WO2019072988A1 - Joint de canal de travail - Google Patents

Joint de canal de travail Download PDF

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Publication number
WO2019072988A1
WO2019072988A1 PCT/EP2018/077777 EP2018077777W WO2019072988A1 WO 2019072988 A1 WO2019072988 A1 WO 2019072988A1 EP 2018077777 W EP2018077777 W EP 2018077777W WO 2019072988 A1 WO2019072988 A1 WO 2019072988A1
Authority
WO
WIPO (PCT)
Prior art keywords
seals
sealing system
working channel
inlet nozzle
closure element
Prior art date
Application number
PCT/EP2018/077777
Other languages
German (de)
English (en)
Inventor
Martin Horn
Hannes Miersch
Original Assignee
Olympus Winter & Ibe Gmbh
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 Olympus Winter & Ibe Gmbh filed Critical Olympus Winter & Ibe Gmbh
Publication of WO2019072988A1 publication Critical patent/WO2019072988A1/fr

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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
    • A61B1/012—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
    • 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
    • A61B1/00112—Connection or coupling means
    • A61B1/00119—Tubes or pipes in or with an endoscope
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00131—Accessories for endoscopes
    • A61B1/00137—End pieces at either end of the endoscope, e.g. caps, seals or forceps plugs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00064—Constructional details of the endoscope body
    • A61B1/00066—Proximal part of endoscope body, 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
    • A61B1/00112—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
    • 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
    • A61B1/303—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the vagina, i.e. vaginoscopes
    • 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
    • A61B1/307—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the urinary organs, e.g. urethroscopes, cystoscopes

Definitions

  • the invention relates to a medical endoscope with a shaft portion referred to in the preamble of claim 1.
  • Medical endoscopes are instruments with an elongate tubular flexible or rigid shaft and optics used for the optical, minimally invasive examination of interiors of the human body. Endoscopes usually have one or more working channels for inserting through instruments such as guidewires, catheters, flexible forceps, hypodermic needles, laser fibers, stone baskets or stents.
  • these working channels terminate at the proximal end of the endoscope in an inlet nozzle which is either angled away from the shaft longitudinal axis or, if the optical device required for viewing the surgical area is angled away from the shaft axis, is arranged in the proximal end region of the endoscope shaft.
  • the endoscope should be liquid-tight and substantially gas-tight during operation to its proximal end, which is external to the patient in the hands of the surgeon.
  • this requirement concerns the working channels since, when open, they would allow passage of relatively large quantities of liquid or gas.
  • the working channels must therefore be sealed so that they ensure sufficient tightness, both when they are not in use, as well as when a through instrument is pushed through them.
  • current inlet connections comprise a lock system. These systems consist, for example, of a combination of a proximal sealing cap closing the open end of the inlet nozzle with a valve located inside the inlet nozzle.
  • the cleaning of such lock systems is associated with considerable difficulties.
  • the operation is made difficult by the fact that the sealing cap usually seals only with the instrument plugged in, so that the valve disposed in the interior of the inlet nozzle valve should be opened after inserting the instrument in the sealing cap. Since the endoscope is usually held with one hand, the surgeon must use the second hand - one-handed - to insert the passage instrument and open the valve in the inlet port.
  • the invention relates to a medical endoscope having a shaft part, wherein the endoscope comprises one or more working channels passing through the shaft part, wherein the working channel (s) each lead in its proximal end region through an inlet connection to a proximal instrumentation opening and wherein the inlet nozzle comprises a sealing system for fluid-tight sealing of the working channel in the axial direction, and the sealing system has at least two seals, the seals being axially spaced from each other by a cavity and each having a passageway through which through-instruments can be inserted into the working channel, characterized in that at least one passage of the sealing system is formed as a self-closing opening and that the seals are reversibly removable for cleaning the working channel from the inlet nozzle and the seal at the proximal end and / or the seal at the distal end of the cavity reversible from the respective end of the cavity to Cleaning the cavity is removable.
  • the lock system described herein may be used in any type of medical endoscope.
  • the medical endoscope can z. B. be a urological or gynecological endoscope.
  • the endoscope is preferably a cystoscope or a hysteroscope.
  • the endoscope has an elongated shaft part in typical endoscopic design.
  • the shaft part or shaft tube of the endoscope can, for. B. have a length of at least about 150 mm, z. B. a length between 150 mm and 400 mm.
  • the shaft diameter can z. B. be about 3 to 10 mm.
  • Endoscopes can be both rigid and flexible. For example, arthroscopes and cystoscopes are rigid, while gastroscopes, colonoscopes or bronchoscopes are flexible.
  • the shaft part of the endoscope according to the invention can thus be rigid, flexible or semi-flexible, d. H. only partially flexible.
  • the shaft part is preferably a rigid shaft part.
  • the shaft part is preferably tubular. More preferably, the shaft part is made of metal.
  • the endoscope comprises one or more of the shaft part continuous working channels, for. B. one, two, three or four working channels.
  • the endoscope has one or two working channels.
  • the working channels allow the insertion of instruments such as catheters, forceps, stone scavengers, lithotriptors, etc.
  • the working channels terminate at the distal end in the face of the shaft portion.
  • the proximal End of the endoscope terminate the or the working channels in an inlet nozzle.
  • the opening at the proximal end of the inlet nozzle may also be referred to as instrumentation channel opening.
  • the inlet nozzle comprises a sealing system for liquid-tight sealing of the working channel in the axial direction.
  • the sealing system is particularly suitable for preventing leakage of body fluids from the inlet nozzle during surgery.
  • the system may also be suitable for preventing the escape of gases from inside the body.
  • the sealing system is designed for gas-tight sealing of the working channel in the axial direction.
  • the sealing system seals the working channel substantially completely when no through instrument is inserted into the working channel.
  • the sealing system is able to seal the working channel around the passage instrument such that preferably no liquid or very little liquid can escape from the instrument opening of the working channel along the passage instrument.
  • liquid-tight as used herein thus means that no (significant amounts of) liquid can pass through the sealing system.
  • Axial refers to the longitudinal axis of the working channel in the area of the inlet nozzle, which means that fluid passage through the sealing system along the longitudinal axis of the working channel or inlet nozzle is prevented In the axial direction, therefore, no liquid can pass through the sealing system.
  • the sealing system has at least two seals, which means that the sealing system has two or three seals
  • the sealing system has exactly two seals, two seals are sufficient according to the invention to ensure the tightness of the system, and also save manufacturing costs and cleaning Compared to a system that has more than two seals. Nevertheless, in cases where a particularly outstanding sealing performance must be ensured, be indicated to use a sealing system with more than two seals, e.g. B. with three seals.
  • the seals are axially spaced from each other by a cavity (within the working channel or its proximal extension).
  • axial refers to the longitudinal axis of the working channel
  • a seal also referred to herein as the proximal seal, is disposed within or on the input port proximal of the other seal.
  • the distance will be so great that the passage instrument is liquid-tightly enclosed by the proximal seal when the distal end of the passage instrument is distal Seal achieved
  • “Liquid sealed” means that the seal encloses the instrument adjacent to the longitudinal axis in such a way that no liquid can escape between the seal and the instrument.
  • the distance between the two seals thus corresponds to the distance between the distal end of a commonly used passage instrument and a portion of the passage instrument, from which the instrument can be liquid-tightly enclosed by the proximal seal when displaced in the distal direction.
  • the distance between the two seals can, for. B. from 3 to 15 mm, preferably from 5 to 10 mm, z. B. 8 mm.
  • the seals are preferably flat, more preferably flat.
  • the seals can z. B. have the shape of a flat cylinder, ie a cylinder with a low height. So the seals z. B. circular membranes whose thickness is the height of the cylinder.
  • the height of the cylinder or the thickness of the seal can, for. B. from 0.5 mm to 3 mm, preferably from 0.8 mm to 3 mm, z. B. 1 mm to 1, 1 mm.
  • the radius of the cylinder is at least the size of the radius of the working channel, ie at least the size of the radius of the inner circumference of the working channel.
  • the intersecting surfaces of the proximal cylindrical seal are disposed parallel to the intersecting circular surfaces of the distal cylindrical seal.
  • the cylinder may be an elliptical cylinder, ie a cylinder whose sectional circular surfaces have an elliptical shape. Such a seal shape is particularly indicated when the working channel has a corresponding elliptical shape.
  • the seals may alternatively or additionally be formed spherical. So z. B. the lateral surface of a substantially cylindrical seal to be crowned. In other words, the seals can thus have a flat, substantially cylindrical shape, wherein the lateral surfaces of the cylinder are formed crowned. Balanced seals have a particularly good sealing effect. In particular, at a high internal pressure in the inlet nozzle, it may be appropriate to use a spherical seal.
  • the seals are alternatively or additionally executable in free-form contours.
  • the choice of the seal shape may be made depending on the manufacturing process and / or the shape of the inlet nozzle and / or the sealing system.
  • the seals of the sealing system each have a passage through which through instruments can be inserted into the working channel.
  • This passage is preferably in the center of the seals, z. B. in the center of the cutting circle surface, attached.
  • through instruments can be introduced essentially parallel to or in the longitudinal axis of the working channel.
  • At least one passage of the sealing system is formed according to the invention as a self-closing opening.
  • a self-closing opening assumes a closed position unless it is held open by an inserted instrument or other force. By inserting an instrument into the opening, the opening assumes an open position. Even in the open position, the edges of the opening around the instrument guided around, in particular around its Schafttteil that the connection between the opening edges and the shaft portion of the instrument is liquid-tight.
  • the self-closing opening may preferably be a slot (ie a slot-shaped opening).
  • a slot-shaped opening has the advantage that it is easy to manufacture and clean.
  • the self-closing opening is designed as a cross slot.
  • the self-closing opening is arranged in a thin sealing membrane. This has the advantage that the opening is particularly easy to clean.
  • the remaining seals of the sealing system can also be designed as self-closing openings. However, it is preferred that the remaining seal (s) is / are formed as a circular opening (bore). The circular opening encloses sealing a through-inserted instrument. The diameter of the circular opening may, for. B.
  • the diameter can z. B. from 0.3 mm to 7 mm, preferably from 0.5 mm to 5 mm.
  • the passage of the seal at the proximal end of the cavity is formed as a slit-shaped, self-closing opening
  • the passage of the seal at the distal end of the cavity is formed as a slit-shaped self-closing opening or as a circular opening, preferably a circular opening.
  • the seals are according to the invention for cleaning the working channel reversibly removable from the inlet nozzle. This means that the seals for cleaning the working channel can be removed from the longitudinal axis of the working channel and can be re-attached to the inlet nozzle after cleaning so that the working channel is sealed in the axial direction. This has the advantage that the working channel can be cleaned thoroughly in a simpler manner and no dead spaces are created within the working channel, in which stubborn dirt can hold.
  • the sealing system can be cleaned more easily after removing the seals from the inlet nozzle.
  • the seal at the proximal end and / or the seal at the distal end of the cavity are reversibly removable from the respective end of the cavity for cleaning the cavity. This means that either the seals can be separated from each other or by removing the sealing system from the inlet nozzle other boundaries of the cavity, for. B. the outer walls of the inlet nozzle, can be separated from the sealing system.
  • the cavity between the seals can according to the invention lie within the working channel or in its proximal extension.
  • a cavity can be created within the working channel by the axially spaced apart seals are inserted at different positions in the inlet nozzle.
  • a cavity outside of the working channel, in Proximal extension of the working channel are created by two seals spaced from each other on the proximal end of the working channel and the inlet nozzle are arranged.
  • the seals are made of a material that has sufficient flexibility (ie, elasticity). Due to the flexibility of the material, the passages in the seals can be flexibly adapted to passage instruments, e.g. B. at broadened positions of the instruments.
  • the flexibility of the material is thus such that the seal (s) can adapt to different instrument diameters, whereby the instrument diameter may even be larger than a diameter of the passage. At the same time, the material is so strong that the seal can sealingly cling to the instruments and thus an unwanted fluid passage is prevented.
  • the sealing system according to the invention can thus consist of a flexible plastic or comprise a flexible plastic, wherein at least the seals consist of the flexible plastic.
  • the sealing system consists of a flexible plastic.
  • the flexible plastic is well lubricious. Suitable plastics are known to those skilled in the art.
  • the flexible plastic is preferably silicone.
  • both seals can be arranged on an insertable into the working channel sealing system.
  • This sealing system may comprise a base part on which the seals are arranged.
  • the inlet nozzle has two complementary to the seals slots, in which the seals are at least partially inserted such that the sealing system seals the working channel in the axial direction liquid-tight.
  • the invention thus relates to a medical endoscope with a shaft part, the endoscope comprising one or more working channels passing through the shaft part, the working channel or channels leading in each case in its proximal end region through an inlet nozzle to a proximal instrumentation opening and wherein the inlet nozzle is a sealing system for fluid-tight sealing of the working channel in the axial direction, and the sealing system has at least two seals, wherein the seals (in the inserted position) are axially spaced from each other by a cavity and each have a passage, be introduced through the passage instruments in the working channel, characterized in that at least one passage of the sealing system is designed as a self-closing opening and that the sealing system comprises a base member on which the seals are arranged and the inlet nozzle has two complementary to the seals slots, in which the seals are at least partially inserted in such a way that the sealing system seals the working channel in the axial direction liquid-tight.
  • the sealing system is preferably integrally formed, comprising the base part and two or more seals arranged thereon.
  • the sealing system is integrally formed from a flexible plastic and comprises a base part with two or more seals arranged thereon.
  • the base part is preferably designed so that it rests in the position in which the two seals are inserted into the inlet connection and axially seal the working channel, rests on the outer shell of the inlet nozzle and sealingly surrounds the insertion of the slots.
  • the slots provided for the seals are overlapped by the base part.
  • the base part can be concave on the side at which the seals are arranged.
  • the seals are preferably arranged and spaced so that the seals are introduced simultaneously in parallel in the slots provided for on the inlet nozzle slots, z. B. can be inserted.
  • Cylindrical seals can this z. B. be connected to a portion of its lateral surface with the base part.
  • Lateral surface and base part can, for. B. over 30 ° to 85 ° along the lateral surface of the cylinder, preferably over 40 ° to 75 °, more preferably above 55 ° to 60 °.
  • the gaskets in these embodiments preferably each have a bead on its distal and proximal intersecting circular surface, which is arranged such that, in the position in which the sealing system is fully inserted into the inlet nozzle, it extends circumferentially around the working channel.
  • the bead can z. B. be circular on the seal.
  • the inlet port may be flat around the slots. So the inlet nozzle z. B. distally and proximally of the slots have the usual cylindrical shape and have a flat indentation at a portion around the slots around. Accordingly, the base part in this embodiment may also have a planar shape, for. B. the shape of a flat cuboid.
  • the hollow cylindrical inlet nozzle may for this purpose comprise a planar portion, on which the base part may be arranged, when the seals are arranged in their complementary slots.
  • the inlet nozzle will have two plug-in slots that are complementary to the gaskets into which the gaskets can be inserted at least in sections, preferably completely.
  • the slots are preferably arranged as arranged in the inlet port and extending through the working channel slots.
  • the slots can extend through the insertion opening opposite side of the input nozzle, d. H. across the inlet nozzle, and z. B. also be open on the opposite side of the insertion of the inlet nozzle to the outside.
  • the seals can be inserted into the complementary slots such that the sealing system seals the working channel in the axial direction in a liquid-tight manner.
  • the seals seal the working channel in the slots in the radial direction.
  • the seal is not only fluid but also gas-tight.
  • the seals can be made as an oversize, ie be slightly larger than the slot provided in each case.
  • the flexibility of the sealing material still allows insertion of the seal in the slot.
  • the installation of the seals on the surrounding walls of the inlet nozzle is so tight that a possible non-slip stop occurs, but the seals are still inserted into the inlet nozzle during assembly.
  • the two seals in alternative embodiments can also be each comprised of a cap-like closure element, wherein the two cap-like closure elements can be arranged one behind the other in the proximal extension of the proximal end of the inlet nozzle.
  • this sealing system comprises two closure elements, wherein the first closure element has an opening region, which surrounds the proximal end of the inlet nozzle, preferably liquid-tight, and the second closure element has an opening region which encloses the proximal end of the first closure element.
  • the invention thus relates to a medical endoscope with a shaft part, the endoscope comprising one or more working channels passing through the shaft part, the working channel (s) each leading in its proximal end region through an inlet nozzle to a proximal instrumentation opening and wherein the inlet nozzle is a sealing system for fluid-tight sealing of the working channel in the axial direction, and the sealing system has at least two seals, wherein the seals are axially spaced from each other by a cavity and each have a passage through which through instruments can be inserted into the working channel, characterized in that at least one Passage of the sealing system is designed as a self-closing opening and that the sealing system comprises at least two closure elements, each comprising one of the seals, wherein the first Verschl
  • the second closure element has an orifice area which encloses the proximal end of the first closure element, wherein the closure elements are reversibly removable from the inlet nozzle.
  • This sealing system comprises at least two closure elements, which can be reversibly separated from each other and from the inlet nozzle, that are reversibly removable from each other. This means that the user of the instrument, in particular for cleaning purposes, the closure elements from each other and from the Can separate input port and after cleaning can reassemble easily.
  • the seals of the sealing system can be reversibly removed from the working channel.
  • the sealing system can be secured by means of a retaining strap to the inlet nozzle.
  • the sealing system may comprise a safety system which has a ring whose inner circumference corresponds to an outer circumference of the inlet nozzle and which can be pushed onto the inlet nozzle in such a way that it encloses the inlet nozzle.
  • the safety system includes a tether that holds the sealing system to the inlet port.
  • the locking system connects the sealing system and the inlet connection both in the position in which the seals seal the working channel and in the position in which the seals are reversibly removed from the working channel.
  • the tether preferably includes a ring that can be disposed about the input tube transverse to its longitudinal axis.
  • this ring has an inner diameter which substantially corresponds to an outer diameter of the inlet nozzle.
  • the inlet nozzle may have a circumferential groove on its outer shell, with which the ring can be engaged.
  • the ring and the remaining components of the retaining band can be made of a flexible or rigid plastic. If the sealing system comprises a corresponding holding strap, arranging the seals in the working channel after cleaning is facilitated by the fact that the cleaning force can locate the sealing system directly on the instrument. The cleaning performance is also improved because the sealing system does not have to be deposited while cleaning the rest of the instrument.
  • the closure elements preferably have a cap-like or (hollow) cylinder-like shape.
  • the seals can each form a circular sectional area of the closure elements.
  • the seal is preferably arranged in each case in the end region of a closure element, for. B. in the proximal end region.
  • the longitudinal axis (cylinder axis) of the closure elements each represents an extension of the longitudinal axis of the inlet nozzle.
  • the interior of the hollow cylinder-like closure elements thus forms an extension of the working channel.
  • the first closure element has a mouth region which encloses the proximal end of the inlet nozzle.
  • the second closure element has an opening region which encloses the proximal end of the first closure element.
  • the first closure element is removed from the mouth region of the second closure element and the inlet nozzle is removed from the mouth region of the first closure element.
  • the inlet nozzle and the first closure element each have a section (in the proximal end region) which can be inserted into the corresponding mouth region.
  • the respective mouth region and the section which can be introduced into this mouth region are formed complementary to one another in terms of shape.
  • connection between the closure elements and between the first closure element and the inlet nozzle seals the working channel not only, as described above, in the axial direction, but is in particular liquid-tight in the radial direction.
  • the two closure elements can be assembled in different ways and attached to the inlet port.
  • the first closure element and the second closure element and / or the first closure element and the inlet nozzle can, for. B. be connected to each other by a connector.
  • a suitable plug-in connection is e.g. a luer connection, for example a simple luer connection or a luer lock connection.
  • the Luer connection serves to connect the inlet nozzle with the first closure element and / or to connect the first closure element to the second closure element.
  • the working channel is closed liquid-tight by the Luerkonus.
  • Suitable luer compounds are known to the person skilled in the art.
  • the seal in a Luer system is achieved by a conical construction of the connecting parts, the so-called Luer cone.
  • a Luer variant with a thread for locking the connection is called Luer-Lock.
  • the first closure element and the second closure element and / or the first closure element and the inlet nozzle may alternatively be connected to one another by a screw connection.
  • the mouth section and the area provided for introduction into the mouth section preferably have complementary thread structures for this purpose. Suitable screw connections are known to those skilled in the art.
  • the first and / or the second closure element may furthermore comprise gripping pieces.
  • the grips can ensure a secure mounting in the hand of the surgeon when screwing and screwing the screw (s).
  • the grips can z. B. take the form of corrugations on the outside (lateral surface) of the respective closure element.
  • the closure elements in this embodiment comprise sections of a solid plastic and sections of a flexible plastic.
  • the seals and the extending in the interior of the closure elements in the extension of the working channel channel of a flexible plastic while the screw thread, the tether and / or the grips can be made of a hard plastic.
  • the sections of a flexible plastic with the solid plastic for the formation of screw threads and / or handles can be encapsulated and thus connected without gaps.
  • the inlet nozzle is connected to the first closure element by means of a luer connection and the first closure element to the second closure element by means of a screw connection.
  • the sealing system comprises two closure elements
  • the first closure element and the second closure element can be connected to one another by a holding strap.
  • the first closure element and the inlet nozzle can be connected to each other by a tether.
  • the tether preferably comprises a ring which can be arranged transversely to its longitudinal axis around the inlet nozzle or the other closure element around.
  • this ring has an inner diameter which substantially corresponds to an outer diameter of the inlet nozzle or the other closure element.
  • the inlet nozzle or the other closure element may have a circumferential groove on its outer shell, with which the ring can be brought into engagement.
  • the ring and the remaining components of the retaining band can be made of a flexible or rigid plastic.
  • the inner diameter of the ring is selected so that the ring on the other closure element or the inlet nozzle, for. B. in the groove provided for the ring, around the longitudinal axis of the input nozzle around, is rotatable.
  • the sealing system may also comprise more than two closure elements, for. B. three, four or five, wherein the one or more further closure elements are formed as alternatives to the second closure element, ie as closure elements, which can be reversibly connected to the first closure element instead of the second closure element.
  • the alternative closure elements may comprise circular openings for passage of passage instruments, the diameter of these circular openings being different from that of the circular opening of the second closure element and the optional further closure elements.
  • the first closure element preferably has a self-closing, z. B. slot-shaped opening. In this way, depending on the instrument used, the operator can also select the closure element adapted to the diameter of the transit instrument during the operation.
  • the sealing system comprises a plurality of closure elements configured as an alternative to the second closure element, the elements may be fastened with retaining straps to the first closure element or the inlet connection, which correspond to the retaining straps described elsewhere herein. In this way, the alternative closure elements are always available during the operation.
  • the proximal end of the working channel may be formed funnel-shaped widened.
  • the sealing system comprises a base part on which the two seals are arranged, since in this embodiment the proximal end of the working channel is freely accessible to the user.
  • the sealing system comprises two closure elements which can be attached or screwed on one another, alternatively the second (proximal) closure element can have at its proximal end a funnel-shaped widening of the channel running in the interior of the closure element.
  • the invention also relates to the sealing systems described herein for liquid-tightly sealing a working channel in a medical endoscope.
  • FIG. 1 is a side sectional view of a prior art inlet nozzle provided with a valve and a sealing cap:
  • FIG. 2 shows schematic representations of the inlet nozzle of an endoscope according to the invention, which has a sealing system comprising a base part on which two seals are arranged; while the figure parts (A) show a plan view showing two slots with inserted seals; (B) is a sectional view of the inlet nozzle from the proximal axis 2-2 in (A) to a seal with a self-closing opening; (C) a side sectional view illustrating the structure of the sealing system and in which the seals are fully inserted into the complementary slots; (D) a bottom view showing the base part and the sealing system of the sealing system; (E) is a sectional view of the sealing system from the direction indicated by an arrow on the axis 3 in (F); (F) is a side sectional view showing the sealing system in a position in which the seals are removed from the working channel, while the sealing system is connected via a securing system to the inlet nozzle. and (G) is a sectional view of an
  • Figure 3 is a side view of a medical endoscope of the prior art
  • FIG. 4 shows schematic representations of the input socket of an endoscope according to the invention, which has a sealing system which comprises two closure elements which can be successively pushed onto the proximal end of the inlet nozzle and establish tightness by means of a Luer connection;
  • the Figure parts (A) show a side sectional view illustrating the structure of the sealing system and in which the seals are detached from the distal end of the inlet nozzle; (B) is a side sectional view illustrating the attachment of this sealing system to the proximal end of the inlet nozzle; (C) an exemplary, inventive seal with a circular opening, in the second Closing element may be included; (D) an exemplary inventive seal having a self-closing opening that may be included in the first closure member; (E) is a side sectional view showing an alternative to (A) sealing system, which has alternative closure elements, which instead of the second closure element on the first
  • Closing element can be plugged
  • FIG. 5 shows schematic representations of the inlet nozzle of an endoscope according to the invention, which has a sealing system comprising two closure elements which can be successively screwed onto the proximal end of the inlet nozzle;
  • the Figure parts (A) show a side sectional view illustrating the structure of the sealing system and in which the seals are detached from the distal end of the inlet nozzle; (B) is a side sectional view illustrating the attachment of this sealing system to the proximal end of the inlet nozzle; and (C) a
  • FIG. 1 shows a side sectional view of a prior art inlet nozzle 16 provided with a valve 58 and a sealing cap 60.
  • the inlet connection 16 has a working channel 14 which runs through the inlet connection 16 in the longitudinal direction and can be introduced through the passage instruments into the medical endoscope, which comprises the inlet connection 16.
  • the working channel 14 terminates in a corresponding instrumentation opening 18.
  • the inlet nozzle 16 comprises a valve 58 which is firmly integrated into the inlet nozzle 16 and which can be brought into at least one open position and a closed position. In the closed position, the valve seal 56 is in the working channel 14 arranged to seal the working channel liquid-tight. The valve is manually actuated from outside the input nozzle 16.
  • a sealing cap 60 which can be pushed onto the proximal end region of the inlet nozzle 16 and which comprises two seals 52, 52. Between the seals 52, 52 is formed in the proximal extension 54 of the working channel 14, a cavity which is extremely difficult to clean. In order to clean the cavity between the seals 52, 52, a large pressure must be used and, moreover, a particularly great care in cleaning is required. There is therefore a considerable risk that the cleaning is incomplete and there is cross-contamination between patients.
  • FIG. 2 shows schematic representations of the input nozzle 16 of an endoscope according to the invention, which has a sealing system 20 which comprises a base part 30 on which two seals 22, 24 are arranged.
  • the drawing parts (A) to (G) show the following:
  • Fig. 2 (A) shows a plan view of the input port 16, the two slots 32, 34, namely a distal slot 32 and a proximal slot 34, with inserted seals 22, 24 shows. All components of the sealing system 20 are shown hatched. Accordingly, in this figure, the seal 22 at the proximal end of the cavity, the seal 24 at the distal end of the cavity and the ring 48 of the security system 46 are shown hatched. It can be seen in the plan view that the seals 22, 24 have a cuboid shape, wherein the cuboid shape completely seals the working channel in a manner not recognizable here (without consideration of the passages).
  • the ring 48 of the security system 46 encloses the input port 16 proximally of the two slots 32, 34. In this way, the ring 48 can be applied by the operator in a simple manner to the input port 16.
  • the sealing system 20 is held in the open position of the working channel 14, ie in the position in which the seals 22, 24 are removed from the working channel 14 at the inlet nozzle 16 (see Fig. 2 (F)).
  • Fig. 2 (B) shows a cross-sectional view of the input nozzle 16 from the proximal axis 2-2 in (A) to a seal 24 having a passageway 27.
  • the base member 30 is not shown here. The embodiment shown differs from that shown in Fig. 2 (C and D).
  • the passage 27 is formed as a self-closing opening 28 having a slit-like shape. Since the seal 24 is made of a flexible plastic, a passage instrument can be inserted into the working channel 14 through the slot-shaped, self-closing opening 28. The edges of the self-closing aperture 28 will then seal against the stem portion of the passage instrument so as to prevent leakage of substantial quantities of fluid.
  • Fig. 2 (C) shows a side sectional view of the inlet nozzle 16, illustrating the structure of the sealing system 20 and in which the seals 22, 24 are fully inserted into the complementary slots 32, 34.
  • the sealing system 20 has a base part 30, on which - substantially at 90 ° to the base part 30 - two seals 22, 24 are arranged.
  • the sealing system 20 is made entirely of a flexible plastic, preferably silicone.
  • a cavity 26 Between the two seals 22, 24 of the sealing system 20 is formed in the position in which the seals substantially completely seal the working channel (ie in the fully inserted into the slots position), a cavity 26.
  • the two seals 22, 24 with the intermediate Cavities 26 have a sluice-like action and efficiently prevent leakage of significant quantities of liquid from within the working channel 14.
  • the seal 22 at the proximal end of the cavity 26 has a passage 27 formed as a circular opening 29.
  • the diameter of the circular opening 29 is adapted to the outer diameter of the through instrument to be used, e.g. B. to the outer diameter of the shaft portion.
  • the seal 24 at the distal end of the cavity 26 has a passage 27 which is formed as a slot-shaped, self-closing opening 28.
  • the base part 30 is arranged on the outer wall of the inlet nozzle 16 in a planar section 62.
  • the outer wall has in this section 62 with respect to the other convex outer wall a smaller distance from the longitudinal axis of the inlet nozzle 16. This prevents slippage of the sealing system 20 on the inlet nozzle 16 as well as a disability of the surgeon.
  • the sealing system 20 can still be completely removed in a relatively simple manner from the inlet nozzle 16, since the sealing system 20 is made of a plastic having sufficient flexibility and ductility to the ring 48 of the Securing system 46 over the flattened by the flattening of the outer wall of the inlet nozzle 16 at the planar portion 62 burr 84 from the inlet nozzle 16 strip.
  • the proximal end of the working channel 14 is widened funnel-shaped. As a result, the insertion of the passage instruments in the Instrumentierö réelle 18 and in the working channel 14 is facilitated.
  • Fig. 2 (D) shows a view from below of the inlet nozzle 16, which shows in particular the base part 30 and the securing system 46 of the sealing system 20.
  • the base part 30 has the shape of an elongated and flat cuboid.
  • the shape of the planar portion 62 on the outer wall of the input nozzle 16 may be adapted to the shape of the base member 30, for. B. substantially complementary to form.
  • the base part 30 is connected by means of the retaining band 44 with the ring 48, which surrounds the inlet nozzle 16.
  • Fig. 2 (E) shows a sectional view of the sealing system 20 from the direction indicated by an arrow on the axis 3 in the imaging part (F).
  • the seals have in the variant shown here the shape of a flat cylinder whose lateral surface is connected to the base part 30. Shown is a view of the circular section surface of the cylinder, which forms the seal 22 at the proximal end of the cavity 26.
  • the circular section surface is rectangularly elongated in the direction of the base part 30 in order to establish a connection to the base part 30.
  • the seal 22 includes a passage 27 formed as a circular opening 29.
  • the flexible plastic material of the sealing system is shown hatched.
  • FIG. 2 (F) shows a side sectional view of the inlet nozzle 16 showing the sealing system 20 in a position in which the seals 22, 24 are removed from the working channel 14 while the sealing system 20 is connected to the inlet nozzle 16 via a safety system 46 is.
  • the sealing system 20, in particular the base part 30 connected to the seals 22, 24, is held at the inlet connection 16, but is directly removed from the inlet connection 16, ie from its longitudinal axis and thus from the working channel 14.
  • the sealing system 20 is in particular connected by the tether 44 to the ring 48, which encloses the outer wall of the inlet nozzle 16 adjacent. In the position shown here, both the working channel 14 and the Sealing system 20 can be cleaned in a simple and reliable manner.
  • the slots 32, 34 can be cleaned.
  • FIG. 2 (G) shows a sectional view of an alternative (E) sealing system, the seals have a substantially rectangular shape. Seal 22 and base member 30 are the same width. The seal 22 has a passage 27 which is formed as a circular opening 29. Also shown is the ring 48, with which the sealing system 20 can be attached to the inlet nozzle.
  • Fig. 3 shows a side view of a medical endoscope 10 of the prior art.
  • the endoscope 10 has an eyepiece 64 for viewing the surgical site, as well as two handle portions 66 with which the surgeon is enabled to hold the endoscope 10.
  • the endoscope 10 has in a conventional construction a tubular shaft part 12, through which the passage instruments can be guided to the surgical site.
  • the endoscope 10 has an optical fiber input connection piece 70, through which the light guide can be inserted into the endoscope 10 for illumination of the surgical site.
  • the endoscope 10 in a conventional construction also includes an inlet nozzle 16 for introducing corresponding passage instruments.
  • the inlet nozzle 16 comprises, as shown in Fig. 1, a valve 58 and a sealing cap 60.
  • the valve 58 is opened or closed by the operating element 68.
  • 4 shows schematic representations of the inlet nozzle 16 of an endoscope 10 according to the invention, which has a sealing system 20 which comprises two closure elements 36, 38 which can be slid one after the other onto the proximal end of the inlet nozzle 16 and seal by means of a luer connection.
  • the image parts (A) to (E) show the following:
  • FIG. 4 (A) is a side sectional view illustrating the structure of the sealing system 20 and in which the seals 22, 24 are disengaged from the distal end of the inlet nozzle 16. Shown is thus the open position of the working channel 14, in the liquid can emerge freely from the working channel 14.
  • the working channel 14 is not sealed in the open position by a sealing system 20.
  • the sealing system 20 comprises a first closure member 36 formed as a sealing cap with a single seal and a second closure member 38 formed as a sealing cap with a single seal.
  • the first (distal) closure member 36 is connected to the tether 16 with a tether 44.
  • the second (proximal) closure element 38 is connected to a holding band 44 with the first (distal) closure element.
  • the tether 44 is each made of a flexible plastic.
  • the first closure element 36 comprises an opening region 40, which is designed to be complementary to the outer wall of the proximal end region of the inlet nozzle 16.
  • the outer wall of the proximal end portion of the input nozzle 16 is formed as a luer cone.
  • the first closure element 36 and the outer wall of the proximal end region of the input nozzle 16 are thus the two connecting parts of a luer connection.
  • the luer connection between the first closure element 36 and the inlet nozzle is liquid-tight.
  • the first closure member 36 includes at its proximal end a seal formed as a sealing membrane which, when the sealing system 20 described herein is assembled, has the seal 24 at the distal end of the cavity 26 (for the lock system).
  • the seal 24 encompassed by the closure element 36 has a passage 27 for passage instruments, which is designed as a circular opening 29.
  • the second closure element 38 comprises an opening region 42, which is formed complementary to the outer wall of the proximal end region of the first closure element 36.
  • the outer wall of the proximal end region of the first closure element 36 is designed as a luer cone.
  • the second closure element 38 and the outer wall of the proximal end region of the first closure element 36 are thus the two connection parts of a luer connection.
  • the luer connection between the second closure element 38 and the first closure element 38 is liquid-tight.
  • the second closure element 38 comprises at its proximal end a seal which is designed as a sealing membrane and which, when the sealing system 20 described here is assembled, has the seal 22 at the proximal end of the cavity 26 (for the lock system).
  • the of the closure element 38 includes seal 24 has a passage 27 for through instruments, which is designed as a self-closing opening 28.
  • FIG. 4 (B) shows a side sectional view of the inlet nozzle 16 shown in FIG. 4 (A) illustrating the attachment of the sealing system 20 shown in FIG. 4 (A) to the proximal end of the inlet nozzle 16. It can be seen that by the successive sliding of the closure elements 36, 38 onto the proximal end region of the inlet nozzle 16, two liquid-tight luer connections are produced.
  • a cavity 26 is created between the seals 22, 24 of the two closure elements 36, 38.
  • the cavity 26 extends (also) in the proximal extension of the working channel 14.
  • FIG. 4 (C) shows an exemplary seal 52 according to the invention with a passage 27 formed as a circular opening 29.
  • the seal 52 may, for. B. in the second closure element 38 may be included.
  • FIG. 4 (D) shows an exemplary seal 52 according to the invention with a passage 27, which is designed as a self-closing opening 28.
  • the seal 52 may, for. B. may be included in the first closure element.
  • 4 (E) shows a side sectional view of the inlet nozzle according to the invention from FIG. 4 (A) with a variant of the sealing system 20 shown there.
  • the sealing system 20 shown in FIG. 4 (E) has, in addition to the components described above, two alternative closure elements 72 on.
  • the two alternative closure elements 72 can be plugged onto the first closure element 36 instead of the second closure element 38.
  • the two alternative closure elements 72 are likewise fastened in each case to the first closure element 36 with a holding strap 44.
  • the straps 44 are formed of a correspondingly flexible plastic to ensure flexible handling of the sealing system.
  • the alternative closure elements 72 each have a passage 27, which is formed as a circular opening 29.
  • the circular openings 29 of the alternative closure elements 72 each have a diameter that is different from that of the circular opening 29 of the second closure element 38 and the other alternative closure elements 72 different. In this way, depending on the used fürgangsinstrument a passage 27 can be selected with a compatible diameter.
  • 5 shows schematic representations of the input socket 16 of an endoscope 10 according to the invention, which has a sealing system 20 which comprises two closure elements 36, 38, which can be successively screwed onto the proximal end of the inlet nozzle 16.
  • the image parts (A) to (C) show the following:
  • Fig. 5 (A) shows a side sectional view of the input nozzle 16 of an endoscope 10 according to the invention, illustrating the structure of the sealing system 20 and in which the seals 22, 24 are released from the distal end of the inlet nozzle 16.
  • the inlet connection 16 has a working channel 14 running through the inlet connection in the longitudinal direction.
  • In its proximal end region of the input nozzle 16 is formed in sections as a Luerkonus 74.
  • the first closure element 36 has a mouth region 40, which is partially complementary in shape to this luer cone 74. In this way, the first closure element 36 can enter into a liquid-tight luer connection with the proximal end region of the inlet nozzle.
  • the first closure element 36 also has, on the outer wall of its proximal end region, a thread 80 (not shown here in detail, visible in FIG. 5C).
  • the second closure element 38 has an opening region 42 which is at least partially complementary in shape to this thread. The complementary shape thread in the mouth region 42 is not shown in detail.
  • the first closure element 36 and the second closure element 38 are in each case composite workpieces, which are sections of a flexible plastic marked here by crossed lines and sections of a hard plastic marked here by oblique hatching.
  • the interlocking parts of the thread 80 and the second closure member 38 and provided for gripping parts of the second closure member 38 of a hard, inflexible plastic, while the necessary to seal the working channel and the extension of the working channel components are made of a flexible plastic
  • the different plastics are in the illustrated embodiment in the closure elements 36, 38 in each case by a groove 82 in which a plastic part and a shape-complementary, with the groove 82 engageable extrusion 86 connected to each other.
  • the first closure element 36 has a seal 24, which is formed of a flexible plastic and forms the seal at the distal end of the cavity.
  • the seal 24 has a passage 27, which is designed as a self-closing, slot-shaped opening 28.
  • the second closure element 38 has a seal 22, which is formed of a flexible plastic and forms the seal at the proximal end of the cavity.
  • the seal 22 has a passage 27 which is formed as a circular opening 29.
  • the first closure element 36 is connected to the second closure element 38 by means of a tether 44, which is made of a flexible plastic.
  • the tether has a ring 48 at both ends.
  • a ring surrounds the first closure element 36 while the second ring 48 in the second closure element 38 engages in a circumferential groove 78.
  • grooves are formed on both closure elements, or that the tether 44 is secured by a bond to the closure elements 36, 38.
  • Fig. 5 (B) is a side sectional view illustrating the attachment of the sealing system shown in Fig. 5 (A) to the proximal end of the inlet nozzle. It can be seen that a cavity 26 between the two seals 22, 24 is formed by the successive sliding or screwing the closure elements 36, 38 on the inlet nozzle. By the intermediate cavity 26, the two seals act together as a lock system.
  • Fig. 5 (C) shows a detailed view of the sealing system shown in (A) and (B) in which the fasteners are not fixed to each other.
  • the closure element 36 has a thread 80 on its outer surface, which can be screwed into the complementary mouth region 42 of the second closure element 38.
  • the first closure element 36 has a peripheral ring 48 on the first Closure element 36 permanently attached tether 44.
  • the tether 44 also has at its free end a ring 48 which can be slid onto the second closure element 38 and inserted into its groove 78.
  • the engagement formed between the groove 78 and the ring 48 connects the two closure elements with each other, but does not prevent the two closure elements against each other, can be rotated around the longitudinal axis of the sealing system around.
  • the first closure element further comprises a seal 24, which comprises a central passage 27 which is formed as a self-closing, slot-shaped opening 28.
  • the second closure element has a circumferential corrugation 76, which is suitable as a non-slip handle. The surgeon can securely grasp the second closure element 38 in this area and screw it onto the first closure element 36, without having to fear slipping.
  • the second closure element 38 has a seal 22, which comprises a central passage 27, which is formed as a circular opening.
  • Passage 66 handle part
  • Base part 72 alternative closure element distal slot 74 Luerkonus
  • Mouth area 82 Groove for joining plastics

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Abstract

L'invention concerne un endoscope médical (10) comprenant une partie de tige (12), l'endoscope (10) comprenant un ou plusieurs canaux de travail (14) traversant la partie de tige (12), le ou les canaux de travail (14) menant dans la zone de leur extrémité proximale vers une ouverture d'instrument proximale (18) à travers une tubulure d'entrée (16) et la tubulure d'entrée (16) comprenant un système d'étanchéité (20) pour la fermeture de manière étanche aux liquides du canal de travail (14) en direction axiale, et le système d'étanchéité (20) comprenant au moins deux joints (22, 24), les joints (22, 24) étant séparés axialement l'un de l'autre par une cavité (26) et comprenant chacun un passage (27), à travers lequel les instruments de passage peuvent être insérés dans le canal de travail (14), caractérisé en ce qu'au moins un passage (27) du système d'étanchéité (20) est conçu comme une ouverture à fermeture automatique (28) et que les joints (22, 24) peuvent être retirés de manière réversible de la tubulure d'entrée (16) pour le nettoyage du canal de travail (14) et le joint (22) à l'extrémité proximale et/ou le joint (24) à l'extrémité distale de la cavité (26) peut être retiré de manière réversible de l'extrémité correspondante de la cavité (26) pour le nettoyage de la cavité (26).
PCT/EP2018/077777 2017-10-13 2018-10-11 Joint de canal de travail WO2019072988A1 (fr)

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DE102017123905.7 2017-10-13
DE102017123905.7A DE102017123905A1 (de) 2017-10-13 2017-10-13 Arbeitskanaldichtung

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2022008844A1 (fr) * 2020-07-10 2022-01-13 Advance Medical Integration Systems Piston endoscopique medical
DE102021104516A1 (de) 2021-02-25 2022-08-25 avateramedical GmBH Instrument für ein robotisches Operationssystem

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6117070A (en) * 1996-11-28 2000-09-12 Fuji Photo Optical Co., Ltd. Plug device for endoscopic instrument channel
EP1314392A1 (fr) * 2001-11-27 2003-05-28 Karl Storz GmbH & Co. Joint d'étanchéité pour endoscope
US20120071713A1 (en) * 2010-09-17 2012-03-22 Us Endoscopy Biopsy inlet valve improvements

Family Cites Families (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE1226241B (de) * 1963-06-28 1966-10-06 Medizintechnik Leipzig Veb Endoskop
US4809679A (en) * 1986-11-19 1989-03-07 Olympus Optical Co., Ltd. Forceps plug for endoscopes
DE19925324C1 (de) * 1999-06-02 2001-01-25 Winter & Ibe Olympus Trokarhülse mit Duckbillventil

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6117070A (en) * 1996-11-28 2000-09-12 Fuji Photo Optical Co., Ltd. Plug device for endoscopic instrument channel
EP1314392A1 (fr) * 2001-11-27 2003-05-28 Karl Storz GmbH & Co. Joint d'étanchéité pour endoscope
US20120071713A1 (en) * 2010-09-17 2012-03-22 Us Endoscopy Biopsy inlet valve improvements

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2022008844A1 (fr) * 2020-07-10 2022-01-13 Advance Medical Integration Systems Piston endoscopique medical
FR3112278A1 (fr) * 2020-07-10 2022-01-14 Advance Medical Integration Systems Piston endoscopique medical
DE102021104516A1 (de) 2021-02-25 2022-08-25 avateramedical GmBH Instrument für ein robotisches Operationssystem
EP4049608A1 (fr) 2021-02-25 2022-08-31 avateramedical GmbH Instrument pour un système opérationnel robotique

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