a connecting section that connects the reflector arm to the instrument shaft. Filling the filling chamber can stiffen the filling chamber and / or the connecting section. By increasing gas pressure, the filling chamber and / or the reflector arm can stiffen and / or be brought into a defined position and retained in this position. A gas-pressure-controlled joint can be formed by the filling chamber. The reflector arm can be articulated to the instrument shaft by means of the gas-pressure-controlled joint, in particular comprising the filling chamber.The reflector arm can be moved into the operating state by filling it with gas.

[0057] Furthermore, the reflector arm can comprise a light guide that extends along the reflector arm and is configured to guide light to a light output point on the reflector arm. This allows high illumination quality to be achieved. An object region can be homogeneously illuminated right up to the edge region. The light output point can comprise a viewing window, a lens, and / or another optical element. The light output point can be arranged on a distal end surface of the reflector arm with respect to the main extension direction of the reflector arm. A light input point can be arranged on a proximal end surface of the reflector arm. Light can be output from the instrument shaft in a region close to the light input point such that it can be input into the reflector arm via the light input point. Light can be reliably input at least substantially independently of the angle of the reflector arm.In other embodiments, the light guide can also be guided via a joint by means of which the reflector arm is coupled to the instrument shaft.

[0058] A space-saving reflector that is small in the stowed state can be provided if the reflector comprises an expansion body. By means of the expansion body, a reflector can be formed that is characterized by a large ratio between the radiation area in the deployed state and the area defined by the base circumference. The expansion body can comprise the reflection section. The expansion body can define an interior space that can be delimited, in particular, on at least one side by the instrument shaft. The interior space can define a volume, wherein the volume can be enlarged when the stowed state is converted to the deployed state. The expansion body can have a variable volume. The volume can be increased, for example, by increasing the gas pressure within the expansion body.Furthermore, the expansion body can comprise an at least partially wave-permeable, in particular light-permeable, distal section. A wave and / or the like reflected by the expansion body, in particular by a radiating surface of the expansion body and / or the reflective section of the expansion body, can be coupled out of the interior of the expansion body into an environment through the light-permeable distal section. The light-permeable distal section can be flat.

[0059] Furthermore, the expansion body can be inflatable and / or made of a shape-memory material. This allows the reflector assembly to be arranged on the instrument shaft in a space-saving manner. The volume of the expansion body can be easily and quickly increased. Furthermore, common endoscopes often already have gas guides and devices for gas supply. This allows a means of operating the expansion body to be provided with relatively little design effort. Furthermore, the use of the shape-memory material ensures that the expansion body assumes a defined shape in an inflated state, in which the reflector assumes the operational state. This allows for high reliability.

[0060] A powerful instrument device with high radiation performance can be provided if the expansion body comprises a balloon that extends circumferentially around the distal portion. The balloon can be gas-tight. The balloon can be made of an expandable plastic, such as an elastomer. Furthermore, the balloon can be made of latex.

[0061] Furthermore, the expansion body can comprise struts between which an elastically deformable film is stretched. The struts are arranged on the endoscope shaft in such a way that the struts open distally in the deployed state. The struts can achieve high dimensional stability in the deployed state. Furthermore, the struts can have a shape memory and / or be made of a shape memory material. This can ensure high reliability in maintaining the deployed state.

[0062] In principle, the shape memory material can be a nickel-titanium alloy (nitinol), a nickel-titanium-copper alloy, an iron-manganese-silicon alloy, a copper-zinc alloy, a copper-zinc-aluminum alloy and / or the like.

[0063] Furthermore, carbon dioxide can in principle be used as a gas, especially in connection with the filling chamber and / or the expansion body.

[0064] Furthermore, the reflector can be detachably attached to the instrument shaft. The reflector can be quickly and easily replaced. Should the reflector become defective and / or worn, a new reflector can be provided. There is no need to replace the entire instrument assembly.

[0065] Cost-effective operation of the instrument device can be achieved if the reflector is designed for single use. Complex, moving parts do not need to be reused multiple times and undergo extensive reconditioning before use. The reflector can be manufactured inexpensively, especially as a volume item.

[0066] Furthermore, the reflector can open distally in the deployed state and, together with the instrument shaft, define an opening angle of up to 90°. Advantageously, waves can be efficiently and reliably redirected to an object area located distal to the instrument device.

[0067] Furthermore, the reflector, in the deployed state, can be configured to at least partially distally deflect a radial portion of a wave to be deflected that impinges on the reflector. Advantageously, it can be ensured that waves impinge on a large area distal to the instrument device and / or that the wave power of the waves impinging on the area is greater. In particular, the area can be larger compared to an instrument device without a reflector. A wave can comprise electromagnetic radiation, for example light in the visible wavelength range, (near) infrared light, UV light, X-rays, and / or mechanical waves, such as ultrasonic waves. In general, the reflector can be configured to deflect illuminating light, laser light, ultrasound, measuring light, and / or the like. Illuminating light can comprise light in the visible wavelength range and / or outside the visible wavelength range.The wave to be deflected can generally be deflected to a working area, or the reflector can be configured to deflect the deflected wave to the working area. The working area can be arranged distally of the instrument device. The working area can comprise an object area of ​​an imaging device such as a camera. In this case, the illumination light can be deflected. Furthermore, the working area can comprise an intervention area that is to be irradiated, for example with X-rays, and / or to which ultrasound waves are to be applied.

[0068] In addition, the reflector can comprise a reflective section on a side facing radially inward in the stowed state, which section is at least partially facing distally in the deployed state. Advantageously, the reflective section can thus be open distally in the deployed state, and in the stowed state, the reflective section can be protected by the instrument shaft. This ensures that the reflective section is not contaminated and / or damaged during insertion.

[0069] The reflective portion may comprise a surface configured to reflect and / or scatter light.

[0070] Furthermore, the reflection section can be configured to spectrally convert light. Light can be provided in a desired spectral range and / or in a specific spectral band. For example, the reflector can comprise a fluorescent layer on the inward-facing side, in particular on the reflection section, which converts incident light from one wavelength range into another wavelength range and / or radiates it distally. Furthermore, the reflection section can thereby convert narrowband light into broadband light and radiate it. "Narrowband" can mean a spectral width of, for example, up to 25 nm, up to 50 nm, and / or up to 100 nm. "Broadband" can mean a spectral width of, for example, at least 100 nm, 200 nm, 400 nm, or even up to 800 nm. For example, narrowband light can be converted into white light.Excitation light, such as blue, violet, and / or UV light, which can be used to illuminate the reflection section and which is provided for deflection, can be convertible into a broader spectral range, particularly white light, and / or can be converted by the reflection section. This can be advantageous for water-filled organs such as the bladder, since in such a cavity, radiation attenuation in the blue spectral range can be lower than outside the blue spectral range, particularly in the green and / or red spectral range. As a result, the light's path, which can be extended due to deflection compared to direct radiation onto an object area, can have a lesser impact on radiation attenuation.The reflection section may comprise a spectrally converting layer and / or coating, and / or may comprise spectrally converting substances such as fluorescent substances, fluorescent particles and / or quantum dots.

[0071] Furthermore, the reflector can be configured to at least partially distally deflect a radial portion of a wave to be deflected that impinges on the reflector, wherein the wave to be deflected comprises electromagnetic radiation and / or a mechanical wave, in particular a sound wave and / or ultrasound. Advantageously, the wave can be deflected to a region distal to the instrument device. The radial portion of the wave can at least substantially constitute a large portion of the wave to be deflected. The wave can travel at least substantially primarily radially. The wave can be reflectable according to the law of reflection. According to some embodiments, the wave can be deflectable by at least substantially 90°.

[0072] Furthermore, the deployment state can define several different reflector positions in which the reflector is configured to at least partially distally deflect a radial portion of a wave to be deflected that impinges on the reflector. This allows for flexible use of the instrument device. An object region onto which the wave is deflected can be specifically changed. For example, a reflector position with a larger angle can be used to effect a larger object region. Furthermore, a smaller angle can be used to effect a greater power density and / or energy density of waves deflected onto the object region. By means of the different reflector positions, a reflection path can be changed such that a point at which the path intersects the object region can be selectively set.This can be achieved, in particular, if the reflector arm is articulated to the instrument shaft and defines a rotation axis. This allows different reflector positions to be defined, particularly in a design with a functional sleeve.

[0073] A flexible and efficient instrumentation device can be provided if the reflector is continuously movable between the multiple reflector positions. Continuous can mean that the step size when moving from one reflector position to the next is small. In other words, the deployment state can define many different reflector positions, for example, at least 10, 20, 50, and / or 100 reflector positions.

[0074] In principle, the rotation axis can be arranged at a distance from a distal end of the instrument shaft. This can reduce the risk of damage to the reflector and / or the reflector arm. The reflector arm can rest at least partially against the instrument shaft, especially when stowed.

[0075] Furthermore, the reflector and / or the reflector arm can be hinged to the instrument shaft and / or the sleeve body, defining a rotation axis. This allows for a cost-effective design.

[0076] Furthermore, the reflector, in particular the reflector arm, can open distally in the deployed state and, together with the instrument shaft, enclose an opening angle of up to 90°. A wave to be deflected can thus be deflected to an area, in particular an object area, distal to a distal end of the instrument shaft and / or the functional sleeve.

[0077] In addition, the reflector assembly can comprise at least one further, in particular similar, reflector that is movable between the stowed state and the deployed state, wherein the reflector and the further reflector are arranged at different circumferential positions. A larger object area can be illuminated and / or reached with deflected waves, and the functionality and / or efficiency of the instrument device can be increased. The further reflector can have at least substantially the same features as the reflector and, in particular, can comprise and / or form a reflector arm. In principle, a symmetrical structure can be provided. The reflector and the further, in particular similar, reflector can be arranged on opposite sides of the instrument shaft and / or the functional sleeve.Furthermore, the reflector assembly can comprise at least one further reflector arm, which can be arranged at a different circumferential position, in particular opposite the longitudinal axis of the sleeve body, and can be configured at least substantially identically to the reflector arm. Furthermore, the reflector can be arranged at a first circumferential position on the instrument shaft, and the further reflector can be arranged at a second circumferential position on the instrument shaft, wherein the second circumferential position is arranged on an opposite side of the instrument shaft.

[0078] A small radial expansion in the stowed state can be achieved if the reflector assembly is attached to a distal end of the sleeve body. This allows the reflector and / or at least one other reflector to be inclined and / or angled inward toward a center of gravity axis of the sleeve body when the reflector is in the stowed state.

[0079] The sleeve body can be hollow-cylindrical. Furthermore, the sleeve body can have an inner diameter that is slightly larger than the outer diameter of the instrument shaft to be inserted. The instrument shaft can be movably mounted in the sleeve body. A distance between the instrument shaft and an inner surface of the sleeve body can be designed such that the instrument shaft can be movably arranged in the sleeve body and, in addition, the instrument device has a small radial extension. A small radial extension can mean a radial extension of a common instrument device and / or an instrument device with a smaller radial extension.

[0080] Furthermore, in the stowed state, the reflector can extend at least partially into a space that encompasses an imaginary distal continuation of the sleeve body. The instrument device and / or the reflector assembly can thus have the smallest possible radial extension in the stowed state. Furthermore, it can be achieved that the instrument device comprises at most parts, sections, and / or the like that protrude at least substantially slightly radially from an outer side of the sleeve body. The risk of damage to the reflector assembly can thus be minimized.

[0081] Furthermore, the reflector can be pivotally mounted on the sleeve body and define a rotation axis, wherein the reflector rotates about the rotation axis when it is transferred from the stowed state to the deployed state. A functional sleeve that is cost-effective to manufacture can thereby be provided. The design can be simple and therefore safe to use. The risk of malfunction can be small. A reliable instrument device can be provided if the reflector assembly comprises at least one hinged reflector arm. Hinged does not mean a rotatable and / or pivotable reflector arm. Since the reflector arm itself can be rigid, it can be achieved that the reflector arm can reliably and reproducibly assume reflector positions, in particular those of the deployed state.

[0082] Furthermore, the actuating mechanism can comprise an actuating section which, in the stowed state, has at least one point which is located radially further inward than an inner surface of the sleeve body. This allows the reflector to be actuated easily and efficiently. In particular, if the reflector is mounted so as to be rotatable, rotatable and / or pivotable, the reflector can be moved easily and efficiently by means of the actuating section. The actuating section can comprise a section of the reflector and / or the reflector arm. In particular, the sleeve body can be hollow-cylindrical, have an opening and / or a channel, and the instrument shaft can be movable in the sleeve body. Radially further inward can mean that the actuating section projects into the opening and / or the channel.

[0083] A cost-effective instrument device can be provided if the actuating section defines a contact surface that is configured to interact with the instrument shaft. The instrument shaft can be advanced in the sleeve body to contact the contact surface. Upon further advancement, the actuating section can be displaced distally, thereby transferring the reflector into the deployed state. By means of the actuating section and / or the contact surface, a linear movement of the instrument shaft can be converted into a rotational movement of the reflector. Interaction can be understood, in particular, as a material-locking and / or form-locking contact. The instrument shaft can be used to actuate the actuating mechanism and / or to transfer the reflector from the stowed state to the deployed state.

[0084] In addition, the actuating section can have a chamfer that at least partially defines the contact surface, wherein the chamfer extends radially inwardly and distally in the stowed state. This makes it possible to provide a predefined movement path of the reflector when transferred into the deployed state. Furthermore, each instrument shaft position within the functional sleeve can be clearly assigned a reflector position. In a lateral sectional view, the chamfer can taper distally in the stowed state. A radially outer point and / or section of the chamfer can be configured to initially contact the instrument shaft when the instrument shaft is advanced. This point can in particular be the most proximal point of the chamfer and / or be defined as a first contact point.By further advancing the instrument shaft from the first contact point, a contact point and / or section of the instrument shaft can be guided along the bevel, wherein, in particular, a material-to-material contact of the contact point and / or section of the instrument shaft with the bevel can be maintained. In a deployed state, the bevel can bear against the instrument shaft with at least substantially its entire length and / or form a material-to-material and / or form-fitting connection with the instrument shaft.

[0085] This allows the reflector to retain its shape in its operational state. The larger the reflector's contact surface on the instrument shaft, the greater the force that can hold the reflector in the operational position.

[0086] According to some embodiments, the contact surface may have a bend that is inclined, in particular, toward the center of gravity of the sleeve body. This allows a large deflection of the reflector to be achieved and / or allows different reflector positions to be adjusted, in particular continuously.

[0087] Furthermore, the actuating section can comprise a mandrel which at least partially defines the contact surface, the tip of which points at least partially proximally in the stowed state. By means of the mandrel, a clearly defined contact point for the reflector with the instrument shaft can be defined. Even if the instrument shaft has play in the sleeve body, the mandrel can be reliably contactable in the same instrument shaft position within the sleeve body. The mandrel can have the tip. The mandrel can protrude at least partially into a cavity of the sleeve body, in particular in the stowed state. In particular, the tip of the mandrel can have a point which is located radially further inward than the inner surface of the sleeve body.

[0088] Wear on the outer side of the instrument shaft and the risk of damage to the instrument shaft and / or components arranged on the instrument shaft can be prevented by the actuating section comprising a rotatably mounted roller element. The roller element can be provided, in particular, instead of the contact surface, the draft angle, and / or the mandrel. When the instrument shaft is advanced in the sleeve body, the instrument shaft can contact the roller element, and the roller element can roll on the instrument shaft during the advancement. This allows the reflector to be transferred into the operating state while avoiding grinding along an immovable section such as the mandrel, the contact surface, and / or the draft angle on the instrument shaft.

[0089] According to some embodiments, the actuating mechanism comprises a retaining element configured to hold the reflector in the stowed state, wherein a force can be applied to the retaining element by actuating the actuating mechanism. This advantageously ensures that the reflector is always in the stowed state. The reflector can only be transferred into the deployed state upon actuation of the actuating mechanism. If a force causing the actuation ceases, the reflector is transferred back into the stowed state by means of the retaining element. For example, the retaining element can be provided on a reflector, in particular a reflector arm, which can be transferred into the deployed state by means of the instrument shaft, in particular by advancing the instrument shaft in the sleeve body.An actuating portion of the reflector, such as the mandrel, the draft angle, the contact surface, and / or the like, can protrude into the cavity of the sleeve body in the stowed state. The reflector, in particular the actuating portion, can be displaced radially outward by advancing the instrument shaft in the sleeve body, and the retaining element can be subjected to a displacement force by radially outward displacement of the reflector. If the instrument shaft is pushed back in the opposite direction and past a contact position with the actuating portion, the displacement force disappears, and the retaining element returns the reflector to the stowed position. The retaining element can comprise a spring, in particular a coil spring, pneumatic spring, and / or the like. For example, a rotational movement of the reflector can cause compression of the spring in the longitudinal direction of the sleeve body.The reflector can comprise a stop surface and / or a fastening section for the spring and / or a force transmission element between the spring and the reflector. Furthermore, the retaining element can be elastically deformable and expand radially when subjected to the force. A cost-effective retaining element can be provided. The retaining element can comprise, for example, an O-ring, a rubber ring, a tensioning rubber, a rubber band, and / or the like. By means of the retaining element, the reflector can be held on the sleeve body and / or the reflector can be tensioned towards the sleeve body. "Elastically deformable" can mean that elastic deformation is provided during operation. It is understood that any body can be elastically deformable within limits, even one that would commonly be referred to as rigid. It can be provided that the retaining element deforms elastically upon actuation of the actuating section.The retaining element can stretch in the radial direction by up to 5%, 10%, 20%, or even up to 50%, especially depending on the deflection of the reflector.

[0090] In some embodiments in which at least two reflectors are provided, a retaining element may be provided jointly for the at least two reflectors. In particular, the reflector assembly may comprise at least two reflectors, wherein the reflector assembly comprises a retaining element configured to jointly hold the at least two reflectors in the stowed state, wherein the retaining element can be subjected to a force by actuating the actuating mechanism.

[0091] An instrument device having a small base circumference can be provided in that, in the deployed state, the instrument shaft presses the reflector radially outwards, or the reflector is pushed and / or can be pushed radially outwards by the instrument shaft when transferred into the deployed state. This can mean that the entire reflector is pushed outwards. The reflector is not merely turned, rotated and / or the like. It can be provided that the instrument shaft displaces the reflector. By pushing it outwards, the retaining element can be tensioned or subjected to a force. This can ensure that the reflector moves back radially inwards when the instrument shaft is retracted into the sleeve body.

[0092] A cost-effective instrument device can be provided if the functional sleeve is designed for single use. The functional sleeve can be disposable. The functional sleeve does not require disinfection and / or reprocessing.

[0093] In addition, the instrument shaft can comprise at least one output device configured to provide a wave to be deflected. The at least one output device can define an exit axis for the wave to be deflected, which is oriented at least primarily radially or proximally. Advantageously, this allows efficient use of the installation space of the instrument shaft. An output device can be provided that is designed to interact with the reflector. An output device can comprise a radiation source and / or a radiation decoupling device. The output device can passively and / or actively provide the wave to be deflected. The output device can comprise an emitter device and / or emit radiation, a wave, and / or the like. For example, the output device can comprise a light source and / or the like.Furthermore, the output device can also comprise an optical element, for example a lens and / or a viewing window, by means of which light can be coupled out of the instrument shaft. The light can be guided along the instrument shaft to the optical element, for example, via a light guide such as a fiber optic cable. In general, the output device can define an exit location from which the wave to be deflected travels away from the instrument shaft. The exit axis can define a direction in which the wave to be deflected travels away from the instrument shaft. In particular, the exit axis can define a central axis of a light cone and / or the like, in particular an optical axis and / or main optical axis, which extends at least partially radially and / or proximally from the instrument shaft. According to some embodiments, the wave to be deflected can be provided as a focused and / or bundled beam.

[0094] The output device can extend circumferentially and comprise a plurality of output elements, each of which can be configured to provide a wave to be deflected and each of which can define an exit axis for the corresponding wave to be deflected, which is oriented at least primarily radially or proximally. The output device can extend circumferentially of the instrument shaft. The output elements can be arranged at various circumferential positions. The output device can comprise a first output element and a second output element, wherein the second output element can be arranged opposite the first output element with respect to a shaft longitudinal axis.

[0095] Alternatively or additionally, the dispensing device may comprise a further dispensing element, wherein the further dispensing element, the first dispensing element and the second dispensing element are arranged together in an evenly distributed manner on the circumference of the instrument shaft and each define an exit axis which is at least primarily oriented radially.

[0096] Furthermore, in the deployed state, the exit axis can intersect the reflector. The wave to be deflected can be specifically provided for interaction with the reflector, particularly while the reflector is in the deployed state. Consequently, a primarily radially and / or proximally oriented wave can be specifically provided, which is intended for deflection by means of the reflector. Preferably, the reflector can deflect the wave distally.

[0097] The inventors have recognized that the installation space can be efficiently utilized and / or even expanded if the at least one output device is arranged laterally in the distal section, in particular of the instrument shaft. The output device does not necessarily have to be arranged on a distal end surface of the instrument shaft. The inventors have recognized that the installation space can be expanded and a larger number of output elements can be provided if the at least one output device is arranged laterally in the distal section. The reflector can deflect the wave provided by the output device at least as if the output device were arranged on the distal end surface.

[0098] In principle, the object region can comprise a region, in particular of the cavity, that includes anatomical structures, tissue, and / or the like and that is to be imaged. The object region is preferably arranged distal to the instrument device.

[0099] According to some embodiments, the at least one output device comprises at least one luminous element. Advantageously, this allows light to be provided and an object region distal to the instrument shaft to be illuminated with light that was primarily coupled radially or proximally from the instrument shaft. Installation space can be utilized efficiently. The luminous element can comprise a light-emitting diode, a laser diode, and / or the like. Alternatively or additionally, a viewing window and / or a lens can be provided, which is configured to couple light out of the instrument shaft. The luminous element can be configured to emit white light and / or colored light.

[0100] Furthermore, the output device can comprise an LED light strip and / or a light element array that extends at least partially along the circumference of the instrument shaft. Installation space can be utilized along the longitudinal axis of the instrument shaft and additionally along the circumference of the instrument shaft. The inventors have recognized that high illumination quality can be achieved if light elements and / or the like are arranged circumferentially along the instrument shaft. Because the LED light strip or the light element array can provide at least substantially uniform light across the circumference, illumination of an object region with high homogeneity and intensity can be achieved.

[0101] In addition, the instrument shaft can have a lighting unit that encompasses the output device, wherein the lighting unit comprises a plurality of lighting elements, each defining an exit axis that is at least primarily radially oriented. The inventors have recognized that the available installation space along the instrument shaft of common instruments, in particular endoscopes, is not used efficiently and / or is even disregarded. By providing a plurality of lighting elements there, more complex lighting plans and / or the like can be incorporated. For example, the object area can be illuminated in a structured manner. "Structured" can mean that the object area can be specifically illuminated with inhomogeneous intensity. In particular, illumination with an intensity gradient can be provided. The exit axis can in particular be arranged perpendicular to an emitter plane of a lighting element.

[0102] Illumination for multi- and / or hyperspectral imaging can be achieved if the illumination unit comprises a plurality of different lighting elements that are configured to provide illumination light in different spectral ranges and, in particular, each defines an exit axis that is at least primarily radially oriented. The object region can be illuminated with illumination light in different spectral ranges. The spectral ranges can, in particular, be narrowband. "Narrowband" can mean a spectral width of, for example, up to 25 nm, up to 50 nm, and / or up to 100 nm. The illumination light can each comprise colored illumination light. The different lighting elements can, for example, comprise a green LED, a red LED, a blue LED, a yellow LED, and / or the like. The different lighting elements can together cover the spectral range of visible light.In some embodiments, the different luminous elements can jointly cover a spectral range that extends into the infrared spectral range. The different luminous elements can jointly cover a spectral range of, for example, 200 nm to 1500 nm, in particular 300 nm to 1200 nm, preferably from 350 nm to 1000 nm. The different luminous elements can comprise a luminous element that is configured to emit light in the ultraviolet spectral range and / or in the infrared, in particular near-infrared, spectral range. Advantageously, this makes it possible to provide an endoscope for multi- and / or hyperspectral imaging that does not rely on an external illumination device that provides light in different spectral ranges. The illumination quality can be improved by the luminous elements arranged in the endoscope itself.

[0103] Alternatively or additionally, the instrument device can comprise an imaging device with at least one input optic arranged on a distal end surface of the instrument shaft. Advantageously, the illumination device and / or the reflector can be used in combination with a standard endoscope. The distal end surface of the instrument shaft can generally define a distal end surface of the distal section of the instrument shaft. The imaging device can be configured to image the object area, create an image of the object area, and generate image data. The imaging device can comprise at least one optical element, in particular a lens and / or an objective lens, which can be configured to couple light into the instrument shaft and image the object area.In particular, the imaging device can comprise at least one image sensor which, when the object region is imaged onto it, can generate image data of the object region. The image sensor can be arranged in the distal end piece. The image sensor can be arranged in a horizontal position, in particular such that a surface onto which the image is generated extends along the longitudinal axis of the instrument shaft. Illumination light can be provided by the illumination device and decoupled from the instrument shaft, in particular radially. The decoupled illumination light can be deflected distally by means of the reflector. By deflecting the illumination light, the object region arranged distal to the distal end surface of the instrument shaft can be illuminated by means of the illumination light.Illumination light reflected from the object area can be coupled into the instrument shaft by means of the imaging device, in particular the optical element, and the object area can be imaged.

[0104] According to some embodiments, the imaging device defines an image cone with an optical imaging axis, wherein the imaging axis extends at least partially distally from the distal end surface. The instrument shaft can comprise at least one laterally arranged illuminating element that defines an exit axis that is at least primarily radially oriented and that does not intersect the image cone. The illuminating light emitted by the at least one laterally arranged illuminating element is thereby only directed onto the object region by deflection by the reflector in such a way that light reflected by the object region can be coupled into the instrument shaft by the imaging device. Based on the image cone, image planes along the imaging axis can be described, in which image planes an image can be created by the imaging device.The imaging axis can, analogously to the exit axis, define an axis that is arranged perpendicular to the imaging device, in particular the optical element of the imaging device, and / or the distal end surface.

[0105] The image cone can refer to a three-dimensional space that can be captured by the optical element of the imaging device. It can define an area in the vicinity of the instrument shaft from which light falls onto the image sensor, which can be coupled into the instrument shaft by means of the optical element and / or from which a sharp image can be generated. The image cone can be defined by the viewing angle of the imaging device, in particular of the optical element. This can define the perspective and depth of field of an image of the object area generated by the imaging device. The exit axis can define a central axis of the image cone.

[0106] A small-diameter instrument shaft can be provided, for example, if the instrument shaft does not include a laterally arranged illuminating element that defines an exit axis that intersects the image cone of the imaging device. In other words, the instrument shaft can only include illuminating elements arranged laterally on the instrument shaft. The instrument device can exclusively include illuminating elements that are provided for illuminating the object area in such a way that it can be imaged, and whose emitted illumination light can be deflected onto the object area by the reflector.

[0107] According to some embodiments, the instrument device comprises at least one luminous element configured to illuminate a first, in particular central, portion of an object region distal to the instrument shaft with illuminating light, wherein the output device provides the wave to be deflected and the reflector deflects the wave to be deflected such that it impinges on a second portion of the object region arranged at least partially adjacent to the first portion. Structured illumination can thereby be achieved. Furthermore, different waves to be deflected and / or different illuminating light can be specifically deflected or radiated onto different portions of the object region. Furthermore, the first portion can be illuminated for imaging, and the waves to be deflected can be deflected onto the second portion, for example, for therapy, imaging, marking, and / or the like.The first section can be larger than the second section. The second section can at least partially overlap the first section. Distal from the distal end surface of the instrument shaft can comprise, for example, white light and illuminate the first section of the object area, in particular centrally within the object area. Light deflected onto the object area by means of the reflector can illuminate the second section, in particular decentrally within the object area. This light can comprise, for example, light intended for fluorescence imaging and / or narrowband light for multi- and / or hyperspectral imaging.

[0108] Furthermore, the output device can comprise at least one laser source. Laser light can be provided by the laser source. Laser light can be provided for marking, imaging, therapy, and / or the like. A function of the instrument device can be expanded, particularly compared to a conventional endoscope. The laser source can comprise a diode laser.

[0109] According to some embodiments, the output device may comprise an optical

[0110] Element configured to couple laser light, in particular therapy laser light, out of the instrument shaft. This makes it possible, for example, to provide an instrument device that can be used as a therapy laser instrument. A medical system comprising the instrument device can, for example, comprise a therapy laser source, such as a neodymium-YAG (Nd:YAG), an erbium-YAG (Er:YAG), and / or a CO2 (carbon dioxide) laser source. The therapy laser light can be coupled into the instrument shaft on the proximal side and guided along the instrument shaft to the distal section. For example, the instrument shaft can comprise an optical fiber, a glass fiber, a fiber bundle, a rod lens system, a lens system, and / or the like, by means of which the therapy laser light can be guided along the instrument shaft.It is conceivable that, if the reflector, together with the instrument shaft, encloses various angles in the deployed state, a therapeutic laser line scan can be provided. Alternatively, the instrument shaft, in particular the output device, can comprise a beam deflection element that is displaceably and / or movably mounted in the instrument shaft along the longitudinal axis of the instrument shaft. A laser line scan can also be realized by displacing the beam deflection element. In addition to laser coagulation and laser cutting, therapeutic laser light can also be used in conjunction with an administered photosensitive and tissue-specific marker substance as photodynamic irradiation light for photodynamic therapy (PDT).

[0111] A user can be assisted in performing a procedure and / or imaging if the output device is configured to project a light pattern onto the object area. The light pattern can be scalable by deflection. The angle of the reflector in the operating state can be known. If the angle is known, the radiation angle of a laser beam deflected by the reflector can be determined. This makes it possible to measure the object area by imaging it with the imaging device.

[0112] According to some embodiments, the imaging device is configured for stereo imaging. The imaging device can, in particular, comprise at least two separate image sensors. The light pattern can comprise markings that mark geometric reference points of the object region. In particular, the light pattern can comprise markings that are intended to mark geometric reference points of the object region. By projecting the reference points, fixed points can be defined in partial stereo images of the object region, each captured by the at least two separate image sensors. A spatially resolved stereo image can be generated based on the partial stereo images. The fixed points can facilitate a spatial reconstruction of the object region. In general, the light pattern can be provided in such a way that geometric information about the object region can be generated based on it.

[0113] To create clearly identifiable reference points, different colored markings can be used. For example, one reference point can be blue and another reference point can be red. The output device can comprise multiple laser sources, wherein the laser sources are configured to emit light in different spectral ranges of visible light, in particular light of different colors. For example, one of the laser sources can emit red light and another of the laser sources can emit blue light.

[0114] To assist a user in performing a procedure, imaging, therapy, and / or the like, an area can be marked using the light pattern, with the marked area defining a work area. The work area can define a sub-area of ​​the object area that is of primary importance. For example, the user can more easily orient themselves within the cavity and / or easily and efficiently locate anatomical target structures where a procedure is to be performed. For example, boundaries of the work area can be marked with light of different colors.

[0115] An ultrasonic instrument device can be provided if the output device comprises at least one ultrasonic emitter. Ultrasound emitted by the ultrasonic emitter, in particular ultrasonic waves, can be deflected by means of the reflector. The reflector can be designed such that it is suitable for reflecting ultrasonic waves. For example, the reflector can have a coating suitable for efficiently reflecting ultrasonic waves. The coating can comprise, for example, an aluminum coating, a gold coating, and / or the like. The reflector can be optimized with respect to the reflection of ultrasonic waves and / or be configured to reflect ultrasonic waves with low distortion and / or low loss.For example, the reflector's material absorption may be low; the interface reflection may be adjusted to cause minimal interference phenomena and / or a small phase shift, particularly for certain wavelengths used; the surface roughness may be low; the surface for reflection may be smooth and / or smoothed, and / or the like. The ultrasonic emitter may, for example, comprise a piezoelectric transducer.

[0116] It is conceivable that therapeutic ultrasound can be provided using the ultrasound emitter. For example, endoscopic ultrasound treatment can be performed using the therapeutic ultrasound. The therapeutic ultrasound can be redirected to the target area using the reflector. Further focusing of the ultrasound can be achieved by curving the reflector. The instrument device can additionally comprise the imaging device in the distal shaft section. The target area can be imaged using the imaging device. This allows the cavity to be visually examined while an ultrasound treatment is being performed.

[0117] In principle, when using ultrasound, it can be provided that the instrument device is operated in a state in which at least the distal section of the instrument shaft is surrounded by a liquid medium or is immersed in a liquid medium. For example, the cavity to be examined and / or treated can be filled with a liquid. The liquid can comprise an endogenous fluid, for example synovial fluid, and / or an introduced fluid, such as a rinsing solution and / or the like. The instrument device can comprise a rinsing solution supply unit, by means of which rinsing agent can be provided within a cavity.

[0118] An instrument device configured for ultrasound imaging can be provided if the instrument device comprises an ultrasound sensor configured to convert spatially resolved sound signals, in particular ultrasound signals, and to generate image data based on the sound signals. Sound waves emitted by the ultrasound emitter, deflected by the reflector, and reflected by the object region can be detected by the ultrasound sensor. The ultrasound emitter and the ultrasound sensor can be formed jointly by a single component. For example, a piezoelectric transducer can function as both emitter and sensor. The ultrasound sensor can be arranged, for example, in the distal end surface.

[0119] A compact and versatile instrument device can be provided if the ultrasound sensor is arranged laterally in the distal section such that it converts sound signals that impinge at least primarily radially on the instrument shaft. It can be provided that the sound signals can be deflected from distal to radial onto the ultrasound sensor by means of the reflector. Advantageously, the instrument shaft can basically comprise a conventional endoscope, which additionally comprises the reflector assembly and the ultrasound elements. This makes it possible to provide a multifunctional device by means of which ultrasound imaging and optical imaging can be performed sequentially and / or simultaneously.

[0120] Furthermore, the output device can comprise at least one output optics configured to output an interferometric measuring beam as a wave to be deflected, primarily radially or proximally. This allows an interferometric measurement to be performed intracorporeally. Because the interferometric measuring beam is deflected by means of the reflector, a large object region can be illuminated by the measuring beam. The object region can be larger, in particular, than an object region that can be illuminated by means of a measuring beam that can be output at the distal end surface. Furthermore, if the reflector is continuously movable, the measuring beam can be continuously deflected to different positions in the object region. In particular, a line scan can be realized. The instrument device and / or the medical system can comprise a reference arm for a reference beam.The interferometric measuring beam can be arranged on a measuring arm. Based on the path length difference between the measuring beam and the reference beam, an interferometric measurement, in particular a distance measurement and / or a distance measurement, can be performed.

[0121] Accurate measurements with high reliability and precision can be performed if the interferometric measurement beam is a short-coherent light beam from an optical coherence tomograph. Using this instrument, intracorporeal optical coherence tomography (OCT) can be performed. OCT can be used to perform high-resolution, non-invasive imaging of biological tissue. Detailed cross-sectional images of biological tissue within the cavity can be generated. Optical coherence tomography is a non-invasive imaging technique that uses short-coherent light to create high-resolution cross-sectional images of biological tissue.

[0122] In addition, the output device may comprise a beam deflection element.

[0123] Advantageously, the installation space can be utilized efficiently. The measuring beam can be guided along the instrument shaft and deflected in the direction of the output optics by means of the beam deflection element. In particular, the measuring beam can be deflected radially along the longitudinal direction of the instrument shaft by means of the beam deflection element. The beam deflection element can, in particular, comprise a beam splitter. By means of the beam splitter, an interferometric laser beam can be split into the measuring beam and the reference beam. The beam deflection element can be arranged in the distal section of the shaft.

[0124] A line scan can also be performed if the output optics are mounted and / or movable axially along the instrument shaft. Using the line scan, OCT imaging can be performed along an axis of the object region. The reflector can be rigid and / or comprise a reflector arm. For OCT imaging, the reflector can preferably form an angle of 45° with the instrument shaft and open distally. An interferometric measuring beam can be coupled out of the instrument shaft at one position, deflected onto the object region by the reflector, and a portion reflected by the object region can be deflected again by the reflector and recoupled into the instrument shaft at the same position. A space-saving instrument device can be provided.

[0125] Furthermore, the instrument shaft can comprise a locking device for a reflector arm. The position of the reflector arm can be held securely and reliably. The locking device can be particularly advantageous in conjunction with the functional sleeve. An angle of the reflector arm in the deployed state can be defined and / or predetermined by means of the locking device. The locking device can comprise a notch, a groove, a round groove, a recess, a slot, and / or the like on the instrument shaft. The locking device can extend along the circumference of the instrument shaft and / or be arranged, in particular, on an outer side of the instrument shaft.

[0126] The present invention is described below by way of example with reference to the attached figures. The drawings, the description and the claims contain numerous features in combination. A person skilled in the art will expediently also consider the features individually and use them sensibly in combination within the scope of the claims. If there is more than one example of a particular object, only one of them will be provided with a reference symbol in the figures and the description. The description of this example can be applied accordingly to the other examples of the object. If objects are named in particular using numerical words such as first, second, third object etc., these serve to name and / or assign objects. Accordingly, for example, a first object and a third object may be included, but not a second object.However, using number words, it might also be possible to derive a number and / or order of objects.

[0127] They show:

[0128] Fig. 1 is a schematic representation of a medical instrument system;

[0129] Fig. 2 is a schematic representation of an instrument device;

[0130] Fig. 3 is a further schematic representation of the instrument device;

[0131] Fig. 4 is a schematic representation of an instrument device;

[0132] Fig. 5 is a schematic representation of an instrument device in a

[0133] Distal view;

[0134] Fig. 6 is a further schematic representation of the instrument device in a distal view;

[0135] Fig. 7 is a schematic representation of an instrument device;

[0136] Fig. 8 is a schematic representation of an instrument device;

[0137] Fig. 9 is a schematic representation of an instrument device;

[0138] Fig. 9a is a schematic representation of an instrument device with a reflector in a normal state;

[0139] Fig. 9b is a schematic representation of the instrument device with the reflector in a stowed state; Fig. 9c is a schematic representation of the instrument device with the reflector in the stowed state;

[0140] Fig. 9d is a schematic representation of the instrument device with the reflector in an operational state;

[0141] Fig. 10 is a schematic representation of an instrument device;

[0142] Fig. 11 is a further schematic representation of the instrument device;

[0143] Fig. 12 is a schematic representation of an instrument device;

[0144] Fig. 13 is a schematic representation of an instrument device;

[0145] Fig. 14 is a further schematic representation of the instrument device;

[0146] Fig. 15 is a schematic representation of an instrument device;

[0147] Fig. 16 is a schematic representation of an instrument device;

[0148] Fig. 17 is a schematic representation of a medical system;

[0149] Fig. 18 is another schematic representation of the medical system;

[0150] Fig. 19 is a schematic representation of a medical system;

[0151] Fig. 20 is another schematic representation of the medical system;

[0152] Fig. 21 is a schematic representation of a medical system;

[0153] Fig. 22 shows another schematic representation of the medical system;

[0154] Fig. 23 is a schematic representation of a medical system;

[0155] Fig. 24 is a schematic representation of an instrument shaft in a distal view; and

[0156] Fig. 25 shows a schematic representation of an object area. Fig. 1 shows a schematic representation of a medical instrument system 20. The instrument system comprises a supply unit 32, a display device 28, and an instrument device 100. The supply unit comprises a light source 22. The light source 22 is connected to the instrument device 100 by means of a light guide 23 such that light generated by the light source can be coupled into the instrument device 100. Embodiments in which the instrument device 100 comprises a light source are also conceivable. The light source of the instrument device 100 can be provided alternatively or additionally. Such embodiments are described in connection with other figures.

[0157] The instrument device 100 is designed as an endoscope device 102, in particular as an endoscope 26. The instrument device 100 has an instrument shaft 104 comprising a distal section 108 and a proximal section 106. The proximal section 106 is arranged on a handle 30, by means of which the endoscope 26 can be handled by a user. The instrument shaft 104 is elongated and has a main extension along the longitudinal axis 105 of the instrument shaft 104. The instrument shaft 100 has a rounded cross-section. The length of the instrument shaft 100 is approximately 20 times greater than a diameter of the instrument shaft. A reflector assembly 110 is arranged in the distal section 108. Some of the following figures show different embodiments of the reflector assembly 110.

[0158] The instrument shaft has a distal end surface 170, which can also be a distal end surface 170 of the distal section 108. An imaging device 1100 can be arranged in the distal section 108. The imaging device 1100 can be configured to create an image of an object region 172 and generate image data using light coupled into the instrument shaft 104 via the distal end surface 170. The object region 172 includes, for example, anatomical structures within a cavity of a patient. By means of the instrument shaft 104, the instrument device 100 can be at least partially guided into the cavity and / or introduced into the patient. The image data can be guided along the instrument shaft 104 to the proximal section 106 and transmitted to the supply unit 32 via a data cable 24.The image data can be processed, for example, and / or the like, using the supply unit 32. Furthermore, the image data can be transmitted to the display device 28, which is configured to generate a representation of the object region 172 based on the image data. The user can thus visually examine the patient's cavity using the instrument device 100.

[0159] As explained below, the reflector assembly can provide a multifunctional instrument device. This device can be configured to emit X-rays, laser light, ultrasound, and / or the like for patient treatment in addition to imaging. Furthermore, it is also conceivable to enable OCT imaging using the reflector assembly 110.

[0160] Due to the significant similarities between the following figures, some reference numerals are used multiple times. Furthermore, different embodiments can be combined with one another. For example, the imaging device 1100 can be provided only optionally. There may be embodiments in which no imaging device 1100 is provided.

[0161] The various embodiments may have a common reflector assembly 110. The basic principle will be described with reference to Figs. 2 and 3. At least some features of the embodiment shown in Fig. 2 can be transferred, at least substantially, to the other embodiments shown in the following figures.

[0162] Reference is made below to Figures 2 and 3. Figure 2 shows a schematic representation of an instrument device, with a reflector in a deployed state. Figure 3 shows a schematic representation of the instrument device with the reflector in a stowed state.

[0163] Basically, the distal section 108 comprises the reflector assembly 110 with a reflector 112 that is movable between a stowed state and a deployed state. In the stowed state of the reflector 112 (see Fig. 3), the distal section 108 defines a base perimeter 114. In the deployed state, the reflector 112 is located at least partially radially outside the base perimeter 114 and defines a deployed perimeter 115. In Figs. 2 and 3, a diameter of the deployed perimeter 115 and the base perimeter 115, respectively, is shown. As can be seen in Fig. 3, an additional reflector 162 can be provided. The additional reflector can have the same features as the reflector 112. Therefore, the following primarily discusses the reflector 112. Features that are described in connection with one of the two reflectors 112, 162 can be transferred analogously to the other of the two reflectors 112, 162.Embodiments with three, particularly identical, reflectors and / or additional reflectors are also conceivable.

[0164] The reflectors 112, 162 are arranged at various circumferential positions 164 of the instrument shaft 104. The reflectors 112, 162 are designed as reflector arms 124. They have an inherently stable shape that is at least not significantly deformable during use. The reflector arms 124 are rigid, for example, as an injection-molded part and / or by means of additive manufacturing. According to the exemplary embodiment shown, the reflector arms 124 are made of a plastic. In the stowed state, the reflector arms 124 rest against the instrument shaft 104. The instrument shaft 104 has a small overall radial extension. In the deployed state, however, the reflector arms 124 extend angularly from the instrument shaft 104 (see Fig. 2). The instrument shaft 104 has a large overall radial extension.

[0165] The distal portion 108 has a sectional taper which is shaped such that the reflector arms 124 can be arranged and / or applied such that the base circumference 114 does not project beyond a circumference of the instrument shaft 104 at a distal end portion 109, wherein the distal end portion 109 is arranged distal to the sectional taper.

[0166] The reflector 112 is detachably attached to the instrument shaft 104 by means of a fastening mechanism (not shown in detail). This allows the reflector 112 to be removed after use of the instrument shaft 104 and replaced with a new, sterile reflector. The reflector 112 is intended for single use.

[0167] The imaging device 1100 is arranged in the distal section 108, in particular in the distal end section 109, and has an input optics 1101 arranged on the distal end surface 170 of the instrument shaft 104. Light emitted by the object region 172 can be coupled into the instrument shaft via the input optics 1101. Furthermore, the light can be guided to an image sensor 1105, which is also arranged in the end section 109, and / or the object region 172 can be imaged there using the input optics 1101. Alternatively or additionally, the coupled light can be guided along the instrument shaft 104 to the proximal section 106. The imaging device 1100 defines an image cone 1102 having an optical imaging axis 1104, wherein the imaging axis 1104 extends perpendicularly distally from the distal end surface 170.An angled end surface 170 is also conceivable, by means of which an oblique-view endoscope can be foreseen. The instrument shaft 104 comprises at least one laterally arranged illuminating element 1006, 1018, 1020, 1022, which defines an exit axis 1004 that is at least primarily radially oriented and does not intersect the image cone 1102. In other words, the illuminating elements 1006, 1018, 1020, 1022 emit light onto an area that cannot be captured by the imaging device 1100. According to the embodiment shown, the instrument shaft 104 does not comprise a laterally arranged illuminating element that defines an exit axis 1004 that intersects the image cone 1102 of the imaging device 1100. As explained below, the object area 172 is illuminated exclusively with light elements whose emitted light is deflected by the reflector assembly 110 and directed onto the object area 172.This allows for the provision of an instrument shaft 104 with a small shaft diameter, in this case with a diameter of 2 cm. The illumination density and quality can nevertheless be better and / or at least equivalent to an endoscope with a larger shaft diameter and / or with luminous elements arranged on the distal end surface.

[0168] The reflectors 112, 162 are movably mounted on the instrument shaft 104. For transferring the reflector assembly into the deployed state and back into the stowed state, it has an actuating mechanism. The actuating mechanism 116 has a drive 118, in particular an electric motor. The electric motor and / or the actuating mechanism 116 can be actuated by a user. The user can issue a control command, for example, via a user interface, thereby generating a control signal by means of which the electric motor can be actuated.

[0169] When actuated, the articulated reflector arm 124 rotates about a rotation axis 126 into the operating state and back again as required.

[0170] For example, the user can initiate the movement into the deployed state once he has positioned the distal section 108 in the patient's cavity.

[0171] Preferably, the instrument shaft 104 is fed into the cavity and / or inserted into the patient with the reflector in the stowed state. The rotation axis 126 is spaced from the distal end 128 of the instrument shaft 104. The rotation axis 126 can be defined by a pivot joint 125 configured to pivotally connect the reflector arm 112 to the instrument shaft 104. The reflector 112, 162, or the reflector arm 124, opens distally in the deployed state, as can be seen in Fig. 2. The reflector arms 124 open in the distal direction 160. In a view looking from the distal direction onto the instrument shaft 104 (not shown), the two reflector arms 124 define a radiation surface from which light radiates distally onto the object area (see Figs. 5 and 6).Together with the instrument shaft 104, each of the reflector arms 124 and / or the reflectors 112, 162 defines an opening angle 150°, which can be up to 90°, depending on the embodiment. Preferably, the opening angle is at least substantially 45°. In the illustrated case, the opening angle is 40°.

[0172] In the deployed state, the reflector 112, 162 is configured to at least partially distally deflect a radial portion 152 of a wave 154 to be deflected, which impinges on the reflector 112, 162. In the illustrated case, the wave to be deflected exits perpendicularly from the instrument shaft 104. The radial portion 154 at least substantially constitutes the wave 154 to be deflected. According to Figs. 2 and 3, the wave 154 to be deflected comprises a wave of illuminating light, by means of which the object region 172 is to be illuminated. To deflect the illuminating light, the reflector 112 comprises a reflective section 158 on a side 156 directed radially inward in the stowed state, which reflective section is at least partially directed in the distal direction 160 in the deployed state. The reflective portion 158 includes a reflective coating on the reflector arm 124, for example a glass coating, such as an aluminum and / or silver coating.The coating extends along the entire side 156. Alternatively, a diffusely scattering coating can be provided, see, for example, Fig. 4. The reflector 112, 162, in particular the reflection section 156, is designed to at least partially deflect the radial portion 152 of the wave 154 to be deflected impinging on the reflector 112, 162 distally.

[0173] As will be shown in the further figures, the wave 154 to be deflected can comprise electromagnetic radiation and / or a mechanical wave, in particular a sound wave and / or ultrasound. The electromagnetic radiation can comprise light, X-rays, and / or the like.

[0174] The operational state defines several different reflector positions (not shown), in which the reflector 112 is configured to redirect the light, in particular the illumination light, distally. The various reflector positions can be approached and / or adjusted by the drive 118. The reflector 112 is continuously movable between the several reflector positions, in particular by means of the drive 118.

[0175] At least one output device 1002 is arranged on an outer side of the instrument shaft 104, which is configured to provide the wave 154 to be deflected. In other words, the at least one output device 1004 is arranged laterally in the distal section 108. The output device 1002 defines an exit axis 1004 for the wave 154 to be deflected, which in the illustrated case is primarily radially oriented. The exit axis 1004 is at least substantially perpendicular to the longitudinal axis 105 of the instrument shaft. In the illustrated case, as already described, the output device is configured to provide illumination light that can be deflected distally by means of the reflector 112. The wave is deflectable because, in the deployed state, the exit axis 1004 intersects the reflector 112, in particular the reflection section 158.To provide the illumination light, the at least one output device 1004 comprises at least one illuminating element 1006. More specifically, the instrument shaft 104 comprises an illumination unit 1014, which comprises the output device 1004. The illumination unit 1014 comprises a plurality of illuminating elements 1006, 1018, 1020, 1022, each defining an exit axis 1004 that is at least primarily radially oriented. The illuminating elements 1006, 1018, 1020, 1022 are arranged laterally on the distal end piece 108 of the instrument shaft 104. Illuminating light can be generated within the patient's cavity using the illuminating elements 1006, 1018, 1020, 1022. The lighting elements 1006, 1018, 1020, 1022 are arranged at different circumferential positions of the instrument shaft 104, in particular such that their exit axes 1004 each intersect at least one of the two reflector arms 124.In the illustrated embodiment, the instrument shaft comprises lighting elements 1006, 1018, 1020, 1022 on two sides, with the sides being opposite one another. Likewise, a single-sided instrument device 100 can also be provided (not shown), which comprises a reflector and / or lighting elements 1006, 1018, 1020, 1022 on only one side. Likewise, only one of the 1006, 1018, 1020, 1022 can be provided. The lighting elements 1006, 1018, 1020, 1022 are arranged at a distance from the image acquisition unit 1100 in the distal section 108 such that the installation space within the instrument shaft 104 is efficiently utilized. The installation space within the end section 109 is at least substantially filled by the image acquisition unit 1100 and utilized efficiently.

[0176] In addition, at least one opening for a channel can be arranged on the distal end surface 170, wherein the channel extends from the distal end surface 170 to the proximal section 106. Through the channel, for example, a tool can be fed to the cavity and / or a rinsing solution can be introduced into the cavity and / or the like. To increase clarity, no embodiment with a channel and / or an opening is shown. Further proximal to the end section 109, the installation space in conventional endoscopes is often unused, or usually no lighting elements are arranged there that are intended for illuminating an object region distal to the instrument device 100. However, the inventors have recognized that this installation space can be efficiently utilized if at least one lighting element 1006, 1018, 1020, 1022 is arranged there and a reflector 112, 162 is provided.Furthermore, this ensures that the object region 172 can be homogeneously illuminated, in particular up to an edge region of a region imaged by the image acquisition unit 1100. This ensures high image quality. In particular, high homogeneity can be achieved if the reflection surface is configured for diffuse scattering. See, for example, Fig. 4. According to some embodiments, it may be expedient to provide at least substantially perfect reflection, while, as mentioned, in other embodiments, it may be expedient to provide at least substantially complete diffuse scattering.

[0177] The lighting elements 1006, 1018, 1020, 1022 of the lighting unit 1014 can be different or configured to provide illumination light in different spectral ranges. One of the lighting elements 1006, 1018, 1020, 1022 can be a green LED, one of the lighting elements 1006, 1018, 1020, 1022 a blue LED, one of the lighting elements 1006, 1018, 1020, 1022 a red LED, and / or emit illumination light in the corresponding colors. One of the colored LEDs mentioned is arranged on each side of the instrument shaft 104. Alternatively, the LEDs can be configured to emit white light. If the reflector is designed to be diffusely scattering, homogeneous illumination of the object area can be achieved using one of the colored LEDs 1006, 1018, 1020, 1022. The LEDs can then be controlled and / or operated sequentially, for example, to perform multi- and / or hyperspectral imaging.Further lighting elements can be provided, each capable of emitting light in a further spectral range. For example, an LED can be provided that is configured to emit illumination light in the infrared, particularly near-infrared, spectral range. Fluorescence imaging can also be performed in a targeted manner using the LEDs. A fluorescent substance in the object region can be specifically excited to emit light using one of the LEDs. Each of the LEDs can be used, for example, for a specific fluorescent substance. This makes it possible to provide an instrument device 100 by means of which multiple fluorescence imaging methods can be performed sequentially and / or simultaneously.

[0178] Fig. 4 shows a schematic representation of another embodiment of an instrument device 200. Due to the great similarity, some of the same reference numerals are used as in Figs. 2 and 3 to increase comprehensibility. Furthermore, differences are primarily discussed. The instrument device 200 comprises a reflector arm 124, which includes a filling chamber 140. Filling the filling chamber 140 using a fluid and / or gas transfers the reflector arm 124 from the stowed state to the deployed state. In the case shown, the reflector arm 124 is in the deployed state. Carbon dioxide (CO2) is used as the gas. This is guided from the proximal section 106 to the distal section 108 via a channel (not shown in detail). The filling chamber 140 extends from a proximal end, at which the gas can be filled into the filling chamber 140, over a length of 80% of the reflector arm 124.The reflector arm 124 can only be rigid if the filling chamber 140 is filled with CO2. As an alternative to the reflector arm 124, an inflatable reflector shield (not shown) can be provided, which surrounds the filling chamber 140.

[0179] The reflector arm 124 has a reflection section 158 configured to diffusely scatter incident light, in particular from a lighting unit 1014 of the instrument device 200. The scattering can be at least nearly perfect scattering. The scattering can occur in the manner of a projection screen. This allows the object area 172 to be homogeneously illuminated. With diffuse scattering, a main direction of scattering can be arranged perpendicular to the reflection section 158. The reflector arm 124 can be adjusted accordingly, so that a size of a homogeneously emitted object area 172 can be adjusted.

[0180] Alternatively, the reflection section 156 can be configured to spectrally convert light. For example, the reflection section 156 can be configured to convert colored light into white light.

[0181] The illumination unit 1014 comprises two additional light sources 1022, in particular LEDs, on each side of the instrument shaft 104. In the illustrated embodiment, all light sources of the illumination unit 1014 are configured to emit white light.

[0182] Furthermore, the distal section 108 of the instrument shaft 104 differs.

[0183] The distal section 108 has a constant diameter from a coupling point 127 of the reflector arm 124 to the instrument shaft 104. Further proximally, the diameter of the instrument shaft 104 is larger than the diameter of the distal section 108 by at least the thickness of at least one reflector arm 124. The instrument shaft 104 tapers at the coupling point 127. According to Fig. 4, two reflector arms 124 are provided; therefore, the instrument shaft 104 tapers by the thickness of at least two reflector arms 124. The distal section 108 further comprises two illuminating elements 1108 arranged on the distal end surface 170. Illumination light can be provided by means of the illuminating elements 1108. The homogeneity of the illumination can be improved.

[0184] Figures 5 and 6 each show a schematic representation of another embodiment of an instrument device 600. Due to the great similarity to the previous embodiments, some of the same reference numerals are used as in the previous figures to increase clarity. Furthermore, differences will be discussed primarily.

[0185] 5 and 6 show a distal view of an instrument device 300 which merely has a reflector 112 and / or reflector arm 124. The reflector 112 can be at least substantially identical in construction to the reflector 112 of FIG. 2. In FIG. 5, the reflector is shown in the stowed state, and in FIG. 6, it is shown in the deployed state. In the stowed state, the distal portion 108 defines a base circumference 114. The base circumference 114 is defined by an outer imaginary contour 166, wherein the contour 166 encloses the instrument shaft 104 and the reflector 112. It can be seen that the instrument shaft 104, together with the reflector 112, has an at least substantially circular cross-section in the stowed state. Furthermore, lighting elements 1108 and an entrance optic 1101 can be seen on a distal end surface 170 of the instrument shaft 104.The reflector arm 124 includes a side 134 facing the instrument shaft 104, which has a width 136 corresponding to 70% of a diameter 138 of the base circumference 114. The reflector can be configured for reflection across the entire width 136.

[0186] However, it may be necessary to transfer the reflector into the deployed state so that it can be used for reflection in the distal direction (see Fig. 6). In the deployed state, the reflector opens distally, exposing the facing side 134. As a result, the reflector 112 defines a radiation surface 603 (hatching) from which waves to be deflected radiate distally and / or can be deflected. In the deployed state, the reflector 112 and / or the reflector arm 124 is located partially outside the base circumference 114 or outside the imaginary contour 166, respectively. The base circumference 114 defines an area which is delimited in Fig. 6 by the instrument shaft 104 and the dashed line (imaginary contour 166). In the stowed state, the reflector 112 is located within the area, whereas in the deployed state the reflector 112 is at least partially outside the area. The reflector arm 124 is unfolded.This opens the reflection section 158 distally. In the stowed position (Fig. 5), the reflector arm 124 rests against the instrument shaft 104.

[0187] Figure 7 shows a schematic representation of another embodiment of an instrument device 400. Due to the great similarity to the previous embodiments, some of the same reference numerals are used as in the previous figures to increase clarity. Furthermore, differences will be discussed primarily.

[0188] The instrument device 400, in particular the reflector assembly 110, comprises an actuation mechanism 416 comprising a cable pull 419. The user can actuate the cable pull 419, for example by exerting a tensile force on an actuation strand 417 at a proximal section (not shown). A cable pull actuated by means of a drive and / or motor is also conceivable. By actuating the actuation mechanism 416, the reflector 112 can be rotated about a rotation axis 126 and transferred from the stowed state to the deployed state. The reflector 112 is rotatably attached to the instrument shaft 104. Furthermore, the rotation axis 126 is arranged at a distance from a distal end 128 of the instrument shaft, and the reflector 112, which is designed as a reflector arm 124, opens distally upon actuation. As a result, a shaft to be deflected can be deflected distally.

[0189] The actuating mechanism 416 comprises the actuating strand 417, a web 130, and a retaining element 418. The web 130 is movably mounted on the reflector arm 124 in that the reflector arm 124 rests on the web 130, in particular on a proximal portion of the web 130. The web 130 is slidable along the reflector arm 124. However, the web 130 is not anchored to the reflector arm 124 and / or the like. However, such embodiments are also conceivable. Furthermore, the web 130 and the instrument shaft 104 define a pivot point 132. The pivot point 132 is slidable along the instrument shaft 104. The web 130 is pivotally connected to the instrument shaft 104 at the articulation point 132, and the instrument shaft 104 has a guide track 420 along which the web 130 is displaceable.The guide track 104 can be designed as a T-slot rail (not shown), and the web 130 can have two projections at one end section that engage the T-slot rail. As a result, the web 130 is mounted in an articulated and displaceable manner. The projections (not shown) define the articulation point 132. The web is further coupled to a distal end of the guide track 420 by means of the retaining element 418. The retaining element 418 is designed as a spring element and counteracts an axial displacement of the web 130 in the proximal direction.

[0190] In the stowed state, the web 130 rests against the instrument shaft 104, and its longitudinal axis is arranged at least substantially parallel to the longitudinal axis of the reflector arm 124 (not shown). When the user actuates the actuating mechanism 416 and pulls on the actuating strand 417, the web 130 moves proximally. This actuation causes an axial displacement of the pivot point 132 of the web 130 along the instrument shaft 104. The actuating strand 417 is designed, for example, as a thin wire, thread, and / or the like. At one position, the web 130 contacts with its proximal end a deflection element arranged on the instrument shaft 104 and located distal to the rotation axis 126. As a result, the web 130 partially rotates radially, while the distal end is retained by the projections and the T-slot rail. By turning the bar 130, the reflector arm 124 opens.As a result, the actuation of the actuating mechanism 416 causes the movement of the web 130, wherein the actuation of the actuating mechanism 416 allows the reflector 112 to be transferred from the stowed state to the deployed state.

[0191] Upon actuation, the retaining element 418 is tensioned. If the actuating force is removed, the retaining element exerts a force on the pivot point 132 in the distal direction, causing the web 130 to move along the instrument shaft 104 and transitioning the reflector 112 from the deployed state to the stowed state. The actuating strand 417 can be locked in a position in which the reflector is in the deployed state. Releasing the lock automatically transitions the reflector 112 to the stowed state.

[0192] The web 130 is manufactured as an injection-molded component and intended for single use. Instead of the T-slot rail, another type of articulated bearing can also be provided, allowing for movement.

[0193] Figure 8 shows a schematic representation of another embodiment of an instrument device 500. Due to the great similarity to the previous embodiments, some of the same reference numerals are used as in the previous figures to increase clarity. Furthermore, differences will be discussed primarily.

[0194] The instrument device 500 comprises a reflector arm 124, which includes a light guide 142 extending along the reflector arm 124 and configured to guide light to a light output point 144 on the reflector arm 124. The light output point 144 includes a diverging lens (not shown). The instrument shaft 104 includes a luminous element 146, which is configured and arranged on the instrument shaft 104 such that light emitted by the luminous element 146 can be coupled into the light guide 142. For this purpose, the reflector arm 124 includes a light input point 145, which includes a converging lens. The light input point 145 is arranged in close proximity to the luminous element 146, in particular at a distance of 0.1 cm. A distance of 0.2 cm, 0.5 cm, or even 1 cm or more is also conceivable. This creates a light joint.Light can be coupled into the light guide 142 at least substantially independently of a reflector position. Instead of the luminous element 146, an optical element can also be provided that is configured to couple light out of the instrument shaft 104, which can be guided along the instrument shaft by means of a light guide.

[0195] Figure 9 shows a schematic representation of another embodiment of an instrument device 700. Due to the great similarity to the previous embodiments, some of the same reference numerals are used as in the previous figures to increase clarity. Furthermore, differences will be discussed primarily.

[0196] The instrument device 700 includes an actuating mechanism 716 that can be actuated by pushing it through a trocar 120. The trocar has a channel 121 through which the instrument shaft 104 can be pushed to guide it into the patient's cavity. For this purpose, the instrument device 700 is advanced in the direction of arrow 704.

[0197] During advancement, an actuating arm 702 strikes the trocar 120, or contacts the trocar 120. Further advancement causes a radially inward rotation of the actuating arm 702 and an actuation of the actuating mechanism 716. The actuating arm 702 is rotatably mounted on the instrument shaft 104 by means of a retaining element 122, more precisely a torsion spring. The radially inward rotation is counteracted by a retaining force, more precisely a spring force, of the retaining element 122. If the instrument shaft 104 is subsequently retracted, the actuating arm 702 moves back to its starting position. In the starting position, the actuating arm 702 projects at an angle from the instrument shaft 104 and holds a reflector 112 in the deployed state, in which the reflector 112 also projects at an angle from the instrument shaft 104. The passive reset element 122 is thus configured to keep the reflector 112 in the deployed state.For this purpose, the actuating arm 702 includes a retaining projection 703. The actuating arm 702 is guided laterally past the reflector 112, with the retaining projection 702 extending laterally from the actuating arm 702 and along a transverse side of the reflector 112. In the initial state, the reflector 112 rests on the retaining projection 703 (not shown).

[0198] Spaced apart from the retaining projection 703, the actuating arm 702 has an actuating projection 701 at a proximal end. This projection extends partially radially inward and, like the retaining projection, laterally from the actuating arm 702 and along the transverse side of the reflector 112. The actuating projection 701 can contact the reflector 112 and is configured to push the reflector 112 radially inward when the actuating arm 702 is pushed radially inward and the actuating mechanism 716 is actuated by sliding it through. By sliding it through, the reflector 112 is thereby transferred to the stowed state and is folded in by means of the actuating arm 702.If the force applied to move the reflector 112 into the stowed state is removed, the actuating arm 702 moves back to its original position due to the restoring force caused by the restoring element 122, and the reflector 112 is unfolded by means of the retaining projection 703 and held in the deployed state. In principle, the restoring element 122 is thus configured to at least partially store the energy applied to move the reflector 112 into the stowed state in such a way that it returns the reflector 112 to the deployed state when the force causing the movement into the stowed state is removed.

[0199] Figs. 9a to 9d show a further embodiment of an instrument device 700', which comprises an actuating mechanism 716 that can be actuated by pushing through a trocar 120. Due to the significant similarities to the other embodiments, differences will be discussed primarily. The actuating mechanism 716 comprises a reflector 112, which is designed as a passive return element 122. The reflector 112 is made at least partially and / or in sections from a superelastic material and / or from a shape memory material, in this case from Nitinol. Alternatively or additionally, the reflector can be rotatably attached to an instrument shaft 104 by means of a spring element (not shown). In a normal position, as shown in Fig. 9a, the reflector 112 is located at least partially radially outside a base circumference of a distal portion 108 of the instrument shaft 104.Without a radially inward force acting on the reflector 112, the reflector 112 is in this position. The return element 122 holds the reflector 112 in the deployed state.

[0200] The actuating device 716 also includes a sleeve 720 that is axially movable along a longitudinal axis 105 of the instrument shaft 104. The sleeve 720 can be designed as a clamping sleeve, which in particular has a lateral slot or is not circularly closed. By increasing the diameter of the sleeve 720 through elastic deformation, the sleeve 720 can be pushed laterally onto the instrument shaft 104. According to Fig. 9a, the sleeve 720 is arranged on the distal section 108 of the instrument shaft 104 and is movable thereon.

[0201] To actuate the actuation mechanism 716, the user inserts the instrument shaft 104 into the trocar 120. The instrument shaft 104 has an outer diameter that is smaller than an inner diameter of the trocar 120. The sleeve 720, on the other hand, has an outer diameter that is smaller than an inner diameter of the trocar 120. When the instrument shaft 104 is inserted through the trocar 120 into the patient's cavity, the sleeve 720 remains outside the cavity and is not passed through the trocar 120. The trocar 120 retains the sleeve 720 during insertion, as can be seen in Figs. 9c and 9d.

[0202] The insertion procedure is described with reference to Figs. 9a to 9d. First, a distal end 128 of the instrument shaft 104 is positioned in a proximal section of the trocar 120 (Fig. 9a). In this state, the user slides the sleeve 720 into an axial position on the instrument shaft 104, in which the sleeve 720 is arranged radially on the reflector 112. The sleeve 720 is configured to bend the reflector 112 radially inward. By sliding the sleeve 720 onto the reflector 112, the reflector can be transferred into the stowed state (Fig. 9b). With the reflector 112 in the stowed position, the instrument shaft 104 is inserted by the user along the longitudinal axis 105 through the trocar 120 into the patient's cavity (Fig. 9c). The sleeve 720 abuts the trocar 120 and remains in mechanical contact with the trocar 120 during insertion.The instrument shaft 104 thereby moves relative to the sleeve 720, or the sleeve 720 is thereby displaced proximally relative to the instrument shaft 104. The reflector 112 is therefore no longer subjected to a radial force by the sleeve 720. Instead, the trocar 120 applies a radial force (as shown in Fig. 9c) to the reflector 112 as long as the trocar 120 circumferentially encloses the reflector 112, so that the reflector 112 remains in the stowed state. Upon further advancement (Fig. 9d), the reflector 112 is pushed beyond a distal end of the trocar 120 such that no radial force acts on the reflector 112 any longer. The reflector 112 thereby moves back to its normal state or deployed state. The reflector 1 12 is thus returned to the deployed state when the force causing the movement into the stowed state is removed.The sleeve 720 is configured to transfer the reflector 112 into the stowed state, in particular by means of an axial displacement, in particular onto an axial section of the instrument shaft 104 on which the reflector 112 is arranged.

[0203] Figures 10 and 11 each show a schematic representation of another embodiment of an instrument device 800. Due to the great similarity to the previous embodiments, some of the same reference numerals are used as in the previous figures to increase clarity. Furthermore, differences will be discussed primarily.

[0204] An instrument shaft 104 of the instrument device 800 has at least one output device 1002, which is configured as a luminous element 1006 and is designed to provide a wave 154 to be deflected, in particular illumination light. The output device 1002 defines an exit axis 1004 for the wave 154 to be deflected, which is oriented proximally. The illumination light is emitted in the proximal direction. The luminous element 1006 is arranged obliquely in a distal end section 109. The exit axis 1004 forms an angle of 45° with a longitudinal axis 105 of the instrument shaft 104.

[0205] The instrument device 800 has at least one further output device 1002, which is designed as an ultrasonic emitter 1300. In addition to the ultrasonic emitter 1300, the instrument device 800 comprises an ultrasonic sensor 1302. The ultrasonic emitter 1300 and the ultrasonic sensor 1302 are integrally formed and have a piezoelectric element configured to generate ultrasonic waves and convert spatially resolved sound signals. The ultrasonic emitter 1300 and the ultrasonic sensor 1302 are arranged laterally on the instrument shaft 104 in the distal section 108. Emitted ultrasonic waves travel perpendicular to the longitudinal axis 105 away from the instrument shaft 104 and intersect a reflector 112. The reflector 112 has a reflection section 158 having a gold coating. The reflector 112 precisely redirects the ultrasonic waves distally.Since the reflector has an aperture angle 150 of 45°, the reflector deflects the ultrasonic waves by 90° such that they travel distally parallel to the longitudinal axis 105. There, the sound waves strike an object region 172, are reflected proximally by the object region, and are deflected again by the reflector 112. The reflector 112 is configured to deflect the sound waves radially inward toward the instrument shaft 104 and / or the ultrasonic sensor 1302. The sound waves at least partially strike the ultrasonic sensor 1302, which is configured to convert them into electrical sound signals and to generate image data of the object region 172 based on the sound signals. The ultrasonic sensor 1302 is arranged laterally in the distal section 108 such that it converts sound signals that impinge at least primarily radially on the instrument shaft 104.As an alternative to the described ultrasound imaging, ultrasound therapy and / or the like can be performed. Using reflector 112, the ultrasound waves can be redirected to the area of ​​the object region 172 to be treated.

[0206] Figure 12 shows a schematic representation of another embodiment of an instrument device 900. Due to the great similarity to the previous embodiments, some of the same reference numerals are used as in the previous figures to increase clarity. Furthermore, differences will be discussed primarily.

[0207] The instrument device 900 has a further output device 1002, which is designed as a lighting element 1006. The lighting element 1006 is arranged obliquely in the distal section 108 such that its exit axis 1004 is at least partially oriented proximally. The exit axis 1004 forms an angle of 25 degrees with the instrument shaft 104. The reflector 112 is rotated by 90° with respect to the instrument shaft 104 and has an aperture angle 150 of 90°. The reflector 112 can be set up by means of a bracket 902. The instrument device 900 has exclusively proximally oriented lighting elements 1006, which emit light that can be deflected by the reflector 112.

[0208] Figures 13 and 14 each show a schematic representation of another embodiment of an instrument device 1000. Due to the great similarity to the previous embodiments, some of the same reference numerals are used as in the previous figures to increase clarity. Furthermore, differences will be discussed primarily.

[0209] The instrument device 1000 has a reflector 112 that includes an expansion body 246 or is configured as an inflatable expansion body 246. More specifically, the expansion body 246 includes a balloon 250 that extends circumferentially around a distal portion 108 of an instrument shaft 104 of the instrument device 1000. The instrument device 1000 has a supply line 1001 by means of which the balloon 250 can be filled with CO2 for inflation. By inflating the reflector 112, it is transferred from a stowed state to a deployed state. In the stowed state, the balloon 250 rests loosely on the instrument shaft 104. The balloon 250 is releasably secured to the instrument shaft 104 and can be removed after a single use. There may be a clamping mechanism and / or an adhesive point that is not shown in detail.Balloon 250 has a reflective coating (not shown) and is thus configured to radially deflect light rays impinging on an inner side. The expansion body 246, in particular balloon 250, further comprises an at least partially translucent distal portion 248 through which the deflected light rays can be coupled out of balloon 250. Balloon 250 has a parabolic mirror-shaped and / or similar cross-section and / or is configured to at least partially focus the light rays.

[0210] The instrument shaft 104 has at least one LED light strip 1008 that extends circumferentially around the distal portion 108 of the instrument shaft 104 (see Fig. 14). This allows light to be coupled out along the entire circumference of the instrument shaft 104. The thus coupled out light strikes the inside of the balloon 250 along the entire circumference. The balloon 250 encloses the LED light strip circumferentially.

[0211] Figure 15 shows a schematic representation of another embodiment of an instrument device 1500. Due to the great similarity to the previous embodiments, in particular to the instrument device 1000, some of the same reference numerals are used as in the previous figures to increase clarity. Furthermore, differences will be discussed primarily.

[0212] The instrument device 1500 comprises an expansion body 246, which is at least partially made of a shape memory material, in the illustrated case, Nitinol. The expansion body 246 comprises struts 1502, which are made of the shape memory material, in the illustrated case, Nitinol. The struts 1502 are configured to repeatedly bring the expansion body 246 into a defined shape when the expansion body 246 is inflated. This can improve the accuracy of a deflection, which can be particularly advantageous if, as in the illustrated case, the reflector 112 is configured to at least partially bundle and / or focus a plurality of waves to be deflected. Fig. 16 shows a schematic representation of another embodiment of an instrument device 1600.Due to the great similarity to the previous embodiments, some of the same reference numerals are used as in the previous figures to increase clarity. Furthermore, differences will be discussed primarily.

[0213] The instrument device 1600 comprises a reflector 112 rotatably mounted on an instrument shaft 104, which is designed as a reflector arm 124. The reflector has a reflection section 158 that is aluminum-coated and has an at least nearly perfectly reflective surface.

[0214] The instrument device 1600 further comprises an output device 1002 comprising two laser sources 1200. The laser sources 1200 are arranged spaced apart from one another in a distal section 108 of the instrument shaft 104. More precisely, the laser sources 1200 are arranged behind a viewing window 1602 of the instrument shaft 104, which is made of glass. The laser sources 1200 are configured to emit laser light perpendicular to the instrument shaft 104. The emitted laser light can be deflected onto an object area 172 by means of the reflector 112. As a result, the output device 1002 is configured to project a light pattern 1202 onto the object area 172, in particular together with the reflector 112. The light pattern 1202 comprises markings 1204 that mark geometric reference points 1206 of the object area 172. The markings 1204 are different colors.One of the laser sources 1200 is configured to emit red light, the other of the laser sources 1200 is configured to emit green light. The reference points 1206 therefore have different colors and can be clearly assigned. In particular, the instrument device 1600 can comprise an imaging device (not shown) by means of which the object region 172 and the light pattern 1202 can be imaged. The imaging device can, in particular, be a stereo imaging device. Using the reference points 1206, a stereo image can be more easily calculated.

[0215] Furthermore, an area 1207 can be marked by means of the light pattern 1202, wherein the marked area 1207 defines a working area 1208. The working area 1208 can mark an area to which a wave 154 to be deflected from a further output device 1002" can be deflected. One marking 1204 is red and the other marking 1204 is green. Both markings 1204 can be represented in an endoscopic image and displayed to a user. In a representation of the endoscopic image, the user can thus easily and quickly recognize the area 1208 and / or clearly assign a measurement, which is described below, to the object area.

[0216] The output device 1002" comprises an output optics 1400 configured to radially output an interferometric measuring beam 1402 as a wave 154 to be deflected from the instrument shaft 104. The output optics 1400 is also arranged behind the viewing window 1602. The interferometric measuring beam 1402 is a short-coherent light beam of an optical coherence tomograph 1406. The optical coherence tomograph 1406 is arranged at least partially outside the instrument device 1600, wherein the measuring beam 1402 can be coupled into the instrument shaft 104. The measuring beam 1402 is guided as a free beam along the instrument shaft 104 and impinges on the output optics 1400, which comprises a beam deflection element 1404. The beam deflection element 1404 is designed as a beam splitter. The measuring beam 1402 is partially deflected by 90° by the beam splitter and guided to the reflector 112. Similar to the principle shown in Fig.11, the measuring beam is deflected onto the object area 172, at least partially reflected by it and / or the like, and then projected back onto the reflector 112, which redirects the reflected measuring beam radially inward. In a reflector position, the reflected measuring beam again strikes the beam splitter 1400, 1404 and is coupled into the instrument shaft. In the reflector position, the reflector defines, in particular, an aperture angle 150 of 45° with the instrument shaft 104.

[0217] The output optics 1400 is mounted and / or movable axially along the instrument shaft 104. For this purpose, the instrument shaft 104 comprises a rail 1405. The output optics 1400 can be moved from laser source 1200 to laser source 1200. By moving between the laser sources 1200, a line scan can be performed using the measuring beam 1402 from one of the markings 1204 to the other of the markings 1204. The markings 1204 and / or the light pattern 1202 are configured to indicate boundaries of the line scan.

[0218] The markings 1204 and / or the light pattern 1202 can be provided independently of the output device 1002. Furthermore, the light pattern 1202 can be more complex than described here. A light pattern (not shown) can be projected, by means of which a geometric measurement of the object area 172 can be carried out. Such a measurement can include a calibration and / or the like.

[0219] Furthermore, it can be provided that the reflector 112 is continuously movable and / or moved between different reflector positions, in particular to perform a line scan. A continuously movable reflector 112 can be provided alternatively or in addition to the rail 1405.

[0220] 17 and 18 each show a schematic representation of a medical system 10 comprising a further embodiment of an instrument device 100'. Fig. 17 shows a stowed state, and Fig. 18 shows a deployed state. Due to the great similarity to the previous embodiments, some of the same reference numerals are used as in the previous figures, and apostrophes are used to increase clarity. In addition, differences are primarily discussed. In particular, features of a reflector and / or an instrument shaft can be partially transferred from the previous description. In some of the following figures, the primary difference is that a functional sleeve is provided and a reflector assembly is encompassed by the functional sleeve. The reflector itself can be at least partially structurally identical to that in the previous figures.The following description is therefore primarily limited to the functional sleeve and reference is made to the previous description for other features.

[0221] The medical system 10 comprises a functional sleeve 360 ​​and an instrument device 100' with an instrument shaft 104' that can be inserted into a sleeve body 362 of the functional sleeve 360. The instrument shaft 104' is movably mounted in the sleeve body 362 and can be pushed forward and backward, in particular by a user. The user can thereby actuate an actuating mechanism 116'. To carry out a relative movement of the instrument shaft 104' and the sleeve body 362, the sleeve body 362 can, for example, be fixable, lockable, retainable, and / or the like at a proximal end (not shown) and / or be held, in particular by a user and / or a holding device (not shown), for example, a surgical robot and / or the like.

[0222] Fig. 17 thus shows an instrument device 100' comprising the instrument shaft 104' with a proximal section (not shown) and a distal section 108' and the functional sleeve 360. The functional sleeve 360 ​​comprises the sleeve body 362, into which the instrument shaft 104 can be inserted and moved, a reflector assembly 110' attached to the sleeve body 362 with a reflector 112, which is movable between a stowed state and a deployed state, wherein in the stowed state of the reflector 112 the functional sleeve 360 ​​defines a base circumference 314, and wherein the reflector 112 is located at least partially radially outside the base circumference 314 in the deployed state, and an actuating mechanism 116', which is actuated by a movement of the instrument shaft 104' relative to the sleeve body 362, wherein by a By actuating the actuating mechanism 116' the reflector 112 can be transferred from the stowed state to the deployed state.

[0223] The functional sleeve 360 ​​comprises the sleeve body 362, into which the instrument shaft 104 can be inserted, the reflector assembly 110' attached to the sleeve body 362 with the reflector 112, which is movable between the stowed state and the deployed state, wherein in the stowed state of the reflector 112 the functional sleeve 360 ​​defines a base circumference 114, and wherein in the deployed state the reflector 112 is located at least partially radially outside the base circumference 114, and the actuating mechanism 116', which can be actuated by the movement of the instrument shaft 104' relative to the sleeve body 362, wherein the actuation of the actuating mechanism 116' can transfer the reflector 112 from the stowed state to the deployed state.

[0224] The functional sleeve 360, particularly the sleeve body 362, is at least largely an injection-molded part that can be manufactured inexpensively and is intended for single use. The sleeve body 362 is tubular and has a cavity 363 into which the instrument shaft 104' can be inserted and within which the instrument shaft 104' is movable and / or movably mounted. The cavity 363 is defined and / or delimited by an inner surface 370 of the sleeve body.

[0225] The instrument shaft 104' comprises two output devices 1002, each configured to provide a shaft 154 to be deflected (see Fig. 18). The at least one output device 1002 defines an exit axis 1004 for the shaft 154 to be deflected, which is at least primarily radially oriented. In the deployed state, the exit axis 1004 intersects the reflector 112 (see Fig. 18). The at least one output device 1002 is arranged laterally in the distal section 108'. The instrument shaft 104' comprises a viewing window 391, which can be formed from glass, Plexiglas, acrylic glass, and / or the like, through which the shaft 154 to be deflected can be decoupled from the instrument shaft 104'. The viewing window 391 covers the at least one output device 1002. The at least one output device 1002 comprises at least one lighting element 1006.The at least one lighting element 1006 is configured to emit and / or generate illumination light, which can be deflected by means of the reflector 112 onto an object region (not shown). Instead of a lighting element 1006, it is also conceivable to provide an optical system by means of which a therapy laser beam and / or the like can be coupled out of the instrument shaft. The therapy laser beam can be guided along the instrument shaft 104' and / or coupled into the instrument shaft 104' at a proximal end of the instrument shaft 104' (not shown). By means of the reflector 112, the therapy laser beam can be deflected onto a region in which an anatomical structure to be treated and / or the like is located.The instrument shaft 104' has a distal end surface 170, which may be part of the actuation mechanism 116', may be configured to cooperate in an actuation of the actuation mechanism, and / or may be configured to interact with the reflector 112.

[0226] The reflector assembly 110' is attached to a distal end 364 of the sleeve body 362 and is pivotally mounted. The reflector 112 is rotatable about a rotation axis 126. In the stowed state (see Fig. 17), the reflector 112 extends at least partially into a space 366 that encompasses an imaginary distal continuation of the sleeve body 362 (the space within the dashed lines). The reflector 112 at least partially forms the actuating mechanism 116'. The actuating mechanism 116', in particular the reflector 112, comprises an actuating portion 365, which, in the stowed state, has at least one point 368 that is located radially further inward than the inner surface 370 of the sleeve body 362. The reflector 112 is located partially within the space 366.The actuating section 365, in particular the reflector 112, defines a contact surface 372 configured to interact with the instrument shaft 104', in particular the distal end surface 170. Upon advancement of the instrument shaft 104', the end surface 170, from a relative position between the instrument shaft 104' and the sleeve body 362, contacts the contact surface 372 of the reflector 112, which extends into the space 366. Since the reflector 112 is rotatably mounted, the instrument shaft 104' displaces the reflector 112, causing the reflector 112 to be radially folded and / or transferred into the deployed state. In the deployed state, the reflector 112 partially rests against an outer side 392 of the instrument shaft 104', thereby preventing the reflector 112 from folding shut and / or returning to the stowed state.

[0227] Fig. 19 and Fig. 20 each show a schematic representation of a medical system 10'. Fig. 19 shows a stowed state, and Fig. 20 shows a deployed state. Due to the great similarity to the previous embodiments, some of the same reference numerals as in the previous figures are used, and apostrophes are also used to increase clarity. Furthermore, differences are primarily discussed. In principle, a functional sleeve 360' shown functions similarly to the functional sleeve 360.

[0228] In contrast, an instrument shaft 104" has a locking device 390 for a reflector arm 124 proximal to a viewing window 391. The locking device 390 comprises a channel-like notch on an outer side 392' of the instrument shaft 104", which defines a side wall 394. The notch is groove-shaped. The locking device 390 is designed such that the side wall 394 of the locking device can be engaged behind in the deployed state by a holding section 393 of the reflector arm 124 and / or the reflector 112. By means of the engaging behind, a reflector position can be maintained in the deployed state and / or the reflector 112 can be fixed in a defined reflector position.

[0229] An actuating portion 365', in particular the reflector 112 and / or the reflector arm 124, of an actuating mechanism 116' has a chamfer 374 that at least partially defines a contact surface 372', wherein the chamfer 374 extends distally and increasingly radially inward in the stowed state. In the stowed state, the chamfer 374 extends into the space 366 of the imaginary continuation of a sleeve body 362'.

[0230] Furthermore, the actuating mechanism 116" includes a retaining element 382, ​​which is designed as a rubber ring. The retaining element 382 is configured to hold the reflector 112 in the stowed state, wherein the retaining element 382 can be subjected to a force by actuating the actuating mechanism 116". The retaining element 382 is elastically deformable and expands radially when subjected to the force. The force is generated by pressing the instrument shaft 104" against the bevel 374. This pushes the reflector 112 radially outward and tensions the retaining element 382. Furthermore, the reflector 112 rotates and is unfolded. The axis of rotation 126 of the reflector 112 is determined by a point at which the retaining element 382 is fixed to the reflector 112. The retaining element 382 tensions two identical reflectors 112 against each other and radially inward. Both reflectors 112 can be actuated together.

[0231] Due to the bevel 374, the reflector 112 can be increasingly pushed radially outward by progressively advancing the instrument shaft 104" after an initial contact, and the retaining element 382 can be clamped. The reflector 112 can thus be rotated about the rotation axis 126. At a position of the instrument shaft 104" within the sleeve body 362', the holding section 393 can be clamped into the locking device 390. The holding section 393 is held in the locking device 390 by means of a clamping force applied to the reflector 112 by the retaining element 382. In the deployed state, the holding portion 393 is arranged within the latching device 393, and the holding portion 393 is configured to engage behind the side wall 394 along the longitudinal axis of the instrument shaft 104" (see Fig. 20). In this position, a relative position between the instrument shaft 104" and the sleeve body 362' can be maintained and / or fixed.The reflector 112 can thus be held securely and stably in the deployed position. Fig. 21 and Fig. 22 each show a schematic representation of a medical system 10". Fig. 21 shows a stowed state, and Fig. 22 a deployed state. Due to the great similarity to the previous embodiments, some of the same reference numerals as in the previous figures are used, and apostrophes are also used to increase clarity. Furthermore, differences are primarily discussed. In principle, a functional sleeve 360" shown functions similarly to the functional sleeve 360 ​​and the functional sleeve 360'. The medical system 10" comprises the instrument shaft 104' with the outer side 392.

[0232] In contrast to the functional sleeves 360, 360' shown in Figures 17 to 20, the functional sleeve 360", in particular an actuating section 365" of the functional sleeve 360", has a mandrel 376. The mandrel 376 at least partially defines a contact surface 372" on a proximally exposed surface. Furthermore, the mandrel 376 comprises a tip 378 which, in the stowed state (Figure 21), points at least partially proximally and / or in the direction of the distal end surface 170 of the instrument shaft 104'. The mandrel 376 projects radially inward into a movement path of the instrument shaft 104'. The reflector 112 can be transferred into the deployed state by displacing the instrument shaft 104' distally, whereby the reflector 112 rolls over the tip 378 and folds out.In the deployed state, the retaining element 382, ​​which is designed as an O-ring and is radially expanded when the reflector 112 is transferred into the deployed state, applies a radially inward force to the reflector 112. This force clamps the reflector 112 against the outer side 392 of the instrument shaft 104'. More precisely, the contact surface 372" rests against the outer side 392 and applies the force to the outer side (see Fig. 22).

[0233] Fig. 23 shows a schematic representation of a medical system 10'". Fig. 23 shows a stowed state. Due to the great similarity to the previous embodiments, some of the same reference numerals are used as in the previous figures, and apostrophes are used to increase clarity. Furthermore, differences are primarily discussed. In principle, a functional sleeve 360'" shown functions similarly to the functional sleeves 360, 360', 360". The medical system 10'" comprises the instrument shaft 104' with the outer side 392.

[0234] In contrast, actuating section 365'" comprises a rotatably mounted roller element 380, which at least partially forms an actuating mechanism 316'". The reflector 112 has a bearing arm 381, to whose proximal end the roller element is rotatably mounted. The bearing arm 381 projects radially inward into a movement path of the instrument shaft 104'. Upon actuation of the actuating mechanism 316'", by advancing the instrument shaft 104', the roller element 380 rolls on the outer side 392, while the instrument shaft 104' pushes the reflector 112 radially outward.

[0235] Fig. 24 shows a schematic sectional view of an instrument shaft 104'" perpendicular to a longitudinal axis of the instrument shaft 104'". The instrument shaft 104'" has an output device 1002'" that includes a light-emitting element array 1010 that extends at least partially along a circumference 1012 of the instrument shaft 104'". The light-emitting element array 1010 has three light-emitting elements 1006'" that are equidistantly spaced from one another along the circumference. For each light-emitting element 1006'", for example, a reflector can be provided, which can also be arranged equidistant from one another (not shown). The use of a balloon, an expansion body, and / or the like is also conceivable.

[0236] Fig. 25 shows a schematic representation of an object region 172 with a first section 1110 and a second section 1112. The second section 1112 is arranged next to the first section 1110. By means of at least some of the instrument devices described herein, the first section 1110 can be illuminated with illumination light. In particular, the first section 1110 can be illuminated by means of a lighting element arranged on the distal end surface of one of the instrument devices. An output device can be configured to provide the wave to be deflected in such a way, and the reflector can be configured to deflect the wave 154 to be deflected in such a way that it impinges on the second section 1112 of the object region 172.The reflector can thus be provided to illuminate the second section 1112, or to direct light onto the second section, while the first section 1110 can be illuminated as with a conventional endoscope. The wave to be deflected can, for example, comprise light intended for fluorescence imaging.

[0237] List of reference symbols

[0238] 10 medical system

[0239] 20 medical instrument system

[0240] 22 Light source

[0241] 23 light guides

[0242] 24 data cables

[0243] 26 Endoscope

[0244] 28 Display device

[0245] 30 handle

[0246] 32 supply unit

[0247] 100 instrument device

[0248] 102 Endoscope device

[0249] 104 Instrument shaft

[0250] 105 Longitudinal axis

[0251] 106 proximal section

[0252] 108 distal section

[0253] 109 distal end section

[0254] 110 Reflector assembly

[0255] 112 Reflector

[0256] 114 Basic scope

[0257] 115 Scope of application

[0258] 116 Operating mechanism

[0259] 118 Drive

[0260] 120 Trocar

[0261] 121 channel

[0262] 122 passive return element

[0263] 124 Reflector arm

[0264] 125 swivel joint

[0265] 126 axis of rotation

[0266] 127 coupling point

[0267] 128 distal end

[0268] 130 jetty

[0269] 132 Pivot point

[0270] 134 facing page

[0271] 136 width

[0272] 138 Diameter 140 Filling chamber

[0273] 142 light guides

[0274] 144 Light output point

[0275] 145 Light coupling point

[0276] 146 lighting elements

[0277] 150 opening angle

[0278] 152 radial portion

[0279] 154 wave to be deflected

[0280] 156 inward-facing side

[0281] 158 Reflection section

[0282] 160 distal direction

[0283] 162 additional reflector

[0284] 164 extensive position

[0285] 166 Contour

[0286] 170 distal end surface

[0287] 172 Object area

[0288] 200 instrument device

[0289] 246 expansion bodies

[0290] 248 translucent distal section

[0291] 250 balloons

[0292] 300 instrument device

[0293] 360 functional sleeve

[0294] 362 case body

[0295] 363 Cavity

[0296] 364 distal end

[0297] 365 operating section

[0298] 366 Room

[0299] 368 points

[0300] 370 interior area

[0301] 372 contact surface

[0302] 374 draft angle

[0303] 376 Thorn

[0304] 378 lace

[0305] 380 roller element

[0306] 382 retaining element

[0307] 390 locking device

[0308] 391 viewing window

[0309] 392 Outside 393 Holding section

[0310] 394 side wall

[0311] 400 instrument device

[0312] 416 operating mechanism

[0313] 417 actuating cable

[0314] 418 Retaining element

[0315] 419 Cable pull

[0316] 420 guideway

[0317] 421 deflection element

[0318] 500 instrument device

[0319] 600 instrument device

[0320] 603 radiating surface

[0321] 700 instrument device

[0322] 701 actuating projection

[0323] 702 Actuating arm

[0324] 703 retaining projection

[0325] 704 Arrow

[0326] 716 operating mechanism

[0327] 720 sleeve

[0328] 800 instrument device

[0329] 900 instrument device

[0330] 902 brackets

[0331] 1000 instrument device

[0332] 1001 supply lines

[0333] 1002 Output device

[0334] 1004 Exit axis

[0335] 1006 lighting element

[0336] 1008 LED strip light

[0337] 1010 light-emitting element array

[0338] 1012 circumference

[0339] 1014 lighting unit

[0340] 1018 light element

[0341] 1020 light element

[0342] 1022 additional lighting element

[0343] 1100 imaging device

[0344] 1101 Entrance optics

[0345] 1102 image cones

[0346] 1104 Image axis 1105 Image sensor

[0347] 1108 light element

[0348] 1110 first section

[0349] 1112 second section

[0350] 1200 laser source

[0351] 1202 light patterns

[0352] 1204 markings

[0353] 1206 geometric reference point

[0354] 1207 Area

[0355] 1208 workspace

[0356] 1300 ultrasonic emitters

[0357] 1302 ultrasonic sensor

[0358] 1400 output optics

[0359] 1402 interferometric measuring beam

[0360] 1404 beam deflection element

[0361] 1405 Rail

[0362] 1500 instrument device

[0363] 1502 strut

[0364] 1600 instrument device

[0365] 1602 viewing window

Claims

Claims 1. Instrument device (100, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1500, 1600), in particular endoscope device (102), comprising: an instrument shaft (104) with a proximal section (106) and a distal section (108), in particular for introduction into a patient, wherein the distal section (108) comprises a reflector assembly (110) with a reflector (112) which is movable between a stowed state and a deployed state, wherein in the stowed state of the reflector (112) the distal section (108) defines a base circumference (114), and wherein in the deployed state the reflector (112) is located at least partially radially outside the base circumference (114).

2. Instrument device (100, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1500, 1600) according to claim 1, wherein the reflector assembly (110) comprises an actuating mechanism (116, 216, 416, 716), and wherein by actuating the actuating mechanism (116, 216, 416, 716) the reflector (112) can be transferred from the stowed state to the deployed state and / or from the deployed state to the stowed state.

3. Instrument device (100, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1500, 1600) according to claim 2, wherein the actuating mechanism (116, 216, 416, 716) is actuatable by a user.

4. Instrument device (116, 216, 416, 716) according to claim 2 or 3, wherein the actuating mechanism (116, 216, 416, 716) comprises a drive (118).

5. Instrument device (700) according to one of claims 2 to 4, wherein the actuating mechanism (716) is actuable by pushing through a trocar (120).

6. Instrument device (700) according to one of claims 2 to 5, wherein the actuating mechanism (716) comprises a passive return element (122) configured to hold the reflector (112) in the deployed state, and wherein the return element (122) is configured to at least partially store an energy applied for a movement of the reflector (112) into the stowed state such that it returns the reflector (112) back to the deployed state when a force causing the movement into the stowed state is removed.

7. Instrument device (100, 200, 300, 400, 500, 600, 700, 800, 900, 1600) according to one of the preceding claims, wherein the reflector (112) comprises a foldable reflector arm (124) which, in the stowed state, bears against the instrument shaft (104) and, in the deployed state, extends angularly from the instrument shaft (104).

8. Instrument device (100, 200, 300, 400, 500, 600, 700, 800, 900, 1600) according to claim 7, wherein the reflector arm (124) is pivotally mounted on the instrument shaft (104) and defines an axis of rotation (126).

9. Instrument device (100, 200, 300, 400, 500, 600, 700, 800, 900, 1600) according to claim 8, wherein the axis of rotation (126) is arranged at a distance from a distal end (128) of the instrument shaft (104).

10. Instrument device (400) according to one of claims 8 to 9, comprising an actuating mechanism (416) which comprises a web (130), wherein the web (130) is movably mounted on the instrument shaft (104) and spaced from the axis of rotation (126) is movably mounted on the reflector arm (124), wherein an actuation of the actuating mechanism (116) causes a movement of the web (130), and wherein the reflector (112) can be transferred from the stowed state to the deployed state by actuating the actuating mechanism (416).

11. Instrument device (400) according to claim 10, wherein the actuation comprises an axial displacement of at least one articulation point (132) of the web (130) along the instrument shaft (104).

12. Instrument device (100, 200, 300, 400, 500, 600, 700, 800, 900, 1600) according to one of claims 7 to 11, wherein the reflector arm (124) comprises a side (134) facing the instrument shaft (104) which has a width (136) corresponding to up to 10%, up to 30%, up to 50% and / or up to 70% of a diameter (138) of the base circumference (114).

13. Instrument device (200) according to one of claims 7 to 12, wherein the reflector arm (124) comprises a filling chamber (140), and wherein filling the filling chamber (140) by means of a fluid and / or gas transfers the reflector arm (124) from the stowed state to the deployed state.

14. The instrument device (500) according to any one of claims 7 to 13, wherein the reflector arm (124) comprises a light guide (142) extending along the reflector arm (124) and configured to guide light to a light output point (144) on the reflector arm (124).

15. Instrument device (1000, 1500) according to one of the preceding claims, wherein the reflector (112) comprises an expansion body (246).

16. The instrument device (1000, 1500) of claim 15, wherein the expansion body (246) comprises an at least partially translucent distal portion (248).

17. Instrument device (1000, 1500) according to claim 15 or 16, wherein the expansion body (246) is inflatable and / or made of a Made of shape memory material.

18. The instrument device (1000) of any one of claims 15 to 17, wherein the expansion body (246) comprises a balloon (250) extending circumferentially around the distal portion (108) of the instrument shaft (104).

19. Instrument device (100, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1500, 1600) according to one of the preceding claims, wherein the reflector (112) is releasably attached to the instrument shaft (104).

20. The instrument device (100, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1500, 1600) of claim 19, wherein the reflector (112) is intended for single use.

21. An instrument device (100), comprising: an instrument shaft (104) having a proximal portion (106) and a distal portion (108); and a functional sleeve (360), wherein the functional sleeve (360) comprises: a sleeve body (362) into which the instrument shaft (104) can be inserted; a reflector assembly (110) attached to the sleeve body (362) and having a reflector (112) that is movable between a stowed state and a deployed state, wherein in the stowed state of the reflector (112), the functional sleeve (360) defines a base perimeter (314), and wherein in the deployed state, the reflector (112) is located at least partially radially outside the base perimeter (314); and an actuating mechanism (116) which can be actuated by a movement of the instrument shaft (104) relative to the sleeve body (362), wherein the reflector (112) can be transferred from the stowed state to the deployed state by actuating the actuating mechanism (116).

22. Instrument device (100, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1500, 1600) according to one of the preceding claims, wherein the reflector (112) opens distally in the deployed state and, together with the instrument shaft (104), defines an opening angle (150), wherein the opening angle (150) is up to 90°.

23. Instrument device (100, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1500, 1600) according to one of the preceding claims, wherein the reflector (112) in the deployed state is configured to at least partially deflect distally a radial portion (152) of a wave (154) to be deflected impinging on the reflector (112).

24. Instrument device (100, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1500, 1600) according to one of the preceding claims, wherein the reflector (112) comprises a reflection section (158) on a side (156) directed radially inward in the stowed state, which reflection section is at least partially directed in a distal direction (160) in the deployed state.

25. Instrument device (100, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1500, 1600) according to one of the preceding claims, wherein the reflector (112) is configured to at least partially distally deflect a radial portion (152) of a wave (154) to be deflected impinging on the reflector (112), wherein the wave (154) to be deflected comprises electromagnetic radiation and / or a mechanical wave, in particular a sound wave and / or ultrasound.

26. Instrument device (100, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1500, 1600) according to one of the preceding claims, wherein the deployment state defines a plurality of different reflector positions in which the reflector (112) is configured to at least partially deflect distally a radial portion (152) of a wave (154) to be deflected impinging on the reflector (112).

27. The instrument device (100, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1500, 1600) of claim 26, wherein the reflector (112) is continuously movable between the plurality of reflector positions.

28. Instrument device (100, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1500, 1600) according to one of the preceding claims, wherein the reflector assembly (110) comprises at least one further reflector (162) which is movable between the stowed state and the deployed state, the reflector (112) and the further reflector (162) being arranged at different circumferential positions (164).

29. Instrument device (100) according to one of claims 21 to 28, wherein the reflector assembly (110) is mounted on a distal end (364) of the sleeve body (362).

30. Instrument device (100) according to one of claims 21 to 29, wherein the reflector (112) in the stowed state extends at least partially into a space (366) which comprises an imaginary continuation of the sleeve body (362) distally.

31. The instrument device (100) of any one of claims 21 to 30, wherein the reflector (112) is pivotally mounted on the sleeve body (362) and defines an axis of rotation (126), the reflector (112) rotating about the axis of rotation (126) when transferred from the stowed state to the deployed state.

32. Instrument device (100, 200, 300, 400, 500, 600, 700, 800, 900, 1600) according to one of claims 21 to 31, wherein the reflector assembly (110) comprises at least one hinged reflector arm (124).

33. The instrument device (100) of any one of claims 21 to 32, wherein the actuating mechanism (116) comprises an actuating portion (365) having, in the stowed state, at least one point (368) located radially further inward than an inner surface (370) of the sleeve body (362).

34. The instrument device (100) of claim 33, wherein the actuating portion (365) defines a contact surface (372) configured to interact with the instrument shaft (104).

35. The instrument device (100) of claim 34, wherein the actuating portion (365) has a chamfer (374) that at least partially defines the contact surface (372), the chamfer (374) extending radially inwardly in the distal direction in the stowed state.

36. The instrument device (100) of claim 34 or 35, wherein the actuating portion (365) comprises a spike (376) at least partially defining the contact surface (372), the tip (378) of which points at least partially proximally in the stowed state.

37. Instrument device (100) according to one of claims 33 to 36, wherein the actuating section (365) comprises a rotatably mounted roller element (380).

38. Instrument device (100) according to one of claims 22 to 37, wherein the actuating mechanism (116) comprises a retaining element (382) which is configured to hold the reflector (112) in the stowed state, wherein the retaining element (382) can be subjected to a force by the actuation of the actuating mechanism (116).

39. The instrument device (100) of claim 38, wherein the retaining element (382) is elastically deformable and expands radially upon application of the force.

40. Instrument device (100) according to one of claims 21 to 39, wherein in the deployed state the instrument shaft (104) has the reflector (112) radially outwards.

41. Instrument device (100) according to one of claims 21 to 40, wherein the functional sleeve (360) is intended for single use.

42. Instrument device (100, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1500, 1600) according to one of the preceding claims: wherein the instrument shaft (104) comprises at least one output device (1002) which is configured to provide a shaft (154) to be deflected, wherein the at least one output device (1002) defines an exit axis (1004) for the shaft (154) to be deflected, which is at least primarily oriented radially or proximally.

43. Instrument device (100, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1500, 1600) according to claim 42, wherein in the deployed state the exit axis (1004) intersects the reflector (112).

44. The instrument device (100, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1500, 1600) of claim 42 or 43, wherein the at least one output device (1002) is arranged laterally in the distal portion (108).

45. Instrument device (100, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1500, 1600) according to one of claims 42 to 44, wherein the at least one output device (1002) comprises at least one lighting element (1006).

46. ​​Instrument device (100, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1500, 1600) according to claim 45, wherein the output device (1002) comprises an LED light strip (1008) and / or a light element array (1010) extending at least partially along the circumference (1012) of the instrument shaft (104).

47. Instrument device (100, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1500, 1600) according to claim 46, wherein the instrument shaft (104) has a lighting unit (1014) which comprises the output device (1002), wherein the lighting unit (1014) comprises a plurality of lighting elements (1006, 1018, 1020, 1022), each defining an exit axis (1004) which is at least primarily radially oriented.

48. Instrument device (100, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1500, 1600) according to claim 47, wherein the illumination unit (1014) comprises a plurality of different lighting elements (1006, 1018, 1020, 1022) which are configured to provide illumination light in different spectral ranges and which each define an exit axis (1004) which is at least primarily radially oriented.

49. Instrument device (100, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1500, 1600) according to one of claims 42 to 48, further comprising an imaging device (1100) with at least one input optic (1101) arranged on a distal end surface (170) of the instrument shaft (104).

50. The instrument device (100, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1500, 1600) of claim 49, wherein the imaging device (1100) defines an image cone (1102) having an optical imaging axis (1104), the imaging axis (1104) extending at least partially distally from the distal end surface (170); wherein the instrument shaft (104) comprises at least one laterally arranged luminous element (1006, 1018, 1020, 1022) having an exit axis (1004) which is at least primarily radially oriented and which does not intersect the image cone (1102).

51. The instrument device (100, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1500, 1600) of claim 50, wherein the instrument shaft (104) does not comprise a laterally disposed illuminating element defining an exit axis (1004) intersecting the image cone (1102) of the imaging device (1100).

52. Instrument device (100, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1500, 1600) according to one of claims 42 to 51, further comprising at least one luminous element (1108, 1006, 1018, 1020, 1022) which is designed to illuminate a first, in particular central, section (1110) of an object region (172) distal to the instrument shaft (104) with illuminating light, and wherein the output device (1002) provides the wave (154) to be deflected in such a way and the reflector (112) deflects the wave (154) to be deflected in such a way that it is directed onto a second section arranged at least partially next to the first section (1110). (1112) of the object area (172).

53. Instrument device (1600) according to one of claims 42 to 52, wherein the output device (1002) comprises at least one laser source (1200).

54. Instrument device (1600) according to one of claims 42 to 53, wherein the output device (1002) is arranged to output a light pattern (1202) onto the object area (172).

55. The instrument device (1600) of claim 54, wherein the light pattern (1202) comprises markings (1204) that mark geometric reference points (1206) of the object area (172).

56. The instrument device (1600) of claim 55, wherein the markings (1204) are of different colors.

57. Instrument device (1600) according to one of claims 54 to 56, wherein an area (1207) can be marked by means of the light pattern (1202), wherein the marked area (1207) defines a working area (1208).

58. Instrument device (800) according to one of claims 42 to 57, wherein the output device (1002) comprises at least one ultrasonic emitter (1300).

59. Instrument device (800) according to one of claims 42 to 58, comprising an ultrasonic sensor (1302) which is configured to convert spatially resolved sound signals and to generate image data based on the sound signals.

60. Instrument device (800) according to claim 59, wherein the ultrasonic sensor (1302) is arranged laterally in the distal portion (108) is arranged such that it converts sound signals which fall at least primarily radially onto the instrument shaft (104).

61. Instrument device (1600) according to one of claims 42 to 60, wherein the output device (1002) comprises at least one coupling-out optics (1400) which is configured to couple out an interferometric measuring beam (1402) as a wave (154) to be deflected, primarily radially or proximally.

62. Instrument device (1600) according to claim 61, wherein the interferometric measuring beam (1402) is a short-coherent light beam of an optical coherence tomograph.

63. The instrument device (1600) of claim 61 or 62, wherein the output device (1002) comprises a beam deflecting element (1404).

64. Instrument device (1600) according to one of claims 61 to 63, wherein the coupling-out optics (1400) is mounted and / or displaceable axially along the instrument shaft (104).

65. Instrument device (100) according to one of the preceding claims, wherein the instrument shaft (104) has a locking device (390) for a Reflector arm (124).

66. Functional sleeve (360), in particular for an instrument device (100) according to one of the preceding claims, as long as it refers back to claim 21 at least, comprising: a sleeve body (362) into which an instrument shaft (104) can be introduced; a reflector assembly (110) attached to the sleeve body (362) with a reflector (112) which is movable between a stowed state and a deployed state, wherein in the stowed state of the reflector (112) the functional sleeve (360) defines a base circumference (114), and wherein in the deployed state the reflector (112) is located at least partially radially outside the base circumference (114); and an actuating mechanism (116) which can be actuated by a movement of the instrument shaft (104) relative to the sleeve body (362), wherein the reflector (112) can be transferred from the stowed state to the deployed state by actuating the actuating mechanism (116).

67. A medical system (10), comprising: a functional sleeve (360) according to claim 66; and an instrument device (100), in particular according to one of claims 1 to 65, unless dependent on claim 21, with an instrument shaft (104) which can be inserted into a sleeve body (362) of the functional sleeve (360).

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