Working channel device and endoscope system

Abstract

The invention discloses a working channel device and an endoscope system designed with such an external working channel device, wherein an instrument inserted into the external working channel device can be controlled by means of a pivotable control head of the working channel device. The control head is preferably adjusted by means of a handle which is designed in the manner of a joystick and which is operatively connected to the control head by means of tension means.

Description

[0001] Working channel setup and endoscope system

[0002] Description

[0003] The invention relates to a working channel device according to the preamble of claim 1 and an endoscope system equipped with such a working channel device.

[0004] Such a working channel device, also called an "Additional Working Channel (AWC)," is described in publication WO 2018 / 185 293 A1. This device allows an external working channel to be attached to an existing endoscope, which, for example, has a flexible shaft and a distal endoscope head containing functional units such as the outlet of a primary / internal working channel, an imaging optic, and / or a light source. A handle with various controls and connections for the aforementioned functional units (working channel, optic, light source) is typically located at the proximal end of the endoscope. The known external working channel device is designed to be attached to the endoscope at the handle on one side and at the endoscope head on the other, with this connection being force-fit, form-fit, or material-fit.The additional working channel then runs section by section approximately parallel to the flexible shaft of the endoscope, so that, in addition to its functional units, further instruments, such as biopsy instruments for taking tissue samples, can be introduced into the application area via the external working channel.

[0005] In cases where the instrument guided in the external working channel needs to be controlled, the conventional solution requires the use of an endoscopic instrument with integrated control capabilities. However, such controllable instruments have the disadvantage that, firstly, they do not fit into every working channel, and secondly, they are expensive due to their complexity. In contrast, the invention aims to create a working channel device and an endoscope system equipped with such a working channel device that, by implementing the necessary control capabilities, allows the use of conventional, flexible, standard instruments.

[0006] This problem is solved with regard to the working channel device by the features of claim 1 and with regard to the endoscope system by the features of the dependent claim. Advantageous embodiments of the invention are the subject of the dependent claims.

[0007] The working channel device according to the invention is designed for external mounting on an endoscope, so that the endoscope can optionally be provided with an additional working channel. The working channel device has a working channel that is at least partially tubular or tube-shaped, with a distal tip and a proximal end section, and is provided with fastening means for fixing it to the endoscope.

[0008] According to the invention, the tip of the working channel device is equipped with a control head which is controllable, preferably by means of a handle arranged on the proximal end section, and into which the working channel opens.

[0009] This tip, which can be controlled via the handle and is equipped with the control head, thus enables the use of flexible standard instruments, whereby the respective standard instrument can be moved in the desired direction by adjusting the tip of the working channel device accordingly.

[0010] This allows the tip to be angled at a large angle in the immediate vicinity of the endoscope, enabling maneuvers to be performed directly in front of the endoscope head, or conversely, allowing tissue or similar materials to be held as far away from the endoscope head as possible, thus facilitating thorough preparation. OV0282P-WQ-0004

[0011] 3 / 25

[0012] In a particularly preferred embodiment of the invention, the control head and the handle are mechanically connected, in particular via a traction element, so that actuation of the handle is essentially directly translated into a corresponding movement of the control head. In principle, this connection can also be established electronically via a signal or data link, so that the adjustment of the control head is carried out by a motor depending on the position of the handle.

[0013] In a particularly simple and compact embodiment, the traction elements are designed as flexible control filaments. Such control filaments can be, for example, multi-stranded rope or thread strands or wire strands, via which a positioning movement of the handle can be transmitted to the control head with virtually no backlash. The term "strand" or "strand" refers to a filament in which the actual filament structure is formed by a multitude of fine strands / threads / wires.

[0014] In one variant of the invention, the control head is designed with a spring that can be deflected via the traction means, by means of which the instrument can then be controlled accordingly.

[0015] A preferred solution is one in which the control head is designed with a partially spherical head, which is mounted in a complementary bearing shell or bearing shell section and is preferably acted upon by the tension means in the direction of the bearing shell, thus ensuring both reliable mounting and low-friction adjustability of the control head. This means that the distal tip comprises the (preferably partially spherical) control head and the bearing shell for the (movable, preferably sliding or ball-bearing) mounting of the control head. This allows for rotation / pivoting of the control head about a first transverse axis of the working channel as well as rotation / pivoting of the control head about a second transverse axis of the working channel (perpendicular to the first transverse axis). Furthermore, rotation of the control head about a longitudinal axis of the working channel is also possible.According to a preferred embodiment, the handle can be designed as a preferably manually operated handle. Adjusting the distal control head is particularly easy if the handle is designed like a joystick with an actuating lever that essentially forms the proximal end section of the working channel and is mounted by means of a bearing arrangement. That is to say, the handle has the actuating lever as well as a bearing arrangement for the (movable) mounting of the actuating lever.

[0016] Preferably, the handle can be mounted to rotate around a longitudinal axis of the handle and / or the working channel relative to the mounting device. This has the advantage that, in every mounting position (or in every camera configuration of the endoscope), the direction of movement of the control lever or handle can be adapted to or synchronized with the direction of movement of the control head. For example, this ensures that a rightward movement of the control lever corresponds to a rightward movement of the control head (in the endoscope image). This allows for intuitive control.

[0017] It is particularly preferred if the bearing arrangement is designed with an adjusting ball which is mounted in a control housing of the working channel device by means of a sliding or ball bearing and into which an end section of the adjusting lever is inserted, so that the adjusting ball is adjustable according to the positioning movement of the adjusting lever. This means that the bearing arrangement comprises the adjusting ball, which is coupled to the adjusting lever, and the control housing in which the adjusting ball is mounted by means of a sliding or ball bearing.

[0018] The transmission of the actuating movement of the actuating lever to the control head is particularly easy if the traction elements, especially the control filaments, are attached to the actuating ball in such a way that an actuating movement of the actuating lever is transmitted to the control head.

[0019] Preferably, the actuating ball and the control head can have different diameters. This means that the deflection amplitude of the control head differs from the deflection amplitude of the actuating ball. In this way, a transmission between the actuating movement (of the actuating ball) and the control head movement can be achieved. In particular, the actuating ball can have a larger diameter than the control head. This has the advantage that, in particular, any elongation of the traction elements can be compensated for.

[0020] Preferably, the control head can be mounted in the bearing shell and the adjusting ball in the control housing, and the control head and the adjusting ball can be connected to each other via the tension members such that a control head movement direction corresponds to an adjusting ball movement direction. This means that the directions of movement are synchronized, or rather, no change in the direction of movement occurs. In particular, the tension members can be attached to the control head and the adjusting ball in the same way. In other words, the same kinematic suspension is used on both the handle and control head sides.This means, for example, that the relative positioning between a (distal) connection point of a first traction element and a (distal) connection point of a second traction element on the control head is identical to the relative positioning between a (proximal) connection point of the first traction element and a (proximal) connection point of the second traction element on the actuator ball. This has the advantage that control at the actuator ball can be performed particularly intuitively.

[0021] The technical complexity of the device is further reduced if the actuating ball and control head are operatively connected via at least three (alternatively four, five, or six) traction elements, each arranged at the same angular distance to the actuating ball and control head. This allows the control mechanism to be implemented with simple kinematics, since the same kinematic suspension is used on both the handle and control head sides. In particular, the angular distances can be uniformly distributed in the circumferential direction. Using three traction elements offset by an angular distance of 120° (or four by 90°, five by 72°, or six by 60°) enables a particularly smooth and jerk-free actuating movement.

[0022] According to an alternative preferred embodiment, the handle can be designed as a motorized / automated handle. In particular, OV0282P-WO-OOQ4

[0023] 6 / 25 The handle shall be designed such that a tensile force is applied to the traction elements. For this purpose, the handle preferably has an actuator / motor for each traction element, by which an (adjustable) tensile force can be applied to each of the traction elements.

[0024] In particular, the tractive force on the at least three traction elements can be set / controlled using a sine function for each. Preferably, the sine functions (of the traction elements) can each have the same periodicity and amplitude. Preferably, the sine functions (of the traction elements) can have a phase shift relative to each other, the phase shift preferably corresponding to the angular distance between a traction element connection on the control head. This means that for a desired direction of movement of the control head, a corresponding tractive force is calculated for the individual actuators / motors and applied by the actuator / motor to the traction element and thus to the control head.

[0025] Preferably, at least three (alternatively four, five, or six) traction elements arranged at an angular distance from one another can be attached to the control head. In particular, three traction elements offset from one another by an angular distance of 120° (or four by an angular distance of 90°, five by an angular distance of 72°, or six by an angular distance of 60°) can be used.

[0026] In one variant of the invention, the traction elements are guided in a traction element guide arrangement in the area between the handle and the control head, which extends approximately parallel to the working channel.

[0027] Guiding the traction elements is particularly simple when the traction element guide assembly uses a single tube or pipe, providing a lumen or cavity for each element. This allows the traction elements to be spaced apart, with the material selected to ensure minimal friction and a low stick-slip effect within the guide assembly. This ensures a compact working channel design. However, it is essential that the traction element guide assembly, while possessing sufficient flexural rigidity, remains flexible enough to avoid impeding the endoscope's movement. Alternatively, a separate traction element tube can be provided for each element.

[0028] The guidance of the instrument within the working channel is particularly precise when the head features a conical tip extending from the spherical section. This allows for a compact, radially narrow, and minimally protruding control head, thus minimizing the risk of injury during insertion.

[0029] In an advantageous further development of the invention, the head-side end sections of the traction means are guided section by section along the outer circumference of the spherical section of the head and are fixed in position in the transition area to the mouth cone.

[0030] The handle-side end sections of the tensioning elements can be guided section by section along the outer circumference and then through a bore to a spherical pole on the actuating ball on the lever side, in which clamping devices are provided to secure the tensioning elements with a preload. The tensioning elements, guided section by section through the actuating ball, ensure reliable contact of the actuating ball with its bearing section.

[0031] Ease of use can be further improved if the handle is equipped with a position fixing device that makes it possible to fix the handle in a swivel position, so that the instrument can then be operated in this setting.

[0032] This position fixing can be achieved, for example, by mounting the actuating lever in the actuating ball so that it can rotate around its longitudinal axis by a predetermined angle and has at least an actuating cam on its outer circumference which, when rotated, exerts a clamping force on the actuating ball via a control cam, thereby securing the actuating ball within the control housing.

[0033] Attaching the working channel device to the endoscope is particularly easy when the working channel device is equipped with a distal attachment device for the Po-OV0282P-WO-OOQ4

[0034] 8 / 25 The control head is positioned on an endoscope head and equipped with a proximal mounting device for positioning the end section of the working channel device with the handle on the endoscope, in particular on an endoscope handle, wherein this positioning is variable depending on the type of endoscope. In this way, it is possible, for example, to adjust the handle relative to the endoscope handle so that the movement of the control lever can be synchronized with the movement on the image captured via the endoscope's optics, thus enabling intuitive movement and coordination of the degrees of freedom. Such variable relative positioning of the working channel device with respect to the endoscope is advantageous because many manufacturers differ in the arrangement of the working channel and the optics.

[0035] According to an advantageous embodiment of the invention, the pivoting range of the handle, in particular the actuating lever, can be limited by a device.

[0036] The applicant reserves the right to direct separate independent patent claims to the design of the control head with the spherical controllable head and the optional conical working channel opening, as well as to the handling with an actuating lever and the associated sliding or ball-bearing actuating ball.

[0037] Examples of embodiments of the invention are explained in more detail below with reference to schematic drawings. These show:

[0038] Figure 1 shows a three-dimensional representation of an embodiment of a working channel device according to the invention;

[0039] Figure 2 shows a partial representation of an endoscope system to which a working channel device according to Figure 1 is attached;

[0040] Figure 3 shows a detailed view of a control head of the working channel device according to Figure 1;

[0041] Figure 4 is a front view of the control head according to Figure 3; Figure 5 is a longitudinal section through the working channel assembly according to Figure 1;

[0042] Figure 6 shows a sectional view of the control head of a working channel device according to Figure 1;

[0043] Figure 7 shows a partial representation of a working channel device according to the invention with section planes shown;

[0044] Figures 8, 9, 10 are sectional views according to the cutting planes in Figure 7;

[0045] Figure 11 shows a partial representation of the working channel device according to Figure 1 to illustrate the structure of a handle and

[0046] Figure 12 shows a detailed representation of the handle according to Figure 11.

[0047] Figure 1 shows a three-dimensional view of a working channel device designed to be attached to an endoscope. The working channel device – hereinafter referred to as AWC 1 – has a flexible working channel 2 into which an instrument 4, for example, biopsy forceps, a drill, optics, or the like, can be inserted, thus expanding the application possibilities of the endoscope. In contrast to the prior art mentioned above according to WO 2018 / 185 293 A1, this instrument 4 is controllable within the AWC 1.

[0048] For this purpose, a pivotable control head 6 is provided at the distal end section of the working channel 2, into which the working channel 2 opens. The design of this control head 6 is explained in detail below. In the region of the control head 6, the AWC 1 is equipped with a distal fastening element, which in the illustrated embodiment is designed as a clip 8, by means of which the control head 6, or the end section of the working channel 2, can be attached to an endoscope shaft 10, indicated by dashed lines in Figure 1. In the illustrated embodiment, the control head 6 is adjusted by means of traction elements 12, each formed by a rope, thread, or wire. Only one of these traction elements 12 is visible in the illustration according to Figure 1.Since these traction elements 12 are subjected to a comparatively high tensile stress, which ensures backlash-free control of the control head 6, it is preferred according to the invention to design these traction elements 12 as multi-stranded rope or thread strands or wire strands. These traction elements 12 are guided into the area of ​​a handle 16 by means of a traction element guide arrangement 14. As will be explained in more detail below, this handle 16 is designed in the manner of a joystick with an actuating lever 18, which forms, so to speak, the proximal end section of the AWC 1 and which is penetrated by the instrument 4.

[0049] The actuating lever 18 is operatively connected to the control head 6 via the traction means 12, so that a pivoting of the actuating lever 18 via the traction means 12 is directly translated into a corresponding movement of the control head 6 and thus of the instrument 4 guided therein.

[0050] The handle 16 is designed with a control housing 20, in which – as described below – the bearing of the actuating lever 18 and the connection of the traction elements 12 to the actuating lever 18 are accommodated. As shown in Figure 1, the control housing 20 tapers towards the working channel 2 and the traction element guide assembly 14 to a shaft 22, to which a cuff 26 is attached via two clamping rings 24a, 24b. This cuff 26 is designed to be attached to an endoscope handle 34 shown in Figure 2. The cuff 26 can be designed as a clamping cuff, which achieves clamping through its own elasticity. Alternatively or additionally, suitable clamping devices, such as hook-and-loop fasteners or the like, can be provided to ensure reliable positioning of the clamping cuff 26 and thus of the proximal end section of the AWC 1 on the endoscope.In the illustrated embodiment, the cuff 26 is designed with two actuating levers 28a, 28b, via which two clamping arms 30, 32 can be moved apart for attachment to the endoscope handle 34 without the use of tools and then spring back after assembly, reliably fixing the AWC 1 in position. By appropriately positioning this cuff 26 and also the clamping rings 24, it is possible to adjust the adjustment range or the adjustment of the handle 16 relative to the endoscope handle 34, so that the direction of movement of the actuating lever 18 can be synchronized with the movement of the image captured by the optics of the endoscope.

[0051] Figure 2 shows the handle 16 with the joystick-type actuating lever 18 in its position attached to an endoscope handle 34 of an endoscope 36, with the cuff 26 partially encompassing the outer circumference of the endoscope handle 34. This endoscope handle 34 is equipped in a known manner with various actuating elements 38 and connections for attaching further functional elements, such as instruments or media connections. At the endoscope tip of the endoscope shaft 10 (not shown in Figure 2), the distal end section of the AWC 1, specifically its control head 6, is then fixed in position by the clip 8 or a similar force-fit, form-fit, or material-fit connection. As further indicated in Figure 2, the endoscope shaft 10 and the working channel 2 then run parallel to each other.The traction element guide arrangement 14 is essentially parallel or at a slight angle to each other, wherein the handle 16, fixed via the cuff 26, is positioned approximately in the area of ​​the endoscope handle 34, so that the operator can comfortably operate both the actuating elements 38 of the endoscope 36 and the handle 16 of the AWC 1, wherein an actuating movement of the handle 16 or the actuating lever 18 is converted without play via the traction elements 12 into a corresponding control movement of the control head 6 and thus of the instrument 4.

[0052] Figure 3 shows detail I from Figure 1, from which the basic structure of the steering head 6 can be deduced. Reference is subsequently made to Figure 4, which shows a front view of the steering head 6 according to Figure 3.

[0053] As explained above, the flexible working channel 2, formed by a hose or tube, and the parallel traction element guide arrangement 14 are integrated into this control head 6. The instrument 4, with the pliers shown in Figure 3, extends from the AWC 1 via a working channel control head opening 40, the angle of attack α to the working channel axis being variable according to the adjustment of the control head 6 by means of the handle 16. As shown in Figure 3, the control head 6 has an approximately partially spherical head 42, which—as explained below with reference to Figure 6—is pivotably mounted in a bearing shell 56 on the control head side. The approximately spherical or convex head 42 transitions into a conical opening 44 towards the control head opening 40, which is penetrated by the instrument 4.

[0054] In the area of ​​this mouth cone 44, the aforementioned traction elements 12 are fixed in position, wherein in the illustrated embodiment three traction elements 12a, 12b, 12c designed as a filament structure (rope, thread strand or wire strands) (see Figure 4) are fixed in position. As can be seen in particular from Figure 3, these three traction elements 12a, 12b, 12c, each offset by 120° from the traction element guide arrangement 14, extend out through a recess 46 (only one of the three recesses 46 is visible in Figure 3) of a control head housing 48 and then run, each slightly angled with respect to the axis of the traction element guide arrangement 14, along the outer circumference of the control head housing 48 into the area of ​​a passage 50a, 50b, 50c, via which the respective traction elements 12a, 12b, 12c are aligned in the direction of the outer circumference of the head 42.The traction elements 12a, 12b, 12c then run section by section along an outer circumferential section of the head 42 in the direction of the mouth cone 44. On its circumferential wall, as can be seen in particular in Figure 4, a fixing slot 52a, 52b, 52c is formed for each traction element 12a, 12b, 12c, which extends into the control head opening 40, so that the end sections of the traction elements can be inserted into the fixing slots 52a, 52b, 52c from the control head opening 40. As explained below with reference to Figure 6, fixing nipples 54 are formed on the end sections of the traction elements 12a, 12b, 12c which are then arranged within the head 42, the diameter of which is larger than the width b of the fixing slots 52, so that the respective end section of the traction elements 12a, 12b, 12c is fixed in position in the associated fixing slot 52a, 52b, 52c.

[0055] The control head housing 48 also incorporates the aforementioned bearing shell 56 for pivoting the head 42, whereby the head 42 is held in contact with the bearing shell 56 by the tensile stress generated via the tension elements 12a, 12b, 12c. The tensile stress is selected such that, on the one hand, virtually backlash-free actuation of the head 42 is enabled, and on the other hand, sliding friction is also minimized.

[0056] 13 / 25 within the bearing shell area and also within the guide of the traction element guide assembly 14 is minimized. Accordingly, the material of the traction element guide assembly 14 and the traction elements 12a, 12b, 12c is also designed with a view to minimizing friction losses and the stick-slip effect. However, it must be ensured that the material of the traction element guide assembly 14 is flexible enough to follow the guidance of the endoscope 36, but on the other hand, sufficient buckling stiffness must also be ensured to prevent the traction elements 12 from jamming.

[0057] In the illustrated embodiment, according to the inset cross-section, the traction element guidance arrangement 14 is designed in a very compact manner by means of a flexible hose or a flexible tube in which three lumens 15a, 15b, 15c (cavities) arranged uniformly on a common pitch circle are formed, in each of which a traction element 12a, 12b, 12c is guided.

[0058] In the illustration according to Figures 3 and 4, the clip 8 for clamping the AWC 1 to the endoscope head is also visible. This clip 8 is placed axially onto the endoscope shaft 10, the clip design being such that sufficient clamping force is ensured. Such fastening methods are described in the aforementioned prior art, so further explanations are unnecessary.

[0059] Figure 5 shows a longitudinal section of the AWC 1 according to Figure 1, in detail H according to Figure 6 the previously described structure of the control head 6 is clearly illustrated.

[0060] Accordingly, as explained above, the instrument 4 extends from the control head opening 40 out of the opening cone 44 of the head 42, the opening cone 44 being slightly longer towards the instrument tip in the upper section shown in Figure 6 than in the lower section. As explained above, the traction elements 12 (only traction element 12c is visible in Figure 6) are guided towards the head 42 via the traction element guide assembly 14 and the adjoining control head housing 48. The end section of traction element 12c is led out of the control head housing 48 via the through-hole 50c and then enters the fixing slot 52c, where this end section is then secured in position by means of the fixing nipple 54 on a stepped extension 58 in the head 42. The guidance and positioning of the traction elements 12a, 12b is carried out accordingly, whereby these - as mentioned above - are led out of the control head housing 48 via a recess 46 each.

[0061] In the sectional view according to Figure 6, the bearing shell 56 formed on the steering head housing 48 can also be seen, along which the pivotable head 42 with its spherical, convex, or convex bearing section is guided slidingly on the steering head housing 48. The sliding pair is optimized with regard to the most friction-free guidance possible, with the head 42 being preloaded into the contact position against the bearing shell 56 by the tension elements 12a, 12b, 12c.

[0062] Figure 5 also shows a section through the handle 16, although the cuff 26 and its associated fastening means are not shown. This section reveals the central passage of the instrument 4 through the actuating lever 18, whereby the pivoting movement of the actuating lever 18 is transmitted directly to the head 42 and thus to the instrument 4 by the mechanism according to the invention. Accordingly, a movement of the instruments guided within the actuating lever 18 leads "virtually" directly to a movement of the instruments 4 at the control head 6. As can be seen particularly in the section in Figure 5, the actuating lever 18 is partially inserted into an actuating ball 60, which in turn is mounted in the control housing 20. In the illustrated embodiment, this is achieved by means of a ball bearing 62, so that low-friction pivoting of the actuating ball 60 is ensured depending on the adjustment of the actuating lever 18.This ball bearing 62 will be described in more detail below with reference to Figure 10. The diameter of the adjusting ball 60 is significantly larger than the effective diameter of the spherical area of ​​the head 42.

[0063] The ball bearing 62 is formed in a bearing section 64 that is wider than the shaft 22 and, as shown in Figure 5, accommodates approximately half of the adjusting ball 60. To fix the adjusting ball 60 in position within the bearing section 64, a ring cover 66 is attached to it, so that the ring cover and the bearing section 64 positively engage the outer circumference of the adjusting ball 60.The traction elements 12, of which only traction element 12c is visible in the sectional view according to Figure 5, are guided away from the traction element guide arrangement 14 by means of guide bores 68 angled relative to its axis towards the bearing area of ​​the adjusting ball 60. In this area, the traction elements 12a, 12b, 12c emerge from the bearing section 64 and are then guided along a circumferential region of the adjusting ball 60. They are then guided via an adjusting ball bore 70 each towards a ball pole 72 on the adjusting lever side, in which the respective end sections of the traction elements 12a, 12b, 12c are pre-tensioned and fixed in position. Accordingly, both the adjusting ball 60 and the head 42 are pre-tensioned into their respective bearing positions by the tensile stress of the traction elements 12a, 12b, 12c.

[0064] As can be further seen in the illustration according to Figure 5, the traction elements 12 (here only traction element 12c is visible) extend from the traction element guide arrangement 14 in the direction of the guide bore 68 along a shaft bore 74, in which the hose-like traction element guide arrangement 14 is also supported. This is subjected to a tension force via a tension spring 76.

[0065] Accordingly, the connection between the handle 16 on the one hand and the control head 6 on the other hand is made firstly by the hose of the additional working channel 2 and secondly by the traction element guide arrangement 14, which is also designed as a pipe or hose.

[0066] As shown in the sectional view in Figure 5, the adjusting lever 18 has a radially stepped adjusting lever section 78, which engages in a corresponding axial bore 80 of the adjusting ball 60. An annular groove 84 is formed on this adjusting lever bolt 78, into which a fixing screw 82 or a fixing bolt, screwed laterally into the adjusting ball 60 at right angles to the adjusting lever bolt axis, engages to fix the adjusting lever 18 in its axial position. However, the adjusting lever section 78 is not clamped, so that, as explained below with reference to Figure 8, it is rotatable to fix the handle 16 in a predetermined pivot position, allowing the user to remove the hand guiding the adjusting lever 18. Figure 7 again shows the handle 16 of the AWC 1 according to the invention, with three sectional planes JJ, CC, and DD depicted. The cutting plane JJ extends through the bearing section 64 in the transition area to the shaft 22.The further section plane CC extends through the area where the ring cover 66 is placed on the bearing section 64 and the section plane DD extends through the ring cover 66.

[0067] Figure 8 shows the section along the section plane DD in Figure 7. This view reveals the outer ring cover 66, which surrounds and overlaps the adjusting ball 60. The section plane runs centrally through the previously described adjusting lever section 78, which is guided in the axial bore 80. In the area through which the section plane passes, the adjusting lever section 78 is provided with two diametrically opposed adjusting cams 86a, 86b, which are guided along control cams 88a, 88b when the adjusting lever 18 is rotated about its longitudinal axis. The adjusting cams 86a, 86b and the associated control cams 88a, 88b are designed such that when the adjusting lever 18 is rotated, a force is exerted on the adjusting ball 60, causing it to spread and thus clamp in the bearing. This spreading is made possible by spreading grooves 90a, 90b, which are formed in adjusting ball 60.

[0068] To release the jam, the adjusting lever 18 is then turned in the opposite direction so that the adjusting cams 86 rest on the control cams 88 without tension or are spaced apart from them.

[0069] According to Figure 8, three pockets 92a, 92b, 92c are provided on the inner circumferential areas of the ring cover 66 adjacent to the outer circumference of the adjusting ball 60, along which the traction elements 12a, 12b, 12c are guided on the outer circumference of the adjusting ball 60.

[0070] These three pockets 92a, 92b, 92c are also visible in section CC according to Figure 9. Reference numerals 94a and 94b in Figure 9 designate components of a device for limiting the pivoting range of the handle 16.

[0071] This device 94a, 94b each has an adjustable guide pin 108a, 108b, which can be brought into effective engagement with the adjusting ball 60 to limit the pivoting range. Further details of this device 94a, 94b are explained below with reference to Figures 11 and 12.

[0072] Section JJ according to Figure 10 extends through the area of ​​bearing section 64 in which the ball bearing 62 of the adjusting ball 60 is formed. In the illustrated embodiment, this ball bearing 62 is designed with three bearing balls 96a, 96b, 96c, each of which is guided in a bearing pocket 98 on the bearing section side and a complementary bearing pocket 100 on the adjusting ball side, whereby in the illustration according to Figure 10 only the bearing pockets 98, 100 of the bearing ball 96c are provided with reference numerals. These bearing balls 96 ensure an almost frictionless bearing of the adjusting ball 60 in the handle 16.

[0073] The illustrated embodiment of an AWC 1 is designed, for example, such that standard instruments up to a diameter of approximately 2.8 mm can be used, wherein the deflection swivel angle of the instrument 4 in each direction is preferably approximately 30° to 35°.

[0074] Figure 11 shows a three-dimensional representation of the embodiment of an AWC 1 shown in Figure 1, wherein the ring cover 66 of the control housing 20 described above is not shown, so that the optional device shown in Figure 9 for limiting the pivoting range of the handle 16 is more clearly visible.

[0075] Figure 12 shows detail L of Figure 11, which depicts the handle 16. In this illustration, the traction elements 12a, 12b are also visible, which are guided section by section along the outer circumference of the adjusting ball 60. In this area, similar to the inner circumferential wall of the ring cover 66, pockets 101 are provided on the inner circumferential wall of the bearing section 64, forming a space for the respective traction elements 12a, 12b, 12c to pass through. In the illustration according to Figure 12, only one of the pockets 101 is shown. As explained above with reference to Figure 12, the end sections of the traction elements 12a, 12b, 12c are guided through each of an adjusting ball bore 70 to the flattened spherical pole 72 and fixed in position there with preload, the anchoring of the other end sections of the traction elements 12a, 12b, 12c is effected via the fixing nipples 54 (see Figure 6) in the head 42.The position is fixed at the spherical pole 72 by means of three clamping screws 112a, 112b, 112c screwed into it.

[0076] On the annular end face of the bearing section 64 facing the ring cover 66 (not shown), two projections 102a, 102b are provided in which the guide pins 108a, 108b are adjustably guided. The end sections of the guide pins (see Figure 9) engage in grooves 104a, 104b on the outer circumference of the adjusting ball 60. These grooves 104 widen upwards (view according to Figure 12) and downwards, i.e., into the overlap area with the bearing section 64 (not visible in Figure 12), in a teardrop shape, so that these grooves 104 have an approximately figure-eight shape. The visible widened areas of the grooves 104a, 104b are designated 106a, 106b in Figure 12. In the illustrated basic position of the adjusting lever 18, the guide pins 108 thus dip into the central waist, so that the pivoting of the adjusting lever 18 is limited.When the actuating lever 18 is pivoted such that the guide pins 108a, 108b dip into the extended areas 106a, 106b of the grooves 104a, 104b, the pivoting range of the actuating lever 18 is increased and is in principle determined by the groove width.

[0077] To enable the actuating lever 18 to pivot in all directions, the guide pins 108a, 108b can be pulled out of the grooves 104a, 104b.

[0078] As can be further seen in Figure 12, a coupling 110 for attaching an instrument 4 or other working equipment can be provided on the free end section of the adjusting lever 18.

[0079] In the illustrated embodiment, the control head 6 is designed with a broadly spherical head 42, which is mounted on a sliding bearing and can be adjusted by means of the tensioning elements 12. Alternatively, instead of such a control head 6, a spring or the like could be used to adjust the instrument position. This spring would be penetrated by the instrument 4 and could be deflected / folded by means of the tensioning elements 12 or the like.

[0080] In principle, it is also possible to provide shear elements instead of the comparatively flexible traction elements 12. Hydraulic adjustment is also conceivable. Disclosed are a working channel device and an endoscope system equipped with such an external working channel device, wherein an instrument inserted into the external working channel device can be controlled via a pivotable control head of the working channel device. The adjustment of the control head is preferably effected via a handle designed in the manner of a joystick, which is operatively connected to the control head via traction elements.

[0081] Reference mark:

[0082] 1 Working channel device I AWC

[0083] 2 working channel

[0084] 4 Instrument

[0085] 6 Steering head

[0086] 8 clips

[0087] 10 Endoscope shaft

[0088] 12 traction elements

[0089] 14 Traction element guidance arrangement

[0090] 15 lumens

[0091] 16. Handling

[0092] 18 adjusting levers

[0093] 20 control housings

[0094] 22 shaft

[0095] 24 clamping ring

[0096] 26 cuff

[0097] 28 operating levers

[0098] 30 clamping legs

[0099] 32 clamping legs

[0100] 34 Endoscope handle

[0101] 36 Endoscope

[0102] 38 Actuator

[0103] 40 Steering head muzzle

[0104] 42 heads

[0105] 44 Mouth cone

[0106] 46 Exclusion

[0107] 48 Steering head housing

[0108] 50 Implementation

[0109] 52 fixing slots

[0110] 54 fixing nipples

[0111] 56 bearing shell

[0112] 58 Extension

[0113] 60 ball bearings

[0114] 62 Ball bearing bearing section

[0115] Ring lid

[0116] guide bore

[0117] Actuating ball bore

[0118] Spherical pole

[0119] shaft bore

[0120] Tension spring

[0121] Actuating lever section

[0122] Axial bore

[0123] fixing screw

[0124] Ring groove

[0125] Adjusting cam

[0126] Tax backdrop

[0127] Spreader groove

[0128] Bag

[0129] Device for limiting the swivel range

[0130] bearing ball

[0131] storage bag

[0132] storage bag

[0133] Bag

[0134] bulge

[0135] Nut extended area

[0136] guide pen

[0137] coupling

[0138] Clamping screw

Claims

Patent claims 1. Working channel device for optional mounting on an endoscope (36), with a working channel (2) that is at least partially designed in a tubular or hose-like manner, which has a distal tip and a proximal end section and on which fastening means for positioning on the endoscope (36) are provided, characterized in that the tip is designed with a control head (6) which is controllable, preferably by means of a handle (16) arranged on the proximal end section, and in which the working channel (2) opens.

2. Working channel device according to claim 1, wherein the control head (6) and the handle (16) are mechanically connected, in particular via traction means (12) or electronically via a signal or data connection.

3. Working channel device according to claim 2, wherein the traction means (12) are flexible control filaments, in particular multi-stranded rope, thread strands or wire strands, via which an actuating movement of the handle (16) can be transmitted to the control head (6).

4. Working channel device according to one of the preceding claims, wherein the control head (6) is designed with a spring deflectable via the tension means (12) or with a sectionally approximately spherical head (42) which is mounted in a complementarily designed bearing shell (56) and is preferably acted upon in the bearing shell (56) in the bearing direction via the tension means (12).

5. Working channel device according to one of the preceding claims, wherein the handle (16) is designed in the manner of a joystick with an actuating lever (18) substantially forming the proximal end section of the working channel (2), which is mounted by means of a bearing arrangement.

6. Working channel device according to claim 5, wherein the bearing arrangement has an actuating ball (60) which is slidably or ball-bearing mounted in a control housing (20) of the working channel device (1) and into which an actuating lever section (78) of the actuating lever (18) is inserted.

7. Working channel device according to claims 3 and 6, wherein the traction means (12), in particular the control filaments, are attached to the actuating ball (60) in such a way that an actuating movement of the actuating lever (18) can be transmitted to the control head (6).

8. Working channel device according to one of claims 2 to 7, wherein the actuating ball (60) and the control head (6) are operatively connected via at least three traction elements (12) arranged at equal angular distances from each other.

9. Working channel device according to one of claims 2 to 8, wherein the traction means (12) are guided in a traction means guide arrangement (14) with one lumen (15) for each traction means (12).

10. Working channel device according to one of claims 4 to 9, wherein the head (42) is designed with an outlet cone (44) adjoining the spherical section.

11. Working channel device according to claim 8, wherein head-side end sections of the traction means (12) are guided section by section along the outer circumference of the spherical section of the head (42) and are fixed in position in the transition area to the mouth cone (44).

12. Working channel device according to one of claims 6 to 1 1 , wherein the end sections of the traction means (12) facing the handle (16) are guided section by section along the outer circumference of the actuating ball (60) and through each actuating ball bore (70) to an actuating lever-side ball pole (72), in the area of ​​which clamping means for fixing the traction means (12) with a preload are provided.

13. Working channel device according to one of the preceding claims, with a position fixing device for fixing the handle (16) in a pivot position. OV0282P-WQ-0004 24 / 25 14. Working channel device according to claim 13 and one of claims 5 to 12, wherein the actuating lever (18) is rotatably mounted in the actuating ball (60) about a predetermined angle of rotation about its longitudinal axis and has at least one actuating cam (86) which, when rotated via a control cam (88), applies a clamping force to the actuating ball (60).

15. Working channel device according to one of the preceding claims, wherein the fastening means comprise a distal fastening device for positioning the control head (6) on an endoscope head and a proximal fastening device for positioning the end section with the handle (16) on the endoscope (36), in particular on an endoscope handle (34), wherein this positioning may be variable depending on the type of endoscope (36).

16. Working channel device according to one of the preceding claims, comprising a device (94) for limiting the pivoting range of the handle (16).

17. Endoscope system comprising an endoscope (36) to which an external working channel device (1) is attached according to one of the preceding claims.

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