ES2432616T3 - Sistema de accesorios para su uso con broncoscopios - Google Patents
Sistema de accesorios para su uso con broncoscopios Download PDFInfo
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- ES2432616T3 ES2432616T3 ES09157586T ES09157586T ES2432616T3 ES 2432616 T3 ES2432616 T3 ES 2432616T3 ES 09157586 T ES09157586 T ES 09157586T ES 09157586 T ES09157586 T ES 09157586T ES 2432616 T3 ES2432616 T3 ES 2432616T3
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Classifications
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- 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
- A61B1/012—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 characterised by internal passages or accessories therefor
- A61B1/018—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 characterised by internal passages or accessories therefor for receiving instruments
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- A61B1/00112—Connection or coupling means
- A61B1/00121—Connectors, fasteners and adapters, e.g. on the endoscope handle
- A61B1/00128—Connectors, fasteners and adapters, e.g. on the endoscope handle mechanical, e.g. for tubes or pipes
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- A61B1/00131—Accessories for endoscopes
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- F—MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
- F16—ENGINEERING ELEMENTS AND UNITS; GENERAL MEASURES FOR PRODUCING AND MAINTAINING EFFECTIVE FUNCTIONING OF MACHINES OR INSTALLATIONS; THERMAL INSULATION IN GENERAL
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Abstract
Una pinza para sujetar temporalmente una parte del cuerpo sustancialmente cilíndrica de un accesorioen relación predefinida con el mango de un broncoscopio, comprendiendo la pinza: (a) una abrazadera exterior (10) configurada para rodear en al menos 180° el mango del broncoscopio; (b) una parte de fiador flexible (12) desplegada dentro de dicha abrazadera exterior y que rodea en al menos 180° elmango del broncoscopio; (c) un mecanismo de apriete (16) asociado con dicha abrazadera exterior y configurado para flexionar al menosparte de dicha parte de fiador flexible hacia el interior con respecto a dicha abrazadera exterior de manera que sujetela pinza en el mango del broncoscopio; y (d) un par de mordazas resilientes (18) interconectadas con al menos una entre dicha abrazadera exterior y dichaparte de fiador flexible, estando dicho par de mordazas resilientes configurado para sujetar un accesorio.
Description
Sistema de accesorios para su uso con broncoscopios.
CAMPO Y ANTECEDENTES DE LA INVENCIÓN
[0001] La presente invención se refiere a la broncoscopia y, en particular, se ocupa de un sistema de accesorios para su uso cuando se realizan procedimientos quirúrgicos mediante el uso de un broncoscopio.
[0002] El procedimiento intervencionista más común en el campo de la Medicina Pulmonar (es decir, la medicina relacionada con el sistema respiratorio) es la broncoscopia, en la que se introduce un broncoscopio en las vías respiratorias a través de la nariz o la boca del paciente. El instrumento consiste en un tubo flexible largo y delgado que normalmente contiene tres elementos, un conjunto de iluminación para iluminar la región distal en la punta del broncoscopio por medio de una fibra óptica conectada a una fuente de luz externa, un conjunto de obtención de imágenes para suministrar una imagen de vídeo desde la punta distal del broncoscopio y un ’canal de trabajo’ a través del cual se introducen instrumentos de tipo diagnóstico (por ejemplo, herramientas de biopsia) y terapéutico (por ejemplo, láser, crioterapia o sondas de eliminación de tejidos por RF). La punta distal del broncoscopio es orientable; el giro de una palanca colocada en el mango del broncoscopio acciona el mecanismo de dirección por deflexión de la punta en dos direcciones opuestas.
[0003] Las broncoscopias se aplican de forma rutinaria al diagnóstico y tratamiento de enfermedades como Cáncer de Pulmón, Estenosis de las Vías Respiratorias y Enfisema. Son realizadas por un neumólogo experto, también conocido como broncoscopista.
[0004] Las broncoscopias son realizadas por un equipo de al menos dos personas, el broncoscopista y al menos un asistente, normalmente un profesional de enfermería. Durante un procedimiento típico, el broncoscopista sostiene el mango del broncoscopio con una mano y el tubo del broncoscopio con la otra mano. Manipula la punta distal del broncoscopio dentro del pulmón haciendo girar la palanca de deflexión y empujando el tubo o tirando de él. Una vez que la punta se lleva hasta el objetivo, se consigue un diagnóstico médico y/o se aplica un tratamiento mediante la introducción de una herramienta broncoscópica en el canal de trabajo y la retirada a través de la punta distal del tubo del broncoscopio y la realización del diagnóstico o tratamiento.
[0005] Durante la introducción y el manejo de la herramienta broncoscópica, la punta distal del broncoscopio debe mantenerse firme en el objetivo. La realización de todas estas tareas de forma simultánea a menudo requiere tres o cuatro manos, dos para asegurar el broncoscopio en su lugar, y una o dos manos más para introducir y accionar la herramienta broncoscópica. La complejidad de esta operación con varias personas, que requiere una delicada coordinación entre el médico y el asistente, a menudo menoscaba la precisión resultante de los procedimientos médicos, y la necesidad de otras manos como ayuda eleva con frecuencia su coste.
[0006] De particular relevancia para la presente invención es un dispositivo y un procedimiento descritos en la solicitud de patente PCT de publicación nº WO-03/086.498 titulada "Endoscope Structure and Techniques for Navigation in Brunched Structure" de Gilboa. Esta solicitud de patente describe un procedimiento y un aparato en el que se usa una guía localizable ("LG"), envuelta por una vaina, con el fin de guiar una herramienta broncoscópica hasta un lugar determinado dentro del pulmón. La combinación de guía/vaina se introduce en el pulmón por medio del canal de trabajo de un broncoscopio. Una vez que la punta de la guía está situada en su objetivo, se acciona un bloqueo, que se coloca en el orificio ("abertura de conexión") del canal de trabajo del broncoscopio, para evitar que la vaina se deslice dentro o fuera del broncoscopio. A continuación se retira la guía de la vaina, dejando la vaina en su lugar para guiar una herramienta hasta el lugar objeto requerido.
[0007] Por otra parte, cuando se usa el mismo broncoscopio con su función principal de investigación de los bronquios, se usa el mismo canal de trabajo para limpiar la mucosidad molesta de las vías respiratorias, usando una bomba de vacío conectada a un conector especial separado del orificio del canal de trabajo. Para que la aspiración funcione adecuadamente, el orificio del canal de trabajo debe cerrarse de forma estanca durante la aplicación de la aspiración.
[0008] Se desprende que, durante el procedimiento, el médico normalmente necesita intercambiar dos dispositivos diferentes en la abertura de conexión del canal de trabajo del broncoscopio, un cierre estanco y un bloqueo, y ambos deben intercambiarse dependiendo de la función que esté realizando el broncoscopio en ese momento.
[0009] Durante el cambio entre guía localizable y otras herramientas, es necesario introducir la guía o herramienta en el extremo proximal libre de la vaina. Se ha encontrado que esta etapa es un tanto "complicada" y difícil de conseguir rápidamente debido a la flexibilidad y a la consiguiente inestabilidad mecánica del extremo de la vaina. El problema puede abordarse fácilmente sosteniendo el extremo de la vaina en una mano y la herramienta en la otra, pero de nuevo se necesitarían manos adicionales libres durante la ejecución del procedimiento.
[0010] Con el fin de facilitar el manejo de un sistema tal como se ha descrito en la solicitud mencionada anteriormente por un solo profesional, sería preferible permitir que el profesional soltara temporalmente el agarre de una herramienta o dispositivo secundario usado a través del canal de trabajo del broncoscopio. Al mismo tiempo, es preferible que el dispositivo permanezca accesible y accionable inmediatamente, y no que cuelgue libremente.
[0011] Por tanto existe la necesidad de accesorios para su uso con un broncoscopio que faciliten el manejo de un broncoscopio y sus herramientas asociadas por un único profesional. También sería ventajoso proporcionar un adaptador para la abertura de conexión del canal de trabajo de un broncoscopio que realizaría tanto las funciones de cierre estanco como de bloqueo de la herramienta sin requerir la recolocación de una fijación durante el procedimiento. Sería ventajoso además proporcionar una disposición según las enseñanzas de la publicación de patente PCT mencionada anteriormente que facilitara la introducción de herramientas en la vaina de la guía.
[0012] La fig. 66 del documento US-2003/0.040.657 desvela una pinza que representa la técnica anterior más cercana.
RESUMEN DE LA INVENCIÓN
[0013] La presente invención se refiere a una pinza para su uso cuando se realizan procedimientos quirúrgicos mediante el uso de un broncoscopio.
[0014] Según las enseñanzas de la presente invención se proporciona una pinza para sujetar temporalmente una parte del cuerpo sustancialmente cilíndrica de un accesorio en una relación predefinida con respecto al mango de un broncoscopio, comprendiendo la pinza: (a) una abrazadera exterior configurada para rodear en al menos 180° el mango del broncoscopio; (b) una parte de fiador flexible desplegada dentro de la abrazadera exterior y que rodea en al menos 180° el mango del broncoscopio; (c) un mecanismo de apriete asociado con la abrazadera exterior y configurado para flexionar al menos parte de la parte de fiador flexible hacia el interior con respecto a la abrazadera exterior de manera que asegure la pinza en el mango del broncoscopio; y (d) un par de mordazas resilientes interconectadas con al menos una entre la abrazadera exterior y la parte de fiador flexible, estando el par de mordazas resilientes configurado para sujetar un accesorio.
[0015] Según una característica adicional de la presente invención, se proporciona también una pieza intercalada resiliente desplegada en la parte de fiador.
[0016] Según una característica adicional de la presente invención, el par de mordazas resilientes está conformado íntegramente con la parte de fiador flexible.
[0017] Según una característica adicional de la presente invención, el par de mordazas resilientes está configurado para sujetar la parte del cuerpo sustancialmente cilíndrica del accesorio sustancialmente en perpendicular a una dirección de elongación del mango del broncoscopio.
[0018] Según una característica adicional de la presente invención, la parte de fiador flexible rodea en al menos aproximadamente 200° el mango del broncoscopio.
[0019] Según una característica adicional de la presente invención, la parte de fiador flexible rodea en no más de aproximadamente 250° el mango del broncoscopio.
BREVE DESCRIPCIÓN DE LOS DIBUJOS
[0020] La invención se describe en la presente memoria descriptiva, sólo a modo de ejemplo, con referencia a los dibujos adjuntos, en los que:
la fig. 1 es una vista isométrica esquemática de parte del mango de un broncoscopio que muestra un canal de trabajo al que se acopla un adaptador de cierre estanco y bloqueo, construido y operativo según las enseñanzas de la presente invención;
la fig. 2A es una vista isométrica esquemática ampliada que muestra el adaptador de la fig. 1 antes de su fijación al mango del broncoscopio;
la fig. 2B es una vista isométrica esquemática ampliada que muestra el adaptador de la fig. 1 fijado al mango del broncoscopio;
la fig. 3A es una vista isométrica en despiece ordenado que ilustra los componentes del adaptador de la fig. 1;
la fig. 3B es una vista isométrica del adaptador de la fig. 1 cuando está montado;
la fig. 4 es una vista axial en sección transversal tomada transversalmente del adaptador de la fig. 1; la fig. 5 es una vista longitudinal en sección transversal esquemática tomada a través de una vaina de flexibilidad variable construida y operativa según las enseñanzas de la presente invención;
la fig. 6 es una vista isométrica de una pinza de accesorios de un broncoscopio construida y operativa según las enseñanzas de la presente invención;
la fig. 7 es una vista desmontada de la pinza de la fig. 6 que indica la secuencia de ensamblaje;
la fig. 8 ilustra el montaje de la pinza de la fig. 6 en un broncoscopio;
la fig. 9 ilustra la pinza de la fig. 6 en uso para sujetar un accesorio de broncoscopio;
la fig. 10 es una vista lateral de una extensión de mango envolvente, construida y operativa según las enseñanzas de la presente invención, en un estado aplanado;
la fig. 11 es una vista lateral de la extensión de mango envolvente de la fig. 10 en un estado desplegado que forma un manguito cónico para sujetar un mango de broncoscopio;
la fig. 12 es una vista lateral que ilustra el uso de la extensión de mango envolvente de la fig. 10 con un broncoscopio y un accesorio durante una primera fase de un procedimiento; y
la fig. 13 es una vista lateral que ilustra el uso de la extensión de mango envolvente de la fig. 10 con un broncoscopio y un accesorio durante una segunda fase de un procedimiento.
DESCRIPCIÓN DE LAS FORMAS DE REALIZACIÓN PREFERIDAS
[0021] La presente descripción se refiere a varios accesorios para su uso cuando se realizan procedimientos quirúrgicos mediante el uso de un broncoscopio del cual sólo la pinza de las fig. 6-7 forma parte de la invención reivindicada.
[0022] Los principios y el manejo de accesorios de broncoscopios según la presente invención pueden comprenderse mejor con referencia a los dibujos y a la descripción que se acompaña.
[0023] A modo de introducción, debe observarse que la presente invención incluye una serie de diferentes aspectos, cada uno de los cuales se considera de importancia patentable por derecho propio. Específicamente, con referencia a las fig. 1 a 4, se describirá un adaptador de cierre estanco y bloqueo. A continuación, con referencia a la fig. 5, se describirá una estructura de vaina preferida. A continuación, con referencia a las fig. 6 a 9, se describirá una estructura de pinza para sujetar una herramienta de accesorio. Finalmente, con referencia a las fig. 10 a 13, se describirá una disposición de extensión de mango envolvente.
[0024] En referencia seguidamente a los dibujos, las fig. 1 a 4 ilustran un primer accesorio, a saber, un adaptador de cierre estanco y bloqueo 200 para su fijación en una abertura de acceso ("interfaz") 110 de un canal de trabajo 130 de un broncoscopio 100 con el fin de permitir la introducción y el bloqueo de una herramienta (no mostrada) a la vez que se cierra de forma estanca la abertura de acceso 110 cuando no está en uso. En términos generales, como se aprecia mejor en la fig. 4, el adaptador 200 incluye un alojamiento 13 configurado para acoplarse con la abertura de acceso 110 y una configuración de fijación asociada con el alojamiento 13 y configurada para fijar el alojamiento 13 a la abertura de acceso 110 del canal de trabajo 130. El adaptador 200 incluye una disposición de cierre estanco, desplegada dentro del alojamiento 13, que incluye una válvula elastomérica 20 orientada elásticamente a un estado normalmente cerrado (fig. 4) en el que la válvula elastomérica 20 forma parte de una disposición de cierre estanco para oponer resistencia al paso de aire a través de la abertura de acceso 110 del canal de trabajo 130. La válvula elastomérica 20 está configurada también para permitir la introducción de una herramienta (no mostrada) a través de la válvula y en el interior del canal de trabajo. En el alojamiento 13 se despliega también una disposición de fiador que incluye un bloque de fiador elastomérico 11 y un mecanismo de apriete accionable manualmente para deformar el bloque de fiador elastomérico 11 de manera que bloquee en su posición una herramienta introducida a través del alojamiento 13 y en el interior del canal de trabajo
130.
[0025] En esta fase, quedará claro de forma inmediata que el adaptador 200 proporciona ventajas importantes con respecto a la técnica anterior. Específicamente, al proporcionar una disposición de cierre estanco y una configuración de bloqueo dentro de un único adaptador, se resuelve el problema mencionado anteriormente de necesitar sustituir las fijaciones durante la realización de diferentes partes de un procedimiento quirúrgico. Estas y otras ventajas de este aspecto de la presente invención quedarán más claras a partir de la descripción detallada que se ofrece a continuación.
[0026] En referencia ahora específicamente a la fig. 1, se muestra un dibujo esquemático del mango 100 de un broncoscopio. Dentro del mango 100 se incluye un canal de trabajo 130. Las herramientas se introducen en el canal de trabajo a través de un orificio de entrada 125. El canal de trabajo se incorpora en el interior de toda la longitud del broncoscopio hasta su extremo proximal. Además, el canal de trabajo está conectado también a una bomba de vacío (no mostrada) u otra fuente de aspiración a través de una válvula 140 y a través de un segundo conector 160. Cuando la válvula se presiona para su apertura, la bomba aspira el contenido del canal de trabajo. Para que la aspiración funcione adecuadamente, es preciso que el canal de trabajo permanezca cerrado de manera estanca. En la entrada del canal de trabajo se incluye un empalme de junta de estanqueidad 120 en el que puede fijarse una junta de estanqueidad de caucho para cerrar de manera estanca el orificio (no mostrada).
[0027] En una forma de realización preferida, el adaptador 200 se monta en la interfaz del canal de trabajo 110 mediante la conexión al empalme de la junta de estanqueidad 120. Las fig. 2A y 2B muestran una configuración preferida de fijación para la conexión del adaptador 200 a la interfaz del canal de trabajo 110. El adaptador 200 acepta una llave bifurcada 14 en una ranura lateral 24. La llave bifurcada sujeta el adaptador 200 fijo a la interfaz acoplando los lados entallados del empalme 120. La forma del alojamiento 13 del aparato se corresponde con la forma de la interfaz 110 e incluye paredes laterales que se extienden de manera que forman un surco o canal 21 que coopera con el cuerpo del mango del broncoscopio para impedir la rotación del alojamiento 13. Así, el alojamiento 13 se coloca primero de manera que envuelva la interfaz 110, y que la llave bifurcada 14 se introduzca en la ranura 24 para fijarse y mantener la presión de contacto entre el adaptador 200 y el orificio del canal de trabajo.
[0028] Las fig. 3A, 3B y 4 muestran el adaptador combinado de bloqueo y cierre estanco en más detalle. Cuando se coloca en la parte superior del canal de trabajo, su superficie inferior 22 es presionada contra el empalme de la junta de estanqueidad 120 y cierra el orificio 125 de forma estanca. La luz 18 queda bloqueada por la válvula elastomérica 20, implementada preferentemente como una membrana elastomérica cortada a lo largo de una rendija. Cuando la luz está vacía, la rendija adopta su estado cerrado normalmente, cerrando de manera estanca el orificio del canal de trabajo de manera que la aspiración puede aplicarse por medio de la válvula 140 al canal de trabajo 130 sin una fuga significativa en la interfaz 110. Cuando se introduce una herramienta a través de la luz, la rendija se abre, lo que permite que la herramienta se deslice a través de la membrana y en el interior del canal de trabajo. El material de válvula 20 es preferentemente suficientemente flexible para formar un cierre estanco alrededor de la herramienta introducida.
[0029] La válvula elastomérica 20 y el bloque de fiador elastomérico se implementan preferentemente como una pieza intercalada elastomérica unitaria 11 desplegada en el alojamiento 13. El material elastomérico es preferentemente un material flexible como caucho o silicona. La pieza intercalada 11 tiene una luz central 18 a través de la cual pueden introducirse herramientas. El bloque de fiador elastomérico está formado preferentemente como un collar sustancialmente cilíndrico 27 alrededor de la parte de la luz central, definiendo con ello un calibre de fiador central para el paso de la herramienta. El collar 27 contiene preferentemente al menos un reborde proyectado hacia el interior 28 que sobresale en el calibre de fiador central para mejorar la sujeción.
[0030] El collar 27 tiene preferentemente partes superficiales cónicas (es decir, partes biseladas) 29 alrededor de su circunferencia. El mecanismo de apriete incluye preferentemente al menos un elemento desplazable axialmente desplegado para acoplar la superficie cónica 29 de manera que se aplica una presión hacia el interior para retener la herramienta dentro del calibre del fiador central.
[0031] En la implementación ilustrada en este caso, como se aprecia mejor en la fig. 4, la pieza intercalada flexible 11 se mantiene dentro del alojamiento 13 por medio de dos anillos, un anillo inferior 12 y un anillo superior 15 que puede desplazarse axialmente, los dos desplegados para acoplar las superficies cónicas 29. Una tuerca 16 soporta el anillo superior, desplazándolo axialmente hacia abajo. Al apretar la tuerca 16 se empujan los anillos uno contra el otro. El desplazamiento descendente del anillo inferior 12 se evita indirectamente mediante la presión de acoplamiento con el empalme 120. Las superficies internas de los anillos son oblicuas, con lo que cuando el tornillo se aprieta y se presionan los anillos, presiona la parte flexible 11, forzando a la luz 18 a estrecharse. El estrechamiento de la luz 18 bloquea la herramienta situada dentro de la luz, evitando que se deslice hacia dentro o hacia fuera de la luz. La parte inferior del alojamiento 13 tiene un surco 21, que se corresponde con la forma de la interfaz del canal de trabajo 110. Evita que el aparato gire cuando se aprieta la tuerca 16.
[0032] Volviendo ahora al segundo accesorio ilustrado con referencia a la fig. 5, se hace referencia a una vaina para su uso según la funcionalidad mencionada anteriormente de herramientas de guiado hasta un punto de interés tal como se describe adicionalmente en la publicación de patente PCT nº WO-03/086.498 mencionada anteriormente. Específicamente, se refiere a una estructura de vaina en la que la parte proximal 30, es decir, la parte que permanece en saliente desde el mango del broncoscopio, está formada con una flexibilidad reducida en comparación con la parte de vaina primaria 32. Se ha encontrado que este hecho facilita enormemente la introducción de diversos dispositivos, por ejemplo para el intercambio de la guía localizable y diversas herramientas tal como se menciona anteriormente.
[0033] La parte de vaina primaria 32, que se extiende a lo largo de una parte importante (y normalmente más del 80%) de una longitud de la vaina, está configurada por medio de selección de material y dimensiones para tener un primer grado de flexibilidad adecuado para su función pretendida tal como se conoce en la técnica.
Específicamente, la parte de vaina primaria debe ser suficientemente flexible para adaptarse a la estructura ramificada de las vías respiratorias de los pulmones a la vez que suficientemente rígida para permitir que sea empujada hacia delante a través de las vías respiratorias y se doble sin colapsar la luz interna.
[0034] Por otra parte, la parte de vaina proximal de flexibilidad reducida 30 tiene un grado de flexibilidad menor medido, por ejemplo, por la extensión de la flexión provocada por una fuerza dada aplicada en perpendicular a una sección en voladizo del tubo a una distancia dada del punto de apoyo. En términos prácticos, así se asegura que la longitud de la vaina sin soporte que sobresale del mango del broncoscopio mientras está en uso sea relativamente estable y no se ondule como haría si fuera tan flexible como la parte de vaina primaria. Así se facilita la introducción de herramientas, etc., en la vaina. La parte de vaina proximal y la parte de vaina primaria definen conjuntamente una luz interna contigua. Con la máxima preferencia, una pieza de extremo proximal 40, asociada mecánicamente con un extremo proximal de la parte de vaina proximal 30, está modelada para definir una guía de introducción cónica para guiar una herramienta en la luz interna, facilitando con ello adicionalmente la introducción de herramientas, etc., en la vaina.
[0035] En las implementaciones más preferidas, la vaina tiene también una parte distal 34 que muestra un grado de flexibilidad superior que la parte de vaina primaria para facilitar la dirección de la vaina por medio de una guía localizable introducida. En consecuencia, la implementación preferida de una vaina según la presente invención muestra tres niveles distintos de flexibilidad.
[0036] Estructuralmente, la parte proximal relativamente menos flexible se implementa preferentemente mediante la adición de un manguito exterior 36 a la estructura de la vaina. Un ejemplo de un material adecuado para un manguito relativamente menos flexible es la poliamida. Como la poliamida no es fácil de soldar a los materiales usados normalmente para la parte principal de la vaina, por ejemplo, materiales a base de nailon como "PEBAX", se prefiere una implementación en forma de un manguito exterior que se superpone a la estructura interna de la vaina. La estructura de PEBAX subyacente 38 puede prepararse opcionalmente más fina de manera que el grosor global de la vaina no aumente significativamente en la parte menos flexible. La parte distal relativamente más flexible puede implementarse modificando el grosor y/o la composición del tubo de PEBAX, como se conoce en la técnica.
[0037] Volviendo ahora al aspecto de la presente invención, las fig. 6 a 9 ilustran una pinza según la invención, y su uso. La pinza está diseñada para permitir la fijación y la liberación a ciegas de un accesorio broncoscópico, lo que incluye, pero no se limita a, el sistema de la publicación de patente PCT nº WO-03/086.498 mencionada anteriormente. La pinza proporciona una sujeción sin manos del accesorio, liberando con ello la mano del profesional cuando no se está usando de forma activa. La pinza también permite preferentemente un manejo parcial o total del accesorio desde su posición retenida. La pinza se monta en el eje del broncoscopio (fig. 8 y 9) y no interfiere con el manejo normal del broncoscopio.
[0038] Estructuralmente, la parte de la pinza que se fija al broncoscopio tiene preferentemente una abrazadera exterior 10 relativamente rígida para rodear en al menos 180°, y más preferentemente entre aproximadamente 200° y 250°, el broncoscopio. Dentro de la abrazadera exterior 10 se monta una parte de fiador relativamente flexible 12, que normalmente también rodea en al menos 180°, y más preferentemente entre aproximadamente 200° y 250°, el broncoscopio. La parte de fiador 12 tiene normalmente una sección transversal en forma de "C", es decir, como un cilindro parcial abierto a lo largo de un lateral. La parte de fiador 12 tiene preferentemente un recubrimiento o pieza intercalada resiliente 14 de un material como silicona que sirve para proteger la superficie del endoscopio y mejorar el rozamiento de sujeción. La parte de fiador 12 se cierra hacia el interior con respecto a la abrazadera exterior 10 mediante un mecanismo de apriete, normalmente en forma de un tornillo de apriete 16 tal como se muestra. Opcionalmente, la abrazadera exterior 10 y la parte de fiador 12 pueden fijarse permanentemente o estar conformadas íntegramente en el lateral alejado del mecanismo de apriete.
[0039] Fijado o conformado íntegramente con una o ambas entre la abrazadera exterior 10 y la parte de fiador 12 está un par de mordazas resilientes 218 que forman conjuntamente la pinza de accesorios. En el ejemplo mostrado en este caso, las mordazas resilientes están conformadas íntegramente con la parte de fiador 12 y pasan en lados opuestos de la abrazadera exterior 10. Con la máxima preferencia, la forma de la pinza de accesorios está configurada para retener una parte del cuerpo sustancialmente cilíndrica de un accesorio en una orientación sustancialmente perpendicular a un eje central del mango del broncoscopio/cuerpo. Así se amplía al máximo la accesibilidad del dispositivo accesorio para su manejo mientras está fijado a la pinza.
[0040] La abrazadera exterior 10, la parte de fiador 12 y la pinza de accesorios pueden estar hechas de cualquier material adecuado, y pueden ser todas del mismo material o de una combinación de materiales diferentes. Entre las opciones preferidas en particular se incluyen, pero no se limitan a, acero inoxidable, aluminio y plástico.
[0041] Volviendo ahora a un accesorio final, las fig. 10 a 13 ilustran una extensión de mango envolvente 220 para su uso con un mango del broncoscopio. En términos generales, la extensión de mango envolvente 220 ayuda al broncoscopista a sujetar con una mano el mango del broncoscopio y al mismo tiempo el mango de la herramienta broncoscópica, y a manejar los dos sin que interfieran entre sí, mientras se deja la segunda mano libre para cualquier acción requerida adicional. Para este fin, la extensión del mango 220 incluye una capa envolvente flexible 228 provista de disposiciones de sujeción complementarias 224 desplegadas de manera que forman un manguito cónico (fig. 11) para sujetar el mango del broncoscopio tal como se muestra en las fig. 12 y 13. La extensión del mango 220 incluye también un asa manual 222 asociada con la capa envolvente flexible 228 y configurada para recibir la mano de un usuario con el fin de permitir la suspensión del manguito cónico de la mano del usuario.
[0042] En referencia al ejemplo ilustrado en la presente memoria descriptiva en más detalle, la capa envolvente flexible 228 se implementa preferentemente como una capa fina de espuma de plástico blando. El asa manual 222 está hecha normalmente de un material de espuma similar. Las disposiciones de sujeción complementarias 224 se implementan preferentemente como regiones complementarias de una disposición de sujeción con Velcro, aunque pueden usarse otras disposiciones de bridas o fiadores.
[0043] La extensión de mango envolvente 220 incluye también preferentemente una brida de suspensión de accesorio 226 asociada con la capa envolvente flexible 228 y configurada para suspender un accesorio del manguito cónico (véase fig. 12). La brida de suspensión de accesorio 226 está configurada preferentemente con una configuración de sujeción desprendible (por ejemplo, Velcro) para formar un asa de suspensión desprendible. En una implementación preferida en particular tal como se muestra en este caso, la brida de suspensión de accesorio 226 se implementa como una cola de extensión de una de las bridas de Velcro de la disposición de sujeción 224.
[0044] Tal como se menciona anteriormente, la capa envolvente 228 forma un manguito cónico diseñado para envolver y ajustarse al mango del broncoscopio 240. Cuando el broncoscopio se usa para orientación, la herramienta broncoscópica 242 se instala pendiente del asa 226 tal como se muestra en la fig. 12. Se permite así que el broncoscopista manipule el broncoscopio con las dos manos sin verse estorbado por la herramienta broncoscópica, aunque está sujetando también esa herramienta. Cuando la punta del broncoscopio llega al objetivo, el broncoscopista coloca la palma dentro del mango 222 de manera que el broncoscopio cuelgue, o se apoye, en el dorso de su mano. Entonces el broncoscopista puede manejar la herramienta broncoscópica 242 usando los dedos libres, tal como se muestra en la fig. 13.
[0045] La implementación ilustrada en la presente memoria descriptiva es preferentemente un accesorio desechable de un solo uso. Otras implementaciones similares, que usan materiales diferentes y técnicas diferentes para fijar la herramienta broncoscópica al mango del broncoscopio, también se sitúan dentro del ámbito de la presente invención. En todos los casos, la extensión del mango emplea principios similares en los que el mango de la herramienta está suspendido en una posición que no interfiere con el uso del broncoscopio por parte del médico para desplazarse dentro de los pulmones, y después incluso de alcanzar el objetivo permite al médico manejar la herramienta broncoscópica usando la misma mano a la vez que sigue sujetando el mango del broncoscopio.
[0046] Aunque los aspectos anteriores de la presente invención se han descrito en el contexto de un broncoscopio y de herramientas broncoscópicas, debe observarse que otras aplicaciones que usan otro tipo de endoscopios y herramientas endoscópicas, en las que se requiere sostener las herramientas y el mango del endoscopio al mismo tiempo, también se sitúan dentro del ámbito de la presente invención.
[0047] Se observará que las descripciones anteriores pretenden servir sólo como ejemplos, y que son posibles otras muchas formas de realización dentro del ámbito de la presente invención tal como se define en las reivindicaciones adjuntas.
Claims (4)
- REIVINDICACIONES1. Una pinza para sujetar temporalmente una parte del cuerpo sustancialmente cilíndrica de un accesorio en relación predefinida con el mango de un broncoscopio, comprendiendo la pinza:
- (a)
- una abrazadera exterior (10) configurada para rodear en al menos 180° el mango del broncoscopio;
- (b)
- una parte de fiador flexible (12) desplegada dentro de dicha abrazadera exterior y que rodea en al menos 180° el mango del broncoscopio;
- (c)
- un mecanismo de apriete (16) asociado con dicha abrazadera exterior y configurado para flexionar al menos parte de dicha parte de fiador flexible hacia el interior con respecto a dicha abrazadera exterior de manera que sujete la pinza en el mango del broncoscopio; y
- (d)
- un par de mordazas resilientes (18) interconectadas con al menos una entre dicha abrazadera exterior y dicha parte de fiador flexible, estando dicho par de mordazas resilientes configurado para sujetar un accesorio.
-
- 2.
- La pinza según la reivindicación 1, que comprende además una pieza intercalada resiliente (14) desplegada en dicha parte de fiador.
-
- 3.
- La pinza según la reivindicación 1, en la que dicho par de mordazas resilientes (18) está conformado íntegramente con dicha parte de fiador flexible o
en la que dicho par de mordazas resilientes (18) está configurado para asir la parte del cuerpo sustancialmente cilíndrica del accesorio sustancialmente en perpendicular a una dirección de elongación del mango del broncoscopio. -
- 4.
- La pinza según la reivindicación 1, en la que dicha parte de fiador flexible (12) rodea en al menos aproximadamente 200° el mango del broncoscopio o en no más de aproximadamente 250° el mango del broncoscopio.
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-
2004
- 2004-09-14 AT AT04770514T patent/ATE438335T1/de not_active IP Right Cessation
- 2004-09-14 ES ES10191689T patent/ES2387026T3/es active Active
- 2004-09-14 US US10/571,793 patent/US9089261B2/en active Active
- 2004-09-14 DE DE602004022432T patent/DE602004022432D1/de active Active
- 2004-09-14 ES ES09157586T patent/ES2432616T3/es active Active
- 2004-09-14 AT AT10191689T patent/ATE556643T1/de active
- 2004-09-14 JP JP2006526007A patent/JP2007519425A/ja active Pending
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US8663088B2 (en) | 2014-03-04 |
DE602004022432D1 (de) | 2009-09-17 |
ATE556643T1 (de) | 2012-05-15 |
US20150342444A1 (en) | 2015-12-03 |
US10383509B2 (en) | 2019-08-20 |
EP1667749A4 (en) | 2008-10-22 |
US8317149B2 (en) | 2012-11-27 |
JP2007519425A (ja) | 2007-07-19 |
US20100198006A1 (en) | 2010-08-05 |
WO2005025635A3 (en) | 2007-11-08 |
WO2005025635A2 (en) | 2005-03-24 |
EP1667749B1 (en) | 2009-08-05 |
US20100198015A1 (en) | 2010-08-05 |
US9089261B2 (en) | 2015-07-28 |
US20100198007A1 (en) | 2010-08-05 |
EP2113189B1 (en) | 2013-09-04 |
US20070276180A1 (en) | 2007-11-29 |
ES2387026T3 (es) | 2012-09-11 |
EP2113189A2 (en) | 2009-11-04 |
ATE438335T1 (de) | 2009-08-15 |
EP2113189A3 (en) | 2009-12-30 |
EP1667749A2 (en) | 2006-06-14 |
IL174255A0 (en) | 2006-08-01 |
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