GB2602994A - Bladder tumour retrieval device - Google Patents

Bladder tumour retrieval device Download PDF

Info

Publication number
GB2602994A
GB2602994A GB2100890.9A GB202100890A GB2602994A GB 2602994 A GB2602994 A GB 2602994A GB 202100890 A GB202100890 A GB 202100890A GB 2602994 A GB2602994 A GB 2602994A
Authority
GB
United Kingdom
Prior art keywords
housing
shaft
handle
tissue
retrieval device
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.)
Pending
Application number
GB2100890.9A
Other versions
GB202100890D0 (en
Inventor
Musgrove Faith
Nagtegaal Marno
Stokes Talia
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.)
Gyrus Medical Ltd
Original Assignee
Gyrus Medical 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 Gyrus Medical Ltd filed Critical Gyrus Medical Ltd
Priority to GB2100890.9A priority Critical patent/GB2602994A/en
Publication of GB202100890D0 publication Critical patent/GB202100890D0/en
Publication of GB2602994A publication Critical patent/GB2602994A/en
Pending legal-status Critical Current

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22031Gripping instruments, e.g. forceps, for removing or smashing calculi
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/29Forceps for use in minimally invasive surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/221Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00287Bags for minimally invasive surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00353Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery one mechanical instrument performing multiple functions, e.g. cutting and grasping
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0042Surgical instruments, devices or methods, e.g. tourniquets with special provisions for gripping
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0046Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22072Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an instrument channel, e.g. for replacing one instrument by the other

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Medical Informatics (AREA)
  • Animal Behavior & Ethology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Molecular Biology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Vascular Medicine (AREA)
  • Ophthalmology & Optometry (AREA)
  • Surgical Instruments (AREA)

Abstract

A bladder tumour retrieval device comprising a housing 12, a first elongate shaft 14 extending from the housing 12, the housing 12 and first elongate shaft 14 defining an aperture 16 therethrough, a tissue grasper extending from the housing, the tissue grasper comprising a handle 42, a trigger mechanism 44 located adjacent a first end portion of the handle, and a second shaft 40 extending from a second end portion of the handle 42, a tissue retrieval system comprising an elongate deployment handle having a first portion engageable with the housing, a second portion distal to the first portion and extendable through the aperture, and a tissue retrieval bag arranged adjacent the second portion, and an irrigation system engageable with the housing and in fluid communication with the aperture. A portion of the tissue grasper handle is integral with the housing and the first end portion of the handle extends away from the housing in a first direction and the second end portion of the handle extends away from the housing in a second direction opposing the first direction.

Description

BLADDER TUMOUR RETRIEVAL DEVICE
The present invention relates to a bladder tumour retrieval device. In particular, the present invention relates to a bladder tumour retrieval device having a tissue grasper function that is operable by either hand of a user.
BACKGROUND OF THE INVENTION
Endoscopic and laparoscopic surgical techniques are well-known for abdominal operations and, in particular, abdominal operations for the removal of tumour tissue, without the need for the large incisions required by traditional surgery techniques. Typically, when performing tissue removal using endoscopic or laparoscopic techniques, it is necessary to have three separate devices inserted into the patient i.e., the camera, a grasping/cutting device, and a tissue retrieval bag. This requires at least three separate incisions to be made in the patient, or a single enlarged incision. This is undesirable for a patient and it can lead to increased risk of infection, longer recovery times and increased discomfort for the patient during recuperation.
One solution to this is would be to incorporate one of more of these functions within a single device. However, such multifunctional devices present the various functions in a predefined arrangement, which may not suit the preferences of the surgeon using the device. For example, a left-handed surgeon and a right-handed surgeon will have different preferences with respect to the location of the respective manipulation functions of each function within the combined device. Obviously, it is possible to provide a variety of differently designed instruments from which a surgeon may select their preferred instrument for use during surgery. However, this is an expensive option requiring multiple devices with different designs.
There is therefore a need for an alternative surgical instrument design. The present 25 invention seeks to address the problems of prior art devices.
SUMMARY OF THE INVENTION
Aspects of the present invention are set out in the attached claims.
A first aspect of the present invention provides a bladder tumour retrieval device comprising; a housing; a first elongate shaft extending from the housing, the housing and first elongate 30 shaft defining an aperture therethrough; a tissue grasper extending from the housing, the tissue grasper comprising a handle, a trigger mechanism located adjacent a first end portion of the handle, and a second shaft extending from a second end portion of the handle; a tissue retrieval system comprising an elongate deployment handle having a first portion engageable with the housing, a second portion distal to the first portion and extendable through the aperture, and a tissue retrieval bag arranged adjacent the second portion; and an irrigation system engageable with the housing and in fluid communication with the aperture, wherein, at least a portion of the tissue grasper handle is integral with the housing and the first end portion of the handle extends away from the housing in a first direction and the second end portion of the handle extends away from the housing in a second direction opposing the first direction.
The tissue grasper handle may be integral with the housing or may be removably engageable with the housing.
By integrating a portion of the tissue grasper within the housing of the device, it is possible to avoid having to mount the tissue grasper on one side of the device. Thus, no matter whether a user is right-handed or left-handed, they will be able to access the tissue grasper.
This is advantageous over mounting the tissue grasper on a side of the device, which only accommodates either a left-handed user or a right-handed user, depending on what side the tissue grasper is located.
In one embodiment, the shaft defines a first axis, and the handle defines a second axis, the first and second axes extending in a common plane defined by a cross-section through the 20 shaft and housing. Thus, the tissue grasper is centrally located within the housing and therefore equally as accessible from either side of the device.
In a further embodiment, the trigger is arranged proximal to the first shaft and the second end portion of the handle is arranged distal to the first shaft.
Alternatively, the trigger may be arranged distal to the first shaft and the second shaft is 25 arrange proximal to the first shaft.
The trigger and second shaft may be located on the same side of the first axis. For example, the whole of the tissue grasper may be located below the axis defined by the shaft. This is particularly advantageous when the housing is a pistol grip style design.
Alternatively, the trigger may be located on an opposing side of the first axis to the second 30 shaft. This is particularly advantageous when the housing is a straight handle style design.
BRIEF DESCRIPTION OF THE DRAWINGS
Embodiments of the present invention will now be described by way of example only and with reference to the following figures: Figure 1 is a side view of a first embodiment of a bladder tumour retrieval device housing, shaft, deployment bag, syringe, and tissue grasper in accordance with the present 5 invention; Figure 2A is a side view of a second embodiment of a bladder tumour retrieval device housing, shaft, deployment bag, syringe, and tissue grasper in accordance with the present invention; and Figure 2B is a side view of a third embodiment of a bladder tumour retrieval device 10 housing, shaft, deployment bag, syringe, and tissue grasper in accordance with the present invention.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
Figure 1 shows a bladder tumour retrieval device 10 comprising a pistol grip style housing 12 and shaft 14, both of which define an aperture 16 therethrough.
Housing 12 includes a fluid reservoir receiving cavity in the form of a syringe cavity 26 to which a syringe 28 may be connected. Syringe cavity 26 is in fluid communication with aperture 16 such that, in use, fluid expelled from a connected syringe 28 on depression of syringe plunger 29 will flow through syringe cavity 26 and through aperture 16 in housing 12 and shaft 14 and be expelled from the end 30 of shaft 14 distal to housing 12.
Housing 12 further includes a bag deployment handle receiving portion 32 to which a bag deployment handle 34 may be connected. Bag deployment handle 34 is provided with grip 35 for gripping by a user when manipulating the bag deployment handle 34. A collar 36 is provided on housing 12 through which bag deployment handle 34 extends during use. Collar 36 retains bag deployment handle 34 in a suitable position for ease of access by a user. Bag deployment handle 34 is in mechanical communication with a tissue bag (not shown). During use, the tissue bag is located within shaft 14. Once the end 30 of shaft 14 has been inserted into the body cavity of a patient, bag deployment handle 34 may be operated by a user to deploy the tissue bag i.e., to extend the tissue bag beyond the end 30 of shaft 14 within the body cavity. Once deployed, the tissue bag may be used to collect retrieved tissue before being withdrawn, either fully or partially, back into shaft 13 on further operation of the bag deployment handle 34 by the user. Distal end 30 of shaft 14 may then be withdrawn from the body cavity and the retrieved tissue removed from the tissue bag for further analysis and/or disposal.
Bladder tumour retrieval device 10 further comprises a tissue grasper 38. Tissue grasper 38 comprises a shaft 40 and a handle 42 engaged with shaft 40.
A trigger mechanism 44 is provided at an end 47 of the handle 42 distal to shaft 40. Shaft 40 extends from handle 42 and extends into housing 12 through tissue grasper receiving portion 43 and along aperture 16 in housing 12 and shaft 14 of bladder tumour retrieval device 10.
A portion of handle 42 is integral to housing 12. The portion of handle 42 that is integral to housing 12 is centrally located within housing 12 such that the handle may be accessed equally from either side of the housing 12. Thus, whether the device is gripped by a right-handed user or a left-handed user, the user will be able to comfortably access the tissue grasper trigger from either side of the device 10.
Tissue grasper 38 further comprises conventional tissue grasping jaws or surgical tweezers (not shown) at an end of shaft 40 distal to trigger mechanism 44. Opening or closing of the jaws or tweezers may be initiated by operation of the trigger mechanism 44 by a user after shaft 40 has been extended sufficiently through aperture 16 that tissue grasping jaws/surgical tweezers extend beyond distal end 30 of shaft 14.
Figures 2A and 2B show a second embodiment of a bladder tissue retrieval device 10 comprising a straight handle style housing 12, and shaft 14, both of which define an aperture 16 therethrough.
Housing 12 includes a fluid reservoir receiving cavity in the form of a syringe cavity 26 to which a syringe 28 may be connected. Syringe cavity 26 is in fluid communication with aperture 16 such that, in use, fluid expelled from a connected syringe 28 on depression of syringe plunger 29 will flow through syringe cavity 26 and through aperture 16 in housing 12 and shaft 14 and be expelled from the end 30 of shaft 14 distal to housing 12.
Housing 12 further includes a bag deployment handle receiving portion 32 to which a bag deployment handle 34 may be connected. In figure 2A, bag deployment handle receiving portion 32 is located distal to, and in line with, shaft 14, such that shaft 14 and bag deployment handle 34 define a single axis therethrough. In figure 2B, bag deployment handle receiving portion 32 is located on the lower side of housing 12 such that bag deployment handle 34 extends downwards from housing 12 in a direction away from shaft 14.
In the embodiments of figures 2A and 2B, bag deployment handle 34 is provided with grip 35 for gripping by a user when manipulating the bag deployment handle 34.
Bag deployment handle 34 is in mechanical communication with a tissue bag (not shown) via aperture 14. During use, the tissue bag is located within shaft 14. Once the end 30 of shaft 14 has been inserted into the body cavity of a patient, bag deployment handle 34 may be operated by a user to deploy the tissue bag, i.e. to extend the tissue bag beyond the end 30 of shaft 14 within the body cavity. Once deployed, the tissue bag may be used to collect retrieved tissue before being withdrawn, either fully or partially, back into shaft 13 on further operation of the bag deployment handle 34 by the user. Distal end 30 of shaft 14 may then be withdrawn from the body cavity and the retrieved tissue removed from the tissue bag for further analysis and/or disposal.
Bladder tumour retrieval device 10 further comprises a tissue grasper 38. Tissue grasper 38 15 comprises a shaft 40 and a handle 42 engaged with shaft 40.
A trigger mechanism 44 is provided at an end 47 of the handle 42 distal to shaft 40. Shaft 40 extends from handle 42 and extends into housing 12 through tissue grasper receiving portion 43 and along aperture 16 in housing 12 and shaft 14 of bladder tumour retrieval device 10.
In the embodiments of figures 2A and 2B, tissue grasper 38 is arranged such that trigger mechanism 44 is located on the opposite side of the axis through shaft 14 to shaft 40. This facilitates access to trigger mechanism 44 by a user gripping straight handle style housing 12.
A portion of handle 42 is integral to housing 12. The portion of handle 42 that is integral to housing 12 is centrally located within housing 12 such that the handle may be accessed equally from either side of the housing 12. Thus, whether the device is gripped by a right-handed user or a left-handed user, the user will be able to comfortably access the tissue grasper trigger from either side of the device 10.
Tissue grasper 38 further comprises conventional tissue grasping jaws or surgical tweezers 30 (not shown) at an end of shaft 40 distal to trigger mechanism 44. Opening or closing of the jaws or tweezers may be initiated by operation of the trigger mechanism 44 by a user after shaft 40 has been extended sufficiently through aperture 16 that tissue grasping jaws/surgical tweezers extend beyond distal end 30 of shaft 14.
When used, for example by a surgeon carrying out a medical procedure, the user may opt to grip housing 12 with their right-hand and operate the trigger mechanism 44 with their left-hand, or vice versa. The centred location of the integral tissue grasper 38 allow the user to have equal and comfortable unobstructed access to trigger mechanism 44 whether they choose to operate the trigger mechanism 44 with their right or their left hand. The decision on which hand to use to operate the trigger mechanism 44 may be influenced by several factors, including the user's right-handed or left-handed preference and/or the user's hand 10 strength.
It is to be appreciated that, during use of all embodiments of the present invention, a camera feed could be extended through aperture 16 of device 10 to facilitate the user viewing the body cavity throughout the procedure, thus further minimising the number of devices required during a surgical procedure.

Claims (6)

  1. CLAIMS: 1. A bladder tumour retrieval device comprising; a. housing; b. a first elongate shaft extending from the housing, the housing and first elongate shaft defining an aperture therethrough; c. a tissue grasper extending from the housing, the tissue grasper comprising a handle, a trigger mechanism located adjacent a first end portion of the handle, and a second shaft extending from a second end portion of the handle; d. a tissue retrieval system comprising an elongate deployment handle having a first portion engageable with the housing, a second portion distal to the first portion and extendable through the aperture, and a tissue retrieval bag arranged adjacent the second portion; e. an irrigation system engageable with the housing and in fluid communication with the aperture; wherein, at least a portion of the tissue grasper handle is integral with the housing and the first end portion of the handle extends away from the housing in a first direction and the second end portion of the handle extends away from the housing in a second direction opposing the first direction.
  2. 2 A bladder tumour retrieval device as claimed in claim 1, wherein the shaft defines a first axis and the handle defines a second axis, the first and second axes extending in a common plane defined by a cross-section through the shaft and housing.
  3. 3 A bladder tumour retrieval device as claimed in claim 1 or claim 2, wherein the trigger is arranged proximal to the first shaft and the second end portion of the handle is arranged distal to the first shaft
  4. 4. A bladder tumour retrieval device as claimed in claim 1 or claim 2, wherein the trigger is arranged distal to the first shaft and the second shaft is arrange proximal to the first shaft.
  5. 5. A bladder tumour retrieval device as claimed in claim 3 wherein the trigger and second shaft are located on the same side of the first axis.
  6. 6. A bladder tumour retrieval device as claimed in claim 4, wherein the trigger is located on an opposing side of the first axis to the second shaft.
GB2100890.9A 2021-01-22 2021-01-22 Bladder tumour retrieval device Pending GB2602994A (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
GB2100890.9A GB2602994A (en) 2021-01-22 2021-01-22 Bladder tumour retrieval device

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
GB2100890.9A GB2602994A (en) 2021-01-22 2021-01-22 Bladder tumour retrieval device

Publications (2)

Publication Number Publication Date
GB202100890D0 GB202100890D0 (en) 2021-03-10
GB2602994A true GB2602994A (en) 2022-07-27

Family

ID=74858874

Family Applications (1)

Application Number Title Priority Date Filing Date
GB2100890.9A Pending GB2602994A (en) 2021-01-22 2021-01-22 Bladder tumour retrieval device

Country Status (1)

Country Link
GB (1) GB2602994A (en)

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2004002334A1 (en) * 2002-06-28 2004-01-08 Ethicon Gmbh Surgical instrument
US20140025048A1 (en) * 2004-12-01 2014-01-23 Boston Scientific Scimed, Inc. Single operator medical device handles and related methods of use
US20170007345A1 (en) * 2006-12-01 2017-01-12 Boston Scientific Scimed, Inc. Medical systems comprising tool members
US20180206863A1 (en) * 2017-01-23 2018-07-26 Boston Scientific Scimed, Inc. Medical device handles and related methods
US20190038113A1 (en) * 2017-08-07 2019-02-07 Boston Scientific Scimed, Inc. Medical systems, devices, and related methods
US20200060665A1 (en) * 2017-02-15 2020-02-27 Bjerggaard Urologi v Jørgen Bjerggaard Jensen Interventional device for specimen retrieval

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2004002334A1 (en) * 2002-06-28 2004-01-08 Ethicon Gmbh Surgical instrument
US20140025048A1 (en) * 2004-12-01 2014-01-23 Boston Scientific Scimed, Inc. Single operator medical device handles and related methods of use
US20170007345A1 (en) * 2006-12-01 2017-01-12 Boston Scientific Scimed, Inc. Medical systems comprising tool members
US20180206863A1 (en) * 2017-01-23 2018-07-26 Boston Scientific Scimed, Inc. Medical device handles and related methods
US20200060665A1 (en) * 2017-02-15 2020-02-27 Bjerggaard Urologi v Jørgen Bjerggaard Jensen Interventional device for specimen retrieval
US20190038113A1 (en) * 2017-08-07 2019-02-07 Boston Scientific Scimed, Inc. Medical systems, devices, and related methods

Also Published As

Publication number Publication date
GB202100890D0 (en) 2021-03-10

Similar Documents

Publication Publication Date Title
US6282442B1 (en) Multi-fit suction irrigation hand piece
US5186714A (en) Multifunctional surgical instrument
US5830231A (en) Handle and actuating mechanism for surgical instruments
US9579090B1 (en) Surgical instrument with multiple instrument interchangeability
US4261346A (en) Endoscopes
KR102074171B1 (en) Combinational scissor-grasper tool for use in laparoscopy
US5499997A (en) Endoscopic tenaculum surgical instrument
US7666181B2 (en) Multi-purpose minimally invasive instrument that uses a micro entry port
EP0920280B1 (en) Fingertip-mounted minimally invasive surgical instruments
KR102056153B1 (en) Bidirectional vertebral endoscopic device for surgery
US5685877A (en) Mutiple tool laparoscopic surgical instrument
US20190150902A1 (en) Invasive instrument for treating vessels
CN113194808B (en) Ear visualization and processing system
JPH10174689A (en) Surgical tool for endoscope
US20110245602A1 (en) Flexible endoscope with full-length lumen
US9439648B1 (en) Suture passer with retractable needle sheath
CN214966315U (en) Thoracoscope operation aspirator
CN107530194A (en) Eye surgery device handle and associated device, system and method
GB2602994A (en) Bladder tumour retrieval device
GB2602993A (en) Bladder tumour retrieval device for single user operation
CN211511962U (en) Ultrasonic knife handle with flow-adjustable suction device for laparoscopic surgery
EP0638279A1 (en) Endoscope with retractable tool
WO1993008867A2 (en) Apparatus for laparoscopic and endoscopic surgery
EP0578102B1 (en) Dispenser for accessories for endoscopic surgical instrument
JP4465179B2 (en) Anoscope