DE102017103817A1 - Endoscope with a pivot lever with at least one camera and a distal working channel output - Google Patents

Abstract

The invention relates to an endoscope having an endoscope head (1) with a working channel (11) for guiding microtools, and a pivoting lever (2) movably arranged on the endoscope head (1) and capable of moving through the working channel (11). to swing the advanced micro-tool. The pivot lever (2) has at least one camera (18) and a distal working channel exit (111).

Description

The present invention relates to an endoscope. More particularly, the invention relates to an endoscope having an endoscope head with a working channel for guiding micro tools, and a pivot lever movably mounted on the endoscope head. The pivot lever is capable of pivoting a micro-tool advanced through the working channel.

For example, a known from the prior art Albarranhebel such a pivot lever.

An albarran lever can be used, for example, in a duodenoscope, ie an endoscope for examining e.g. the esophagus or the duodenum, the bile duct, bile, pancreatic duct, pancreas, etc. are applied. At the duodenoscope, the albarran lever is arranged at the outlet of the working channel, which allows a targeted deflection of the tools by pivoting, which are pushed through the working channel.

With the help of the duodenoscope, it is possible to enter the duodenum through the esophagus, the stomach and the stomach outlet.

It is the object of the present invention to provide an improved and more versatile endoscope having a pivot lever that can pivot a micro-tool advanced through the working channel.

This object is achieved by an endoscope with the features of claim 1.

Advantageous developments are the subject of the dependent claims.

In the invention, an endoscope has an endoscope head with a working channel for guiding microtools, and a pivoting lever movably mounted on the endoscope head, which is capable of pivoting a micro-tool advanced through the working channel. The pivot lever has at least one camera and a distal working channel output.

In such an endoscope, the camera and the distal working channel output can pivot together. Thus, a micro-tool advanced through the working channel is always in the field of view of the camera.

The endoscope head can be arranged distally of a bending section. Thus, the pivot lever provides an additional deflection possibility to the bending section.

The pivot lever may have a lighting device. The illumination device can thus always be pivoted together with the camera and the distal working channel output. Optimal illumination of the recorded by the camera work of the micro tool is possible.

Alternatively, the endoscope head may comprise an endoscope head body on which the pivot lever is pivotally mounted, wherein the endoscope head body has a lighting device. Here, the illumination device can be arranged separately from the camera and the distal working channel output, with which the pivoting lever can be made smaller.

The pivot lever may be pivotable to a first lateral side with the camera and the distal working channel exit facing in a first lateral direction. In addition, the pivot lever may be pivotable to a second lateral side opposite the first lateral side, the camera and the distal working channel exit facing in a second lateral direction.

The pivoting lever may be pivotable to the distal side with the camera and the distal working channel exit pointing in the distal direction. In this case, insertion of the endoscope can be assisted, since the distal region into which the endoscope is advanced is made visible.

At the endoscope head can be arranged a hinge construction about which the pivot lever is pivotable. Such a hinge construction allows pivoting of the pivot lever in a small space.

The articulated construction can have a cable pulley on which a pull cable which can be actuated from the proximal side of the endoscope rotates. Such a hinge construction requires very little space and still allows pivoting of the pivot lever.

The pivoting lever may have a working portion on which at least the camera and the distal working channel exit are arranged, wherein the endoscope head is surrounded by an envelope between the working portion of the pivoting lever and a proximal portion of the endoscope head. The pivoting range of the pivot lever is protected by the enclosure. Germs or contaminants do not penetrate into the swiveling range of the swivel lever. The wrapper can waterproof seal.

The cladding can be elastic.

The endoscope head has no albarran lever. The task of the Albarran lever is taken over by the swivel lever.

The endoscope can be a rigid endoscope, wherein an endoscope tube is located in the proximal direction of the endoscope head in the proximal direction.

The endoscope may be a flexible endoscope, wherein the proximal portion of the endoscope head is in the proximal direction of the bending portion, which is controllable from the proximal side of the endoscope.

In the endoscope head, a clamping element can be arranged such that in a lateral end position of the pivoting lever a clamping action exerts on the working channel in order to clamp a micro-tool advanced in the working channel. Such a clamping element may be a projection in the endoscope head, which presses in the lateral end position of the pivot lever on the working channel. Such a clamping element may also be a Sollfaltstelle in an outer peripheral region of the working channel, which advances in the lateral end position of the pivot lever in the working channel targeted inward. As a result, an advanced micro-tool can be clamped by the projection or the Sollfaltstelle. This improves the power transmission when inserting the micro-tool e.g. into the bile duct.

The endoscope may be a duodenoscope, a colonoscope, a gastroscope or a bronchoscope. The endoscope can also be any other endoscope.

The above-explained aspects of the present invention can be suitably combined.

list of figures

• 1 shows a schematic perspective view of a distal portion of an endoscope of a first embodiment of the present invention, in which a pivot lever is in a neutral position, with a sheath is removed.
• 2 shows a schematic perspective view of the endoscope of 1 with a serving.
• 3 shows a schematic perspective view of the distal portion of the endoscope of the first embodiment, in which a pivot lever is in a pivoted position to a first side, wherein a sheath is removed.
• 4 shows a schematic perspective view of the endoscope in the position of 3 with a serving.
• 5 shows a schematic perspective view of the distal portion of the endoscope of the first embodiment, in which a pivot lever is in a pivoted to a second side position, wherein a sheath is removed.
• 6 shows a schematic perspective view of the endoscope in the position of 5 with a serving.

Hereinafter, the present invention will be described in detail with reference to the drawings by way of embodiments.

First embodiment

The following is with reference to the 1 to 6 A first embodiment of the present invention is described.

1 shows a schematic perspective view of a distal portion of an endoscope of the first embodiment of the present invention. The endoscope has an elongated endoscope head 1 on. The longitudinal direction of the endoscope head 1 extends in the direction of extent or axial direction of the endoscope.

The endoscope head 1 is thus part of the endoscope according to the invention. This endoscope can be designed as a flexible endoscope for the gastrointestinal tract. The endoscope has an operating part and an insertion section. The operating part is located on the proximal side and the insertion section is located on the distal side of the endoscope. The control panel (not shown in the drawings) includes an operating lever (such as a joystick or a simple lever rod) for actuating a pivoting lever described in more detail below 2 , a working channel inlet and a knob for bending a bending portion (angling portion) of the endoscope. The operating part is connected to a video processor, a light source device and a display device, and the like.

The insertion section is a long tube-like element. The proximal end of the insertion section is connected to the control panel. The insertion section has a flexible portion and the bending portion in this order from the operating part. The flexible section is elastic. The bending portion is angled in response to an actuation of the adjusting knob. At the distal End of the bending portion, a rigid end piece portion is formed. The rigid end piece section forms the so-called endoscope head 1 ,

The endoscope head according to the invention 1 out 1 has the pivot lever 2 and an endoscope head body 3 on.

The endoscope head body 3 has on its proximal side a ring element 4 , The ring element 4 forms the proximal end of the endoscope head 1 , The ring element 4 has a ring portion extending in the proximal direction with an outer peripheral surface as a fastening surface 41 for a distal end of a hose portion of the bending portion. The ring element 4 also has a distally extending annular portion with an outer peripheral surface as a mounting surface 42 for a proximal end of a wrapper explained below 6 , The serving 6 is in 2 shown, but in 1 has been omitted for reasons of clarity.

Through the ring element 4 Different channels extend from the proximal portion of the endoscope to the distal portion of the endoscope head 1 more connected. In particular, extend through the ring member 4 in the longitudinal direction of the endoscope head 1 two cable ducts 50 , A designed as a hose working channel element 110 , a water hose 140 and an air hose 150. Other hoses and channels may pass through the ring member 4 extend. Cable for supplying a lighting device 17 , a camera 18 and a nozzle 19 etc. described below and the like are also provided by the ring member 4 led, but not shown here.

At its proximal side is the endoscope head body 3 via the cables, not shown, or wirelessly connected to a control unit, not shown. The operating unit serves to the endoscope head 1 to control.

Through the two cable channels 50 extends a pull rope 5 for actuating the pivot lever described below 2 ,

The endoscope head body 3 has a working channel 11 located inside the working channel element 110 is formed, and the cable ducts 50 on, each along the longitudinal direction of the endoscope head body 3 extend. The working channel 11 performs micro tools for examining, for example, the esophagus or the duodenum, the bile duct, the bile, the pancreatic duct, the pancreas, etc. The working channel element 110 has a working channel exit at the distal side as a distal opening 111 , On the ring element 4 is a working channel section 112 at the endoscope head entrance in 1 shown.

The endoscope head body 3 is provided at its distal side with a through hole or blind hole, which is perpendicular to the longitudinal direction of the endoscope head 1 and is provided with at least one bearing on which a pivot shaft 21 is rotatably mounted. The pivot shaft 21 thus extends perpendicular to the longitudinal direction of the endoscope head 1 ,

At the pivot shaft 21 is a pulley 22 arranged with the pivot shaft 21 firmly connected or in one piece. Thus, the pulley rotates 22 when the pivot shaft 21 rotates.

The pulley 22 has on its outer circumference a groove section in which the pull rope 5 is arranged. In particular, the pull rope extends 5 from the proximal side (operating unit) of the endoscope to the pulley 5 , runs on the pulley 5 and extends back to the proximal side (control unit) of the endoscope. The following is from the proximal side (operating unit) of the endoscope to the pulley 22 extending section of the pull rope 5 as the first traction cable section 5A referred to, and different from the pulley 22 to the proximal side (control unit) of the endoscope extending portion of the pull rope 5 is as a second Zugseilabschnitt 5B designated. In Fig. 1, the first traction cable section 5A passes through an upper cable channel 50 , and the second Zugseilabschnitt 5B runs through a lower cable channel 50 , In the area of the pulley 22 has the pull rope 5 a Zugseilabschnitt 5C on, on the outer circumference of the pulley 22 is attached. The pull rope section 5C can on the outer circumference of the pulley 22 be clamped, glued or otherwise secured.

The pull rope section 5C is thus between the first Zugseilabschnitt 5A and the second traction cable section 5B arranged.

With the pulley 22 is the pivot lever 2 integrally connected. Thus, the pivot lever pivots 2 integral with the pivot shaft 21 ,

The swivel lever 2 forms the distal end of the endoscope head 1 , The swivel lever 2 has a flat round disc. The outer surface of the flat round disc is defined as a working area. At this workspace is the output 111 of the working channel 11 and the camera 18 arranged. Thus, the working channel element extend 110 and the camera cable to the work area of the pivoting lever 2 , At the work area of the swivel lever 2 forms the working channel 11 the distal opening 111 , By installation at the work area form the output 111 of the working channel 11 and the camera 18 thus a jointly pivoting component.

By pivoting the pivot lever 2 become the camera 18 and the distal output 111 of the working channel 11 pivoted, causing the lateral alignment of the working channel 11 guided micro tools (eg a guide wire or a biopsy forceps) can be changed. In other words, the pivot lever changes 2 the alignment angle of the micro tools passing through the working channel 11 parallel to the axis of the endoscope head 1 be pushed. The orientation of the micro-tools is then changed by the pivoting lever 2 to a lateral direction, the micro-tools are then laterally from the endoscope head 1 before, for example, to be pushed into a bile duct.

Through the camera 18 the laterally advanced micro-tool can be observed and recorded.

Furthermore, at the work area of the pivot lever 2 a lighting device 17 is provided, which in 1 exemplified as three LEDs.

Furthermore, at the work area of the pivot lever 2 a water injection hole 16 and an air / water spray nozzle 19 intended. The air / water spray nozzle 19 may be used to clean a lens of the camera 18 be used.

Like this in 2 is shown at the endoscope head 1 the serving 6 intended. The serving 6 extends from the work area of the pivot lever 2 to the mounting surface 42 on the ring element 4 , More specifically, the wrapper 6 is at the outer edge of the flat round disc, which is the working area of the pivoting lever 2 forms, and at the mounting surface 42 eg by gluing or welding.

The serving 6 surrounds the endoscope head 1 with the exception of the working area of the pivoting lever 2 where the exit 111 of the working channel 11 and the camera 18 are arranged.

The serving 6 is made of an elastic material. For example, the wrapper 6 be formed of rubber or silicone.

The serving 6 serves the hermetically sealed seal on the endoscope head 1 , It is easy to clean.

The serving 6 has areas where they pivot when pivoting the lever 2 can be particularly inflected or folded, folding areas 61 and 62 , At the folding areas 61 and 62 can the serving 6 be strengthened.

Function of the invention

The swivel lever 2 is relative to the endoscope head body 3 of the endoscope head 1 pivotable.

The 1 and 2 show a rest position or neutral position. The rest position is a straight position of the pivot lever 2 , In the rest position, neither the first Zugseilabschnitt 5A nor the second Zugseilabschnitt 5B drawn. Thus, the pivot lever 2 not panned. The resting position can be used to introduce the endoscope. In the rest position of the pivot lever forms 2 and the entire distal region of the endoscope head 1 a minimum cross-sectional area and thus minimal resistance during insertion of the endoscope.

For example, when the endoscope is inserted, the first pull rope section becomes 5A drawn. This pivots the pivot lever 2 to the first lateral side, as in the 3 and 4 is shown. Thus, the pivot lever 2 in an upwardly angled position. The working area of the swing lever 2 and thus the output 111 of the working channel 11 and the camera 18 and the lighting device 17 point aside. More precisely, the output 111 of the working channel 11 and the camera 18 and the lighting device 17 directed in one direction at an acute angle to the longitudinal extent of the endoscope head 1 forms.

In this position, when the endoscope head 1 is located in the duodenum, the bile duct is well illuminated, viewed and recorded, and micro-tools can be well inserted into the bile duct.

If the second Zugseilabschnitt 5B is pulled, pivots the pivot lever 2 to the second lateral side, as shown in the 5 and 6 is shown. Thus, the pivot lever 2 in a downwardly angled position. The working area of the swing lever 2 and thus the output 111 of the working channel 11 and the camera 18 and the lighting device 17 point in the distal direction.

If the second Zugseilabschnitt 5B is pulled further, the pivoting lever pivots 2 even further to the second lateral side.

The swivel angle or deflection angle of the pivot lever 2 can be chosen so that the working range of the pivot lever 2 can be swiveled more than 90 ° in both lateral directions. Preferably, the working range of the pivot lever 2 by more than 120 ° (30 ° beyond the lateral position) in both lateral directions are pivoted.

Advantages of the invention

A duodenoscope often has a lateral (lateral) optic (illumination device and camera). This can complicate the insertion and advancement through the esophagus, since no "forward" viewing is readily possible. Only in the stomach or in the duodenum is there sufficient room to bend the distal end of the duodenoscope about 90 ° in order to be able to look ahead.

In the invention, an endoscope can have a position of the pivoting lever 2 occupy, which facilitates a "forward" viewing.

For the function as a duodenoscope, in particular the inventively made upwardly directed position is advantageous in the 3 and 4 is shown. In the ERCP application, instruments must be inserted into the slightly posterior bile duct / pancreatic duct. Here, the slightly backward position of the working channel outlet and the camera are of great advantage. This position brings an optimal alignment of the camera image with the instrument.

In the conventional duodenoscope, an albaran lever takes over the lateral / backward deflection of the tool exiting the working channel (e.g., guidewire or biopsy forceps). Whether the instrument in the camera image is optimal to see is not always guaranteed.

The invention provides an additional Abwinkelungsmöglichkeit to the known bending section. Furthermore, this additional Abwinkelungsmöglichkeit is located distally in front of the bending section.

Through the use as a pivoting lever, this additional Abwinkelungsmöglichkeit allow a very small space pivoting.

The purpose of the additional Abwinkelungsmöglichkeit is not primarily the control of the endoscope when introduced into the body but the change in the position of the field of view and working relative to the longitudinal extent of the endoscope. This is basically possible with a bending section, but not in such a small space.

In the invention, the conventional Albarranhebel by the pivot lever according to the invention 2 replaced with the aim of lateral to retrograde bending of an instrument. The camera and lighting position remains connected to the direction of the working channel output, as the output 111 of the working channel 11 and the camera 18 thus form a jointly pivotal component. In a conventional albarran lever, the position of the instrument changes relative to the viewing direction.

Other alternatives

In the embodiment, the endoscope head 1 two cable ducts 50 , Alternatively, only one cable channel 50 be provided, and a construction can be selected, in which the cable via a lever mechanism and possibly a translation mechanism, a pivoting of the pivot lever 2 causes.

In the embodiment, the Zugseilabschnitt 5C on the outer circumference of the pulley 22 attached. Alternatively, the Zugseilabschnitt 5C on the outer circumference of the pulley 22 be led curiously.

In the embodiment forms the pulley 22 a construction that allows the pivot lever 2 at the endoscope head 1 is pivotable. The invention is not limited thereto. Another design that allows the pivoting lever 2 at the endoscope head 1 can be swiveled, can be chosen. For example, such a construction may consist of lever arms on which the traction cables engage, in order to pivot the pivoting lever 2 at the endoscope head 1 to effect. Furthermore, a gear-rack combination can be used to the pivot lever 2 at the endoscope head 1 to pan.

In the embodiment, the working range of the pivot lever 2 formed as a flat round disk. The working area of the swing lever 2 can have any shape. The working area of the swing lever 2 does not have to be flat, it can be arched outwards.

In the exemplary embodiment are in the rest position (not pivoted position in 1 and 2 ) the exit 111 of the working channel 11 and the camera 18 directed sideways. Alternatively, in the rest position of the output 111 of the working channel 11 and the camera 18 forward, ie directed in the distal direction. In this alternative, the rest position can be used particularly advantageously for introducing the endoscope, since the distal region can be illuminated and viewed in front of the endoscope.

In the embodiment, the lighting device 17 at the work area of the swivel lever 2 intended. Alternatively, the lighting device 17 proximal to the pivot lever 2 be arranged so that it does not swing. For example, the lighting device 17 on the ring element 4 be arranged.

In an alternative, a clamping element may be arranged in the endoscope head that in a lateral end position of the pivoting lever 2 a clamping action on the working channel 11 exercises to one in the working channel 11 to clamp the advanced microtool. Such a clamping element may be a built-in in the endoscope head projection, which in the lateral end position of the pivot lever 2 on the working channel element 110 suppressed. For example, such a projection may be from the ring element 4 in the distal direction so to the outer periphery of the working channel element 110 extend that projection in the position of 1 the working channel element 110 not pressing, but in the position of 3 the working channel element 110 pushing inwards. Such a clamping element can also be a Sollfaltstelle in an outer peripheral region of the working channel 11 be in the lateral end position of the pivot lever 2 specifically advances in the working channel 11 inward, ie collapses inward. The folded-in material of the Sollfaltstelle narrows the inner cross-section of the working channel 11 so that a pinching or squeezing action is applied to an advanced micro-tool. As a result, the working channel can be kinked or squeezed in the lateral end position by suitable elements. A resiliently elastic working channel tube can perform this clamping movement repeatedly without having to give up the desired hermetic seal of the system at any point. As a result, an advanced micro-tool can be clamped by the projection or the Sollfaltstelle. This serves for better power transmission during insertion of the micro-tool, for example into the bile duct.

The invention can also be applied to a rigid endoscope. Instead of an endoscope tube with a bending section is proximal to the endoscope head according to the invention 1 an endoscope rod (endoscope tube) arranged.

The explained alternatives can be suitably combined.

The invention is applicable to a duodenoscope, a gastroscope, a colonoscope or a similar endoscope. The principle of the invention can also be applied to an ultrasound endoscope and to any other type of endoscope.

LIST OF REFERENCE NUMBERS

1

endoscope head

2

pivoting lever

3

Endoscope head body

4

ring element

5

rope

5A

first traction cable section

5B

second traction cable section

5C

fixed pull rope section

6

wrapping

11

working channel

12

optic extension

16

Water injection hole

17

lighting device

18

camera

19

Air / water spray nozzle

21

pivot shaft

22

pulley

41

Mounting surface for hose section of the bending section

42

Mounting surface for cladding

50

Zugseilkanal

61

fold area

62

fold area

110

Working channel element (hose)

111

distal opening of the working channel

112

Working channel section at the endoscope head entrance

140

water hose

150

air hose

Claims (14)

Endoscope with an endoscope head (1) having a working channel (11) for guiding microtools, and a pivot lever (2) movably mounted on the endoscope head (1) and capable of pivoting a micro-tool advanced through the working channel (11); wherein the pivot lever (2) has at least one camera (18) and a distal working channel exit (111). Endoscope according to Claim 1 wherein the endoscope head (1) is arranged distally of a bending section. Endoscope according to one of Claims 1 or 2 , wherein the pivot lever (2) has a lighting device. Endoscope according to one of Claims 1 or 2 wherein the endoscope head (1) comprises an endoscope head body (3) on which the pivot lever (2) is pivotally mounted, and the endoscope head body (3) has a lighting device. Endoscope according to one of Claims 1 to 4 wherein the pivoting lever (2) is pivotable to a first lateral side, the camera (18) and the distal working channel exit (111) pointing in a first lateral direction, and the pivoting lever (2) being pivotable to a second lateral side to the first lateral side, the camera (18) and the distal working channel exit (111) pointing in a second lateral direction. Endoscope according to one of Claims 1 to 5 wherein the pivot lever (2) is pivotable toward the distal side, the camera (18) and the distal working channel exit (111) facing in the distal direction. Endoscope according to one of Claims 1 to 6 , wherein on the endoscope head (1) has a hinge construction (21, 22) is arranged, about which the pivot lever (2) is pivotable. Endoscope according to Claim 7 in that the articulated construction (21, 22) has a cable pulley on which a traction cable which can be actuated from the proximal side of the endoscope rotates. Endoscope according to one of Claims 1 to 8th wherein the pivoting lever (2) has a working section on which at least the camera (18) and the distal working channel exit (111) are arranged, and the endoscope head (1) between the working section of the pivoting lever (2) and a proximal section (4) of the endoscope head (1) by a sheath (6) is surrounded. Endoscope according to Claim 9 wherein the sheath (6) is elastic. Endoscope according to one of Claims 1 to 10 , wherein the endoscope head (1) has no albarran lever. Endoscope according to one of Claims 1 or 3 to 11 wherein the endoscope is a rigid endoscope, wherein at the proximal portion (4) of the endoscope head (1) is located in the proximal direction of an endoscope tube. Endoscope according to one of Claims 1 to 11 wherein the endoscope is a flexible endoscope, wherein at the proximal portion (4) of the endoscope head (1) in the proximal direction of the bending section is located, which is controllable from the proximal side of the endoscope. Endoscope according to one of Claims 1 to 11 , wherein in the endoscope head (1) a clamping element is arranged, that in a lateral end position of the pivot lever (2) exerts a clamping action on the working channel (11) to clamp a in the working channel (11) advanced micro-tool.

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