JP2020073196A - Endoscopic instrument - Google Patents

Abstract

To enhance operability of an instrument for operating a basket type device for capturing an object removed from a body of an animal.SOLUTION: There is provided an instrument used by a surgeon for operating a basket type device for capturing an object removed from a body of an animal. The instrument includes a first control device and a second control device. The first control device combines with the basket type device to selectively control the basket type device, and move the basket type device between a first closed position and a second open position. The first control device includes a handle that combines with a plunger to operate a relative position of the plunger with respect to a cylinder of a plunger/cylinder mechanism. The second control device is disposed adjacent to the first control device, and combines with the basket type device to selectively and independently control rotation for the first control device.SELECTED DRAWING: Figure 8

Description

  Example and non-limiting embodiments relate generally to endoscopes, and more particularly to devices for use with endoscopes.

  US Pat. No. 6,764,499 discloses a medical device with a basket. US Pat. No. 8,211,115 discloses retrieval baskets of various sizes.

US Pat. No. 6,764,499 U.S. Pat. No. 8,211,115

  The following summary is intended for purposes of illustration only. This summary is not intended to limit the scope of the claims.

  According to one aspect, an exemplary embodiment can be provided in an instrument for use by a surgeon to manipulate a basket-type device for capturing an object to be removed from the body of an animal, The instrument is adapted to couple to a basket-type device for selectively controlling the basket-type device and for moving the basket-type device between a first closed position and a second open position. A first control device having a handle coupled to the plunger for manipulating the relative position of the plunger with respect to the cylinder of the plunger / cylinder mechanism. And a bus located adjacent to the first controller and for selectively controlling rotation of the basket-type device independent of the first controller. Tsu is as binding to preparative device, and a second control device.

  According to another aspect, example embodiments can be provided in an instrument for use by a surgeon to manipulate a basket-type device for capturing an object to be removed from an animal body. The instrument has a housing having a longitudinal axis and including a passageway, a first portion located in the passageway of the housing, and a second portion extending from the housing. A first control device adapted to couple to the basket-type device for selectively controlling the basket-type device between a first closed position and a second open position. Movable axially in the passageway of the housing for moving the basket-shaped device at, and rotatable in the passageway of the housing for rotating the basket-shaped device when in the second open position. Movable to the first Of the control device and the second portion of the first control device, the end surface being axially moved with the first control device while the first control device is rotating. An end surface that rotates and moves independently of the first control device so that it can be in a fixed and rotated state.

  The foregoing aspects and other features will be employed and described in the following description in conjunction with the accompanying drawings.

It is a side view of an endoscope. FIG. 8 is a side view of the distal end of an endoscopic instrument. 3 is a side view illustrating an extension of the instrument shown in FIG. 2 from the distal end of the endoscope shown in FIG. 1. FIG. FIG. 4 is a perspective view of the proximal end of the endoscopic instrument shown in FIGS. 2-3. FIG. 5 is a schematic diagram illustrating a combination of a sheath and basket type device with the assembly shown in FIG. 4. 5 is an exploded perspective view of the assembly shown in FIG. 4. FIG. FIG. 7 is a cross-sectional view of the outer sleeve of the assembly shown in FIGS. 4 and 6. FIG. 7 is a cross-sectional view of the assembly shown in FIGS. 4 and 6. FIG. 9 is a partial cross-sectional view of the upper button and plunger shown in FIG. 8. 9 is a perspective view of the plunger shown in FIGS. 4, 6 and 8. FIG. 11 is a cross-sectional view of the plunger shown in FIG. FIG. 9 is a perspective view of an alternative embodiment of the connector shown in FIGS. 4 and 8. FIG. 13 is an exploded perspective view of the connector shown in FIG. 12.

  Referring to FIG. 1, a side view of an example device 10 is shown. The device 10 in this example is an endoscopic medical device that is configured to be partially inserted into a patient's body, such as for example through the patient's urethra. The endoscope 10 generally comprises a control portion 12 and a flexible or semi-flexible shaft 14 connected to the control portion 12. In this example, the control portion 12 forms a handle for the device. The shaft 14 includes a passive deflection section 16 and an active deflection section 18 at the distal end of the shaft 14. A control system 22 for controlling the active flexure portion 18 extends from the control portion 12 to the active flexure portion 18. The control system 22 generally comprises a bend control wire, a wire sheath and an actuator 28. The wire is connected at one end to the actuator 28 and at the second end to the active flexure portion 18.

  In the example embodiment shown, the control portion 12 comprises a slide or lever (control lever) 30 operated by the user. The lever 30 is connected to the actuator 28. The actuator 28 is adapted to pull and loosen the wires of the control system 22. When the lever 30 is moved by the user, the actuator 28 moves. The actuator 28 can be, for example, a drum or can be rotatably connected to the control portion 12 while pulling one wire and simultaneously loosening the other wire. In alternative embodiments, the actuator may be any suitable type of device, such as a rocker arm, adapted to pull and loosen the wires of the control system 22. In another alternative embodiment, if the control system can have more than one pair of control wires, the control portion has an additional actuator and a counterpart for driving the additional pair of flexible control wires. Have control to. In yet another alternative embodiment, the control portion may comprise a handle with a rack and pinion mechanism or other suitable control for the control system operated by a user.

  The shaft 14 has one end protruding from the control portion 12. Flexible shaft 14 includes the bendable control wire of control system 22, fiber optic image bundle, fiber optic illumination bundle and working channel. A port 60 for inserting an instrument into the working channel 24 of the shaft is located on the control portion 12. The control portion 12 also has a light source post 62 for connecting a light source (not shown) to the illumination bundle. In addition, the control part 12 has an eyepiece 63 for the user to view the image propagated by the image bundle from the front end 20. In an alternative embodiment, the flexible shaft can be housed inside a different system. Shaft 14 generally comprises a frame 26, a cover 32 and an objective head 34.

  Referring also to FIGS. 2-3, the distal end of endoscopic instrument 36 is shown. The instrument 36 is attached to the device 10 and is configured to extend from the distal end 20 of the shaft 14 from the working channel 24. The instrument 36 is, in this example, a surgeon-controlled basket-type device (Surgeon Controlled Basket Device: SCBD). The instrument 36 includes an assembly 33 with a basket-type device 50 and a sheath 56. The basket-type device 50 comprises a basket portion 52 at the distal end and a shaft portion 54 extending from the sheath 56 to the proximal end of the device 36. The shaft portion 54 functions as a control wire for moving the basket portion 52. The sheath 56 and the basket-type device 50 are longitudinally movable with respect to each other so that the basket-type device 50 moves between a front position and a rear position relative to the sheath 56. 2 and 3 show that the shaft portion (control wire) 54 moves forward with respect to the sheath 56, so that the basket portion 52 is located outside the gap 66 at the front end of the sheath 56. .. In a position in front of the sheath 56 on the basket-type device 50, the basket portion 52 is located inside the sheath 56. The basket portion 52 is deflated by the sheath 56 into a smaller shape that fits inside the sheath 56.

  With further reference to FIGS. 4-5, the instrument 36 in this example comprises a control assembly 70. The control assembly 70 is coupled to the basket-type device 50 and the proximal ends of the sheath 56. The control assembly 70 is attached to the control portion 12 at port 60 and is configured to enter the working channel 24. Although this feature is described with reference to the exemplary embodiments of the control assembly shown in the drawings, it should be understood that this feature can be embodied in many alternative forms of embodiments. .. In addition, any suitable size, shape or type of elements or materials could be used.

  In this example, the control assembly 70 comprises an outer sleeve 72, a connector 74 and a plunger 76. Connector 74 is configured to connect control assembly 70 to control portion 12 at port 60. Outer sleeve 72 is slidably connected to connector 74, as indicated by arrow A in FIG. In this example, the proximal end of sheath 56 is attached to outer sleeve 72, which moves sheath 56 longitudinally when outer sleeve 72 is moved. Plunger 76 is movably mounted on outer sleeve 72 and also slides, as indicated by arrow A. FIG. 4 shows the plunger 76 in its outer home position relative to the outer sleeve 72. From this outer home position, the plunger 76 can be pushed down onto the outer sleeve 72, as indicated by arrow B. The proximal end of the shaft portion 54 of the basket-type device 50 is attached to a plunger 76, which moves longitudinally as the plunger 76 moves longitudinally. Can be moved. Thus, when the plunger 76 is pushed down against the outer sleeve 72, the distal end of the basket-type device 50 extends from the front end gap 66 of the sheath 56. When the plunger 76 is not depressed, the distal end 52 of the basket-type device 50 is retracted toward the front end clearance 66 of the sheath 56.

  In the alternative, the proximal end of the sheath 56 may be connected to the plunger 76 and the proximal end of the shaft portion 54 of the basket-type device 50 may be connected to the outer sleeve 72. In this alternative, the plunger 76 can be depressed from its extended home position to its depressed position on the outer sleeve 72 to move the sheath 56 over the basket portion 52, and the plunger can be moved from its depressed position. Loosen to its extended home position, the sheath 56 can move and clear the basket portion 52.

  Referring also to FIG. 6, an exploded view of control assembly 70 is shown. In the example shown, the control assembly 70 comprises two springs 78, 79 and a top button 80. Referring also to FIG. 7, the top spring 78 is located in the area 82 of the outer sleeve 72 and the bottom spring 79 is located in the area 83 of the outer sleeve 72. As also shown in FIG. 8, a slightly different button 80 'is used. The upper spring 78 is compressed between the surface 92 shown in FIG. 7 and the bottom end 90 of the plunger 76 to extend its extension relative to the outer sleeve 72 as shown in FIGS. 4 and 8. In the home position, the plunger 76 is biased. The top member 88 is connected to the top end of the outer sleeve 72 to maintain the bottom end 90 of the plunger 76 within the region 82.

  The bottom spring 79 biases the outer sleeve 72 away from the connector 74. However, the bottom member 84 is connected to the bottom end of the outer sleeve 72. The bottom member 84 is adjustably positioned on the connector 74. The bottom member 84 engages a recess 86 in the connector 74 at one of a plurality of different longitudinal positions of the connector 74 to adjustably lock the longitudinal position of the outer sleeve 72 on the connector 74. Has a protrusion configured as described above. In the example shown, the outer sleeve 72 can rotate axially with the bottom member 84 and away from the recess 86. The outer sleeve 72 can then be longitudinally slid along the connector 74 to a new longitudinal position. The outer sleeve 72 can then be axially rotated in a direction opposite the bottom member 84 to reengage with the new pair of recesses 86. This can be used to act on the device 10 as a fine adjustment for both the basket-type device 50 and the sheath 56 to move together.

  The upper button 80 is attached to the upper portion of the plunger 76. The upper button 80 is adapted to rotate in the axial direction on the upper portion of the plunger 76. 4 and 6 show an upper button 80 that covers less than half of the upper side of the plunger. 8 and 9 show an upper button 80 'that covers most of the upper surface. However, both upper buttons 80, 80 'function similarly. In particular, the upper buttons 80, 80 'provide an upper surface for the user's finger to push again, yet the plunger 76 is still easily rotatable axially on the outer sleeve 72. Is.

  As seen in FIGS. 9-11, the plunger 76 has an upper end 94. The upper end 94 has finger grooves 96 to provide good frictional contact with the user's fingers. The upper end 94 has a hole 98. The upper buttons 80, 80 'have protrusions 100 that extend into the holes 98. Buttons 80, 80 'are rotatably mounted on the plunger 76 at this ridge / hole boundary. The proximal end of the shaft portion 54 of the basket-type device 50 is fixedly connected to the plunger 76 in the channel that provides the hole 98. However, the shaft portion 54 of the basket-type device 50 is not directly connected to the buttons 80, 80 '. Therefore, when the user places his or her finger on the button 80, 80 ', the user is prevented from axially rotating the button 80, 80' and the user's finger on the button while the plunger is being rotated. By rotating 76 axially, the basket-type device 50 can be rotated axially. This provides a more comfortable sensation to the user's finger, which is less likely to slip off the button / plunger assembly while the plunger is rotating. Become.

  The above-identified example embodiments provide an instrument with a first controller and a second controller. The first controller is formed by a plunger / cylinder mechanism with a button 80 and an outer sleeve 72. This first controller is adapted to move the basket type device linearly. The second controller is formed by the plunger 76 and is adapted to rotate the basket-type device 50 independent of the control of the first controller of the linear movement or position of the basket-type device 50. In the above example, the plunger 76 connects the button 80 to the cylinder formed by the basket-type device 50 and the outer sleeve 72.

  Referring also to FIGS. 12 and 13, an alternative connector is shown. In this example embodiment, connector 102 is configured to replace connector 74. The connector 102 generally comprises an extension shaft 104 and an inner insert 106, a plunger shaft 108 and two buttons 110. The front end 112 of the plunger shaft 108 is adapted to be located in the working channel 24 at port 60. The protrusion facing the interior of the bottom member 84 on the outer sleeve 72 is located in the groove 114. The bottom spring 79 biases the outer sleeve 72 away from the extension shaft 104, but internal protrusions on the bottom member 84 located in the groove 114 maintain the connection of the outer sleeve 72 to the extension shaft 104. .. The bottom spring 79 is compressed to allow the outer sleeve 72 to move downward on the exterior of the extension shaft 104. This allows the sheath 56 and basket type device 50 to move together with respect to the connector 102 and the device 10. The outer sleeve 72 and attached bottom member 84 rotate axially on the extension shaft 104 to move the inner ridges on the bottom member 84 to rotate within the region 116 and above the connector 102 in the forward position. Alternatively, the outer sleeve 72 at the longitudinal position may be fixed.

  Plunger shaft 108 includes a lateral slot 118 and a tooth pocket 120 opposite the slot 118. The slot 118 allows the button 110 to move relative to one another along the longitudinal length of the plunger shaft 108. The tooth pocket 120 allows the teeth 122 in the tooth pocket 120 to mate and be fixed relative to the plunger shaft 108 such that the position of the button 110 is adjustable. The button 110 extends through the slot 118 through a button hole 124 in the inner insert 106. The button 110 can be biased outward by a spring (not shown). The button 110 is depressed inward to move the tooth 122 from the tooth pocket 120 and extend the extension shaft 104 (with attached internal insert 106) longitudinally along the direction of the plunger shaft 108, or Or it can be withdrawn. This feature may allow the use of different endoscopic-equipped instruments with varying lengths of working channels. The length of the connector 102 can be adjusted to accommodate various lengths of working channels. Therefore, the instrument can be used with various types of endoscopes.

  For example, the features described herein may provide an endoscopic instrument having a spin plate, such as a plunger 76, for axially rotating another member, such as, for example, a basket-type device. it can. The features described herein are not necessarily limited to Surgeon Controlled Basket Device (SCBD) controlled surgeons. The features described herein may be used to integrate a plunger mechanism with an axial rotation mechanism into a single simplified design.

  A conventional surgeon-controlled basket-type device (SCBD) device allows a plunger-style basket operator to hold the basket open and rotate the plunger when he desires to rotate the basket. , It is difficult to maintain a stable position and pressure of the finger on the plunger.

  The features described herein allow a finger to maintain pressure on a plunger while rotating the plunger without imposing a rotation on an operator's finger used to maintain pressure. Can be provided. The upper surface rotates independently of the plunger. This allows the plunger to rotate freely without having to be adjusted by the fingers used to apply downward pressure. For example, the top surface, such as button 80 or 80 ', can be attached to the plunger in a manner that holds the top surface stable against the plunger in a direction of movement that results in basket placement (axial). It does not link the radial position of the upper surface with the radial position or movement of the plunger mechanism. This allows the two components to rotate independently of each other while still maintaining a linear relationship.

  In one type of exemplary embodiment, an instrument for use by a surgeon can be provided for manipulating a basket-type device for capturing an object to be removed from the body of an animal, the instrument comprising: Adapted to couple to the basket-type device for selectively controlling the basket-type device and for moving the basket-type device between a first closed position and a second open position. A first control device comprising a plunger / cylinder mechanism and a handle coupled to the plunger for manipulating the relative position of the plunger with respect to the cylinder. A basket located adjacent to the first controller and for selectively controlling rotation of the basket-type device independent of the first controller. It is such as to bind to a device includes a second control device.

  The instrument may further comprise a sheath having a first end and a second end, the sheath for receiving the basket-type device and with respect to the basket-type device, the first closure. Adapted to slide longitudinally between the open position and the second open position, the sheath being coupled to a first control device for translational movement relative to the basket-type device. , The basket type device is coupled to a second controller for rotational movement with respect to the first controller. The instrument can further comprise a first operatively positioned biasing mechanism for biasing the plunger with respect to the cylinder to move the basket-type device toward the first closed position. The instrument may further comprise a locking mechanism coupled to the first controller for locking the plunger in the second open position. The second controller can remain operational when the locking mechanism locks the first controller. The second controller can continue to rotate the basket-type device while the first controller is locked. The instrument may further comprise a second biasing mechanism for biasing the basket-type device relative to the handle and sheath toward the first closed position, the basket-type device secured to the second controller. It is coupled to rotate with. The second biasing mechanism may be coupled to a second control device for biasing the plunger 76 in the direction that the basket moves to the first closed position. The instrument may further comprise a luer coupler, such as connector 74, for selectively coupling the instrument to the endoscope, for example.

  Example embodiments can be provided in an instrument for use by a surgeon to manipulate a basket-type device for capturing an object to be removed from the body of an animal, the instrument having a longitudinal axis. A first control device having a housing including a passage, a first portion located in the passage of the housing, and a second portion extending from the housing. And for coupling the basket-type device to selectively control the basket-type device, for moving the basket-type device between a first closed position and a second open position. , Axially movable in the passageway of the housing and movable in the passageway of the housing to rotate in the passageway of the housing for rotating the basket-type device when in the second open position; Control device of the first, An end surface coupled to the second portion of the control device that moves axially with the first control device and remains stationary and rotated while the first control device is rotating. An end surface that rotates and moves independently of the first control device so that it can be taken.

  The instrument may further comprise a sheath having a first end and a second end, the sheath for receiving the basket-type device and with respect to the basket-type device, the first closure. Adapted to slide longitudinally between the open position and the second open position, the basket-type device is coupled to a first control device for translational movement relative to the sheath, The sheath is coupled to the housing. The instrument further comprises an operatively positioned first biasing mechanism for biasing the first controller with respect to the passage within the housing to move the basket-type device toward the first closed position. be able to. The instrument may further comprise a locking mechanism coupled to the housing for locking the first controller in the second open position. The first controller can continue to take a rotational operation when the locking mechanism locks the first controller in the second open position. The instrument may further comprise a luer coupler for selectively coupling the instrument to the endoscope.

  It should be understood that the above description is merely exemplary. Various alternatives and modifications can be devised by those skilled in the art. For example, the features recited in various dependent claims may be combined with each other in any suitable combination. Moreover, features from the various embodiments described above can be selectively combined in the novel embodiments. Accordingly, this description is intended to embrace all such alterations, modifications and variations that fall within the scope of the appended claims.

(Item 1)
An instrument for use by a surgeon for operating a basket-type device for capturing an object to be removed from a human or animal body, comprising:
Adapted to selectively control the basket-type device and to move the basket-type device between a first closed position and a second open position. The first control device,
Plunger / cylinder mechanism,
A handle coupled to the plunger of the plunger / cylinder mechanism for manipulating the relative position of the plunger / cylinder of the plunger / cylinder mechanism relative to the cylinder;
A second controller disposed adjacent to the first controller for selectively controlling rotation of the basket-type device independently of the first controller. A second controller adapted to couple to the mold device,
An instrument, comprising:
(Item 2)
A sheath having a first end and a second end, the sheath housing the basket-type device between the first closed position and the second open position. And a sheath adapted to slide in the longitudinal direction of the basket-type device,
The sheath is coupled to the first controller for translational movement with respect to the basket-type device, and the sheath for rotational movement of the basket-type device with respect to the first controller. The device according to claim 1, further comprising a sheath coupled to the second control device.
(Section 3)
Further comprising a first biasing mechanism operatively arranged to bias the plunger relative to the cylinder and move the basket-type device toward the first closed position. The device according to item 1 or 2.
(Section 4)
4. A locking mechanism coupled to the first control device for locking the plunger in the second open position, further comprising a locking mechanism. The equipment described in.
(Section 5)
The device according to claim 4, wherein the second control device is in an operable state when the fixing mechanism fixes the first control device.
(Section 6)
A second biasing mechanism for biasing the basket-type device in the direction of the first closed position relative to the handle and the sheath, the basket-type device being the second controller; The device according to any one of claims 1 to 5, characterized in that it is firmly rotationally coupled.
(Section 7)
7. The instrument according to any one of paragraphs 1-6, further comprising a luer coupler for selectively coupling the instrument to an endoscope.

2 Plunger shaft 10 device (endoscope)
12 Control Part 14 Shaft 16 Passive Bend Part 18 Active Bend Part 20 Distal End 22 Control System 24 Working Channel 26 Frame 28 Actuator 30 Lever 32 Cover 33 Assembly 36 Instrument 50 Basket Type Device 52 Basket Part 54 Shaft Part 56 Sheath 60 Port 76 Plunger 78 Spring 79 Spring 80 Button 80 'Button 96 Finger Groove 114 Groove 116 Area 118 Slot 122 Teeth

Claims (6)

An instrument for use by a surgeon for operating a basket-type device for capturing an object to be removed from a human or animal body, comprising:
A housing having a longitudinal axis and including a passage;
A first controller including a first portion located in the passageway of the housing and a second portion extending from the housing, wherein the basket-type device is selectively An axis is provided in the passageway of the housing adapted to couple to the basket-type device for control and to move the basket-type device between a first closed position and a second open position. A first controller movable in a direction and movable in the passageway of the housing to rotate the basket-type device when in the second open position. ,
An end surface coupled to the second portion of the first controller, configured to move axially with the first controller, the first controller rotating. An end surface configured to move rotatably independently of the first controller of the end surface so as to remain rotatably fixed for a period of time;
An instrument, comprising:   Adapted to receive the basket-type device and to slide the basket-type device longitudinally of the basket-type device between the first closed position and the second open position. A sheath having a first end and a second end, the basket-type device being coupled to the first controller for translational movement relative to the sheath; The device of claim 1, further comprising a sheath coupled to the housing.   A first biasing mechanism disposed for biasing the first controller with respect to the passage in the housing to move the basket-type device toward the first closed position; The device according to claim 1, further comprising:   4. The fixing mechanism according to claim 1, further comprising a fixing mechanism coupled to the housing for fixing the first control device in the second open position. The described equipment.   5. The device of claim 4, wherein the first control device continues to take a rotational operation when the locking mechanism locks the first control device in the second open position.   6. The device according to any one of claims 1-5, further comprising a luer coupler for selectively coupling the device to an endoscope.

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