EP1385415A2 - Tube rectoscopique servant a redresser le colon - Google Patents

Tube rectoscopique servant a redresser le colon

Info

Publication number
EP1385415A2
EP1385415A2 EP02705029A EP02705029A EP1385415A2 EP 1385415 A2 EP1385415 A2 EP 1385415A2 EP 02705029 A EP02705029 A EP 02705029A EP 02705029 A EP02705029 A EP 02705029A EP 1385415 A2 EP1385415 A2 EP 1385415A2
Authority
EP
European Patent Office
Prior art keywords
overtube
colon
colonoscope
distal end
lumen
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP02705029A
Other languages
German (de)
English (en)
Inventor
Frank Bonadio
John Butler
Aoibheann Gill
Edmund Brennan
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Atropos Ltd
Original Assignee
Atropos Ltd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Atropos Ltd filed Critical Atropos Ltd
Publication of EP1385415A2 publication Critical patent/EP1385415A2/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00147—Holding or positioning arrangements
    • A61B1/00154—Holding or positioning arrangements using guiding arrangements for insertion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00064—Constructional details of the endoscope body
    • A61B1/00071—Insertion part of the endoscope body
    • A61B1/00078—Insertion part of the endoscope body with stiffening means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00131—Accessories for endoscopes
    • A61B1/00135—Oversleeves mounted on the endoscope prior to insertion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00131—Accessories for endoscopes
    • A61B1/00137—End pieces at either end of the endoscope, e.g. caps, seals or forceps plugs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/31—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the rectum, e.g. proctoscopes, sigmoidoscopes, colonoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2210/00—Anatomical parts of the body
    • A61M2210/10—Trunk
    • A61M2210/1042—Alimentary tract
    • A61M2210/1064—Large intestine
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/0021—Catheters; Hollow probes characterised by the form of the tubing

Definitions

  • the overtube has more than one laterally flexible portion spaced along the overtube.
  • the overtube comprises a plurality of corrugations.
  • the corrugation is provided on an interior surface of the overtube.
  • an exterior surface of the overtube is smooth.
  • the overtube may comprise a composite material.
  • the overtube is of a layered construction.
  • the overtube comprises a reinforcement means.
  • the reinforcement means may be embedded in the overtube.
  • the reinforcement means is of a metallic material.
  • the overtube is extendable between a shortened configuration and an elongated configuration for cannulating at least portion of a colon.
  • the overtube may comprise a flexible seal at the distal end for sealing between the overtube and a colonoscope extending through the colonoscope lumen.
  • the seal preferably comprises a film material.
  • the seal may comprise a sheath of film material.
  • the seal comprises an inner sealing layer and an outer sealing layer around the inner sealing layer.
  • the seal is mounted to an exterior surface of the overtube.
  • the seal may extend inwardly to seal between the overtube and a colonoscope extending through the colonoscope lumen. Desirably the seal extends distally of the distal end of the overtube.
  • the overtube may be of polytetrafluoroethylene.
  • the overtube is preferably extendable between a shortened configuration and an elongated configuration for cannulating at least portion of a colon.
  • the invention provides a colonic overtube having a proximal end for location externally of a colon, a distal end for insertion into a colon, and a colonoscope lumen extending therethrough for passing the overtube over a colonoscope;
  • the overtube according to the invention provides an ergonomic and easily workable means of cannulating the colon as far distally as the caecum, without requiring a long, awkward length of tubing externally of the colon.
  • the overtube comprises limiting means to prevent complete insertion of the overtube into a colon.
  • the position of the limiting means on the overtube may be adjustable.
  • the limiting means is releasably mounted to the overtube.
  • the limiting means is threadably mounted to the overtube.
  • the limiting means comprises a flange.
  • the overtube has a discontinuous interior surface for ease of passage of the overtube over a colonoscope.
  • the overtube comprises one or more inwardly projecting elements on the interior surface for contacting a colonoscope.
  • the projecting element may comprise a corrugation. In another case the projecting element comprises a protruding strip.
  • the projecting element may extend longitudinally along the overtube.
  • the projecting element may extend at least partially circumferentially around the overtube.
  • the projecting element may extend along the overtube in a convoluted manner.
  • the projecting element comprises a plurality of discrete protrusions.
  • the colonic overtube may be used for maintaining a sigmoid colon in a straightened configuration.
  • the method comprises the step of withdrawing the colonoscope from the colon while the overtube remains in place in the colon.
  • the method may comprise the step of advancing a medical device through the overtube to access a point in the colon distally of the straightened section of colon.
  • the method comprises the step of mounting the overtube to the colonoscope before inserting the colonoscope into the colon.
  • the overtube is advanced by extending the overtube from a shortened configuration to an elongated configuration.
  • the overtube may be advanced by pushing the overtube from externally of the colon.
  • the overtube is advanced to a point distally of the descending colon.
  • the overtube provides a bridge between the fixed rectum and the fixed descending colon over the floppy sigmoid colon, thus preventing loops from reforming in the sigmoid colon.
  • the overtube provides a bridge between the fixed descending colon and the fixed ascending colon over the floppy transverse colon, thus preventing loops from reforming in the transverse colon.
  • the overtube of the invention is configured to be relatively thermally stable. In this way the overtube at room temperature (insertion temperature) is selected to be sufficiently compliant or floppy to be easily inserted into a colon over a colonoscope. There is then a minimal drop in stiffness between ambient room temperature and body temperature compared to other materials, so that at body temperature the overtube is above the minimum threshold of stiffness required to prevent sigmoid loops from reforming.
  • Figs. 12 to 17 are schematic views of the colonoscope and overtube of Figs. 9 and 10 in use in the colon of Fig. 11;
  • Fig. 24 is a perspective view of a distal end of a further colonic overtube according to the invention.
  • Fig. 25 is a perspective view of the colonoscope and overtube of Fig. 9 with a limiting means mounted to the overtube;
  • Fig. 30 is a partially cross-sectional, side view of the colonoscope of Fig. 29 advancing through another overtube;
  • Fig. 33 is a partially cross-sectional, side view of another overtube according to the invention.
  • a colonic overtube 1 for maintaining a section of a colon, in this case especially a sigmoid colon in a straightened configuration.
  • the overtube 1 has a proximal end 2 for location, in use, externally of a colon, and a distal end 3 for insertion into a colon.
  • a typical length for the overtube 1 is 0.5m.
  • the sealing sheath 6 can evert from this distally extending configuration to a proximally extending configuration upon movement of the colonoscope relative to the overtube 1. This ensures a relatively large area of contact between the sheath 6 and the colonoscope which results in a secure seal between the colonoscope and the overtube 1.
  • the sheath 6 is folded over to define an inner sealing layer 9, and an outer sealing layer 8 around the inner sealing layer 9.
  • the heat-shrink tubing 7 is provided between the inner and outer layers 9, 8 (Fig. 2).
  • the flexible nature of the seal 6 enables the seal 6 to adapt itself to the size of the colonoscope extending through the colonoscope lumen 4. In this manner, a secure, effective seal between the overtube 1 and a colonoscope is achieved regardless of the size diameter range of a colonoscope.
  • the film seal 6 has a very low profile which facilitates easier passage of the overtube 1 over a colonoscope through a colon, while minimising the resultant discomfort to the patient.
  • the overtube 1 comprises another section of heat-shrink tubing 10 fixed to an exterior surface of the overtube 1 at the distal end 3 of the overtube 1.
  • the tubing 10 extends around the distal end 3 of the overtube 1 partially into the colonoscope lumen 4 to define a rounded tip at the distal end 3 of the overtube 1.
  • the rounded tip tubing 10 ensures that there are no sharp edges at the distal end 3 of the overtube 1 for atraumatic advancement of the overtube 1 through a colon.
  • the distal end 3 of the overtube 1 may be rounded off in a variety of different ways, such as by a separately mountable tip, or during the manufacturing process.
  • the overtube 1 is of a material which is thermally stable in use in a colon.
  • the thermally stable material used for the overtube 1 is polytetrafluoroethylene (PTFE)
  • the overtube 1 is not overly stiff so that insertion of the overtube 1 into a colon, and navigation of the overtube 1 through a colon may be achieved without undue difficulty, and without causing undue discomfort to a patient.
  • the stiffness of the overtube 1 remains above the minimum threshold of stiffness required to maintain a section of colon in a straightened configuration, and to prevent sigmoid loops from reforming as a colonoscope is passed through the colonoscope lumen 4.
  • overtube 1 Manufacture of the overtube 1 will be described with reference to Figs. 3 to 7.
  • the overtube 1 is extruded to a typical length of 0.5 m with the convoluted corrugation
  • the section of heat-shrink tubing 10 is positioned around the distal end 3 of the overtube 1, partially overlapping the distal end 3, and a mandrel 11 is partially inserted into the colonoscope lumen 4 from the distal end 3 (Fig. 3). Heat is applied to shrink the tubing 10 down partially onto the exterior surface of the overtube 1 and partially onto the mandrel 11. The mandrel 11 is moved further into the colonoscope lumen 4 while rotating the mandrel 11 (Fig. 4).
  • the tubing 10 is folded around the distal end 3 of the overtube 1 partially into the colonoscope lumen 4, and by rotating the mandrel 11, the tubing 10 is detached from the mandrel 11. The mandrel 11 is then removed from the colonoscope lumen 4.
  • a proximal end 12 of the tubular sheath 6 is rolled inwardly, and the sheath 6 is positioned around the distal end 3 of the overtube 1, partially overlapping the distal end 3.
  • the tubular sheath 6 has a smaller diameter than the overtube 1, so the sheath 6 is stretched to position it around the distal end 3 of the overtube 1.
  • the section of the heat-shrink tubing 7 is positioned around the sheath 6 distally of the rolled proximal end 12 (Fig. 5), and heat is applied to shrink the tubing 7 down onto the sheath 6 to fix the sheath 6 to the exterior surface of the overtube 1 (Fig. 6).
  • the rolled proximal end 12 is then rolled out distally over the tubing 7, off the distal end 3 of the overtube 1 to define the outer sealing layer 8 around the inner sealing layer 9 (Fig. 7).
  • a colonoscope 14 is inserted into the colonoscope lumen 4 at the proximal end 2 of the overtube 1 and advanced through the lumen 4 until a distal end 15 of the colonoscope 14 emerges from the distal end 3 of the overtube 1 through the sealing sheath 6 (Fig. 9).
  • the colonoscope 14 has a power/light source 16 at a proximal end 17 of the colonoscope 14, and the overtube 1 is moved proximally over the colonoscope 14 until the proximal end 2 of the overtube 1 is adjacent the power/light source 16
  • the colonoscope 14 is now ready for insertion into the colon of a patient.
  • a typical colon 18 is illustrated in Fig. 11, in which the rectum 19 leads from the anus 20 to the sigmoid colon 21.
  • the redundancy in the sigmoid colon 21 may be seen in Fig. 11.
  • the descending colon 22 leads from the sigmoid colon 21 to the transverse colon 23.
  • the distal end 15 of the colonoscope 14 is inserted through the anus 20 into the rectum 19, and the colonoscope 14 is advanced into the sigmoid colon 21 (Fig. 12).
  • a loop may form in the sigmoid colon 21, which results in stretching of the mesentery 24 to which the sigmoid colon 21 is attached (Fig. 13).
  • the distal end 15 of the colonoscope 14 reaches the proximal end of the descending colon 22, the distal end 15 is anchored in the fixed descending colon 22, and the sigmoid colon 21 is straightened by manipulating the colonoscope 14 (Fig. 14).
  • the anchor is released (Fig. 15).
  • the distal end 3 of the overtube 1 is then inserted through the anus 20 into the rectum 19, and the overtube 1 is advanced through the straightened sigmoid colon 21 until the distal end 3 of the overtube 1 is at the proximal end of the descending colon 22 (Fig. 16).
  • the overtube 1 is then advanced through the colon 18 over the colonoscope 14, as illustrated in Fig. 16. In this manner, the colonoscope 14 acts as a guiding track for the overtube 1 as it advances through the colon 18.
  • the sheath 6 effects a double-layered seal between the overtube 1 and the colonoscope 14 at the distal end 3 of the overtube 1.
  • This seal ensures that no parts of the interior wall of the colon 18 become trapped between the colonoscope 14 and the overtube 1 as the overtube 1 is advanced over the colonoscope 14, and thus prevents shearing off of any parts of the colon wall, or puncturing the colon wall, or any other damage to the interior wall of the colon 18.
  • the sealing sheath 6 also presents faeces or other bodily materials leaking between the colonoscope 14 and the overtube 1 proximally out through the anus 20.
  • the colonoscope 14 may then be advanced further distally through the descending colon 22 and into the transverse colon 23 (Fig.17).
  • the overtube 1 acts as a splint to maintain the sigmoid colon 21 in the straightened configuration.
  • the splinting overtube 1 ensures that further advancement of the colonoscope 14 through the descending colon 22 and into the transverse colon 23 is possible by preventing loops from reforming in the sigmoid colon 21. In this manner, the overtube 1 minimises the pain or discomfort experienced by the patient during this procedure.
  • the corrugation 5 which extends along the overtube 1 in a convoluted manner results in a discontinuous interior surface 211 of the overtube 1, as illustrated in Fig. 29.
  • the corrugation 5 projects inwardly for contacting the colonoscope 14 in the colonoscope lumen 4.
  • the area of contact between the colonoscope 14 and the corrugated overtube 1 is less than the area of contact that would otherwise result with a continuous interior surface 210, as illustrated in Fig. 30. Because the area of contact between the colonoscope 14 and the corrugated overtube 1 is reduced, the frictional force acting between the colonoscope 14 and the corrugated overtube 1 is also reduced. In this manner, the corrugated overtube 1 enables an easier passage of the colonoscope 14 through the colonoscope lumen 4 of the overtube 1.
  • the exterior surface 212 of the overtube 1 may be smooth, as illustrated in Fig. 29.
  • This smooth surface 212 reduces the discomfort and/or pain experienced by the patient during the colonoscopy procedure while maintaining the kink-resistant and low-friction properties of the corrugation 5 on the interior surface 211.
  • corrugated overtube may be provided in alternative forms to that described above.
  • the corrugation on the overtube may extend at least partially circumferentially around the overtube, and/or more than one corrugation may be provided on the overtube.
  • Fig. 33 illustrates another colonic overtube 230 according to the invention, which is similar to the overtube 1, and similar elements in Fig. 33 are assigned the same reference numerals.
  • the overtube 230 comprises a reinforcement means, in the form of a coil 231 of metallic material embedded within the wall 232 of the overtube 230.
  • This composite construction enables the overtube 230 to flex laterally during advancement over a colonoscope through a potentially tortuous path in a colon substantially without kinking.
  • the reinforcement means may be provided in any suitable form, such as a mesh, or a braided construction.
  • the composite overtube may have a layered construction.
  • a flange 200 which may be used with the overtube 1 to prevent complete insertion of the overtube 1 into the colon 18.
  • the flange 200 is releasably mounted to the overtube 1, in this case by means of a threaded arrangement 201.
  • the threaded mounting arrangement enables the position of the flange 200 on the overtube 1 to be adjusted by a simple rotation of the flange 200 relative to the overtube 1, as illustrated in Figs. 26 and 27. Because the flange position is adjustable the colonoscopist can quickly and effectively adjust the flange 200 to suit the particular characteristics of the colon 18 undergoing treatment.
  • the flange 200 may be provided with alternative means of adjusting the position on the overtube 1, and/or with alternative means of releasable mounting to the overtube 1. Also the flange 200 could alternatively be provided fixed to or integral with the overtube 1 towards the proximal end 2 of the overtube 1. Furthermore, the limiting means may be provided in an alternative form to a flange.
  • FIGs. 18 to 23 there is illustrated another colonic overtube 100 according to the insertion for cannulating a colon.
  • the overtube 100 is similar to the overtube 1 of Figs. 1 to 17, and similar elements in Figs. 18 to 23 are assigned the same reference numerals.
  • the overtube 100 is extendable between a shortened configuration, as illustrated in Figs. 18 to 20, and an elongated configuration, as illustrated in Figs. 21 to 23, for cannulating at least portion of the colon 18, in particular cannulating the colon 18 to a point distally of the descending colon 22.
  • a portion 101 of the overtube 100 has a concertina-type configuration in the shortened configuration (Fig.18), and a flattened out configuration in the elongated configuration (Fig. 21).
  • the concertinaed portion 101 is provided at the proximal end 2 of the overtube 100.
  • the overtube 100 is mounted to the colonoscope 14 with the portion 101 retracted into the concertina-like manner before insertion of the colonoscope 2 into the colon 18. Insertion of the colonoscope 14 into the colon 18, straightening of the sigmoid colon 21 and advancement of the overtube 100 over the colonoscope 14 are performed in a manner similar to that described previously with reference to Fig. 12 to 17.
  • the overtube 100 acts as a splint to maintain the sigmoid colon 21 in the straightened configuration.
  • the colonoscope 14 may therefore be easily advanced through the transverse colon 23 to the hepatic flexure 25 (Fig. 18).
  • the transverse colon 23 is straightened in the normal manner as routinely performed by those skilled in the art (Fig. 19), and the colonoscope 4 is further advanced into the ascending colon 26 (Fig. 20).
  • the concertinaed portion 101 of the overtube 100 is then extended from the shortened configuration to the elongated configuration, by pushing the overtube 100 distally from externally of the colon 18.
  • the overtube 100 is advanced distally over the colonoscope 14 through the descending colon 22 and the transverse colon 23 until the distal end 3 of the overtube 100 reaches any desired point of interest in the colon 18 as far distally as the caecum (Fig. 21).
  • the overtube 100 of the invention acts as a colonic cannula and maintains in a straightened configuration the sections of the colon 18 that are normally mobile such as the sigmoid colon 21 and the transverse colon 23. This gives the colon 18 the classic question mark configuration as shown in Fig. 21.
  • the colonoscope 14 may therefore be removed through the colonoscope lumen 4 from the colon 18 leaving the overtube 100 in place in the cannulated colon 18 (Fig. 22).
  • the overtube 100 can then be used to facilitate insertion of an endoscopic instrument through the overtube 100, for example an instrument 103 to remove polyps from the ascending colon 26 (Fig. 23), or the overtube 100 can be used to facilitate reinsertion of a colonoscope.
  • the overtube 100 can be shortened or elongated until the distal end 3 is at the desired region of interest. While shortening or withdrawal of the overtube 100 may be achieved by simply withdrawing the overtube 100 from the colon 18, advancement or lengthening of the overtube 100 is preferably achieved with the colonoscope 14 in situ in the colon 18.
  • the overtube 100 provides a large working channel through the colon 18 through which any instrument may be quickly and easily passed to access any point in the colon 18 as far distally as the caecum. Rapid and less painful exchange of instruments and/or colonoscopes is thus facilitated by the overtube 100 because there is no contact between the instruments/colonoscopes and the inner wall of the colon 18 during insertion or withdrawal of the instruments/colonoscopes.
  • the overtube 100 has a much larger diameter than the diameter of a typical colonoscope working channel. Thus, larger instruments may be used during a colonoscopy procedure with the overtube 100. Larger samples may also be removed using the overtube 100.
  • the overtube may be extended in a number of alternative ways.
  • the overtube may comprise a plurality of overtube sections which are releasably mountable to one another to extend the overtube to the elongated configuration in a manner similar to the extension of a chimney sweeping brush, as a further possibility.
  • the overtube may comprise one or more telescopable sections.
  • a connecting means such as a drawstring, may be passed distally through the colonoscope working channel out of the distal end 15 of the colonoscope 14 and attached to the distal end 3 of the overtube 100.
  • a connecting means such as a drawstring
  • the distal end 3 of the overtube 100 can be advanced over the colonoscope 2 thereby extending the concertinaed portion 101 of the overtube 100.
  • Other means of activating an actuator of the overtube from externally of the colon may also be applied to extend the overtube in situ to the elongated configuration.
  • the overtube may at least partially comprise an energy actuated polymer. By application of energy, such as a voltage difference across the overtube, a portion of the overtube may be extended.
  • the overtube 100 may have one or more laterally flexible portions spaced along the overtube 100, similar to the corrugated arrangement of Fig. 1, and/or the composite arrangement of Fig. 33. These laterally flexible portions may assist navigation of tight bends in the colon 18, such as the splenic and hepatic flexures.
  • Fig. 24 illustrates another colonic overtube 110 according to the invention which is similar to the overtube 1 of Figs. 1 to 17.
  • the overtube 110 comprises at least one, and in this case three, exchange lumena 105, 106, 107, extending through the overtube 110 in addition to the colonoscope lumen 108.
  • the lumen 105, 106, 107 are suitable for exchanging a fluid, or a medical device through the lumena 105, 106, 107.
  • the lumen 105 may be used to provide a channel through which means for viewing the colon 18 from externally of the colon 18 can be provided, or the lumen 106 may be used to provide a channel through which means for illuminating the colon 18 can be provided.
  • the lumen 107 may be used to provide a channel for flushing or insufflating the colon 18, for example to blow a protruding piece of the colon 18 laterally to clear a path for safe advancement of the overtube 100 through the colon 18.
  • the exchange lumena 105, 106, 107 are provided on an interior surface of the overtube 110 extending inwardly into the colonoscope lumen 108. It will be appreciated that one or more of the exchange lumena may alternatively be provided on an exterior surface of the overtube 110 extending outwardly.
  • the colonoscope lumen 4 has a diameter, in this case approximately 15 mm, which results in a significantly larger cross sectional area than that of a typical colonoscope working channel.
  • a guide device may be used, such as the guide device described in International Patent Application No. PCT IEOl/00039, the relevant contents of which are incorporated herein by reference.
  • the overtube of the invention may be applied to maintain sections of the colon other than the sigmoid colon in a straightened configuration. Indeed the overtube could also be applied to cannulate other body lumena, in which medical instruments are to be inserted.

Abstract

Tube rectoscopique (1) servant à redresser un côlon sigmoïde et possédant une extrémité proximale (2) conçue pour être placée à l'extérieur du côlon et une extrémité distale (3) s'introduisant dans le côlon. Une lumière (4) s'étend à travers ce tube (1) afin de faciliter son passage au-dessus de l'instrument de coloscopie. Ce tube (1) présente une ondulation en volutes (5) s'étendant sur la totalité de la longueur de ce tube (1) depuis son extrémité proximale (2) jusqu'à son extrémité distale (3). Cette configuration ondulée confère au tube rectoscopique (1) une souplesse latérale, ce qui permet de l'incurver pratiquement sans coudure pendant sa progression à travers le colôn. Un joint flexible, se présentant sous la forme d'une gaine tubulaire siliconée (6) de matériau pelliculaire, est situé à l'extrémité distale (3) du tube rectoscopique (1), de manière à créer un joint entre ce dernier et l'instrument de coloscopie s'étendant à travers la lumière coloscopique (4). La souplesse de ce joint (6) lui permet de s'adapter à la dimension de l'instrument coloscopique s'étendant à travers la lumière coloscopique (4), de manière à obtenir une étanchéité efficace entre le tube (1) et l'instrument coloscopique indépendamment de la dimension de celui-ci.
EP02705029A 2001-03-08 2002-03-08 Tube rectoscopique servant a redresser le colon Withdrawn EP1385415A2 (fr)

Applications Claiming Priority (5)

Application Number Priority Date Filing Date Title
IE20010220 2001-03-08
IE20010220 2001-03-08
IE20010916 2001-10-18
IE20010916 2001-10-18
PCT/IE2002/000029 WO2002069841A2 (fr) 2001-03-08 2002-03-08 Tube rectoscopique servant a redresser le colon

Publications (1)

Publication Number Publication Date
EP1385415A2 true EP1385415A2 (fr) 2004-02-04

Family

ID=26320313

Family Applications (1)

Application Number Title Priority Date Filing Date
EP02705029A Withdrawn EP1385415A2 (fr) 2001-03-08 2002-03-08 Tube rectoscopique servant a redresser le colon

Country Status (4)

Country Link
EP (1) EP1385415A2 (fr)
JP (1) JP2004524903A (fr)
AU (1) AU2002238816A1 (fr)
WO (1) WO2002069841A2 (fr)

Families Citing this family (27)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7637905B2 (en) 2003-01-15 2009-12-29 Usgi Medical, Inc. Endoluminal tool deployment system
US7744613B2 (en) 1999-06-25 2010-06-29 Usgi Medical, Inc. Apparatus and methods for forming and securing gastrointestinal tissue folds
US6468203B2 (en) 2000-04-03 2002-10-22 Neoguide Systems, Inc. Steerable endoscope and improved method of insertion
US6858005B2 (en) 2000-04-03 2005-02-22 Neo Guide Systems, Inc. Tendon-driven endoscope and methods of insertion
US8888688B2 (en) 2000-04-03 2014-11-18 Intuitive Surgical Operations, Inc. Connector device for a controllable instrument
US8517923B2 (en) 2000-04-03 2013-08-27 Intuitive Surgical Operations, Inc. Apparatus and methods for facilitating treatment of tissue via improved delivery of energy based and non-energy based modalities
US6610007B2 (en) 2000-04-03 2003-08-26 Neoguide Systems, Inc. Steerable segmented endoscope and method of insertion
CN1764416A (zh) 2002-01-09 2006-04-26 新引导系统公司 用于内窥镜结肠切除术的设备和方法
US7041052B2 (en) 2002-06-13 2006-05-09 Usgi Medical Inc. Shape lockable apparatus and method for advancing an instrument through unsupported anatomy
US6790173B2 (en) 2002-06-13 2004-09-14 Usgi Medical, Inc. Shape lockable apparatus and method for advancing an instrument through unsupported anatomy
US8882657B2 (en) 2003-03-07 2014-11-11 Intuitive Surgical Operations, Inc. Instrument having radio frequency identification systems and methods for use
ATE506887T1 (de) 2004-01-30 2011-05-15 Fujifilm Corp Endoskop- applikator und endoskop
US7703459B2 (en) 2004-03-09 2010-04-27 Usgi Medical, Inc. Apparatus and methods for mapping out endoluminal gastrointestinal surgery
JPWO2007032055A1 (ja) * 2005-09-12 2009-03-19 オリンパスメディカルシステムズ株式会社 推進力発生手段、挿入補助具及び内視鏡システム
WO2007032085A1 (fr) * 2005-09-16 2007-03-22 Olympus Medical Systems Corp. Auxiliaire d’insertion
DE102005048675A1 (de) * 2005-10-11 2007-04-12 Invendo Medical Gmbh Medizintechnische Vorrichtung mit selbstschmierendem Element
US20070161857A1 (en) 2005-11-22 2007-07-12 Neoguide Systems, Inc. Method of determining the shape of a bendable instrument
JP2009517608A (ja) 2005-11-23 2009-04-30 ネオガイド システムズ， インコーポレイテッド 操舵可能な装置用の非金属マルチストランド制御ケーブル
WO2007137208A2 (fr) 2006-05-19 2007-11-29 Neoguide Systems, Inc. Procédés et appareil pour afficher l'orientation tridimensionnelle d'une extrémité distale orientable d'un endoscope
DE102007000214A1 (de) * 2007-04-10 2008-10-16 Invendo Medical Gmbh Verfahren zur Reibungsverringerung eines medizintechnischen Kautschukschlauchs
US8287447B2 (en) 2007-08-29 2012-10-16 Minos Medical Outer tube for natural orifice surgery
US9220398B2 (en) 2007-10-11 2015-12-29 Intuitive Surgical Operations, Inc. System for managing Bowden cables in articulating instruments
KR101707924B1 (ko) 2008-02-06 2017-02-17 인튜어티브 서지컬 오퍼레이션즈 인코포레이티드 제동 능력을 가지고 있는 체절식 기구
US8182418B2 (en) 2008-02-25 2012-05-22 Intuitive Surgical Operations, Inc. Systems and methods for articulating an elongate body
US8403889B2 (en) * 2008-06-25 2013-03-26 Covidien Lp Access assembly
JP6017707B2 (ja) * 2014-06-05 2016-11-02 オリンパス株式会社 挿入具及び挿入システム
JPWO2020017534A1 (ja) 2018-07-17 2021-03-25 富士フイルム株式会社 挿入補助チューブ用組成物、挿入補助チューブ、挿入補助チューブと内視鏡とのセット、及び内視鏡装置、並びに挿入補助チューブの製造方法

Family Cites Families (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE4113265A1 (de) * 1989-10-23 1992-03-12 Bauerfeind Peter Einfuehrvorrichtung fuer schlauchfoermige fiberoptische instrumente, insbes. kolonoskope
DE3935256C1 (fr) * 1989-10-23 1991-01-03 Bauerfeind, Peter, Dr., 8264 Waldkraiburg, De
GB2306111A (en) * 1995-10-14 1997-04-30 William Barrie Hart Expandable hydraulic oversleeve for advancing an endoscope into a body cavity
DE19729499A1 (de) * 1997-07-10 1999-01-14 Friedrich Schiller Uni Jena Bu Vorrichtung zum Erleichtern der Vorschubbewegung von flexiblen Endoskopen
US6083152A (en) * 1999-01-11 2000-07-04 Welch Allyn, Inc. Endoscopic insertion tube

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See references of WO02069841A3 *

Also Published As

Publication number Publication date
WO2002069841A2 (fr) 2002-09-12
JP2004524903A (ja) 2004-08-19
AU2002238816A1 (en) 2002-09-19
WO2002069841A3 (fr) 2003-11-27

Similar Documents

Publication Publication Date Title
US6793621B2 (en) Colonic overtube
US20050203339A1 (en) Colonic overtube
EP1385415A2 (fr) Tube rectoscopique servant a redresser le colon
US20060020164A1 (en) Evertable insertion tube for colonoscope
CA2784097C (fr) Capuchon d'endoscope avec rampe
US20060270978A1 (en) Expandable esophageal access device
MX2012013661A (es) Recubrimiento para un dispositivo medico visualizacion.
US20100331625A1 (en) Endoscopic overtube
AU2007257793B2 (en) Endoscopic apparatus having an expandable balloon delivery system
JP6886200B2 (ja) 内視鏡補助装置及び内視鏡システム
JP2003180611A (ja) 内視鏡挿入補助具
IE20020177A1 (en) A colonic overtube
EP1897583B1 (fr) Structure de fil guide avec fil guide médical
IE20030581A1 (en) Evertable insertion tube for colonoscope
US20220096094A1 (en) Expandable guide devices, systems, and methods

Legal Events

Date Code Title Description
PUAI Public reference made under article 153(3) epc to a published international application that has entered the european phase

Free format text: ORIGINAL CODE: 0009012

17P Request for examination filed

Effective date: 20030908

AK Designated contracting states

Kind code of ref document: A2

Designated state(s): AT BE CH CY DE DK ES FI FR GB GR IE IT LI LU MC NL PT SE TR

AX Request for extension of the european patent

Extension state: AL LT LV MK RO SI

GRAP Despatch of communication of intention to grant a patent

Free format text: ORIGINAL CODE: EPIDOSNIGR1

STAA Information on the status of an ep patent application or granted ep patent

Free format text: STATUS: THE APPLICATION IS DEEMED TO BE WITHDRAWN

18D Application deemed to be withdrawn

Effective date: 20071201