WO2024035401A1 - Dispositifs et systèmes d'urétéroscope ayant une partie distale sélectivement extensible - Google Patents

Dispositifs et systèmes d'urétéroscope ayant une partie distale sélectivement extensible Download PDF

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Publication number
WO2024035401A1
WO2024035401A1 PCT/US2022/039954 US2022039954W WO2024035401A1 WO 2024035401 A1 WO2024035401 A1 WO 2024035401A1 US 2022039954 W US2022039954 W US 2022039954W WO 2024035401 A1 WO2024035401 A1 WO 2024035401A1
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WO
WIPO (PCT)
Prior art keywords
catheter
distal portion
handpiece
distal
ureteroscope
Prior art date
Application number
PCT/US2022/039954
Other languages
English (en)
Inventor
Justin Wolfe
Cecille Canary
Original Assignee
C.R. Bard, Inc.
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 C.R. Bard, Inc. filed Critical C.R. Bard, Inc.
Priority to PCT/US2022/039954 priority Critical patent/WO2024035401A1/fr
Publication of WO2024035401A1 publication Critical patent/WO2024035401A1/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
    • A61B1/307—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
    • 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
    • A61B1/00133—Drive units for endoscopic tools inserted through or with the 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
    • A61B1/005—Flexible endoscopes
    • A61B1/0051—Flexible endoscopes with controlled bending of insertion part
    • 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
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
    • A61M25/0133—Tip steering devices
    • A61M25/0136—Handles therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
    • A61M25/0133—Tip steering devices
    • A61M25/0147—Tip steering devices with movable mechanical means, e.g. pull wires

Definitions

  • Endoscopes of small size are desired in many industrial and medical applications. For example, when natural orifices and lumens of a human body are small, small endoscopes are used for insertion through such orifices and lumens to target locations within the body. For single incision laparoscopy, smaller endoscopes are preferred to provide an inside-the-body view of the surgical site, particularly when the incision itself is of minimal dimensions. Sometimes, patients may feel irritation when an endoscope is being inserted into his or her body, and a smaller endoscope may mitigate such unpleasant experience and may minimize trauma to the patient. Moreover, a physician may improve diagnostic and procedural protocols with a smaller endoscope. For example, transnasal endoscopy may sometimes replace trans-oral endoscopy.
  • ureteroscope system includes a handpiece and a catheter.
  • the handpiece has a distal end region, a proximal end region, an interior region, and a working channel port.
  • the catheter extends from the distal end region of the handpiece.
  • the catheter includes a working channel in fluid communication with the working channel port, a proximal portion proximal to the handpiece, and a distal portion distal to the handpiece and selectively extendable to an extended position and selectively retractable to a retracted position relative to the proximal portion.
  • the distal portion includes a distal end defining a working channel opening in fluid communication with the working channel.
  • a method of operating a catheter of a ureteroscope in a subject includes inserting the catheter of the ureteroscope into a urethra of a subject to a selected position.
  • the method also includes selectively extending a distal portion of the catheter from a retracted position to an extended position using a control member.
  • FIG. 1A illustrates a ureteroscope as part of an endoscope system having a catheter with an extendable distal portion in a retracted configuration, according to an embodiment.
  • FIG. IB illustrates an end view of a distal end of the catheter of the ureteroscope of FIG. 1A, according to an embodiment.
  • FIG. 1C illustrates the ureteroscope of the endoscope system of FIG. 1A with the extendable distal portion in an extended configuration, according to an embodiment.
  • FIG. 2 is a side view of the handpiece of the ureteroscope of FIG. 1A with a side of the handpiece removed, according to an embodiment.
  • FIG. 3 is a side view of the handpiece of a ureteroscope with a side of the handpiece removed, according to an embodiment.
  • FIG. 4 is a side view of the handpiece of a ureteroscope with a side of the handpiece removed, according to an embodiment.
  • FIG. 5 is a flow diagram of a method of operating a ureteroscope system, according to an embodiment.
  • Embodiments disclosed herein relate to devices, systems, and methods of using an endoscope, such as a ureteroscope.
  • an endoscope such as a ureteroscope.
  • At least one, some, or all embodiments of ureteroscope systems and methods described herein include a catheter having a selectively extendable distal portion.
  • at least one, some, or all embodiments of ureteroscope systems and methods described herein include a catheter having a driven or tensioned distal portion.
  • An extendable e.g.
  • linear deformation) distal portion of the catheter of the ureteroscope results in the technical effect of allowing the operator to reach a lower pole calyces of a kidney (e.g., a stone in a lower calyces) of a subject, particularly under severe deflection of the catheter.
  • a kidney e.g., a stone in a lower calyces
  • At least one, some, or all embodiments of ureteroscope systems described herein include a hydrophilic coating on at least a portion (e.g., the distal portion) of the catheter.
  • the hydrophilic coating on at least a portion of the catheter, and in particular the distal portion of the catheter as the distal portion is translate forward or extends, results in the technical effect of reducing the chance of subject injury (e.g., ureteral/uretheral abrasion) and/or suffering from the catheter.
  • the hydrophilic coating results in the technical effect of facilitating easier insertion and/or movement of the catheter into the anatomy of the subject.
  • at least a portion of the catheter may be dipped into a hydrophilic material to coat at least a portion of the catheter with a hydrophilic material (e.g., carbopol coating).
  • the ureteroscope may include a small, plastic gripper that goes over at least some of the catheter.
  • the gripper results in the technical effect of allowing the medical provider to advance the catheter without having to touch the hydrophilic coating of the catheter.
  • This gripper may be left in place once the catheter is advanced to the desired location, or may have a slit that allows the medical provider to remove the gripper after insertion.
  • FIG. 1A illustrates an endoscopic system 10.
  • the endoscopic system 10 includes a digital ureteroscope 100 operably coupled to one or more electronic devices, such as a host machine 170 and one or more external terminals including a display 190 and a computer 180.
  • the ureteroscope 100 may be operably coupled to one or more of the host machine 170, the computer 180, or the display 190 wirelessly or through a cable 102.
  • the ureteroscope 100 includes a catheter 104 and a handpiece 110 having a catheter end 114 (e.g., distal end region) and a control end 112 (e.g., proximal end region) opposite to the catheter end 114.
  • both the catheter 104 and the handpiece 110 are disposable.
  • the catheter 104 and the handpiece 110 are manufactured as an integral part, or the catheter 104 is fixed with the handpiece 110 via a handpiece-catheter connector 103.
  • the catheter 104 is disposable, and the handpiece 110 may be sterilized and reused multiple times.
  • the catheter 104 is removably connected to the handpiece 110 and the catheter end 114 via a handpiece-catheter connector 103.
  • the catheter 104 of the ureteroscope 100 may be used for imaging an interior surface of a tubular structure, such as a lumen in the body of human or animal.
  • the catheter 104 may be inserted via a subject’s urethra to access various parts of the urinary tract.
  • the ureteroscope 100 also may be used for imaging, examination, and/or treatment within other organs of the body, such as a kidney.
  • at least one, some, or all embodiments of the ureteroscope 100 described herein provide the technical effect that results in improved treatment of calyces of a kidney.
  • the ureteroscope 100 may be employed as an industrial endoscope when tubular structure is a part of an industrial apparatus, an equipment, a product, a machine, a production line, and the like.
  • the catheter 104 may serve as a tether, and may include a plurality of scale markings or fiducials that enable a physician to measure a distance traveled by optoelectronic module into the tubular structure, such as a lumen of a body.
  • the handpiece 110 may include a steering controller 124 configured to control one or more steering wires 158 (FIG. 2) that are connected to an active bend portion 106 of the catheter 104 to deflect the distal end 105 to the desired location. Accordingly, a user may bend or curve the catheter 102 by moving the steering controller 124 on the handpiece 110.
  • a wire wheel 125 is rotatably secured to the interior region 155 of the handpiece 110.
  • the steering controller 124 on the handpiece 110 may be directly or indirectly connected to the wire wheel 124 and configured to at least partially and selectively rotate the wire wheel 125 in two different directions.
  • the one or more steering wires 158 are secured to the active bend portion 106 of the catheter 105 and adjustable responsive to rotation of the wire wheel effective to at least partially bend the active bend portion 106 one or more (e.g., at least two) directions.
  • the active bend portion 106 of the catheter 104 is made of certain flexible medical-grade polymer materials to allow for steerability of the catheter 104 and reduce discomfort to patients.
  • the catheter 104 may include the active bend portion 106 and a passive bend portion 101.
  • the active bend portion 106 may be generally distal to the handpiece 110 and may be controlled by one or more (e.g., two) control wires 158 (e.g., steel wires) to bend in two directions, one being used for bending the active bend portion 106 to one direction with a 0° to about 275° range, the other being used for bending the active bend portion 106 to the opposite direction with the same degree range.
  • Other number of steering wires e.g. , 1, 3, or 4
  • the passive bend portion 101 may be between the active bend portion 106 and the handpiece 110 and may bend according to the shape of urinary tract during insertion. Suitable active bend portions of catheters are disclosed in U.S. Patent No. 11,129,519 and U.S. Patent Publication No. 2018/0140177, the disclosures of which are incorporated herein, in their entirety, by this reference.
  • the catheter 104 having a selectively extendable and/or retractable distal portion 140 (visible in FIG. 1C).
  • the distal portion 140 is selectively adjustable to at least extend from a retracted configuration (e.g. , retracted position, shown in FIG. 1A) to an extended configuration (e.g., extended position, shown in FIG. 1C).
  • the distal portion 140 is also selectively adjustable to retract from the extended configuration to the retracted configuration.
  • An extendable e.g.
  • the catheter 104 includes a proximal portion (e.g. , at least some of the passive bend portion 101) proximal to the handpiece 110.
  • the distal portion 140 of the catheter 104 is distal to the handpiece 110 and may extend from a region of the catheter 104 generally distal to the handpiece 110.
  • the distal portion 140 of the catheter extends from an end region of the active bend portion 106 such that, when the distal portion 104 is extended, the active bend portion 106 is disposed between the distal portion 140 and the passive bend portion 101 of the catheter 104.
  • This configuration of the catheter 104 results in the technical effect of allowing an operator to bend the end of the catheter 104 a desired direction, and if necessary, linearly extend the distal end 105 of the catheter 104 to position the distal end 105 of the catheter 104 closer to a target or area in need of treatment or viewing (e.g., calyces of a kidney).
  • the distal portion 140 is configured to linearly extend from the active bend portion 106 (e.g.
  • the operator of the ureteroscope 100 can selectively extend the distal portion 140 to a preferred or selected distance X based on the circumstances during use.
  • the distal portion 140 may be configured to selectively extend from the active bend portion 106 (or lengthen the catheter 104 as a whole) to a selected position within any of the ranges provided above.
  • the ureteroscope 100 includes an actuator and a control member configured to allow an operator of the ureteroscope to selectively extend and/or retract the distal portion 140, according to an embodiment.
  • the ureteroscope 100 may include an actuator 160 disposed in the interior region 155 of the handpiece 110 and operably connected to the distal portion 140 and configured to at least extend and/or retract the distal portion 140 of the catheter 104 relative to the proximal portion of the catheter 104.
  • the actuator 160 may include a base member 164 and one or more wires 162 or cables secured to the base and the distal portion 140 of the catheter 104.
  • the base member 160 may be positioned in the interior region 155 of the handpiece 110 and selectively moveable (e.g., linearly) in the interior region 155 between a first position and a second position.
  • the distal portion 140 of the catheter 104 may be tensioned by the one or more wires 162 when the base is in the first position such that the distal portion is held in the retracted position when the base member 164 is in the first position. Moving the base member 162 to the second position in the interior region 155 of the handpiece 162 may extend the distal portion 140 to the extended position.
  • the distal portion 140 is operably coupled to the actuator 160 such that the distal portion 140 selectively extends and/retracts responsive to the actuator 160.
  • the distal portion 140 of the catheter 104 includes a coiled spring 142 or bellows housed at least partially therein and having a distal end region secured directly or indirectly to the one or more wires or cables 162.
  • the distal end may include any of a variety of springs or other biasing members, such as a compression spring, a tension spring, a coiled spring, a torsion spring, a spring belt, a leaf spring, and/or a compliant piece of material.
  • the distal portion 140 includes a wall or end piece proximate the distal end 105 having the one or more wires 162 or cables secured thereto and holding the coiled spring 142 or bellows in the distal portion 140.
  • the wall or end piece may have the optoelectronic module 109 and/or the light source 111 embedded therein or secured thereto opposite to the coiled spring 142.
  • Moving the base member 164 to the second position in the interior region 155 of the handpiece 110 may at least partially release tension in the coiled spring 142 or bellows such that the coiled spring elongates and pushes the distal end 105 outward linearly to extend the distal portion 140 to the extended configuration.
  • Returning the base member 164 to the first position in the interior region 155 of the handpiece 110 may tension the one or more wires 162 or cables and pull the coiled spring 142 or bellows inward toward the handpiece 110, thereby linearly shortening the coiled spring 142 or bellows and returning the distal portion 140 at least partially toward the retracted configuration.
  • the distal end 140 may include a telescoping distal end that extends and/or retracts responsive to the actuator 160, and the coil spring 142 may be absent.
  • the ureteroscope 100 includes a control member 121 operably connected to the actuator 160 to selectively extend and/or retract the distal portion of the catheter 104 relative to the proximal portion of the catheter 104.
  • the control member 121 may include a sliding tab, grip, or button on the exterior of the handpiece and secured to the base member 164.
  • the base member includes a rigid arm extend from the sliding tab, grip, or button into the interior region 155 of the handpiece.
  • the handpiece 110 may include an elongated slot that allows the sliding tab, grip, or button to slide from a first position corresponding to the first position of the base member 164 to a second position corresponding to the second position of the base member 164.
  • the handpiece 110 includes one or more locking elements between the first position and the second position of the sliding tab, grip, or button that allow an operator to lock the sliding tab, grip, or button in a selected position between the first position and the second position of the sliding tab, grip, or button, thereby holding the distal portion at a selected partially extended configuration.
  • the locking elements may include addition perpendicular slots or a friction locking element.
  • the control member 121 is separate from the handpiece 110.
  • the control member 121 may include an electronic device remote or separated from the handpiece, but operably connected to the communication interface 150 and/or the base 164.
  • the ureteroscope 100 may include an optoelectronic module (e.g., a camera or other imager) for imaging the interior of the subject.
  • an optoelectronic module 109 e.g., image sensor
  • at least one light source 111 may be located in a distal end 105 of the catheter 104 or other location in the catheter 104.
  • the optoelectronic module 109 may include a micro camera module having an image sensor microchip, a set of micro lenses, and a micro illumination module. Suitable optoelectronic modules are disclosed in U.S. Patent No. 9,942,452, which is incorporated herein, in its entirety, by this reference.
  • the optoelectronic module 109 may be positioned in a rigid or semi-rigid shell-like housing at the distal end 105 configured for insertion into the tubular structure for imaging its interior surface.
  • the optoelectronic module 109 may be inserted into a patient's body through a natural body orifice, such as the mouth, nose, urethra, bladder, vagina, or anus.
  • the ureteroscope 100 may therefore have different configurations for use as a gastrointestinal, a colonoscope, endoscopic ultrasound (EUS), endoscopic retrograde cholangiopancreatography (ERCP), or other suitable application.
  • Applications of the ureteroscope 100 include diagnostic observation associated with endometrial polyps, infertility, abnormal bleeding, and pelvic pain, and surgical procedure such as embryo growth arrest and uterine malformation etc.
  • the ureteroscope 100 may include a receiving device or communication interface 150 (FIG. 2) generally located outside the catheter 104 for receiving the signal from an image sensor within the optoelectronic module 109.
  • the catheter 104 may include at least one electrical lead 162 (FIG. 2) that is coupled to the optoelectronic module 109 and conveys an electrical signal from optoelectronic module 109 to the communication interface 150.
  • the communication interface 150 may be positioned within an interior region 155 (FIG. 2) of the handpiece 110 or adjacent to the handpiece 110.
  • the catheter 104 may be configured to couple the optoelectronic module 109 to the circuitry within the handpiece 110 in any suitable manner.
  • the catheter 104 is configured to detachably couple the optoelectronic module 109 to circuitry within the handpiece 110.
  • the catheter 104 and the optoelectronic module 109 are disposable, and may be detached from the handpiece 110 after a single patient use, thus eliminating the need for sterilization or reprocessing and reducing contamination risks.
  • the handpiece 110 may be disinfected for subsequent reuse with a catheter 104 and optoelectronic module 109 for a different patient.
  • the endoscopic system 10 may include one or more electronic devices for processing and displaying the image data received from the optoelectronic module 109 of the ureteroscope 100.
  • the endoscopic system 10 may include one or more of a host machine 170 having a microprocessor, a computer 180 having a microprocessor, and a display 190.
  • the host machine 170 may be connected to one or more terminals of the computer 180 and the display 190 for further processing and displaying the image data from the optoelectronic module 109.
  • the host machine 170 or the computer 180 may be programmed with image processing software that takes as input the image data output from the optoelectronic module 109 of the ureteroscope 100 and generates two- or three-dimensional reconstructions of the body lumen that may be displayed on the display 190.
  • a processor in at least one of the host machine 170, the computer 180, or the display 190 may be programmed with software that accepts as input a plurality of still images of an object generated by the optoelectronic module 109, and then output for display a three-dimensional rendering of the object based on the plurality of still images.
  • the display 190 may include any suitable display, and may be configured to display a moving image (e.g., movie or video) or a still image collected by the image sensor of the optoelectronic module 109. Although shown in FIG. 1A as separate blocks, the host machine 170, the computer 180, and the display 190 may include a single device, two devices, three devices, or more than three devices.
  • a moving image e.g., movie or video
  • the host machine 170, the computer 180, and the display 190 may include a single device, two devices, three devices, or more than three devices.
  • the endoscopic system also may include a cable 102 configured to operably couple the ureteroscope to at least one of the host machine 170, the computer 180, the display 190, and/or other electronic devices (such as a remote control member 121).
  • the cable 102 may electrically couple the retrieving device 150 (FIG. 2) of the ureteroscope 100 to at least one of the host machine 170, the computer 180, or the display 190.
  • the cable 102 also may allow the communication interface 150 to communicate with and receive electric power from the host machine 170 or other power sources.
  • the cable 102 also may be configured to allow the communication interface 150 to transmit image data captured at the optoelectronic module 109 to the host machine 170 for processing, storing, and displaying.
  • the ureteroscope 100 may include a communication interface 150 or host interface housed in the handpiece 110.
  • the communication interface 150 may contain, for example, one or more of a processor board, a camera board and frame grabber, or a power source.
  • the processor board may be coupled by the cable 102 to the host machine 170 for storage and retrieval of images generated by ureteroscope 100.
  • the communication interface 150 also may be configured to communicate with and receive electric power from the host machine 170 or other power source via the cable 102.
  • the communication interface 150 also may transmit image data captured at the distal end 105 to the host machine 170 for processing, storing, and displaying.
  • the communication interface 150 may be connected to the cable 102 through one or more wires 154 and/or connected to the optoelectronic module 109 through one or more electrical leads 162.
  • the communication interface 150 or handpiece 110 may include an antenna and a wireless chipset, e.g., compliant with the IEEE 802.11 WiFi standards, for wirelessly transmitting the video or still image generated by the ureteroscope 100 to the host machine 170, the computer 180, or the display 190 without the cable 102.
  • the communication interface 150 may include a wireless interface configured to implement various protocols, including but not limited to Wi-Fi, Bluetooth, ZigBee, Z-Wave, etc. This arrangement may be useful in a physician’s office because it permits the computer and display to be placed outside of the sterile field, while also allowing the physician greater maneuverability during use of the ureteroscope 100.
  • the communication interface 150 may be omitted and the image data may be transmitted directly to the host machine 170 and/or the computer 180.
  • the ureteroscope 100 may be operated to perform or complete selected tasks manually, automatically, or a combination thereof. Some ureteroscopic functions may be implemented with the use of components that comprise hardware, software, firmware or combinations thereof. While general-purpose components such as general purpose computers or oscilloscopes may be used in the ureteroscope 100, dedicated or custom components such as circuits, integrated circuits or software may be too. For example, some functions are implemented with a plurality of software instructions executed by one or more data processors, which is part of a general-purpose or custom computer. The one or more data processors may be in at least one of the communication interface 150, the host machine 170, the computer 180, or the display 190.
  • the data processor or computer comprises volatile memory for storing instructions and/or data and/or a nonvolatile storage, for example, a magnetic hard-disk and/or removable media, for storing instructions and/or data.
  • implementation includes a network connection.
  • implementation includes a user interface, generally comprising one or more input devices (e.g., allowing input of commands and/or parameters) and output devices (e.g., allowing reporting parameters of operation and results).
  • the handpiece 110 also includes a working channel port 118 and a working channel opening 107 (FIG. IB) that provides fluid communication between the working channel port 118 and the distal end 105 of the catheter 104.
  • the handpiece 110 also may include a working channel connector 130 that is connected or attached to the working channel port 118 and a working channel 152 that provides fluid communication between working channel port 118 and the working channel opening 107 through the handpiece 110 and/or the catheter 104.
  • the working channel 152 may extend through the distal portion 140 to include the working channel opening 107 at the distal end 105 of the catheter 104.
  • the working channel 152 may include a single, continuous material through the handpiece 110 and the catheter 104.
  • the working channel 152 includes a first portion in the interior region 155 of the handpiece 110 and a second portion in the catheter 104.
  • the first portion and the second portion of the catheter 152 may include different materials or configurations that are fluidly connected to one another.
  • At least one of the working channel port 118 or the working channel connector 130 is configured to engage with various surgical instruments and irrigation devices such as a laser fiber, as needed, for operations such as stone breaking and retrieval, etc.
  • the working channel port 118 may be positioned on a lower/bottom or an upper/top portion of the handpiece 110, proximate to the catheter end 114 of the handpiece 110.
  • the working channel port 118 may be positioned less than one-half of a distance from the catheter end 114 to the control end 112, less than one-third of the distance from the catheter end 114 to the control end 112, less than one-quarter of the distance from the catheter end 114 to the control end 112, or less than one-fifth of the distance from the catheter end 114 to control end 112.
  • the handpiece 110 also may include a cable port 120 for receiving or connecting the cable 102 (FIGS. 1A), thereby operably coupling the ureteroscope 100 to at least one of the host machine 170, the computer 180, or the display 190.
  • Both the cable port 120 and the working channel port 118 also may be positioned on a lower or bottom portion of the handpiece 110, proximate to the catheter end 114 of the handpiece 110.
  • both the cable port 120 and the working channel port 118 may be positioned less than one -half of a distance from the catheter end 114 to the control end 112, less than one-third of the distance from the catheter end 114 to the control end 112, less than one-quarter of the distance from the catheter end 114 to the control end 112, or less than one-fifth of the distance from the catheter end 114 to control end 112.
  • the handpiece 110 may further include a compact battery module for supplying power to the optoelectronic module 109 and the at least one light source 111.
  • the power source in the handpiece 110 may be, for example, one or more conventional dry-cell disposable batteries or lithium ion rechargeable batteries.
  • the ureteroscope 100 shown in FIGS. 1-2 includes a cable port 120 positioned proximate to the catheter end 114 and distal to the control end 112, in some embodiments, the cable port 120 is absent from the handpiece 110 or positioned proximate to the control end 112 and distal to the catheter end 114. Accordingly, in some embodiments, the cable port 120 is absent from the handpiece 110 or positioned proximate to the control end 112. Furthermore, while the ureteroscope 100 shown in FIGS.
  • the working channel port 118 may be disposed elsewhere on the handpiece 110. Accordingly, in some embodiments, the working channel port 118 may be disposed elsewhere than along the longitudinal central plane proximate to the catheter end 114.
  • At least a portion of the catheter 104 may be a lubrisciously coated catheter, such as a hydrophilic coating disposed thereon.
  • at least the distal portion 140 may include the hydrophilic coating.
  • at least one (e.g. , both) of the distal portion 140 and/or the active bend portion 106 include the hydrophilic coating disposed thereon.
  • all of the catheter 104, including the distal portion 140 and the active bend portion 106 include the hydrophilic coating disposed thereon.
  • the hydrophilic coating on the catheter 104 results in the technical effect of allowing for easier insertion of the catheter 104 into the subject and less ureteral trauma/tearing during insertion.
  • the hydrophilic coating may include a carbopol or polyvinylpyrrolidone (PVP), coating.
  • an actuator 360 of a ureteroscope 300 may include a motor 364 positioned in the interior region 155 of the handpiece 110.
  • the ureteroscope 300 may include any aspect of the ureteroscope 100, including the catheter 104, the active bend portion 106, the selectively extendable and/or retractable distal portion 140, the coiled spring 142, the one or more wires or cables 162, the optoelectronic module 109, and/or the light source 111.
  • FIG. 3 is a side view of the handpiece 110 of the ureteroscope 300 with a side of the handpiece 110 removed, according to an embodiment.
  • the motor 364 may be operably connected to the distal portion 140 and configured to extend and retract the distal portion 140 of the catheter 104 relative to the proximal portion of the catheter 104.
  • the one or more wires 162 or cables may be secured to the motor 364 and the distal portion 140 of the catheter 104.
  • the motor 364 may be configured to increase (e.g. , unwind or release) an amount of the one or more wires 162 or cables between the motor 364 and the distal portion 140 of the catheter 104 to extend the distal portion 140 to the extended position.
  • the motor 364 also may be configured to decrease (e.g., wind or retract) an amount of the one or more wires 162 or cables between the motor 364 and the distal portion 140 of the catheter 104 to retract the distal portion 140 to the retracted position.
  • the one or more cables 162 are holding the coiled spring 142 at least partially in tension, the distal portion 140 may be held in the retracted position.
  • the tension in the coiled spring 142 may be at least partially released such that the coiled spring elongates and pushes the distal end 105 outward linearly to extend the distal portion 140 to the extended configuration.
  • tension in the one or more wires 162 or cables may pull the coiled spring inward toward the handpiece 110, thereby linearly shortening the coiled spring 142 and returning the distal portion 140 at least partially toward the retracted configuration.
  • the distal portion 140 telescopes at least partially into the catheter in the retracted position.
  • the motor 364 is positioned in the handpiece 140 proximate to the catheter 104, and the one or more wires 162 or cable are absent.
  • the catheter 104 may include an outer tube secured to the handpiece 110 and an inner tube secured to the motor 364 and including the distal end 105 of the catheter.
  • the inner tube may be slidable or movable within the outer tube, and the inner tube may be secured to the motor 364 such that the motor 364 may push, force, or direct a portion of the inner tube out of the distal end of the outer tube to linearly extend the catheter 104.
  • the motor 364 also may pull or retract the inner tube to retract the inner tube back into the outer tube, thereby linearly retracting the catheter 104.
  • the ureteroscope 300 includes a control member 321 operably connected to the actuator 360 to selectively extend and/or retract the distal portion 140 of the catheter 104 relative to the proximal portion of the catheter 104.
  • the control member 321 may include a button, sliding tab, or grip, on the exterior of the handpiece and operably coupled to the motor 364.
  • the control member 321 is separate from the handpiece 110.
  • the control member 321 may include an electronic device remote or separated from the handpiece 110, but operably connected to the communication interface 150 and/or the motor 364.
  • an actuator of a ureteroscope 400 may include a pneumatic or hydraulic pump 460 positioned in the interior region of the housing 1110.
  • the ureteroscope 400 may include any aspect of the ureteroscope 100, including the catheter 104, the active bend portion 106, the optoelectronic module 109, and/or the light source 111.
  • FIG. 4 is a side view of the handpiece 110 of the ureteroscope 400 with a side of the handpiece 110 removed, according to an embodiment.
  • the catheter 104 of the ureteroscope 400 also includes a selectively extendable and/or retractable distal portion 440.
  • the pump 460 may be positioned in the handpiece at least proximate (e.g., adjacent) to the catheter 104.
  • the pump 460 may selectively pneumatically or hydraulically increase a pressure in at least a portion of the catheter 104 effective to deform at least the distal portion 440 of the catheter 104 to extend the distal portion 440 of the catheter 104 to the extended position.
  • the pump 460 also may selectively pneumatically or hydraulically decrease a pressure in at least a portion of the catheter 104 effective to deform at least the distal portion 440 of the catheter to retract the distal portion 440 of the catheter 104 to the retracted position.
  • the distal portion 440 may include a bellows that extends with increased pressure from the pump 460, and retracts when the pressure is not longer exerted by the pump 460.
  • the ureteroscope 400 includes a control member 421 operably connected to the pump 460 to selectively extend and/or retract the distal portion 440 of the catheter 104 relative to the proximal portion of the catheter 104.
  • the control member 440 may include a button, sliding tab, or grip, on the exterior of the handpiece and operably coupled to the pump 460.
  • the control member 421 is separate from the handpiece 110.
  • the control member 421 may include an electronic device remote or separated from the handpiece 110, but operably connected to the communication interface 150 and/or the pump 460.
  • FIG. 5 is a flow diagram of a method 500 operating a catheter of a ureteroscope in a subject, according to an embodiment.
  • the method 500 may include an act 510 of inserting the catheter of the ureteroscope into a urethra of a subject to a selected position.
  • the method 500 also may include an act 520 of selectively extending a distal portion of the catheter from a retracted position to an extended position using a control member.
  • the act 520 may include activating, with the control member, an actuator disposed in the interior region of the handpiece and operably connected to the distal portion to extend the distal portion of the catheter relative to the proximal portion of the catheter. More particularly, in some embodiments, activating, with the control member, an actuator disposed in the interior region of the handpiece and operably connected to the distal portion to extend the distal portion of the catheter relative to the proximal portion of the catheter may include moving a base of the actuator positioned in the interior region of the handpiece from a first position to a second position to at least partially release tension on one or more wires or cables secured to the base and the distal portion of the catheter.
  • the distal portion of the catheter may include a coiled spring or bellow housed at least partially therein and having a distal end region secured to the one or more wires or cables such that moving the base of the actuator from the first position to the second position at least partially releases tension on one or more wires or cables and the coiled spring in the distal portion.
  • activating, with the control member, an actuator disposed in the interior region of the handpiece and operably connected to the distal portion to extend the distal portion of the catheter relative to the proximal portion of the catheter may include activating a motor positioned in the interior region of the handpiece to increase an amount of one or more wires or cables between the motor and the distal portion of the catheter to extend the distal portion to the extended position.
  • activating, with the control member, an actuator disposed in the interior region of the handpiece and operably connected to the distal portion to extend the distal portion of the catheter relative to the proximal portion of the catheter may include activating a pneumatic or hydraulic pump positioned in the interior region of the housing to pneumatically or hydraulically increase a pressure in at least a portion of the catheter and deform at least the distal portion of the catheter to extend the distal portion of the catheter to the extended position.
  • the distal portion telescopes out from the catheter when the distal portion is selectively extended
  • the control member may include a selectively slidable tab on the handpiece
  • the control member includes an electronic device separate from the handpiece
  • at least a distal portion of the catheter includes a hydrophilic coating on at least the distal portion of the catheter.
  • the method 500 also includes an act of bending an active bend portion of the catheter before selectively extending the distal portion of the catheter.
  • selectively extending the distal portion of the catheter includes selectively extending the distal portion of the catheter about 2 mm to about 30 mm.
  • the acts of the method 500 described above are for illustrative purposes.
  • the acts of the method 500 may be performed in different orders, split into multiple acts, modified, supplemented, or combined.
  • one or more of the acts of the method 500 may be omitted from the method 500.
  • Any of the acts of the method 500 may include using any of the handpieces 110, ureteroscopes 100, 300, 400 and/or the system 10 disclosed herein.
  • the term “about” or “substantially” refers to an allowable variance of the term modified by “about” or “substantially” by ⁇ 10% or ⁇ 5%. Further, the terms “less than,” “or less,” “greater than,” “more than,” or “or more” include, as an endpoint, the value that is modified by the terms “less than,” “or less,” “greater than,” “more than,” or “or more.” [0048] While various aspects and embodiments have been disclosed herein, other aspects and embodiments are contemplated. The various aspects and embodiment disclosed herein are for purposes of illustration and are not intended to be limiting.

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Abstract

La présente divulgation concerne un exemple de système d'urétéroscope (10) qui comprend une pièce à main (110) et un cathéter (104). La pièce à main a une région d'extrémité distale (114), une région d'extrémité proximale (112), une région intérieure (155) et un orifice de canal de travail (118). Le cathéter s'étend à partir de la région d'extrémité distale de la pièce à main. Le cathéter comprend un canal de travail (152) en communication fluidique avec l'orifice de canal de travail, une partie proximale qui est proximale par rapport à la pièce à main, et une partie distale (140) qui est distale par rapport à la pièce à main et extensible sélectivement vers une position étendue et rétractable sélectivement vers une position rétractée par rapport à la partie proximale. La partie distale comprend une extrémité distale définissant une ouverture de canal de travail en communication fluidique avec le canal de travail.
PCT/US2022/039954 2022-08-10 2022-08-10 Dispositifs et systèmes d'urétéroscope ayant une partie distale sélectivement extensible WO2024035401A1 (fr)

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Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20100076264A1 (en) * 2005-05-04 2010-03-25 Stephen Tallarida Rotate-to-advance catheterization system
US9942452B2 (en) 2016-08-25 2018-04-10 NINGBO WISE OptoMech Technology Corporation Optoelectronic module and an imaging apparatus comprising the same
US20180140177A1 (en) 2016-11-24 2018-05-24 NINGBO WISE OptoMech Technology Corporation Flexible Digital Ureteroscope
US20190343538A1 (en) * 2018-05-14 2019-11-14 Stryker Corporation Inverting thrombectomy apparatuses and methods of use
US11129519B2 (en) 2016-08-25 2021-09-28 OTU Medical Inc. Single-use endoscope with built-in optical fibers and fixtures
US20220053995A1 (en) * 2018-12-13 2022-02-24 C.R. Bard, Inc. Ureteroscope devices, systems, and methods cross-reference to related applications

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20100076264A1 (en) * 2005-05-04 2010-03-25 Stephen Tallarida Rotate-to-advance catheterization system
US9942452B2 (en) 2016-08-25 2018-04-10 NINGBO WISE OptoMech Technology Corporation Optoelectronic module and an imaging apparatus comprising the same
US11129519B2 (en) 2016-08-25 2021-09-28 OTU Medical Inc. Single-use endoscope with built-in optical fibers and fixtures
US20180140177A1 (en) 2016-11-24 2018-05-24 NINGBO WISE OptoMech Technology Corporation Flexible Digital Ureteroscope
US20190343538A1 (en) * 2018-05-14 2019-11-14 Stryker Corporation Inverting thrombectomy apparatuses and methods of use
US20220053995A1 (en) * 2018-12-13 2022-02-24 C.R. Bard, Inc. Ureteroscope devices, systems, and methods cross-reference to related applications

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