Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
  • A61B1/005—Flexible endoscopes
  • A61B1/0051—Flexible endoscopes with controlled bending of insertion part
  • A61B1/0052—Constructional details of control elements, e.g. handles
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
  • A61B1/005—Flexible endoscopes
  • A61B1/0051—Flexible endoscopes with controlled bending of insertion part
  • A61B1/0055—Constructional details of insertion parts, e.g. vertebral elements
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
  • A61B1/005—Flexible endoscopes
  • A61B1/0051—Flexible endoscopes with controlled bending of insertion part
  • A61B1/0057—Constructional details of force transmission elements, e.g. control wires

Definitions

• the present invention relates to an endoscope. More exactly speaking, the invention relates to an endoscope comprising an endoscope control body having control elements, a flexible insertion tube on the distal side of the endoscope control body, and a bending portion on the distal end of the endoscope, whose bending is controllable by at least one control element.
• Such an endoscope can be used for examining, for example, the intestine or the esophagus, the duodenum, the bile duct, the gall bladder, the pancreatic duct, the pancreas, etc.
• Such an endoscope is inserted into a patient's body tract (intestine, esophagus, etc.) and is advanced until it reaches the place where the desired examination is to take place. In doing so, it can hardly be avoided that, when the endoscope is being advanced, the outer wall of the endoscope touches the inner wall of the body tract. If the pressure exerted by the endoscope on the inner wall of the body tract becomes too high, if the inner wall of the body tract has a prior injury, or if the endoscope repeatedly pushes against the same spot at the inner wall of the body tract, the inner wall of the body tract can be injured.
• a conventional endoscope 1000 comprising a bending portion 4000 on the distal end of the endoscope 1000 is inserted into a large intestine 100. It is shown in Fig. 1 how the distal end of the endoscope 1000 is inserted into the descending colon 102 and is moved further into the transverse colon 103. Between the descending colon 102 and the transverse colon 103, the large intestine 100 takes a relatively sharp bend. In this particular area, it is difficult to advance the endoscope 1000. A high pressure might be exerted by the endoscope 1000 on the area with the relatively sharp bend between descending colon 102 and transverse colon 103.
• an endoscope comprises an endoscope control body having control elements, a flexible insertion tube on the distal side of the endoscope control body, and a first bending portion on the distal end of the flexible insertion tube, wherein a bending of the first bending portion is controllable by at least one control element. Proximally of the first bending portion, this endoscope is provided with at least one further bending portion whose bending is controllable by at least one control element.
• the deflection of the flexible insertion tube can be controlled in the at least one further bending portion independently of a control of a deflection of the first distal bending portion, which is inserted first.
• the deflection of the flexible insertion tube and, thus, the relative position of the flexible insertion tube to the wall of the body tract can be adapted even better to the respectively present situation.
• the individual course of . a patient's intestine can be taken into account better.
• the risk of injuring an inner wall of the body tract, into which the t endoscope is inserted can be reduced.
• the at least one further bending portion can be proximally adjacent to the first bending portion.
• the first bending portion can comprise three, four or more pulling wires, and the at least one further bending portion can comprise three, four or more pulling wires.
• the first bending portion can comprise three, four or more pulling wires, and the at least one further bending portion can comprise one or two pulling wires.
• a second bending portion can be provided, whose bending is controllable by control element, and proximally of the second bending portion, a third bending portion can be provided, whose bending is controllable by control element.
• the insertion tube can comprise three bending portions deflectable independently of each other.
• a fourth bending portion can be provided, whose bending is controllable by control element.
• a fifth, sixth, etc. bending portion can be provided.
• the control elements for controlling the bending of the first bending portion and the at least one further bending portion can be provided on the endoscope control body. In this way, the deflection control can be handled easily.
• the respective bending portions can respectively be controllable independently of each other.
• control elements for controlling the bending of the first bending portion and of the at least one further bending portion can be manually operable.
• controlling of the bending of the first bending portion and of the at least one further bending portion can be performed by motor.
• the control element for the first bending portion can comprise two control wheels
• the control element for the second bending portion can comprise two control wheels
• the control element for the third bending portion can be a control lever
• a non-controllable flexible intermediate portion can be arranged between the first controllable bending portion and the second controllable bending portion.
• the entire length of the flexible insertion tube can be provided with controllable bending portions.
• the endoscope may be a duodenoscope, a coloscope, a gastroscope, or a bronchoscope. However, the endoscope may also be any other endoscope.
• Fig. 1 shows a schematic view of a conventional endoscope comprising a bending portion inserted into a large intestine.
• Fig. 2. shows a schematic view of an endoscope of a first embodiment of the present invention.
• Fig. 3 shows a schematic view of an endoscope control body of the endoscope according to the first embodiment.
• Fig. 4 shows a schematic view of the endoscope of the first embodiment inserted into a large intestine.
• Fig. 5 shows a schematic view of the endoscope of the first embodiment inserted into a large intestine, as viewed from another side.
• Fig. 6 shows a schematic view of the endoscope of the first embodiment of the present invention.
• Fig. 2 shows a schematic view of an endoscope 1 of a first embodiment of the present invention.
• the distal portion of the endoscope 1 of the first embodiment is shown.
• the endoscope 1 of the first embodiment has an endoscope tube which is designed as a flexible insertion tube 2.
• the insertion tube 2 comprises three bending portions 4A, 4B and 4C respectively designed as bending unit.
• the endoscope 1 comprises a first bending portion 4A, a second bending portion 4B and a third bending portion 4C.
• the first bending portion 4A has an endoscope head 5.
• the first bending portion 4A is designed such that it comprises four pulling wires (not shown).
• These four pulling wires which are not shown, are arranged in a sheath of the first bending portion 4A in a manner evenly spaced apart from one another (by 90°) in the circumferential direction, and extend in the proximal direction from the distal end of the first bending portion 4A to a first control mechanism 11 which will be described in the following.
• the first control mechanism 11 comprises two control wheels. In Figures 3 and 6, the two control wheels of the first control mechanism 11 are arranged one behind the other, so that the viewer only perceives one control wheel. The two control wheels of the first control mechanism 11 are arranged on the same axis. Each control wheel controls two pulling wires arranged radially opposite to each other at the sheath of the first bending portion 4A.
• the first bending portion 4A (more precisely, the endoscope head 5) can be pivoted in one plane relative to the second bending portion 4B towards the viewer and away from the viewer, when looking at Fig. 2, for example.
• the first bending portion 4A (more precisely, the endoscope head 5) can be pivoted upwards and downwards in one plane relative to the second bending portion 4B, when looking at Fig. 2, for example.
• the first bending portion 4A can, by the appropriate actuation of both control wheels of the first control mechanism 11, be bent into any direction relative to the second bending portion 4B.
• the second bending portion 4B is also designed such that it comprises four pulling wires (not shown). These four pulling wires which are not shown are arranged in a sheath of the second bending portion 4B in a manner evenly spaced apart from one another (by 90°) in the circumferential direction, and extend in the proximal direction from the distal end of the second bending portion 4B to a second control mechanism 12 which will be described in the following.
• the second control mechanism 12 comprises two control wheels.
• the two control wheels of the second control mechanism 12 are arranged one behind the other, so that the viewer only perceives one control wheel.
• the two control wheels of the second control mechanism 12 are arranged on the same axis.
• Each control wheel controls two pulling wires arranged radially opposite to each other at the sheath of the second bending portion 4B.
• the second bending portion 4B can be pivoted in one plane relative to the third bending portion 4C towards the viewer and away from the viewer, when looking at Fig. 2, for example.
• the second bending portion 4B can be pivoted upwards and downwards in one plane relative to the third bending portion 4C, when looking at Fig. 2, for example.
• the second bending portion 4B can, by the appropriate actuation of both control wheels of the second control mechanism 12, be bent into any direction relative to the third bending portion 4C.
• the third bending portion 4C is designed such that it comprises two pulling wires (not shown). These two pulling wires which are not shown are arranged in a sheath of the third bending portion 4C in a manner evenly spaced apart from one another (by 180°) in the circumferential direction, and extend in the proximal direction from the distal end of the third bending portion 4C to a third control mechanism 13 which will be described in the following.
• the third control mechanism 13 is formed as a control lever 13.
• the control lever 13 is shown in a neutral position in which the third bending portion 4C is not deflected.
• the control lever 13 is arranged on the same axis as the two control wheels of the first control mechanism 11.
• a wheel (not shown) which is supported on the same shaft in parallel to but independently of the two control wheels of the first control mechanism 11, can be rotated about this shaft by the control lever 13.
• the ends of the pulling wires for the third bending portion 4C are fastened.
• the ends of the pulling wires for the third bending portion 4C are fastened to the wheel of the control lever 13 such that, in the neutral position, a first pulling wire is anchored at the uppermost point of the outer circumference of the wheel of the control lever 13, when looking at Figures 3 and 6, and a second pulling wire is anchored at the lowermost point of the outer circumference of the wheel of the control lever 13, when looking at Figures 3 and 6.
• the third bending portion 4C can be pivoted in one plane relative to the remaining insertion tube 2 towards the viewer and away from the viewer, when looking at Fig. 2, for example, or it can be pivoted upwards and downwards in one plane relative to the remaining insertion tube 2, when looking at Fig. 2, for example.
• the third bending portion 4C can, by the appropriate actuation of the control lever 13, be bent into different directions relative to a portion which is proximal of the third bending portion 4C.
• the two control wheels of the first control mechanism 11, the two control wheels of the second control mechanism 12, and the control lever 13 are arranged at the endoscope control body 10, as is shown in Fig. 3.
• the user can actuate all control mechanisms 11, 12 and 13 by the thumb of the hand holding the endoscope control body 10.
• Each of the bending portions 4A, 4B, 4C can, via its own pulling wires, be controlled completely independently of the other bending portions.
• the endoscope control body 10 is connected to an endoscope plug via a cable 21.
• the flexible insertion tube 2 comprises three bending portions, namely, seen from the distal side, a first bending portion 4A, a second bending portion 4B and a third bending portion 4C.
• the flexible insertion tube 2 additionally comprises a fourth bending portion which is arranged proximally of the third bending portion 4C.
• the fourth bending portion is controlled by pulling wires in a manner similar to the third bending portion 4C.
• a control lever is arranged which, in design and function, resembles the control lever 13.
• the control lever for the fourth bending portion can be arranged on the axis of the second control mechanism 12 and can be actuated in a manner similar to the control lever 13.
• the distal end of the endoscope according to the invention is inserted into the descending colon 102 and is moved further into the transverse colon 103.
• the large intestine 100 takes a relatively sharp bend between the descending colon 102 and the transverse colon 103.
• the first bending portion 4A having the endoscope head 5 has already been pushed past this relatively sharp bend of the intestine.
• the endoscope according to the invention reaches a position in which a wall of the endoscope proximally of the first bending portion 4A can come into contact with the wall of the intestine, as indicated in Figures 4 and 5.
• the second bending portion 4B is controlled such that it bends more strongly, i.e. its bending or curvature is increased, and the endoscope is inserted further.
• the endoscope can be pushed past the relatively sharp bend of the intestine more easily.
• the user can generate an alternate relative position of the respective bending portions.
• the relative position between the inner wall of the large intestine and the respective bending portions of the endoscope changes permanently.
• the endoscope according to the invention can be inserted more easily.
• the present invention provides an endoscope which can adapt well to the respective course of the intestine.
• the user can control the respective bending portions of the endoscope separately in such a manner as is most advantageous for the respectively present insertion situation of the endoscope in the intestine.
• advancing the endoscope becomes easy.
• control elements which control the respective bending portions of the endoscope are all arranged close to each other at the endoscope control body 10. These control elements are easy to reach for the user. The user can actuate these control elements even with one hand or with one thumb. Thus, the invention provides a very compact control mechanism for all bending portions of the endoscope. Moreover, the control elements are clearly arranged.
• control mechanisms 11, 12 and 13 are manually actuatable.
• controlling of the respective bending portions 4A, 4B, 4C is respectively performed by motor.
• the pulling wire actuating elements can (similar as in the first and second embodiment) be wheels which are driven to the desired positions by motor. In respect of the third and further bending portion, also a use of four pulling wires would be conceivable.
• the respective motors can be controlled such that, when inserting the endoscope into a specific large intestine, previously obtained geographic route data about this specific large intestine (data about the exact course of precisely this large intestine) is accessed.
• the endoscope can be fully automatically advanced in the specific large intestine without injuring the wall of the intestine.
• the second bending portion 4B has four pulling wires which are actuated by the two control wheels of the second control mechanism 12.
• the second bending portion 4B may only have one or two pulling wires which are actuated by a control lever which is actuatable in a manner similar to the control lever 13.
• Each of the bending portions can basically be actuated by a suitable arbitrary number of pulling wires, with the respective control mechanisms then being adapted to the number of the pulling wires.
• the use of a higher number of pulling wires per bending portion brings about a more accurate deflection capability of this bending portion; here, a deflection using four pulling wires can be deemed to be sufficiently accurate in many cases.
• the use of a lower number of pulling wires per bending portion makes control easier, in particular if a large number of bending portions are incorporated in an endoscope.
• the first bending portion 4A is arranged adjacent to the second bending portion 4B.
• a flexible endoscope tube portion which is not controllable, can remain between the first bending portion 4A and the second bending portion 4B.
• the entire length of the flexible insertion tube 2 can be provided with controllable bending portions.
• the flexible insertion tube 2 is, in sections, separately bendable in its entire length.
• the length of the respective bending portions can, but does not have to be, equal to each other.
• the use of the endoscope of the present invention in a large intestine is described.
• the invention is not limited thereto.
• the endoscope of the present invention can be designed such that it is suitable for a use in any kind of body tract. List of reference signs
• control mechanism comprising two control wheels
• control mechanism comprising two control wheels
• control mechanism comprising a lever

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• Health & Medical Sciences (AREA)
• Life Sciences & Earth Sciences (AREA)
• Surgery (AREA)
• Biomedical Technology (AREA)
• Medical Informatics (AREA)
• Optics & Photonics (AREA)
• Pathology (AREA)
• Radiology & Medical Imaging (AREA)
• Biophysics (AREA)
• Engineering & Computer Science (AREA)
• Physics & Mathematics (AREA)
• Heart & Thoracic Surgery (AREA)
• Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
• Molecular Biology (AREA)
• Animal Behavior & Ethology (AREA)
• General Health & Medical Sciences (AREA)
• Public Health (AREA)
• Veterinary Medicine (AREA)
• Instruments For Viewing The Inside Of Hollow Bodies (AREA)
• Endoscopes (AREA)

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Citations (6)

Family Cites Families (1)

• 2017
  • 2017-02-24 DE DE102017103819.1A patent/DE102017103819A1/de active Pending
• 2018
  • 2018-02-16 CN CN201890000488.XU patent/CN212661780U/zh active Active
  • 2018-02-16 WO PCT/IB2018/000117 patent/WO2018154376A1/en active Application Filing

Patent Citations (6)

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