DE102010021463A1 - Endoscope for use in ureterorenoscopy, comprises endoscope handgrip, which has grip plate, on which slider is guided, where slider stands in operating connection with elastic control element - Google Patents

Abstract

The endoscope (1) comprises an endoscope handgrip (2), which has a grip plate (4), on which a slider (8) is guided. The slider stands in operating connection with an elastic control element, which is plunged into an inner space embraced by the grip plate. A distal end piece (12) is provided, which carries a catheter probe (10). The end piece is connected with the grip plate by compatible mounting portions.

Description

The invention relates to an endoscope according to the preamble of claim 1 and an endoscope handle for such an endoscope.

Such endoscope is sold for example by the applicant under the brand "PolyScope ^®" and is DE 10 2004 005 709 described. This controllable flexible endoscope has a multi-lumen catheter probe in which at least one optical channel for receiving an optical system, a working channel, for example for receiving a surgical tool, a flushing or suction channel and a control channel for receiving a control element are provided. This is for example a control wire or a guide rope that - as in the PolyScope ^® - is guided in an axially slidable within the catheter tube or also along the probe with an end portion engages the distal end of the flexible catheter probe and the other end to an attached to the catheter probe handle is fixed, by the actuation or movement of a distal probe portion can be bent over with a certain length or rotated about the probe longitudinal axis, so that this therapeutic endoscope can be relatively easily brought into an optimal operative position during a surgical procedure. Such endoscopes are used, for example, in ureteroendoscopy, but can also be used interdisciplinarily for various applications.

At the proximal end portion of the catheter probe, a hub is set, from which protrude the proximal outputs of the optical channel, the flushing channel, the working channel and the control channel / control lumen. From the latter is the handle-side end portion of the control wire before, is attached to the means of a clamping screw handle. When PolyScope ^® this handle has a the end portion of the control wire receiving body to the side, diametrically opposed to each other two annular handle parts for the ring and the middle finger are attached. At a proximal end portion of the base body, a further annular grip part for the thumb is centrally placed, so that the control wire can be actuated by moving the middle handle portion towards the two held by ring finger and middle finger grip parts to deflect the distal end of the probe. In this case, the control wire is biased in a basic position in which the rear side, provided for the thumb grip part is kept at a distance from the two diametrical grip parts for ring and middle finger. This comparatively much space engaging handle is attached to the widening towards the handle stroke. In this area, a protective tube for a 6000-pixel optics is connected, which consists for example of a lighting optics and observation optics.

With a 10,000-pixel optics, the illumination optics and the observation optics are each guided in their own lumen. For working and flushing channel are formed by a common lumen.

In the DE 10 2008 034 425 A1 the applicant is an improved handle for an endoscope explained, in which the handle is designed with a guide body and a control sleeve, which is in operative connection with an end portion of the control wire and is guided adjustably and fixed to the guide body. In this at least one elastic probe element, preferably an optic is added, so that upon rotation of the handle for rotational positioning of an attached to the handle elastic catheter probe the optics and the control are rotated together and thus can not collide.

All the solutions described above have become very successful on the market. A common disadvantage of this very good solution is to be seen in the fact that the handle is optimized with respect to a particular Endoskopart. To control the distal end of the catheter probe, in most cases the physician holds the endoscope in the hand so that the thumb rests from above on the setting sleeve and points towards the distal end of the catheter probe so that actuation of the adjusting sleeve is accomplished by stretching or tightening the thumb. In some applications, such as bronchoscopy, it is preferred by physicians that the thumb is aligned with the proximal end portion of the endoscope - however, such handling is relatively cumbersome with the types of endoscopes described above.

In contrast, the invention has for its object to provide an endoscope that is easily adaptable to the different therapy requirements. A further object of the invention is to provide an endoscope handle suitable for such an endoscope.

This object is achieved with respect to the endoscope by the feature combination of claim 1 and with respect to the endoscope handle on the features of the independent claim 12.

According to the invention, the endoscope is designed with an endoscope handle which has a grip on which a slider is guided for controlling a catheter probe. This slider is operatively connected to an elastic control element which engages around the handle shell Interior dips. The grip is connected on the one hand to a distal end piece which carries the catheter probe, and on the other hand to a proximal end piece on which at least one connection for optics, a tool or the like is formed, the end pieces being detachable from the grip shell via mutually compatible attachment portions are connected. D. bh. The handle shell is formed symmetrically with respect to the attachment of the two end pieces, so that the construction is very simple and beyond the tooling costs in the manufacture of the handle shell due to the identical fastening elements are low. Such a grip with "normalized" attachment sections can thus be used as a basic building block for different Endoskoptypen.

In one embodiment, the handle shell is mounted so that the slider is displaceable from a position adjacent to the distal end piece towards the proximal end piece - this variant corresponds to the functionality of the Polyscope.

In an alternative embodiment, the handle is mounted rotated 180 ° such that the slider is located adjacent the proximal end and is displaced to control the catheter probe toward the distal end - such an application is for example in bronchoscopy.

In the latter case, the control can be deflected by a deflection roller to transmit the control movement of the control sleeve in the correct orientation to the control.

In such a solution, the structure of the endoscope handle can be simplified if the deflection roller is designed replaceable and then used in the latter application.

The endoscope or endoscope handle according to the invention is preferably designed with a proximal end piece on which connections for optics, light and / or a flushing connection are made.

The distal end piece may likewise have a connection, preferably a working connection.

In one embodiment, the optic is embodied as a chip optic which extends through the axial connection.

This chip optics is firmly installed in a particularly inexpensive manufactured endoscope in the catheter probe, both being designed as disposable.

The operation of the slider is particularly simple when it is moved to control in the longitudinal direction and twisted to set.

In one embodiment, a second handle is provided with two sliders through which two controls can be actuated so that the catheter probe can be controlled in virtually any direction.

The endoscope handle according to the present invention, as described above, has a handle cup detachably attached to a distal catheter-side end portion and a proximal terminal-side end portion, the respective attachment portions being compatible with each other.

Preferred embodiments of the invention are explained in more detail below with reference to schematic drawings. Show it:

1 a first embodiment of an endoscope according to the invention with an endoscope handle according to the invention in an embodiment, as used for example in ureteroendoscopy (Polyscope ^® );

2 shows a simplified longitudinal section through the endoscope 1 ;

3 a three-dimensional representation of the endoscope of the 1 and 2 with open handle shell;

4 the endoscope according to 1 with 180 ° rotated grip for use in bronchoscopy and

5 two further embodiments of an endoscope according to the invention.

1 shows a three-dimensional representation of an endoscope, whose application area corresponds to that of the known Polyscope ^® the Applicant. This endoscope 1 has a handle 2 with a handle shell 4 and an adjustable slider 8th over which a distal end portion of a multi-lumen elastic catheter probe 10 is deflectable. This is at a distal tail 12 set, with an approximately Y-shaped work connection 14 for attaching a tool, such as a biopsy forceps or a basket or a guide wire is executed. At the proximal end of the handle 4 is a proximal tail 16 attached to which an axial optical connection 18 , a light connection 20 and a Y-shaped flushing connection 22 are executed.

However, the invention is by no means limited to this number and assignment of connections, in principle, different connection geometries and assignments can be selected.

The control of the distal catheter probe end section takes place by adjusting the slider 8th in the direction of the arrow, which in its desired axial position by rotation in the indicated fixing grooves 24 can be locked. Up to this point, the structure corresponds in principle to that, as in the aforementioned DE 10 2008 034 425 A1 is explained.

The handle shell 4 is composed in the illustrated embodiment of two shell halves, of which in the illustration according to 2 the top is removed, so that only one shell half 26 is visible. The other shell half has the same structure in principle.

On each shell half are alternately centering pins 28 and centering receivers 30 attached, over which the two shell halves can be connected to each other and relatively positioned. Within the enclosed by the two shell halves approximately cylindrical interior 32 then extend light guide 34 the illumination optics 36 passing through the light port 20 through and outside the endoscope handle 2 provided with a protective tube.

Through the axial optical connection 18 An observation optics is introduced therethrough, which in the illustrated exemplary embodiment is in the form of a chip optic having an optical chip which is arranged on the distal end section of the catheter probe and a comparatively thin signal cable 38 is executed, which is coated shear-stiff, for example, over a polyimide spiral. This cable 38 extends through the axial optical port 18 therethrough.

To the flushing connection 22 is inside the handle shell 4 a hose 48 connected, through which the rinsing liquid is guided into the flushing lumen of the catheter probe. The at the distal end piece 12 trained work connection 14 opens in the illustrated embodiment in the same lumen into which opens the flushing port. In principle, a separate lumen can also be provided for the flushing connection. In the illustrated embodiment, the irrigation fluid from the distal end 12 over a Kapton hose 40 led to the catheter probe end section. As stated above, the optics is designed as a chip optic, wherein the actual chip is accommodated in a sleeve, which is covered to the outside by a disk. The catheter probe 10 and the chip are executed in a variant of the invention as disposable and are disposed of after use.

The relative positioning of the optic with respect to the catheter probe tip can be adjusted, for example, via an optic shifter of known design (see homepage of the applicant), but this variant is only necessary for a reusable optic, since with an optic integrated into the catheter probe, this presetting is made at the factory and then subvertible ,

Besides the superior optical performance, another big advantage of a chip optic is that the signal cable 38 is very thin and elastic, so that it exerts no load on the Kathersonde and this is therefore not stiffened.

According to 2 encompasses the slide 8th the handle shell. At its inner peripheral cross section is diametrically a connecting bolt 42 held, which has a longitudinal groove 44 the handle shell 4 interspersed and on which a control cable 46 engages, allowing the sliding movement of the slider towards the distal end piece 12 is transferred to the catheter probe, so that the Kathetersondenendabschnitt is augelenkt. For fixing the position of the slider 8th in the predetermined control position this is rotated, so that the connecting bolt 42 in one of the adjustment grooves lying behind each other in the adjustment direction 24 intervenes.

3 shows a three-dimensional representation of the endoscope 1 with removed upper shell half. You can see the light guides 34 the lighting optics, the cable 38 the optics, such as the chip optics as well as the flushing connection 22 connected hose 48 , 3 also clearly shows the two-part design of the slider 8th , which is formed of two substantially identical slide halves. These two slide halves are diametrically opposed from the connecting bolt 42 interspersed, where the control wire 46 is attached.

In the transition area between the handle shell 4 to the distal end piece 12 This is with a circular segment-shaped centering 50 executed, through which the light guides 34 , the control wire 46 and the cable 38 extend the optics. The hose 48 for the detergent goes in this embodiment laterally at a flattening 52 the centering sleeve over.

This centering sleeve 50 is in the illustration according to 3 with two radially projecting centering protrusions 54 formed, either integral with the sleeve 50 or are designed as a removable insert and are therefore interchangeable. The two handles 26 surround this centering sleeve 50 flush and lie with her face on the the centering sleeve 50 encompassing annular end face 56 of the tail 12 at.

The training of the handles 26 at the proximal end 16 is corresponding, so the handle shell 4 with the slider 8th both in the illustrated configuration and rotated by 180 ° (see following versions 4 ) is mountable. This compatibility of the connections makes it possible in a very simple way by simply replacing end pieces 12 . 16 and / or handles 4 to adapt the endoscope to different applications. Ie. The invention provides a modular endoscope that is adaptable to replacement of individual components so that it is no longer necessary to provide a variety of different endoscopes.

The configuration described above is suitable for endoscopy techniques in which the physician manipulates the endoscope 2 so grips that the thumb is aligned towards the catheter probe, allowing the control by moving the slider 8th towards the proximal end piece 16 he follows.

In bronchioscopy, on the other hand, the handle becomes 2 by the doctor so that the thumb is toward the proximal tail 16 shows. The control with the endoscope described above is then only awkward in this case by grasping or the like feasible. In order to overcome this serious disadvantage, the endoscope is the handle shell according to the invention 2 according to 4 simply twisted 180 ° and then the two end pieces 12 . 16 set - this is due to the compatibility of the mounting portions between the handle and end pieces readily possible. Ie. In this case, then sits the slide 8th adjacent to the proximal end piece 16 and is used to drive toward the distal end 12 postponed.

Because the control wire 46 However, is not designed to be rigid, is used to transmit the control movement of the slider 8th on the catheter probe 10 in the handle 4 a pulley 58 arranged. In the detail F is this pulley 58 shown in plan view. It can be seen that this is carried out in several stages, with the two smaller diameter running end sections 60 62 in appropriate recordings 64 the upper and lower shell half 26 are included. The control wire 46 is then over the pulley 58 deflected and back to the connecting bolt 42 guided and fixed there, so that the sliding movement of the slider 8th is transferred in the desired manner to the Kathetersondenende. Ie. by twisting the handle 2 180 ° and by inserting the pulley 58 in the grip 2 The endoscope can, so to speak, be converted in no time at all to an endoscope suitable for bronchioscopy. As shown in detail F, the shell halves are 26 symmetrically designed, so that accordingly two shots 64 for the respective end section 60 . 62 the pulley 58 are provided and according to only one mold for both shell halves 26 must be provided.

The 5 shows further variants of the endoscope according to the invention.

In the embodiment in 5 on the left is an endoscope with a single axial flush port 28 at the tail 16 and a single Y work connection 14 at the distal end 12 executed - the function corresponds to the endoscope offered by the applicant under the product name Vascoath ^® , the rear output can be used for example as a connection to a contrast medium pump.

The endoscope handle 2 is in this embodiment with a slider 8th provided adjacent to the distal end 12 is arranged.

In 5 on the right is a variant of this embodiment is shown, in which the flexible Kathetersondenendabschnitt two spaced-apart slider 8a . 8b can be variably deflected. The adjustment and the locking of the slide 8a . 8b corresponds to the above-described embodiments, so that further explanations are unnecessary. In such a variant, the rotation of the handle shell 4 not possible at 180 ° or only with comparatively great effort. However, the compatibility of the fasteners allows a simple way to replace the handle shell for the design with two sliders against a handle shell with a single slider, which can then be arranged in any orientation (bronchioscope / Polyscope).

Disclosed are an endoscope and provided for such an endoscope endoscope handle. This has a handle shell which is connected to a distal and a proximal end piece. The fastening means between the grip and the two end pieces are designed to be compatible.

LIST OF REFERENCE NUMBERS

1

endoscope

2

Endoscope handle

4

grip

8th

pusher

10

catheter probe

12

distal end piece

14

working port

16

proximal tail

18

optic connection

20

light connection

22

Flushing connection

24

fixing groove

26

shell half

28

spigot

30

centering

32

inner space

34

optical fiber

36

illumination optics

38

electric wire

40

Kaptonschlauch

42

shear studs

44

longitudinal groove

46

control wire

48

tube

50

centering

52

flattening

54

centering

56

Annular face

58

idler pulley

60

end

62

end

64

admission

QUOTES INCLUDE IN THE DESCRIPTION

This list of the documents listed by the applicant has been generated automatically and is included solely for the better information of the reader. The list is not part of the German patent or utility model application. The DPMA assumes no liability for any errors or omissions.

Cited patent literature

• DE 102004005709 [0002]
• DE 102008034425 A1 [0005, 0029]

Claims (12)

Endoscope with an endoscope handle ( 2 ), which has a handle shell ( 4 ), on which a slider ( 8th ) operatively connected to an elastic control element ( 46 ), which is in one of the handle shell ( 4 ) embraced interior ( 32 ) and for deflecting a distal end portion of a to the endoscope handle ( 2 ), designed with multiple lumens catheter probe ( 10 ) is formed, and with a distal end piece ( 12 ), which is the catheter probe ( 10 ) and a proximal end piece ( 16 ), on which at least one connection for an optic, a tool or the like is formed, wherein the end pieces ( 12 . 16 ) via compatible mounting sections interchangeable with the handle shell ( 4 ) are connected. Endoscope according to claim 1, wherein the slider ( 8th ) is adapted to be moved by a thumb of the operator from a position adjacent to the distal end piece ( 12 ) towards the proximal end piece ( 16 ) is displaceable. Endoscope according to claim 2, wherein the handle shell ( 4 ) rotated by 180 ° with the end pieces ( 12 . 16 ) is connectable, so that then the slider ( 8th ) adjacent to the proximal end piece ( 16 ) and towards the distal end piece ( 12 ) is displaceable. Endoscope according to claim 3, with a deflection roller ( 58 ) in the handle ( 4 ) is received and over which the end portion of the control ( 46 ) is deflected. Endoscope according to claim 4, wherein the deflection roller ( 58 ) replaceable in the handle shell ( 4 ) is arranged. Endoscope according to one of the preceding claims, wherein the proximal end piece ( 16 ) Has connections for an observation optics, a lighting optics and a flushing connection. Endoscope according to claim 6, wherein the distal end piece ( 12 ) a work connection ( 14 ) Has. An endoscope according to claim 6 or 7, wherein the observation optics is a chip optic having an axial connection ( 18 ) assigned. Endoscope according to one of the preceding claims, wherein the slide ( 8th ) is determined by twisting. Endoscope according to one of the preceding claims, having a handle shell ( 4 ) for two slides ( 8a . 8b ), each associated with a control and axially spaced from each other on the handle shell ( 4 ) are guided. Endoscope handle for an endoscope, in particular according to one of the preceding claims, with a grip shell ( 4 ), on which releasably a distal, catheter-side end piece ( 12 ) and a proximal, terminal-side end piece ( 16 ), wherein the attachment portions are each made compatible. Endoscope handle according to claim 11, wherein in the handle shell ( 4 ) a pulley ( 58 ) for a control ( 46 ) is interchangeable recorded.

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