AU2015200767B2 - Endoscope assembly - Google Patents

Abstract

A loconoive endoscope assembly inluding a locomotive endoscope head. incluing a main portion extending along a longitudinal axis anid having a first 5 selectably inflatable balloon associated therewih uand a selectably positionabie portion, seletably axially positionabie along the main portin and having a second selectably inflatable balloon associated therewith and a toinotve endoscope head controller controlling the operation of the locomotive endoscope head and being operative for controlling positioning of the selectably postionable portion relative to 1C the main portion and selectable inflation of the fist and second selectably inflatable balloons.

Description

ENDOSCOPE ASSEMBLY 2015200767 16 Feb 2015

REFERENCE TO RELATED APPLICATIONS

This application is a divisional application of Australian Patent Application 2015200074 which is a divisional of 2012203616 which is a divisional of 2011200624 (which is a divisional of 2005211257), the entire contents of which are to be taken as incorporated herein by reference.

Reference is made to U.S. Provisional Patent Application 60/542,680, filed February 9, 2004 entitled "MICRO-ROBOT AND ACCESSORIES FOR ENDOSCOPY AND INPIPE LOCOMOTION" and to U.S. Provisional Patent Application 60/559,461, filed April 6, 2004 entitled "DEVICES, ACCESSORIES AND METHODS FOR ENDOSCOPY AND INPIPE PROPAGATION", the disclosures of which are hereby incorporated by reference and priority of which is hereby claimed pursuant to 37 CFR 1.78 (a) (4) and (5) (i).

FIELD OF THE INVENTION

The present invention relates to endoscopy generally and more particularly to locomotive endoscopes.

BACKGROUND OF THE INVENTION

The following U.S. Patent Documents are believed to represent the current state of the art: U. S. Patent Nos. 4,040,413; 4,176,662 and 5,662,587 and U. S. Patent Application Publication No. 2002/0156347. 1

SUMMARY OF THE INVENTION

The present invention seeks to provide an improved locomotive endoscope.

The terms "endoscope" and "endoscopy" are used herein in a manner somewhat broader than their customary meaning and refer to apparatus and methods which operate within body cavities, passageways and the like, such as, for example, the small intestine, the large intestine, arteries and veins. Although these terms normally refer to visual inspection, as used herein they are not limited to applications which employ visual inspection and refer as well to apparatus, systems and methods which need not necessarily involve visual inspection.

According to a first aspect, the present invention provides an endoscope assembly for performing endoscopy in a tubular body portion having a variable crosssectional diameter, the endoscope assembly comprising: an endoscope head having an imaging sensor at its forward end, extending along a longitudinal axis and having a first plurality of selectably radially extendible elements associated therewith at at least one first axial location therealong rearwardly of said imaging sensor and a second plurality of selectably radially extendible elements associated therewith at at least one second axial location therealong rearwardly of said imaging sensor, said first plurality of selectably radially extendible elements and said second plurality of selectably radially extendible elements being configured to engage an interior surface of said tubular body portion when radially extended, notwithstanding variations in said cross-sectional diameter of said tubular body portion; and an endoscope head controller being operative for controlling selectable extension of said first and second pluralities of selectably radially extendible elements for engaging said interior surface of said tubular body portion notwithstanding said variations in cross-sectional diameter and for selectable positioning of said endoscope head.

There is thus provided in accordance with a preferred embodiment of the present invention a locomotive endoscope assembly including a locomotive endoscope head, including a main portion extending along a longitudinal axis and having a first selectably inflatable balloon associated therewith and a selectably positionable portion, selectably axially positionable along the main portion and having a second selectably inflatable balloon associated therewith and a locomotive endoscope head controller controlling the operation of the locomotive endoscope head and being operative for controlling positioning of the selectably positionable portion relative to the main portion and selectable inflation of the first and second selectably inflatable balloons. 2

In accordance with a preferred embodiment of the present invention at least one of the first and second selectably inflatable balloons includes a stretchable balloon. Preferably, the locomotive endoscope assembly also includes an endoscope body associated with the locomotive endoscope head. Optionally and preferably, an 5 instrument channel at least partially extends through the locomotive endoscope head and the endoscope body. 2015200767 18 Jan 2017

In accordance with another preferred embodiment of the present invention the locomotive endoscope head has a fixed length. Preferably, the endoscope body includes a multi-lumen tube. Alternatively or additionally, the endoscope body interfaces with 10 the locomotive endoscope head controller.

In accordance with yet another preferred embodiment of the present invention the locomotive endoscope assembly also includes an endoscopy system to which the locomotive endoscope head controller is connectable. 2a 2015200767 16 Feb 2015 is 15 25

In accordance with still another preferred embodiment of the present invention the multi-hunan tube includes at least one lumen operative for at least one of balloon miration; positioning offe®.sdectably pbsiflbnable portion of fee locomotive endoscope headypa&sagifebmfo least oiii of an optical fiber and anelectrical conductor:; buriile and fluid coirurumcatiors. Ihdbr&bly, the multidumen tube includes at least one lumen, operative for each, of balloon inflation; positioning of the ssfeciably positional!® portion of the locomotive endoscope head and passage therethrough of at least one of an optical fiber and an electrical conductor bundle. Typically and preferably, the at least one lumen includes at least one-first lumen operative for inflation of the first seisetubiy inflatable balloon ana at least one second lumen operative &r inflation of the second selectably inflatable balloon. ρ | lo. accordance with a further preferred embodiment of the. present fovemion die seleetably poslionable portion is slidably poshfosifele vwthgp^ectl® fee main portion, Preferably, five locomotive endoscope head includes at least one light source and at least one ifeagfeg sensor. Additionally or alternatively, the first selectaMy inflatable balloon incluiessat least two kdependenfly inflatable balloon portions. As a further alternative, the second sdectably inflatable balloon includes at least two independently inflatable balloon, portions. Preferably, the at least:Mi® ividepeudently inflatable balodn portions of the second.::: sdectably inflalable balboa are asfonuthally offset yfith respect to the at least two independently inflatable balloon portions of the fust sdectably inflatable balloon. in accordance with still further preferred embodiment of the present invention the locovnative, endoscope head controller provides locomotive functionality adapted to sequentiaily displace fee locomotive endoscope head through :g generally tubular body portion. Preferably,., the locomotive ilmolionaiUy includes fimeiianality providing the fcilowiug sequential operations: inflating tire first selectabiy inflatable balloon, thereby anchoring the first sdectably inflatable balloon to an in tenor surface of the generally tubular body portion; axially repositioning: the sdectably posfionable portion and the second sclcotally infiatable· balloon relative to tire first selectabiy inflatable balloon; foilming fee second sdectably inflatable balloon, thereby anchoring the second ssiectably inflatable balfoon to an interior surface of the generally: tabular body portion; deflating the ife# selpctably inflatable balloon, thereby ifoMchorihg the ΐ 2015200767 16 Feb 2015 fijpt selectably inflatable balloon from the interior sitafeee of foeigsnepfiiy tuMar body portion* and axially repositionmg the first seleotabiy inflatable balloon relative to fie selectably positionable portion and the second seleotabiy inflatable balloon, optionally, the first ssl&Gtablyiinfiatable balloon is arranged with respect to the generally tubular S body portion to be forward of the, second selectably inflatable balloon, Alternatively, the second selectably inflatable balloon is arranged with respect to tire generally tabular body portion to be forward of the first selectably inflatable balloon.

There is also provided in accordance with another preferred embodiment of the present invention a locomotive endoscope assembly including a locomotive endoscope; 10 head, Including a main portion extending along a longitudinal axis and having a first selectably radially extendible element associated therewith and a selectably positionable portion, selectably ismally positionable along tbs main, portion and having a second seleetably radially extendible element associated therewith and a locomotive endoscope head controller controlling the operation of the locomotive endoscope head and being IS operative for controlling positioning of:foesselcctably posifonabls portion relatwlo the Strain portion and selectable extension of the first and Second selectably radially extendible elements*

In accordance with a preferred «obodhneht of the present invenlbn at least one of the first and second selectably radially extendible elements includes a seieetsbly 20 inflatable balloon. Kreihrabiy. fixe selectably; inflatable Mlibon includes a stretchable balloon.

In accordance with another preferred embodiment of the present invention foe locomotive eriddscope assembly also includes an endoscope body associated with; fife locomotive endoscope head. Preferably, an instrument channel at least partially extends 25 through fife locomotive endoscope bead and the endoscope body. More preferably the locomotive endoscope head Ms a fixed length.

In accordance with yet another preferred embodiment of the present invention flic endoscope body insludes a finitirlumes tube. Preferably, foe endoscope body raterfaces with foe locomotive endhssepe heat contreller. fodditfonally and preferably, 30 the locomotive endoscope assembly also includes an endoscopy system to winch foe locomotive endoscope head controller is connectable. 2015200767 16 Feb 2015

In accordance with still another preferred embodiment of the present invention the multi-lumen tube includes at least one lumen operative for at least one of radially extending dement extension; posiipning of the sdectabiy positionable portion, of the locomotive endoscope head; passage therethrough of at least one of an optical fiber and S a® electrical conductor bundle; and fluid communication. Preferably, to irmhbfemen tube issmies at least one lumen operative for each of radially extending element extension; positioning of the seieetably positionable portion of the locomotive endoscope head; and passage therethrough of at least one of an optical fiber and pi electrical conductor bundle. Typically and preferably, the at least one lumen Includes at 10 least one first lumen operative for extension of "the first sdectabiy radially extendible-element and at least one second lumen operative for extension of the: Second sdectabiy radially extendible element.

In accordance with a further preferred embodiment of the present invention the seieetably positionable portion is slidably positfonito with respect loathe main portion. 15 Preferably, the: locomotive endoscope head includes^ least one light source and at least one imaging sensor. hi accordance with yet a further preferred embodiment of the present invention die: Irsf: seieetably radially extendible element includes at least two independently extendible .element portions. Additionally or dteruatiVcly, the second seieetably iadi!i!y P extendible element includes at le|sf twos independently extendible dement: portions. Preferably, tlm at least two independently e^pdllll element portions of the second sdectabiy radially extendible tomentare asdkmrftoltoitot with respeqt to die atlpsi two independently extendible dement portions of the first seieetably : radially extendible element. 25 in accordance with still a further preferred embodiment of the present invention the locomotive endoscope bead controller provides locomotive, pnctionality adapted to sequentially displace five locomotive- endoscope- head through a generally tubular body portion. Preferably, the locomotive functionality includes functionality providing the following sequential operations: extending ife first seieetably radially 30 extendible element, thereby anchoring the first seieetably radially extendible element to an interior surface of the generally tubular body portion; axially repositioning the seieetably positionable portion ami the second seieetably radially extendible element 2015200767 16 Feb 2015 5 10 20 25 relative to the first seiectably radially extendible element; extending 'its second seiectably radially extendible dement, thereby anchoring the second seiectably radially extendible element to an interior surface of tire generally tubular body portion; retracting the fifst? sciectabiy radially extendible element, thereby ananehoring the first seleciably radially extendible dement from the interior surface of the generally tubular liody potion; and axially repositioning the first seiectably radially extendible element relative to the seiectably positionabie portion and the second seiectably radially extendible element. Optionally., the first seiectably radially extendible element is arranged with respect to the generally tubular body portion to be forward of the second seiectably radially extendible element Alternatively, the second seiectably radially extendible element is arranged with respect to the generally tubular body portion to be. forward of the first iselectably radially extendible element.

There is further pdvMhd in accordance 'with yet another preferred embodiment of the present invention an endoscope assembly including an endoscope head extending along a. longitudinal axis and having a. iifirst: plurality ibf seiectably inflatable balloons associated therewith at ai leas· one first axial location tberea'icng and a second plurality of seiectably inflatable balloons associated therewith at at least one second axial location therealong and an endoscopefhsad controller being:pperalive ferisoHhoimg selectable inflation of the first and second pluralities of seiectably inflatable hailccns for selectable positioning of theendeseope head

In accordance with a preferred embodiment of the present invention the endoscope head controller is operative for controlling selectable mflpicmni the first aa|: second pluralities # sileotably inflatable hallpips for* selectable parallel off-ceaate orientation of the endoscope head, Preferably, the endoscope head controller is operative for controlling selectable inil avion of the first, and second phualities of seiectably inflatable balloons for selectable flfted orientation ofithe endoscope head. Optionally and preferably, at least one of the first and second Jhualxties of seiectably inflatable balloons includes a plurality of balloons distributed generally aximuthaliy about the endoscqpe head. More preferably, at least one balloon of the first and second pluralities of seiectably inflatable balloons includes a stretchable balloon.

In accordance with another preferred embodiment of the present invention the endoscope head includes a locomotive endoscope head. Preferably, the locomotive 6 2015200767 16 Feb 2015 15 25 endoscope head includes a: main portion emending along a longitudinal axis and associated will the fust plurality of sdsombly iafiatable balloons, and e:: seleetabiy positionable portion, seise tably axially posuiooable along toe main portion and associated with the second plurality of seleetabiy inflatable balloons. 5 .1« accordance with still another preferred embodiment of ihs present invention the endoscope assembly also includes au endoscope body associated with the endoscope head. Preferably, an instrument channel at least partially extends through the endoscope head and the endoscope body. C^tidilly and preferably^ the endoscope head has a fixed length. ID In accordance with a further preferred embodiment of die present invention fete endoscope lo#y includes· m mwltfehimas tube, Additionally or alternatively tire endoscope body interfaces with the endoscope head con trailer. Preferably the endoscope assembly also iifeludes: an mdoscopy system to Much the endoscope head controller is connectable.

In accordance with yet a feriher preferred embodiment of the present irrifeMda the multi-lumen idle includes s§ least one lumen operative fer at least on® of balloon inflation; positioning pf the seleetabiy positionahle portion of the endoscope head; passage therethrough of at least one of an optical fiber and an electrical conductor bundle; and fluid communicatioa. Preferably, the midti-hanen tube includes at least one lumen operative for each of balloon inflation; positioning of the seleetabiy positicnable portion of tic endoscope head; and passage therethrough of at least one of an optical .fiber and. an electrical conductor bundle.

In accordance with a Still further, preferred embodiment of the present iiyehtion the seieerably posifionablh portion is slidably positicmablo with respect ;o ibe main portion. Preferably, the endoscope bead includes at least one light source end at least: one Imaging ssnsor. AddifeanaUy or alternatively. the first plurality of seieerably inflatable balloons includes at least two independently inflatable balloon portions. As a farther alternative, the second plurality of seleetabiy inflatable balloons Includes at least two kidependeiitly inflatable balloon portions. Preferably, the at least two independently inflatable balloon portions of the second plurality of seleetabiy inflatable balloons aid avimuihally offset with respect to the at least two independently inflatable balloon, portions of the first plurality of seleetabiy inflatable balloons. 2015200767 16 Feb 2015 <c 10 20 25 30

In accordance with in additional preferred embodiment of the present invention #e endoscope head controller provides locomotive functionality adapted to seqnentiaby displace: the endoscope Iliad through a gtiuemlly tubular body portion, fheferably; the locomotive fbailo^i%5imebiies functionary providing the following sequential operations; inflating at least part of the first plurality of seleetshly infetable balloons, thereby anchoring the first plurality of selectably inflatable balloons to art interior surface of the generally tubular body. portion; axially repositioning the s|le#fblf position#!® portion shd the second pteatity of seLeetabiy inflatable balloons relati ve to the first plurality of selectably Inflatable balloons: inflating at least part of the second plurality of selectably inflatable balloons, thereby anchoftngihe second phnaify of selectably inflatable balloons to an interior surface of the generally tubular body portion; deflating the first ptealiy of selectably ipflatable killooas, thereby tmahehorrag the first plurality of selectably inflatable hdUflflsg from theptenor spftse of die generally tubular body portion; and axially repositioning the first plurality of selectably inflatable balloons relative to fie selectably positiouablp portion and the second plurality of selectably bxSitable balloons. Optionally, the first plurality of selectably inflatable balloons is arranged with respect to the generally tubular body portion to be generally forward of :he second plurality of selectably inflatable balloons, Mfematively. the second plurality of selectably inflatable balloons Is artnapd with respect to the generally tubular body portion to be generally forward of the first plurality of selectably inflatable balloons.

There is additionally provided |a aecofia&amp;ee: with Still, another preferred embodiment of the present invention an endoscope assembly including an endoscope head extending along a longitudinal axis and having a first plurality of selectably radially extendible dements associated therewith at. at least one first, axial location there,hong and a second plurality of selectably radially extendible elements associated tiierewith at at least one second axial location thereaidng and an endoscope head controller being operative for controlling selectable extension of the fist and second pluralities of selectably radially extendible elements for selectable posifphitig of the endoscope head.

In accordance with a preferred embodiment of the present invention the endoscope head controller is operative for controlling selectable extension of the first 8 2015200767 16 Feb 2015 10 ' and second pluralities of seleetaBff radially extendible elements fen selectable parallel off-center orientation of the endoscope head. Preferably, the endoscope bead controller is operative for controlling wieciEble extension of the first and1 second pluralities of selectably radially extendible dements for selectable tilted orientation of the endoscope head. Additionally or alternatively, at least one of the first and second pluralities of selectably radially extendible elements includes a plurality of radially extendible eletnents distributed generally azimathally about the endoscope head.

In accordance with another preferred embodiment of the present invention the endoscope head includes a locomotive, endoscope head. Preferably, the locomotive endoscope head includes a main portion extending along a longitudinal axis and associated* with the first plurality of selectably radially extendible elements, add . a· selectably positionablc portion, selectably axially positionabie along the main portion and associated with the second plurality of selectably radially oxrendible elements.

In accordance with yet another preferred, embodiment of the present hivention. least one of the first and second pluralities of selectably radially extendible elements includes a plurality of selectably inflatable balloons. Typically and preferably, at least one balloon of the plurality of selectably inflatable balloons includes a stretchable balloon. &amp; accordance with still another preferred embodiment, of the present invention W fee endoscope assembly also includes an endoscope body associated with the endoscope head. Preferably, an. instrument channel at least partially extends through the endoscope head and the endoscope body. Additionally or alternatively, the endoscope head has a fixed length.

In accordance with a further preferred embodiment of the present invention the 25 ehdoasdpe body htelhisa a multi-lumen tube. Preferably, the endoscope body interfaces with the endoscope head controller. Additionally or alternatively, the· endoscope assembly also includes an endoscopy system to which the endcscope bead controller is cormectabls.

In accordance with a still further preferred embodiment of the present 30 invention the multi-lumen tube iaoktdes at least one lumen operative for at least one of: radially extending element extension; positioning of the selectably positions bis portion of the endoscope head; passage therethrough of at least one of an optical fiber and an 2015200767 16 Feb 2015 electrical conductor bundle; and fluid communication. Preferably, the multi-lumen tube includes'at least one lumen operative lot each of; radially extending element extension; positioning, of the selectablf potetibnahfe fortioji of the endoscope head; trad passage thereferough ofiMfeast one of an optical fiber and art electrical conductor bundle, 5 In accordance wife an additional preferred embodiment of the present invention the seieetabiy positionable portion is slidably posiiionable with respect to the main, portion. Preferably, the endoscope bead includes at least one light source and at feast one imagingtsensor, :&amp;ddl|osmiy or alternatively, the first plurality of seieetabiy radially extendible dements iheludes at least two independently spiilMy radially 10 extendible elements. As a ferther alternative, the second pluralily of seieetabiy radially extendible elements-includes-at least, two independently seieetabiy radially extendible-, elements, Preferably; the at feast two independently selasfefblv radially extendible elements pf the second plurality of seieetabiy radially extendible elements are arimuthally offset w|h respect to ft» at feast two m#|paden£if Mectably rafeally 15 extendible elpments of the first plurality of seieetabiy radially extendible eleruehfe.

In accordance with. another preferred embodiment of the present ihmntion the endoscope head controller provides locomotive ihfefionaiity adapted to sequentially displace the endoscope: head through a generally tubular body portion. Preferably,: the locomotive fenctxonilfty includes ibnctiohality providing the feilowmg sequent!!! 20 operations: extending at least part of the first: plurality of seieetabiy radially extendible elements:., thereby anchoring the first plurality' of seieetabiy radially extendible elements to an interior surface of the generally tubular body portion; axially repotetiomng fee sefeetahly potetionible portion and the second phirality· of seieetabiy radially extendible Oieraehfe: relative to the first plurality of seieetabiy radially fafepdible elements; iil extending at least pan of the second plurality of seieetabiy radially extendible elements, thereby anchoring the second plurality of seieetabiy radially extendible elements to an interior surface of the generally tubular holy portion; retracting the first plurality of sefecstabiy radially extendible elements; thereby pnanohoring fee first plurality of seieetabiy radMIy extendible demrerosiqm the interior surface of fete generally tubular 60 body portion; and axially repositioning: the first plurality of seieetabiy: radially extendible elements relative to tire delectably pasiiionabld porfidh and: fee second plurality of seieetabiy radially extendible elements. Optionally, the first: plurality of 2015200767 16 Feb 2015 seleetsbly radMiy extendible elements is arranged with respect to the :gsner$|j.y tubular body portion to be generally forward of the second plurality of sekolably radially extendible elements. Alternatively, thd second phfialify of selectably Sadialiy extendible elements isporanged with fespsct to foe generally Inbdlir body portion to be generally S forward. of foe f! rsl plurality of ssfeetahly radially extendible elements,

Tlere: is also provided in accordance Vviih another preferred embodiment of the present fover An apparatus for fluid supply to the interior of a portfoa of a tubular body portion foeluding an dement extending along: a longitudinal axis and having at least one first selectably extendible tabulae body portion sealing element associated therewith at a 10 first axial location fherealong and at least one second tubular body portion sealing element; psoeiatM.· therewith at a second axial location therealobgi a controller for selectebly extending the at least one first and second tubular body portion sealing elements within a tabular body portion to define a sealed region therebetween and a fluid ppply .functionality supplying a fluid to tire scaled region. IS In accordance with a preferred embodiment of the present Invention, at least one of the first and second tubular body portion sealing elements includes a selcotabiy inflatable: balloon. Preferably, tbs selsciahly inflatable balloon includes a stretchable balloon. More preferably, the selectably inflatable balloon includes a plurality of selectably inflatable balloon portions. 20 In accordance with another preferred embodiment of the present, invention the- appmatus includes a locomotive endoscope head. Preferably, the apparatus for fluid supply also includes at least one fluid supply reservoir which is operative to supply the fluid, to the sealed region. More preferably, foe apparatus for fluid supply also includes fluid suction nmetionality for suctioning fluid hom theiBgfosd region. 25 Higre is feather provided in accordance with aforifer preferred embodiment of the prppi invention apparatus for fluid supply to theduteflof of a portion of a tubular body portion fncluding a multi-lumen tube including at least first, second and laird lumens extending foerethrough, a forward selectably inflatable balloon in fluid cotmnunication with the first lumen, the forward selectably infi^jble^laon. being: || operative to seal the tubular body portion when inflated, a rear selectably inflatable balloon in fluid communication with the second lumso, die rear selectably inflatable; balloon being operative: to seal the tubular body portion when inflated, a fluid supply y outlet, located intermediate the forward and rear selectably inflatable balloons, the outlet being in fluid communication with the third lumen and a controller for selectably inflating the first and second selectably inflatable balloons within a tubular body portion to define a sealed region therebetween and for supplying a fluid to the sealed region. 2015200767 16 Feb 2015

An endoscope assembly may be provided comprising: an endoscope tube having an instrument channel; an endoscope tool arranged to travel along said instrument channel to a utilization location forward of said endoscope tube, said endoscope tool being slidably and sealingly located within said instrument channel; and a fluid endoscope tool positioner for selectably pressurizing said instrument channel for providing fluid driven desired positioning of said endoscope tool along said instrument channel.

In accordance with a preferred embodiment of the present invention the endoscope tool includes a piston-defining portion sealingly and slidably engaging the instrument channel.

An endoscope assembly may be provided including a tube having at least one lumen and an endoscope tool arranged to travel through the at least one lumen, the endoscope tool including a stretchable selectably inflatable anchoring balloon.

An endoscope assembly may be provided including a tube having at least one lumen and an endoscope tool arranged to travel along the at least one lumen to a utilization location forward of the tube, the endoscope tool being selectably bendable forwardly of the tube.

There is additionally provided in accordance with yet another preferred embodiment of the present invention an endoscope assembly including a tube having at least one lumen and an endoscope tool arranged to travel along the at least one lumen, the endoscope tool including a tool head and a multi-lumen tube connected to the tool head.

In accordance with a preferred embodiment of the present invention the tube includes an endoscope tube. Preferably, the at least one lumen includes instrument channel. Additionally or alternatively, the multi-lumen tube includes at least a first 12 2015200767 16 Feb 2015 30 lumen for ihitaiqn:: and deflation of foe stretchable seJectably iaflaMble anchoring dal con and a second lumen.

In accordance with another preferred embodiment of the present invention the endoscope assembly also includes a tensioning wire which extends through, the second 5 |pien pr§ which is operative for seieetably bending the endoscope tool forwardly of the tube. Preferably, the endoscope tool is generally more flexible than the tube, Additionally or s|tomativeiy? the endoscope assembly also includes an endoscopy system to which the endoscope tube is connectable. As a further alternative, the endoscope assembly alsp: includes -an endoscope tool positioning coaiol dimes and a 10 balloon iniiation/deflatior· control. .A accdhiance With yet another preferred enfoedimsst of fie present invention the endoscope assembly also includes a tool port associated with the tube which. is operative for i nsertion and removal of the endoscope tool.

There is further provided in accordance with, a further preferred embodiment of 15 the present Invention an endoscope assembly including an endoscope tube, the endoscope fobs having a first ^stretchable seieetabiy inflatable, anchoring balloon adjacent a forward end thereof and an endoscope tool arranged to travei tMatfve to lid endoscope tubs to a utilization location, forward of the endoscope tube, the endoscope topi having a second stretchable sdeotably inflatable anchoring balloon adjacent a 20 fbrward cad thereof.

In. accordance with a preferred embodiment of the present invention the tool is seieetably bendable forwardly of the endoscope tube. Optionally and preferably., the endoscope tool includes a tool head and a mfofiAumpifube eomiestedfo: the tool head. Additionally or alternatively, the maki-lumen tube includes at least alrst lumen tor inflation, and deflation* of the second strefohable sdeotably inflatable anchoring balloon and. a second lumen.

In accordance vyith another preferred embodiment of foe present invention the endoscope assembly also includes a tensioning wire which extends through the second lumen and Which is operative for seieetabiy beruini foe endoscope fool forwardly of foe endoscope tube. Preferably, the endoscope tool is generally more flexible than the endoscope tube. Additionally or alternatively., foe endoscope assembly also includes an endoscopy system to which the endoscope tube is connectable. Additionally or f o 3.3 alternatively, the endoscope assembly also includes an endoscope tool positioning control device and at least one balloon inflation/deflation control. As a further alternative, the endoscope assembly also includes a tool port associated with the endoscope tube which is operative for insertion and removal of the endoscope tool. 2015200767 16 Feb 2015

An endoscope assembly may be provided including a locomotive endoscope including a locomotive endoscope head and an endoscope body adapted for locomotion through a tubular body portion and for anchoring at a desired location in the tubular body portion and an endoscopy tool adapted for displacement along the endoscope body to a desired tool operation location.

In accordance with a preferred embodiment of the present invention the endoscope assembly also includes at least one selectably radially extendible element associated with the locomotive endoscope head and adapted for anchoring the locomotive endoscope head at a desired location in the tubular body portion Preferably, the at least one selectably radially extendible element includes a selectably inflatable anchoring balloon. Additionally or alternatively, the locomotive endoscope head includes at least one light source and at least one imaging sensor.

In accordance with another preferred embodiment of the present invention the endoscope assembly also includes an overtube which is slidable along the endoscope body. Preferably, the overtube is associated with the endoscopy tool. Additionally or alternatively, the endoscope body is adapted to function as a guide wire for the overtube.

In accordance with yet another preferred embodiment of the present invention the endoscopy tool includes a therapeutic tool. Alternatively, the endoscopy tool includes a diagnostic tool. As a further alternative, the endoscopy tool includes a surgical tool.

There is also provided in accordance with another preferred embodiment of the present invention a locomotive endoscopy method including providing a locomotive endoscope head, including a main portion extending along a longitudinal axis and having a first selectably radially extendible element associated therewith and a selectably positionable portion, selectably axially positionable along the main portion and having a second selectably radially extendible element associated therewith and 14 2015200767 16 Feb 2015 10 providing I0gom.oii.on of the locomotive esdoseimfe head by selectabiy positioning the slidable portion relative: to: the mam portiosiancl sefeembly emending and retracting fife first and second selectabiy radially emsidibie eleiEerte.

In accoridn.ce with a preferred, embodiment of fee present invention at: least one of the first add second selectabiy radially sxtmdihl©::dlenients includes a selectabiy inflatable balloon. Preferably, the loipnfetive mefcd also ineMtes positioning the locomotive· endoscope head in a. selectabiy non-parallel orientation relative to a tabular body portion by selectabiy non-idcnticaliy extending at. least five independently radially extendible element portions of the first selected])' radially extendible element and at least, five independently radially extendible element portions of the Second selectabiy radtely extendible clement. Additiorfeiy or alternatively, the loeotestive endoscopy method also includes positioning the locomotive endoscope head in a selectabiy otf-eehtef fiaMigl orientation relative to a tubular body portion by selectabiy non-kleoftealty extending at least two independently radially extendible element prisms of the first selectabiy radially extendible element and at least tw© huumsndsrdy radially extendible element portions of the second selectabiy radially oxieochble clement.

In accordance with, another preferred embodiment of the present invention, proviling: locomotion pcludes sequentially displacing the locomotive emteseopobead 20 through a generally tubular body portion, Preferably^ providing locomotion insfldes sequentially displacing the locomotive endoscope head, through mf least one of a fp-ge intestine, a small intestine, an aifegy and a vein. More pmfetebly; the sequenti|j|y displacing includes the following sequential operations: extending the fiM selectabiy radially extendible elements thereby anchoring the first sepstably riiihSy eXfesdibte 25 element to an interior surface of the generally tabfilir body portion; axially repositioning the selectabiy posifiosabls portion and the Second selectabiy radially extendible element rdlativs to the first selectabiy radiafiy Extendible element; inflating the second selectabiy radially extendible element, thereby anchoring: fife second selectabiy radially extendible element to an interior surface of the pnefglip tubular p body portion; deflating fife first selectabiy radially extendible efemenl, feereby vinanchorixig the first selectabiy radially extendible element from, the interior surface of the pneraily tubular body portion; and axially repositioning the first selectabiy radially 15 2015200767 16 Feb 2015

I 10 15 20 25 30 extendible clement relative te the selectably positionabfe poiribn and the second selectably radially extendible element

There is additionally provided in accordance with yet another prefctred embodiment of the present invention an Mfluseepe poshiortisg method including providing an endoscope heal extending along a longitudinal. axis and having a first plurality of selectably radially extensilie elements associated therewith, at at least afirsi axial location thereaiong and a second plurality of selectably radially extendible elements associated: therewith at at least a second axial location thereainng and nskctably positioning the. endoscope head by selectable extension of the first and second pluralities of selecthbly r&amp;diMly extendable elements. v In accordance with a preferred embodiment.....of the present invention at least on®: of the first and second pluralities of selectably radially extendible elements includes a plurality of radially extendible elements distributed azim.uthaily about the endoscope head and the positioning the endoscope head includes selectable extension of individual ones of the plurality of radially extendible elements. Preferably, at {east one selectably radially extendable element of the first and second pluralities of dilechisl|· radially extendible elements includes an inflatable balloon.

There is further provided in accordance with still another pmfpred ernbodiiXLsnt of he present invention a method for fluid supply to the interior of a portion of a. tubular body portion including providing an dement extending along a longitudinal axis and having at least one first selectably extendible tubular body portion sealing element associated therewith at a first axial location therealong and at least one second tubular body portion sealing dement associated therewith at a second axial location iherealong, extending the at least one first and second tubular body .portion sealing elements within a tubular body portion to define a sealed region therebetween and supplying a fluid to fits sealed region.

In accordance with a preferred embodiment of the present invention the supplying a fluid includes supplying a therapeutic fluid. Alternatively., the supplying a fluid includes supplying: a contrast enhancing fluid. As a further alternative. the supplying ^ flifli includes supplying an antiseptic fluid. 16

In accordance with another preferred embodiment of the present invention the supplying a fluid includes supplying an acidic solution. Alternatively, the supplying a fluid includes supplying a basic solution. 2015200767 16 Feb 2015

There may be provided an endoscopy method including providing an endoscope tube having an instrument channel and an endoscope tool arranged to travel along the instrument channel to a utilization location forward of the endoscope tube, the endoscope tool being slidably and sealingly located within the instrument channel and selectably pressurizing the instrument channel for providing fluid driven desired positioning of the endoscope tool along the instrument channel.

There is additionally provided in accordance with a still further preferred embodiment of the present invention an endoscopy method including providing a tube having at least one lumen and an endoscope tool arranged to travel through the at least one lumen, the endoscope tool including a stretchable selectably inflatable anchoring balloon and anchoring the endoscope tool forward of the tube within a tubular body portion by inflating the anchoring balloon into anchoring engagement with an interior wall of the tubular body portion.

There is also provided in accordance with another preferred embodiment of the present invention an endoscopy method including providing a tube having at least one lumen and an endoscope tool arranged to travel through the at least one lumen, the endoscope tool being selectably bendable forwardly of the tube and selectably bending the endoscope tool forwardly of the tube.

In accordance with a preferred embodiment of the present invention the endoscope tool includes a stretchable selectably inflatable anchoring balloon and the method also includes anchoring the endoscope tool forward of the tube within a tubular body portion by inflating the anchoring balloon into anchoring engagement with an interior wall of the tubular body portion. Preferably, the endoscopy method also includes sliding the tube forwardly along the endoscope tool, thereby employing the endoscope tool as a guide.

In accordance with another preferred embodiment of the present invention the endoscopy method also includes, prior to sliding the tube forwardly, the step of 17

ο CN 2015200767 16 Feb tubs. There is further provided in accordance with another preferred embodiment of the present invention ah bhdoscopydnetlfed including providing a locomotive endoscope tensioning foe endoscope tool. Preferably, the endoscopy method also inchideg;ihe steps of sequeritidly repeatiag: at least two of the anchoring, tensioning and sliding steps.

In accordance will yet another preferred embodiment of the present invention; the tube Includes an endoscope mbs. Preferably, the at least one lumen includes an 5 instrument channel

There is also provided in accordance with a still further preferred embodiment of the present invention an. endoscopy method including providing an endoscope tube having a firStsstretdhabie selectably inflatable anchoring ballodh adjacent a forward end thereof and an endosgope fool having- a second strhtebabfe seleciably inflatable It anchoring hileon adjacent a forward end thereof and positioning the endoscope tool at a utilisation location forward of the Cndossepe tube.

In accordance with a preferred embodiment of 1ft® present invehllcn the endoscopy method also includes priori to the positioning, inflating tbs first selectably inflatable anchoring balloon on die endoscope tube within a tubular body potion for 1S anchoring the endoscope tubs; to an ftuter wall of the tubular body portion, sifosequsfoto tho poslflohihgiJhflatini the second selectably inflatable anchoring balloon on tire tool forward of fee endoscope tube within flic tubular body portion for anchoring: the endoscope tool to the inner wall of the tubular body portion, thereafter, deflating the first seieetably inflatable anchoring balloon, and advancing the endoscope tube over the 20 endoscope tool by employing thesgndoseope tool as a guide.

In accordance with another preferred embodiment of the: present inventioh the endoscopy method also includes bending the endoscope tool when it is forward of the. endoscope tube and prior to inflating the second seieetably inflatable anchoring balloon. Preferably, tire endoscopy method also includes the step of sequentially repeating at 25 least two of the inflating, posiuoning, deflating and hdvasbmg dfops.

Is accordance with yet another preferred embodiment of foe present invention the endoscopy method also includes foe step of sequentially repeating at least two of the inflating, positioning, bending, deflating and advancing Steps. Preferably, the positioning of the. endoscope tool includes passing the endoscope tool through an 30 instrument channel 18 2015200767 16 Feb 2015 10 including a locomotive endoscope head and an endoscope body-, providing locomotion of die locomotive endoscope head through a tubular body portion, anchoring the locomotive endoscope bead at a desired location in die tubvdar body portion and displacing an endoscopy tec; along the endoscope body to a desired tool operation location.

In accordance with a preferred embodiment of the present invention the endoscopy method also includes tensioning the endoscope body following the anchoring of the locomorivs fendiaeope head and prior to the displacmg the endoscopy tool. Preferably, the endoscopy method also includes, prior to the anchoring, the' step of detecting the desired location In the tubular body portion by use of at least one light source and at least one imaging sensor associated with the locomotive endoscope head. -, ht accordance with another preferred embodiment of the present invention the endoseopy method also includes, prior to the displacing ths endoscopy tool the step of detecting the desired tool operation location.....in ths tubular body portion by use of at least one light source and at least one imaging sensor associated with ths iooornonve endoscope bead. Preferably, the displacing the endoscopy tool includes Sliding an c vertube asscoiared with the endoscopy tool qysrfhe:endoscope body. 20 19 2015200767 16 Feb 2015 10 i!

4 C

S, A

lJUp OESiRIPTIOM OF THE DRA WINGS

The present Invention will be understood and appreciated more Tu.tiy fcm Ore olio wing detailed description, taken in conjunction with the, drawings in which:

Mg. 1 is a simplified pictorial illustration of m 0&amp;we@jji$ spstem constructed and operative in accordancewitla f preferreiumbddinient of the present invention;

Figs, 2 and 3 are respective ^iplificd exploded and assembled view illustrations of a locomotive endoscope head constructed and operative in accordance With a proferfed etnbddisnent of the presold Invention;

Figs. 4A* 4B and 4(2 . are, simplified sectional lUusirations taken along respective linesTVA ~ IVA, IVB ~ IVB and IVC - 1 VC in Fig. 3:,

Figs. 5A, 5B, 5C, SDf 5E, 5F and 5G are simplified sectional illustrations, taken along linos IVB ~ IVB in Fig. 3 of the locomotive endoscope head of Figs. 2 ·· 4C af Various stages of forward motion through an intsstine;:::

Figs. 6A, b’Bs 6C, 6D, 6E, 6F and 6(3 are simplified, sectional iinstrations, taken along lines IVB »IVB in Fig, 3 of the ioconioiive endoscope headj at various stages of remny&amp;rd .motion through an intestiiis;

Figs.. 7A, 7B and *|C are side view illustrations of selectable tilting orientation 20 of (be locomotive endoscope head of Figs. 1 - 6G within &amp; body passageway;

Figs. 8A, 8B and SC.· arc sho.piifk-d rearward feeing views corresponding to Mss, m>: M and iC3 taken along planes VIKA - VffiiA, VIKB - VtlB and VIKC -VIIIC in Figs. 7A. 7B and 7C respectively;:

Figs. 9A, 9B and 9C are simplified forward facing views corresponding to 25 Figs. 7A, 7B and 7C. taken along planes LXA - IXA, IXB ~ TXB and IXC - INC in Figs, 7A,; 713 and 7C respectively;

Figs. 10A and 10B are side view illustrations of selectable parallel orientation ofths locomotive endoscope head iof Figs. 1 - 6Cr within a body passageway;

Figs. HA and lllfere stmpiffisdjearwaid facing views corresponding to Figs. 30 IDA and 10B taken along planes ΧΙΛ - MIA and XEB - XIB in Figs, i 0A and 10B respectively; 20 2015200767 16 Feb 2015 30

Ftp. 12A and 12B ate simplified forward feeing views edrraspcBimg to Figs. lOAand I OB taken along planes XiXA - X'flA find .Χ.ΠΒ - ΧΠΒ 1b Figs. 10A end 10B respectively;

Fig, 13 is a·simplified pictorial iUustrslkm of an accessory which is adapted to | travel through the instrument channel in the locomotive: endoscope head of any of Pigs, : - 12E,

Fig. 14 is a simplified partially block diagram, pariially sehematiG illustration of parti of the endoscopy system of Figs, 1-13, constructed and operative in accordance witMsg: preferred embodiment of the: present invention; 10 Fig. 15 is a .simplified pictorial illustration of the locomotive endoscope head of figs, 1- 12B in an mtesfne fluid treatment mode of ppersdidn; . ..

Figs. 16A, I6B and 16C, are simplified, pictorial illustrations; of the locomotive endoscope head of Figs. 1 - 12B in. a pidiwhe ifiMh bfibpdfeiion.

Pig. 17 is &amp;sirn|sliied pc^ofiallMtWt^ endoscopy system obfistmsfed 15 and operative is accordance with itadthsf preferred embodiment of the present invention;

Figs, 18 s 19A and I9B are respective simplified pictorial and sectional view illustrations of an accessor}' constructed and operative in accordance with a preferred: embodiment of fee present invention; 20 Figs. 20Λ, 20B, 20C, 200, 20E, 20F, 20Q, 20H and 201 are simplified iilustratitim of various fiujcticmali ties which may be provided by the system of Fig. 17.

Fig. 21 is a simplified pictorial illustration of an endoscopy system <^ns|a|©ted and operative in accordance with another preferred embodiment of the present invention; i| Figs. 1¾ 23A and 23B are respective simplified pictorial and SebSdaal view illustrations of an accessory constructed and operative iii accordance with a preferred embodiment of the present invention; and

Figs. 24A, 24B, 24G, 24D, 24E, 24F, 240, 24¾ 241, 243, 24K and 241. are simplified illustrations of varfdtis fufiotionalilies which may be provided by the system of Fig. 21. 2015200767 16 Feb 2015

DETAHED DESCRIPTION OF PREFERRED JEMBOD1M5NTS

Refereiiife is now mads to Fig, 1, a simplified pietetki Mltrstrstiori M an endoscopy system constructed and operative fa accordance with a preferred 5 embodiment of the present hivsntlen.

The terms ''endogeope" mid “endoseopy" are used feoughout M a manner somewhat broader than tietr custoiai^meiSmng ahd refer to apparatus and methods which operate within body cavities, passageways and the like, such as, for example, the small intestine, the large intestine, arteries snd veins. Although these terms normally TO pisr to visual inspection, as used herein they are not: limited to applications which employ visual inspection and refer as well to apparatus, systems and methods which need not necessarily involve visual inspection.

As seep, in Fig, 1, a conventional endoscopy system. 100,: such as a consols including a CV-16Q video system center, a CLC-160 light source, an OEV-203 video 15 monitor, and an OF? flushing pump, all commercially available from Olympus Arastics inc, of 2 Corporate Center Drive, Melville, NY 11747, USA, is being employedb A locomotive endh scope head MS, eonstmeted and operative in aceordanee with a preferred enrboiimiM of the present iuyihfidais located fehih the large intestine of a patient and is coupled to system 100 hy a raMtRmmen tube 104, also constructed and 20 Operative « accordance with a prefeed embodiment of the present irfeahoa, fetch interfaces with locomotive head controller 106 and an operator control. 108, both of which am also constructed and operative in accordance with a preferred embodiment of the present invention.

Reference is now made to Figs, 2 and % which are respective simplified 25 exploded and assembled view iliistcations of a locefetiy© endoscope bead constructed and dperatiyd in accordance with a preferred embodiment of feepresent invention and to figs. 4A, 4B and 4C, which are simplified sectional ilnsimtions tihen along: respedliye lines 1VA - IV A, IVB - IVB and I VC - IV C in Fig, 3.

As seen in Figs, 2 4C, a muiti-Iumen tube '104, having a central passageway IP 202, defining an instrument channel useful inter alia for tool insertion, mssufiation and spgflpn, and a plurality of peripheral lumens 204, typically ten in number, is sealed in a suitably configured recess 206 ibrmed i.u a housing portion 20S. Housing portion 208, 2015200767 16 Feb 2015 18 30 which is generally symmetric about a longitudinal axis 210, includes a relatively wider bear portion 212- viMch id®ses:iseess 206 and a relatively narrowifmaih portion 214.

Rear portion 212 is formed with three pairs 220 of axial slits which extend to the rear of rear portion 212 and which are mutually separated along the akeumfershee of rear portion 212 by 120 degrees. teCTnediSte each pair 220 of axial sits, there is provided an inflation passageway 222, each of which, cornrnumoates with a corresponding Inllatioa passageway®! ibrmed in multi-lundia tube 202, which, in. hi®, communicates with a respective one of three rear balloon inflation lumens 226, which arc included in the nine multiple peripheral lumens 204. Hear balloon inflation lumens 226 are sealed forwardly of inflation passageways 224 by seals 228.

Main Portion 214 is formed with three axial slots 230 which extend to tlte rear of rear ppripri 212 and; watch are mutually separated along the ohc«m&amp;®|nee of rear portion 212. A slidable forward balloon support 23E is slidably mounted onto main portion If 214 of housing portion 208. Forward balloon support 23 8 is formed with three pairs 240 of axial slits which extend to the rear of forward balloon support 238 and which are iautualiy separated along the oiroumferePde Of forward balloon support 238 by 120 degrees Mtupaediatei each pair 240 of axM JliSss there: Is provided an inflation passageway 242, each of ’which ceinnxtraicates with a corresponding inflation 20 passageway 244 which lextends rearwardly into: iSlidails sealing engagement with a respective one of three: forward balloon inflation lumens 246. which are included in die nine multiple penpheraldumens 204, It is!::i^redatei::r^afe::b5flaticft:pa^ageiw^?s 244 are typically relatively rigid and sealingly slide widen suitably configured low Motion liners 248 which are inserted into forward balloon inflation lumens 246 at the forward 25 end of the multi-lumen tube 104. A pair of piston rods 250 are fixed to or integrally formed with forward balloon support 238 and extend inwardly and. marwarpy thereof into slidable sealing engagement with a respective one of two forward balloon support axial, positioning lumens 252, which are included in the ten multiple peripheral lumens 204. It is appreciated that piston rods 250 are typically relatively rigid and s&amp;alingly slide within suitably configured low friction liners 254 which are inserted into forward balloon support axial positioning lumens 252 si the forward end of the multi-lumen tube 104. 23 2015200767 16 Feb 2015 10

The relatively rigid inflation passageways 244 and tbs piston xous 250 axe preferably located within axial slots 230, A fi:cut housing portion 260 is fixedly mo anted onto a forward end 262 of foe main portion 214 of the housing portion. 208. Front: housing portion includes a cap portion 264 which is fixed to or Integra·]}' formed with a cylindrical portion 266 which extends through a central bore 268 of slidable forward balloon support 238, A rearward end of cylindrical portion 266 is seated in a recess 270 and against a shoulder 272 denned in central passageway III of multi-lumen tube 104. An interior bore 274 Of cylindrical port.ion 266 defines a......continuation of the instrument channel defined bv

Cental .passageway 202,

Af a forward end ofcap portion 264 there are preferably provide! tight quitting diode. 280 and one or rhere imaging sensors 282. Electrical current is supplied to the light emitting diode 280 apt imaging data is received from sensors 282 via an optical fiber: and electrical conductor bundle 284 which extends from the forward arid of cap portion 264, through a peripheral lumen 286 in multi-lumen tube 11| to locomotive head controller 106 (Tig, 1).

An additional peripheral fumsn 240 is provided in rnuiti-lumen tube 104 for fliddrCDmihuiiicatfoh with the interior fifths: intestine via slots 230 in housing portion 208, Liquids or pressurized gahmhp he introduced or drained through this lumen. 20 An inflatable balloon iylisdrir 300 is mounted onto rear portion 212 of housing; portion 208. As aeon dearly mifoig; 2, inflatable balloon cylinder 300 has a uniforra cress section which Includes three pairs: 320 of axial -walls which extend along the longitudinal length thereof and engage corresponding axial slits 220 which extend to the rear of rear portion 212. Each pair 320 of axial walls is joined % a cifenm.fereMial wall 25 portion 322, Axial w'alls pairs 320 are mutually separated along the: okeumfersnee of mflatablri: balloon cylinder 300 % f2f degrees, hitermefoate pairs 320 of axial walla there me defined fores inflatable balloon prirtioris 324, each of which separately epnrmunicates with a separate hxiafiih passageway 222. Balloon portions 3|4 are settled with respect % the rear portion 212 at 30 forward and reanpgl ends thereof anti at slits 220 by adhesive; or in any other suitable manner to define three separate and isdepenlcntiy continllabiy inflatable and dcflatable balloon portions, distributed about foe periphery of rear portion 212, it is appreciated 2015200767 16 Feb 2015 that any suitable smaller or larger number of separate and independently controllably inflatable: and deflatfible balloon portions may he altemafiyely employed, alfoougb at least three such separate and dndepbsdmtfy controllably inflatable and deflatable balloon portions arcpre&amp;rfod, 5 An inflatable balloon, cylinder 350 is mounted onto forward saloon support 238. As seen clearly m Fig. 2, inflatable balloon cylinder 350 has a uniform cross .section which includes three pairs .170 of axial walls which extend along the longitudinal length thereof arid engage corresponding: axial slits 240 which extend to tiro rear of forward balloon support 238. Each pair 370 of axial walls is; joined by a P ckppmferential wall portion 372. Axial walls pairs 370 are mutually separated along the phpumfcrence of inflatable balloon cylinder '350 by 1.20 degrees.

Intermediate pairs 370 of axial walls there are defined three inflatable balloon portions 374, each, of which separately communicates with a separate inflation passageway 242. Balloon portions 374 are sealed with respect to die forward balloon 15 support 238 at forward and rearward ends thereof and at slits 240 by adhesive or in· any other suitable manner to define three separate and independently controllably inflatable and deflatable balloon portions, distributed about the periphery of forward balloon support 23 8:, It is appreciated that any suitable smaller or larger number of separate and independently controllably inflatable and defiaiable balloon portions may be 20 dltemntivdy employed, although at least three sleh separate and independently controllably inflatable and deflatable balloon portions which are 6Θ sidpees oat of phase with the balloon portions on rear portion 212 are preferred.

It is appreciated that .in accordance: Mil : a peferrsd embodiment of the present: invention the balloon cylinders 300 and 350 are generally stretchable, and can be· 25 stretched to accommodate expansion to a radius up to about 5-20 times greater than the radius of cylinders 300 and. 350, when uninfiatsd. Preferably inflation of balloon cylinders 300 and ||0 may be achieved using relatively low' pressure, such as in the range of 10-50 milibars,

It is appreciated: fea|in accordance with a preferred ernbodimehisof the present 30 invention useful for in vivo inspection of a generally tubular body portion haying a variable cross-sectional diameter, the expansion diameter range of balloon cylinders 300 and 350 is larger than .the maximum cross-sectional diameter.....of the generally tubular 25 2015200767 16 Feb 2015 ,1:0: is d •p' m body portion, thereby ensuring engagement of expanded, balloon cylinders 300 and 350 with tire interior surface of the generally tubular body portion, and anchoring of the locomotive endoscope head 102 thereto. Preferably, balloon cylinders 300 and 350 are relatively soft, highly compliant balloons, operative to at least partially conform to the 5 shape of the interior surface of tire generally tubular body portion when in engagement theremQi,

It is appreciated that balloon cylinders 300 and 3S0 may be formed of well-known stretchable materials, snob, as latex, flexible silicon* or highly flexible nylon. Alternatively, balloon cylinders 3§G and 350 may be formed of polyurethane which is less stretchable and son terming than latex, flexible silicon, or highly flexible nylon.· Preferably, balloon, cylinders 300 and 350 have diameters which are sufficient to ensure tight anchoring at any part of the generally tubular body portion.

MefsrendOsis now made to Figs, 5A, SB, 5C, 51¾ SB, 5F and 5G, -which, are simplified sectional illustrations, taken along lines 1VB - IVB in Fig. 3, of the locomotive endoscope head of Figs. 2 - 4C at various stages of forward motion Ibipugh an intestine. As seen in Figs, 5A - 5G, locomotion of the locomotive endoscope head 102 of figs. 2 - 4C is achieved bf a combination of sequential mfiaions and dbfidtions of balloons, here respectively designated by reference; numerals 500 and 502 mounted onto the; housing portion 208 and the forward balloon support 238, combined with relative axial displacement of forward balloon support 238 vis-a-vis housing portion e 208. It is appreciated that each of balloons 500 and 502 preferably includes multiple separate and independently controflahly inflatable and deflatablc balloon portions as described hereinabove.

Turning to Fig. 5A, it is seen that balloon 500 is inflated, thus engaging an inner wall of an intestine and fixing the position of foe housing portion 208 relative thereto. In this orientation, the forward balloon support 238 is shown hi a rearward axial ori.entati.on, adjacent rear portion 212. Considering Fig. 5B, it is seen that forward balloon support 238 has moved axially forward relative: to housing portion 208, while the housing portion 208 .remains axially fixed relative to the intestine.

Turning to Fig, 5C, it is seen that with tbs; forward balloon support 23| in its Fig. 5 8 axial orientation, the balloon 502 is inflated, thus; engaging the inner wail of flic 2015200767 16 Feb 2015 m 15 20 25 intestine and fixing fee position of the forward balloon support 238 relative thereto, Thereafter, as sis own in Fig, 5D, balloon 500 is dertatcd.

Turning to Fig. 5E, it is seen that subsequent to deflation of balloon 500, the forward balloon support 238 is moved axially rearward relative to housing: portion 208, while the forward balloon supoit '238; remains axially fixed relative to the intestine. This results in toMI forward movement of the housing portion 208 and thus of the locomotive endoscope head 102,

Turning to Fig. 5F, it is seen that With the Steward halloen supped 238 In its Fig. 5E axial orientation, the balloon 500 is inflated, ttos sngagmg the inner wall of the intestine and fixing tire position of fc hoping portion 2Θ8 relative; thereto. Thereafter, as shown fepig. 5GS-balloon 502 |s |ofiat|d, ....

It is thus appreciated that in iMs manner,: forward displacement of the locomotive end&amp;sfcope head 102 is effected.

Reference is now raade to Figs, 6A, 6R, 6C, 6D, 6E, 6F and 6G, which are simplified sectional illUstiifihhs, taken along lines FVB - IVB in Fig. 3. of the. locomotive endoscope head bf Figs, 2 - 4C: at various stages of rearward motion through fin intestine* seen in Figs. 6A - 6<§, rearward TOerunotion of fee loeomqfiye endoscope head 102. of Figs, 2 - 4C is achieved by a combination of sequential inflations and deflations: of balloons, here too respectively designated by teferenee numerals 500 and 502 mounted onto fee bousing portion 208 and the forward balloon support 238, combined wife, relative axial dtsplacemfed bf ferwam balloon support 238 vis-a-vis housing portion 208. It is appreciated feat each of balloons 500 and 502 preferably includes multiple separate and independently eootrollably inflatable and deflatable balloon portions; as described hereinabove.

Turning to Fig, 6A, it is seen that balloon 500 is inflated, feus engaging an inner wall of an intesfinp and fixing the position of fee housing portion 208 relative thereto In this qrfontaiim, the forward bHlbon support 23 8 is shown fix a rearward axial orientation, adjacent rear portion 2.12. Considering Fig. SB, it is seen that with tire forward; bafidbh support 23 8 in its Fig, 6A axial orientation, the balloon 502 is inflated, thus dagagrh|; fee inner wall of the intestine and fixing; fee position of fee forward balloon support 238 relative thereto. Thereafter, as shown in fig, 6C, balloon 500 is deflated. 27 2015200767 16 Feb 2015

Turning to fig. 61λ 1 |s seen that forward balloon support 238 ha* moved axially forward relative to bousing portion 20¾ while the forward balloon support :23:8 remains axially fixed relative to the intestine. lummg to Fig. 6E, it is seen that with the forward balloon support 238 in its; S Fig. 6D axial orientation, the balloon 500 is inflated, thus engaging (bo iimer wall of the intestine and filing the; position of the bousing portion 208 relati ve thereto. Thereafter, as shown in Fig. 6F, balloon 502 is deflated,

Tferiing nowto fig. ¢5¾ it is seen that forward balloon support 218 has moved axlsfly rearward relative to housmglporllea 208, whilsdlte housing portion 208 remains 10 axially fixeipelaflye infoesbitestirie·

It is thus appreciated that in this manner, rearward dir,placement of the 1 coonsotive endoscope bead 102 is effected. Alternatively, both balloons 500 and 502 may be dilated aoci the locomotive- endoscope head 102 may be pulled out of the intestine by pulling on the mush-lumen lube 104. 15 Reference ia; now male to Figs, 7h ~ 9C. which fiastrate various; different orientations of his locomotive endoscope head 102 of Figs, 2 - W which may ho realized by suitable selectahlpinflation of individual balloon Ipbes of hhHdons 50(1 and 502. These illustrations are eggas^Ies of non-parallel, tilted prientationG s|hieved by any suitable non-identical inflation of balloon lobes of balloon 500 as well as m 2Θ correspondiiig non-identleal Inflation of the balloon lobes 502 in an. opposite sense, taking into ace-cunt the phase difference in the rotational orientations of the. balloon lobes of balloons 500 and 502.

Turning to Figs, 7A, 8A nnd 9,% fessfo are mm illustrations of &amp; first., downward feeing, selectable tilting orientate of the locomotive endoscope bead, of 25 Figs, 1 - 6Q within a body passageway, This orientation is aehieved by relatively: low Marion of one balloon lobe of balloon 500, here designated by reference numeral S ift and relatively high Inflation of balloon lobes of baioou 50(3 designated by reference numerals 512 and 514, at theisdme time as tee As provided relatively low inflate of one balloon lobs of balloon 502, here designated by reference numeral 520 and 30 relatively high inflation of balloon lobes of fealooh 502 desipafed by referenda numerals 522 and 524,: Ms noted that in the orieihation of llgs. ?A - 7C, balloon lobes 28 2015200767 16 Feb 2015 510 and 520 are respectively :si % top and the bcUom of locomotive endoscope head 102, in. the sense of Figs. 7 A ·· 7C.

Turning ίο Figs. 73. 8B and 9B, ihers are seen iHustxations of a second, parallel orientation of the |ogomotrvC endoscope head of Figs. 1 - 6G within a body | passageway. This orientation is dGMbved 'by gstferally identical ififiation of halloos lobes 510, 512 and 514 of ballbcm SOS: adfwell as ! Meniical! hrilafiss of balloon lobes 520, 522 and 524 of balloon 502.

Turning to Pigs. 7C, SC and 9C, there are seen illustrations of a tlrird,supwaid feeing, selectable liking orientation of the locomotive endoscope head of Figs. 1 - CiG 10 Within i. body passageway. This otisntatioa is achieved by relatively high, infliion of balloon lobe 510 of balloon 500 and reiatissiy 1σ# inflation of balloon lobes 512 mid 514 of balloon 500, at the! same time as there is provided relatively high inilation of balloon lobe 52Θ of balloon 502 and relatively; low inflation of balloon lobes 522 and 524 of balloon 502. 15 Reference is now made to Figs. 10A. and 1QB, which are side view illustrations of selectable parallel, off-center orientation of the locomotive endoscope head of Figs. 1 - <56 within a body passageway, to Figs. 11A and 11B, which me rearward facing views corresponding to Figs, M3A and 10B taken along planes XJA - X?A and X1B - XVB in Figs. 10 A and 10B respectively and to Figs. 12Λ and 121, which are tbrwafd tricing. 20 views corresponding to Figs. 10 A and 1 OB taken along planes XL1A - X1IA arid XIIB~ XlIB in Figs, 10A and 101 respectively. These idustatiorts are ojtariiples of parallel orientations achieved by any suitable ntm-idenricsi inSarien of balloon lobes 510, 512 and 514 of balloon 500 as well as a cSj^espoading non-identical inflation of balloon lobes 520, 522 and 524 of balloon 502, taking into account, tire, phase difference in die. 25 rotational^^ibtriatihris of the balloon lobes of balloons 500 and 502.

Turning to Figs. 10A, 11A and Ϊ2.Α, there are seen illustrations of a first, off center parallel orientation of fie Iccomotiye endoscope bead of Figs. 1 SB within. 4 body passageway. TMs orientation is achieved by relatively low inflation of bdildoh lobe 510 and relatively high Marion pf balloon Jobes 512 and 514 Of batlcon 500 as P0 welhas a corresponding relatively hipt inflation of balloon lobe 52© arid relatively low inflation of balloon lobes 522 and 52|; of ballpen 502, Much tabes into! account the 29 2015200767 16 Feb 2015 phase difference· in the rotational orientations of the balloon, lobes of balloons 500 and 502.

Turning to Figs. 10¾ 1 IB and 12B, there are seidillustStlShsiSf a second, off center parallel orientation of the locomotive endoscope head of Figs. 1 - 6G within a 5 |odv jpasss|eway. This orlentaion is achieved by relatively high inflation of balloon lobe 510 and relatively low inflation of balloon lobes 512 and 514 of balloon 500 as well as; anorrgsppuding reiariyeiy low inflation of balloon lobe 520 and relatively high inflation of balloon lobes 522 and 524 of balloon 502. it rnay be appreciated from a consideration of Figs. |A - 12B that, in practice; 10 any desired, geometrically permitted, orientation, of the locomotive endoscopefread 102 may be realized if at least force balloon lobes, are provided: pp both ballpphs |l| and 502. This includes, for example up-down and si|e-fo-side tilts and combinations thereof as well m desired up-down and aide-to~side off-penter parallel orientations and combinations thereof. 15 It is appreciated that various desired, geometrically permitted, orientations of the locomotive endoscope head 102 may be realized if at least two balloon lobes arc provided on each of balloons SQQ and 502, and in paftieular if the at least two balloon lobes of balloons 500 and 502 are azinaathally dSset.

It is a particular feature of the present irwonifon that due to the foot that foe 20 locomotive endoscope is moved other than by a pu.fo mechanism, multi-lumen tube 104 •nay be substantially more flexible than other endoscope tubes.

Reference is now made to Fig. 13, which is a simplified pictorial illustration of an accessory 600 which is adapted to travel through fee instrument channel defined in the central passageway 202 of the rivalli-Uunen tube 104 and in interior bore 274 of 25 cylindrical portion 266 of locomotive endoscope; head |0ii fha accessory 600 may he selected from among any suitable accessories, such as biopsy forceps, polypectomy snares, foreign body retrieval devices, heat probps an| pppdfos* some of which are well known in the art. In accordance with a preferred embodiment of the invention, a piston 602 is associated with foe accessory along its body 60# a®d upstream, of its head 606, 30 The piston 602 is configured for slidable sealed motion along foe Instalment channel in response to pressure differences upstream and downstream thereof, such as provided by suitable positive or negative pressurization of the instrument channel, which may be 30 2015200767 16 Feb 2015 1Θ 15 20 25 512, 514, 520, S22 and 524 ciArried out for example, by convsrstionifoinssuflafliS?arid suction functionalities feat are provided in conventional, endoscope systems,

Reference is sow made to Fig, 14, which Is a simplified. partially block diagram,: partially schematic ί 1 ’ nstrat: on of part of the endoscopy system. of Figs. 1 ~ 13. constructed and operative in -accordance with a preferred embodiment of the: present invention.

As seen, in Fig. 14, a conventional endoscopy system 100, suefo as a console msludisg a CV-160 video system center, a CLC-160 light source, ahfoEWSOl v$iS&amp; monitor, and an OFF flushing pump, ail commercially available from Olympus America Inc, of 2 Corporate Center Drive, fSeMlle, Iff 11747, USA, is being employed, Conventional endoscopy system 100 includes: an inssufiation/suction generator 700 and a liquid, supply 702 which eomnifeubate 'via a flow control valve 704 with foe instrument channel defined by central passageway 202 of the muiti-1 inner; tube 104 and by interior bore 274 of cylindrical portion 266 of locomotive endoscope head 192. The eonveniioEstl endoscopy spread 100 also; psferaMf includes as foraging system 710 and an LED controller 712 which communicate via electrical data and power Ikes preferably embodied in optical fiber and eleeirical conductor bundle 284 wMhh extend through lumen 28:6 iin multi-lumen tube l|4,

Operator control i08, preferably including a joystick 722, tilt/non-tilt fmictloaaity selection switch 724 and a button 725 for governing the direction (ibrward/backwatd) and speed of motion, governs: the operation of locomotive head controller 106. fir a preferred embodiment of foe present invention, as shown, fee operator control 108 provides control inputs to locomotive head control circuitry 7M. which operates an air pressure generator 728, a vacuum generator 730 and a hydraulic: pqsfeve/negafivepressure supply 732.

Air pressure generator 728 and. vacuum generator 730 are coupled to lumens 226 and 246 for selectable Inflation of balloon lobes 510, •via suitable manifolds 734 and 736 and via individual flow valves for each of foe lumens, the flow valves being designated by reference numerals 740, 742. 744, 746,748 and 75th Hydraulic pcsitivs/negative pressure· supply 732 is coupled via a flow valve 752 to lumens 252 for driving piston rods 250. Additionally a flow Valve 754 governs supply of a treatment liuid to lumen 290 tern, a treatment fluid reservoir 756. A further 31 2015200767 16 Feb 2015 fluid valve 758 governs removal of the treatment fluid via lumen 290 finm the intestine to a discard fluid location (not shown) which is maintained under vacuum.

Flow valves 704, 740, 74¾ 744, 746, 74¾ 750, 752, 754 and 758 ers controlled by operator control 108 via locomotive head control circuitry 726 to suitably inflate and 5 deflate balloon lobes SCO, 11¾ 514, 520, |§2 and 524 for providing selected positioning and/or hit of the locomotive endoscope head 102; wiSfe the mdssiine; to suitably displace forward balloon support 238 for locomotion difop Ipeomptive endoscope head 132 and for seleclabiy supplying ireahuent fluid to the intestine Is described hsreinbelo w with reference to Fig. 15. 10 Reference is new made to Fig. 15, which is a simplified pictorial illnshiaida of ; ire locomotive endoscope head-of Figs, 1 - 12B in an. intestine fluid treatment mode of operation., As seen in Fig. IS, tubular body portion 1811¾ elements: such as balloon lobes 510, 512 ami 514 of balloon 500 and balloon lobes 5.20, 522 and 524 of balloon 502 are preferably all mitoed, so as to seal the volume of the intestine intermediate IS;: hailooo. lobes 510. 512 and 514 and. balloon lobes 520, 522 and 524 from tire remainder of the interior volume of the intestine.

Once sealing is achieved, a treatment fluid 760 is stalled from teabnentflind reservoir 756 via valve 754, lumen 290 and slots 230 to the sealed portion of the intestine. Following treatment, the treatment fluid 760 may be suctioned from foe sealed 20 portion of the intestine via slots 230, lumen 290 and valve 758 to a fluid discard lopiSon (not shown). Optionally and preferably, treatment fluid 76Θ IncIiddS st least one of a therapeutic .fluid, a contrast enhancing fluid, an antiseptic, fluid, an acidic solution,: η basic solution or any other suitable fluid.

Reference is now made to Figs. 16A ·· 16C, which are simplified pictorial 25 illustrations of the locomotive endoscope head of Figs. 1 - !2B in a guide wire mode of operation. As seen in Fig ;6A, balloon lobes 510, 512 and 514 of balloon 500 and balloon lobes 520, 522 and 524 of balloon 502 are preferably all inflated, so as to anchor the locomotive endoscope head 102 to the! intestine, ©nee anchoring is achieved at § desired Ideation, multi-lumen babe 104 is tensioned, g&amp;seen in Fig. 16B. 3(3 It is appreciated that respective diameter of balloons S00 and 502 are sufficient to ensure tight anchoring at any part of tbs intestine. 2015200767 16 Feb 2015

As seen in Fig. !6C, an ovsrtube 800 Is slid,o^t*inal#lumaa it as a guidowim fhe overuip 8|Φ preferabif inBfedes, at a forward portion &amp;02: thereof an endoscopy tool 804. Preferably, endoscopy tool: 804 may be a therapeutic, diagnostic or surgical tool, raid may he ssie<rislfly positioned· along the rnoKMiunen tube 104. Τη t |1 pre&amp;rred embodiment of the present invention, endoscopy tool 8:84 is an ultrasonic transducer, fo, another preferred embodiment of the present invention, endoscopy tool 804 is an X-ray radiation source/generator.

Reference is now made to Figs, 17 -r I9B, which are respectively simplified pictorial illustration of an endoscopy system constructed ana operative in accordance 10 with another preferred embodiment of the present invention and respective simplified pictorial and sectional View illustrations of an accessory constructed and operative in accordance with a peferisd embodiment of the present invention,

As seen in Figs. 17 - 19B, a conventional endoscopy system 10©B, such as a a CV-160 video s^stempenter, a CLC-160 light source, an ClS¥-2Q3: .13 video monitor, and an OFF flushing pump, all commercially available from Oljmfeus America lire, of 2 Corporate Oenfer Driver Melville, NT 11747, USA, fo being employed. A, conventional endoscope 100¾ which forms part of coavestional endoscopy system 1Q00 may be employed, such ds a CF-Q160AL video eclonoseops which is commercially available ten OiympSs America Inc, of 2 Corporate Center 20:: Drive, Meiylife, Nf A1747, USA.

An endoscope tool 1010, constructed and operarive in accordance with a preferred embodiment of the present invention extends through the: hastruroeut channel lit 1 of the conventional endoscope 1:092. Bsdosoope tool I Old is charaeterized la that; h includes a ymnti-lumen tubs 1:0:12 which includes at feast a first lumen 1014 for 25 inflation and deflation of a balloon 1016 via an inflation aperture 1017, and a second lumen 161:8:, Preferably the second lumen 1018 may accommodate· a tensioning or compression wire i 020. Alternatively or additionally, the second lumen. 1.018 may have other fbrmtionality. As a further dternative, the multi-lumen tube 1012 forming part of the endoscope tool 1010 may include mors than two lumens, Preferably, the cross-30 sectional area of the multi-lumen tube .1012 is sufficiently less than that of the instrument channel 1011, so as to allow supply of fluid for inssuflatlon and draining of fluid therethrough. 7 'i .:si 2015200767 16 Feb 2015 it is appreciated that m accordance with a preferred embodiment erf the present Invention the endoscope idol 1010 and the raxilti-iumen tube 1012 are generally substantially more flexible than conventional endoscope 1002 and an endoscope tube thereof. 5 Ibis appreciated that in accordance with aipieferred embodiment of fee present invention fee balloon 1016 is generally stretchable, and can be stretched to a diameter about 5--20 tixn^S larger than its diameter when not inflated, in a specific embodiment, useful for small intestine endoscopy, the balloon diameter when felly stretched is four eerdim.etsrs,::: Preferably, inflation: of fee balloon 1016 to n diameter less than four 10 caxflmetersmay be achieved using relatively low pressure, such as in the range of 10-50 millibars,·>Ia another specific embodiment, useful for large intestine endoscopy,, the balloon diameter when fully stretched is seven centimeters. Preferably, inflation of thf balloon 10:6 to a diameter less than seven centimeters may no achieved using relatively low pressure, such as in the range of 10-50 nulibars. 15 it is appreciated that in accordance with a preferred cinbodiment of the present ittipstios aseifl for In vivo mspeotibh df a generally afeular body portiin having a variable cross-sectional flifouster, the expsnsiou diameter range of balloon 1016 is larger than: the maximum cross-sectional diameter of the generally tabular body portion, fosrsby ehshring engagement o'f expanded balloon 1016 with the inferior surface of the 20 generally tubular body portion, and anchoring of the endoscope tool 1010 thereto. Preferably, balloon 1016 is a fofeively sefe, highly compliant balloon, operative to at least partially conform to tire shape of the interior surface of the generally tubular body portion when in engagement feerewith.

It is jppreeiated that balloon 1016 may be formed of weMfobivn stretchable M materials such as latex, flexible silicon, or highly flexible nyloh......Alternatively, balloon 101.6 may be formed of polyurethane, which is less shdidhabld and cQtfonrdag than latex, flexible silicon or highly flexible nylon. Preferably, the diameter of balloon 1016 is sufficient fe ensure tight anchoring at anypart of the geuemlly tubular body portion.

As seen in Figs. 17 - 19B, the endoscope tool 1010 preferably includes a; tool Jii positioning control device 1024 and a balloon Inuaflon/deSatiun conuol interface 1026' It m appreciated t|ft innlfi-lumem tubs 1012 and tire entire endoscope fool 1010 maybe 2015200767 16 Feb 2015

Inserted and reroovod via a: conventional tool port 103 0 on a conventional operator control ] 032 '»vbic:h forms part of conventions! endoscope .1002, ilsferenee is now made to Figs. 20A, 20B| 20C, 20D, 2GB, 20F, 20GS 20H apd 201. which are :simplified ilhisirations of file endoscope too! 1010 of Figs. 17 - 19B la 5 various Operative orientations. In the illustrated embodiment, desired directional orientation of tire forward: end of the endoscope tool 1010 is obtained by suitable axial displacement of the tool through the instrument channel .1011 of the endoscope 1002 combined with, suitable tensioning of wire 1020 and with, suitable rotational orientation of the endoscope tool 1010 relative to the intestine. IS As seen in Pig. 20A, endoscope tool 1010 is principally located within the instrument channel; 10! i of endoscope 1002,. an# has balloon 1016 protruding; therefrom, while m a deflated state.

Fig. 20B shows the endoscope tool 1010 extending furtlier from the instrument channel 101.1, while Fig. 20 C shows the endoscope Idol 1010 having been rotated by 15 180 degrees mlaitye t® its orientation k fig. 2GB by suitable twisting of mtili-lusisi tube;: 1012, p indicated by arrow 1022.

Fig:, 20D shows besding of the forward end of the endoscope tool 1010 resulting from tensioning of wire ) 020, when the tool is in its Fig. 20C orientation having been pushed forward in. a conventional manner,: 20 Fig. 20E shows further progress of the endoscope; tool 1010 through the intestine resulting froth forward pushing: of the tool coupled with release the tension on the Wire 1020 by operation of tool |OsMosihg; control device. 1024.

Fig. 20F shows inflation of the balloon 101# by ojysMipn of the balloon infiatlon/deflation control ikerifep 1026, frr accordance with a preferred embodiment of 25 the invention, this taflafkm anchors the forward end of the endoscope tool 1010 to the intestine at the location of the balloon 1016.

Fig. 20G shows tensioning of the endoscope tool 1010 including;: the mull-lumen tube 1012 by pulling on die multi-.lumen tubs 1012,

Fig. 20.H shows fire endoscope 1002 having been pushed forward along file 30 xnuM-lmnen tube 1.012, using the multirimnen tube as a sort of guide wire. Endoscopes 1002 may be pushed fo rward in a conventional manner. Thereafter, as shown in Fig, ill, the balloon. 1016 may be deflated, 15 2015200767 16 Feb 2015

Further forward progress of the endoscope through the intestine, preferably to a position where the forward end df the instrument channel 1011 lies just behind the balloon 1016, similarly to the orientation shown in Fig. 20A, may be achieved by fepeathig seme or all of:¾ stops described hereinabove will refetesee: to lip. 20A -5 201, as required by the geometries encountered.

Reference is now made to Figs. 21 - 23B, which are respectively a simplified pictorial illustration of an endoscopy sy§i|m constructed sad operative ip accordance with another preferred embodiment of the present invention, and^respective simplified pictorial and sectional view illustrations pf an accessory constmeted and operative in 10 accordance with a preferred embodiment of the present kivention.

As sees in Figs 21 - 23B a co:n.vaiiiooai endoscopy system 1300. such as a consdle inehiimg a £V-16i video system center, a CLC-160 light sour®%in QEV-203 video monitor, and an OFF Hushing pump,ail commercially available from Olympus America Inc, of 2 Corporate Center ©five, MMville. NY 11747, 118¾ is being 15 employed. A conventional endoscope 13(1¾ which forms part of conventional endoscopy system 1300 may be employed, such as a CF-Q160AL vriep colonpssope which is commercially available from Glympus Amefiea Inc, of 2 Gorporate Center Drive, Melville, N Y 11747, USA. m accordance with a preferred embodiment of the invention, a peripheral balloon 1304 may he mounted onto endoscope 1302 as shown. 20 Preferably inflation and deflation of peripheral balloon 1304 may be provided bv a tube 1306 commumcaung with tire interior thereof.

An endoscope tool 1310, constructed pad operative in accordance with a preferred embodiment of the present invention extends through the instrument channel 1311 of the conventional endoscope 1302, Endoscope tool 1310 is characterized in that 25 it includes a mdii~.lum.en tube 1312 which includes at least a first hnfieh 1314 for •inflation and deflation of a balloon 1316 via an inSition aperture 1317., and a seedad lumen 13.18. Preferably the second lumen 1318 may accommodate a teididmig or compression wire 1320. Alternatively or additionally, the second hhhen 1318 may have other fenetionality. As a further dterhative, the mUti-lumen tube 1312 ifiining part of 30 1|ie endoscope tool IBIS may include more than two himehs, Preferably, the cross-sectional area of the multi-lumen tube 1312 is sufficiently less than, that of the 2015200767 16 Feb 2015 fostrumeni chmmel 1311. so as to allow supply of flililfor iMSuflation and draining of fluid therethrough.

It is appreciated that in accordan.ee with, a preferred embodiment of the present invention the etolDseup tool 1310 and die mmti-iumen tube 1312 are generally 5 ndbstantially mote: flexible tharr endoscope 13Q2 and an endoscope hfe© thereof it is appreciated that m aecordanee with a preferred embodimem of the preseat invention die balloon: 13=6 is generally srtetshaMe, urtdyaa he stretched to a diameter about 5-20 times larger than its diafelter when net toflaipd, In a specific embodiment, nsetiil for small IMestme endoscopy, the balloon dipgetsr when ihliy stretched is four 10 centimeters. Preferably, inflation of tire bailopp; 1316 to a diameter less than four centinieters may he achieved using relatively low pressure, such.as in the r&amp;tip of 10-50 mill bars Is another specific embodiment, useful for large intestine endoscopy, fee Bafioon diameter when fully #etdhg| is seven centimeters, Preferably, inflation of the balloon 1316 to a diameter less than seven ceniimewts may beaeideveil using relatively iS low'pressure, such as in the range erf li-SO militants,

It is appreciated that in accordance with a preferred embodiment of fee present' invention, useful for in viho inspection: erf a generally tubular body portfoa having g variable cross-sectional diahiMer, the expansion diameter grange of balloon 13 |;S is larger than the maximum crcss-scetional diameter of the generally tubukr body portion. 20 thereby engnrhrg mg%emenr of expanded balloon 13 lii with tie ifosrior stirface of tire generally tubular body portion, and aneloring of fen endoscope tool p 10 thereto. Preferably, balloon 1316 is a relatively soft, highly compliant bailees!, operative to at least partialp eonferm to the shape of the interior sppace pf fee generally tubular body portion who·;. iu engagement therewith. 25 It is appreciated that balloon Γ.Η6 may be formed of wg]]-known stretchable materials such as latex, flexible silicon, or highly flexible nylon. Ajtornai i vely, balloon 1316 may be formed of ::po].yuret|anp, which is less strstefeahi©.....and conforming than latex, flexible silicon, or highly flexible nylon. Preferably, the diameter of balloon 1316 is sufficient to ensure ligh t anchoring at any part of tlm generally tubular body portion. 30 As seen in Pigs. 21 - 23B, the endoscope tool 1310 preferably includes a tool positioning control device 1324 and a balloon inflation/deflMoaeontrel interface 1326; Additionally, there is preferably provided a peripheral balloon inflation/deflatioo. control 2015200767 16 Feb 2015 30 inter face 1328. which communicates with tube 1306 and goyemssinflaiion: and; delation of peripheral balloon 1304. It is appreciated that nuuu-hnnox· tube 1312 and the entire endoscope tool 1310 may·be inserted and removed via aseonveiilonal tool port:; 1330 on a conventional operator control 1332 which forms part cl' conventional endoscope $ 1302.

Refsrrsnco Is now mads to rigs, 24A, 24BS 24C. 240,2418, 24F, 24(3, 24H, 241, 24j, 24.1C and 241,, which are rixnpUAed illustrations of the endoscope igoI 1310 of Figs. 21 - II® in venous operative orientations. la; the Illustrated embodiment, desired; directional orientation or die forward end of the endoscope tool 1310 is obtained by 10 suitable axial displacement of the tool through the instrurnent channel 1311 of the v endoscope 1302 combined with suitable tensioning of wife; 1320 and whit suitable rotational orientation of tie endoscope tool 13:1:0 relative to the intestine.

As seen in Fig. 24.4., endoscope tool 1310.is principally located within the iiistrumaht; channel 1311 of endoscope 1302, and has balloon 1311 protruding if therefrom* 'While in; a deflated state, AS;seen, peripheral balloon 1304 is is a deflated state.

Fig, 24® shows endoscope tool 1310 being: principally located. within the instrument channel 1311 of epbseope 1302, and has balloon 13lo protixidisi; therefrom, while is a deflated state. As sap, peripheral balloon 1304 is m IP mfl^gd 20 state in. engagement with an Interior wall of the intestine, thereby anchoring the endoscope; :302 thereat.

Fig. 24C shows feu ©adpseope tool 1810 extending further from the ihstamsnt ohaonei 1311, while Fig. 24D shows fee endoscope tool 1310 having been rotated by 180 degrees relative to its orientation in Fig. 24C, by suitable ri®sfmg :bf muM4lhmen tube 1312, as indicated by arrow '1340.

Fig. 24E shows bending of the forward end of the eadombpe tool 1310 resulting from tensioning of wire 1320, when fee tool is in its Fig. 24D orientation having been pushed forward in a conventional mahheri

Fig. 24F shows further progress of the endoscope tool 1310 through the intestine resulting from forward pushing of fee toot coupled with release the tension on the wire 1320 by operation of tool positioning control device 1324. 38 2015200767 16 Feb 2015 10 20 23 F%. MQ shows inflation of tine balloon 1316 by Operation of Ae balloon iuflatiorFdcilation control iiibffaee 1326. In accordance w-ih a preferred, embodiment of tk; irwehflba, this inflation anirifois the forward m&amp;M the endoscope tool 1310 to the intesti ne at the location of the balloon 1316.

Fig. 24H shows tensioning of the endoscope tooi 1310 including the multi-lumen tube 1312 by pilling ott5tomulti«|imen tube 1312.

Fig. 241 shows deflation of peripheral balloon 1304. |||, 24J shows the endiscope 1302 having been pushed forward along the mull-liimsti tube 13:2, using the multi-lumen tube as a sort of guide wire. Endoscope 1302 may be pushed forward in a eonvemionai manner.

Fig. 24K: shows inflation of peripheral balloon: l:304 :iy|e pp|egemeut with ap · iruerior wall of the iniesfhe, thereby anciu -rjug the endoscope 1302 thereat.

Thereafter,, us shown in Fig. WL·, the balloon. 016 may be deflated.

Further forward progress of the endoscope through tho intestine, pUriieMbly to &amp; posi#|p where |he forward end of lie instkameht channel 1311 liis just behind the balloon: 1316, .similady to the oiientafioh shhwn in Fig,: 24B, may be achieved by repeating some or aii of the steps described hetsidabo ve bath reference to Figs, 24B - 24¾ as required by the geometries encountered.

It wiil be appreciated by persons skilled in the art drat the present invention is not limited to what has been particularly shown, and described hereinabove. Rather the scope Of the: present invention: includes both combmations and snbpombinaiioas of various features described hereinabove as well as modifications thereof which would occur to persons skilled in the art upon reading the foregoing specification and winch are not in the prior art. 39

Claims (25)

1. THE CLAIMS DEFINING THE INVENTION ARE AS FOLLOWS:

   1. An endoscope assembly for performing endoscopy in a tubular body portion having a variable cross-sectional diameter, the endoscope assembly comprising: an endoscope head having an imaging sensor at its forward end, extending along a longitudinal axis and having a first plurality of selectably radially extendible elements associated therewith at at least one first axial location therealong rearwardly of said imaging sensor and a second plurality of selectably radially extendible elements associated therewith at at least one second axial location therealong rearwardly of said imaging sensor, said first plurality of selectably radially extendible elements and said second plurality of selectably radially extendible elements being configured to engage an interior surface of said tubular body portion when radially extended, notwithstanding variations in said cross-sectional diameter of said tubular body portion; and an endoscope head controller being operative for controlling selectable extension of said first and second pluralities of selectably radially extendible elements for engaging said interior surface of said tubular body portion notwithstanding said variations in cross-sectional diameter and for selectable positioning of said endoscope head.
2. 2. An endoscope assembly according to claim 1 and wherein said endoscope head controller is operative for controlling selectable extension of said first and second pluralities of selectably radially extendible elements for selectable parallel off-center orientation of said endoscope head.
3. 3. An endoscope assembly according to either of claims 1 and 2 and wherein said endoscope head controller is operative for controlling selectable extension of said first and second pluralities of selectably radially extendible elements for selectable tilted orientation of said endoscope head.
4. 4. An endoscope assembly according to any of claims 1-3 and wherein at least one of said first and second pluralities of selectably radially extendible elements comprises a plurality of radially extendible elements distributed generally azimuthally about said endoscope head.
5. 5. An endoscope assembly according to any of claims 1-4 and wherein said endoscope head comprises a locomotive endoscope head.
6. 6. An endoscope assembly according to claim 5 and wherein said locomotive endoscope head comprises a main portion extending along a longitudinal axis and associated with said first plurality of selectably radially extendible elements, and a selectably positionable portion, selectably axially positionable along said main portion and associated with said second plurality of selectably radially extendible elements.
7. 7. An endoscope assembly according to any of claims 1-6 and wherein at least one of said first and second pluralities of selectably radially extendible elements comprises a plurality of selectably inflatable balloons.
8. 8. An endoscope assembly according to claim 7 and wherein at least one balloon of said plurality of selectably inflatable balloons comprises a stretchable balloon.
9. 9. An endoscope assembly according to any of claims 1-8 and also comprising an endoscope body associated with said endoscope head.
10. 10. An endoscope assembly according to claim 9 and wherein an instrument channel at least partially extends through said endoscope head and said endoscope body.
11. 11. An endoscope assembly according to any of claims 1-10 and wherein said endoscope head has a fixed length.
12. 12. An endoscope assembly according to any of claims 9-11 and wherein said endoscope body comprises a multi-lumen tube.
13. 13. An endoscope assembly according to any of claims 9 - 12, and wherein said endoscope body interfaces with said endoscope head controller.
14. 14. An endoscope assembly according to any of claims 1-13 and also comprising an endoscopy system to which said endoscope head controller is connectable.
15. 15. An endoscope assembly according to any of claims 12 - 14 and wherein said multi-lumen tube includes at least one lumen operative for at least one of: radially extendible element extension; positioning of said selectably positionable portion of said endoscope head; passage therethrough of at least one of an optical fiber and an electrical conductor bundle; and fluid communication.
16. 16. An endoscope assembly according to any of claims 12 - 15 and wherein said multi-lumen tube includes at least one lumen operative for each of: radially extendible element extension; positioning of said selectably positionable portion of said endoscope head; and passage therethrough of at least one of an optical fiber and an electrical conductor bundle.
17. 17. An endoscope assembly according to any of claims 6-16 and wherein said selectably positionable portion is slidably positionable with respect to said main portion.
18. 18. An endoscope assembly according to any of claims 1-17 and wherein said endoscope head comprises at least one light source and at least one imaging sensor.
19. 19. An endoscope assembly according to any of claims 1-18 and wherein said first plurality of selectably radially extendible elements comprises at least two independently selectably radially extendible elements.
20. 20. An endoscope assembly according to any of claims 1-19 and wherein said second plurality of selectably radially extendible elements comprises at least two independently selectably radially extendible elements.
21. 21. An endoscope assembly according to claims 19 and 20 and wherein said at least two independently selectably radially extendible elements of said second plurality of selectably radially extendible elements are azimuthally offset with respect to said at least two independently selectably radially extendible elements of said first plurality of selectably radially extendible elements.
22. 22. An endoscope assembly according to any of claims 1-21 and wherein said endoscope head controller provides locomotive functionality adapted to sequentially displace said endoscope head through a generally tubular body portion.
23. 23. An endoscope assembly according to claim 22 and wherein said locomotive functionality includes functionality providing the following sequential operations: extending at least part of said first plurality of selectably radially extendible elements, thereby anchoring said first plurality of selectably radially extendible elements to an interior surface of said generally tubular body portion; axially repositioning said selectably positionable portion and said second plurality of selectably radially extendible elements relative to said first plurality of selectably radially extendible elements; extending at least part of said second plurality of selectably radially extendible elements, thereby anchoring said second plurality of selectably radially extendible elements to an interior surface of said generally tubular body portion; retracting said first plurality of selectably radially extendible elements, thereby unanchoring said first plurality of selectably radially extendible elements from said interior surface of said generally tubular body portion; and axially repositioning said first plurality of selectably radially extendible elements relative to said selectably positionable portion and said second plurality of selectably radially extendible elements.
24. 24. An endoscope assembly according to claim 23 and wherein said first plurality of selectably radially extendible elements is arranged with respect to said generally tubular body portion to be generally forward of said second plurality of selectably radially extendible elements.
25. 25. An endoscope assembly according to claim 23 and wherein said second plurality of selectably radially extendible elements is arranged with respect to said generally tubular body portion to be generally forward of said first plurality of selectably radially extendible elements.