WO2025103712A1 - Functional tube instrument having axial stroke actuation - Google Patents

Abstract

The invention relates to a functional tube instrument comprising: a tube-like longitudinally extending instrument body (1), which has a bendable sleeve (2) and a bendable core (3) extending therein and is designed to allow an axial relative movement of the sleeve and core and to thereby allow an axial stroke (AH), at least in a distal functional region (1a), in order to actuate a useful element; and an operating unit, to which the instrument body is coupled in an operating region (1b), arranged proximally upstream of the distal functional region, in order to effect the axial stroke. According to the invention, the operating unit is designed, during actuation, to reversibly bend the instrument body in the operating region from a starting position course into a curved course (VK), which is more curved than the starting position course and which effects a curvature length difference, which provides the axial stroke, between the sleeve and core along the curved course. The invention also relates to the use e.g. for endoscopic instruments in the field of medicine.

Description

Functional tube instrument with axial stroke actuation

The invention relates to a functional hose instrument with a hose-like elongated instrument body, which has a flexible sheath and a flexible core extending therein and is designed to enable an axial relative movement of the sheath and core and thereby an axial stroke at least in a distal functional area for actuating a useful element, and with an operating unit with which the instrument body is coupled to an operating area proximally upstream of the distal functional area for effecting the axial stroke.

The term “sheath” is generally understood to mean any elongated component or tubular functional part which has a hollow channel for the passage of the core, whereby, depending on the application, this can be a hose or pipe part which is more flexible or more rigid than the core or a similar sheath made of a metal or plastic material.

The term core is understood here to mean any elongated, wire-shaped component or functional component made of a hollow or solid metal or plastic material, which is accommodated in the hollow channel of the sheath and is axially movable relative to the sheath at least in the distal functional area.

The terms "distal functional area" and "operating area" located proximally upstream of the distal functional area generally refer to two axially spaced or consecutive sections of the elongated, tubular instrument body, of which the operating area lies behind the functional area in a forward, i.e., distal, direction. Typically, but not necessarily, the operating area is located in a rear end area of the instrument body, and the functional area is located in a front end area of the instrument body. Functional tube instruments of this type are commonly used in endoscopic medical technology, for example, specifically in the form of stone basket instruments with an expandable wire basket for capturing and/or removing stones, thrombotic blood clots, and the like in tissue cavities, as well as in the form of similar instruments such as wire filter instruments, wire loop instruments, and net instruments. In these applications, a typically expandable useful element, such as a wire basket, a wire filter, a wire loop, or a net, is located in the distal functional area, often specifically at the distal end of the instrument body. By axially moving the core back and forth relative to the sheath surrounding the core, this element is retracted into the distal end of the sheath while folding it up, or moved out of the sheath while unfolding it.

Another application is guide wire units for catheter instruments, where in this case the core is often a so-called pull wire, in other cases also a push wire that can transmit thrust forces, and the sheath is a tube surrounding it, which is connected to the pull wire in the distal region. Through axial relative movement of the pull wire and tube, a distal section of the guide wire unit or of the tube-shaped catheter, which in this case functions as the useful element, can be deformed, e.g., bent, in a desired manner. The pull wire, hence so called, is typically subjected to tensile stress, i.e., it transmits a tensile force from the operating unit to the distal useful element. Yet another endoscopic application is instruments that have a forceps element or a scissors element as a useful element in the distal functional region and are used, for example, for biopsy applications. In this case, the core can also be formed, for example, by a pull wire.

Typically, the operating unit in these instruments in conventional designs comprises two operating parts coupled to one another for axial relative movement, with one operating part having a fixation for the sheath and the other operating part having a fixation for the core. The fixation can be achieved, for example, by a conventional form-locking and/or frictional connection. The axial stroke movement for the distal useful element is effected by the user by actuating the operating unit by moving or shifting the two actuating parts axially relative to one another. Instruments are described, for example, in the published patent applications US 2005/0113862 A1, DE 10 2010 010 798 A1, WO 2010/133245 A1, WO 2011/095233 A1 and DE 10 2017 210 534 A1.

In this conventional design, the axial relative movement of the two operating elements is transmitted by the user via the instrument body as a corresponding axial stroke for actuating the functional element to the distal functional area. For applications where only a relatively small axial stroke is required or permissible, for example, with a stroke length in the order of only one or a few millimeters, or less than 1 mm, this requires correspondingly sensitive handling of the operating unit by the user. Especially in such cases, precisely setting a desired axial stroke length via the operating unit can be difficult for the user.

The invention is based on the technical problem of providing a functional hose instrument of the type mentioned at the outset which, compared to the above-mentioned prior art, offers manufacturing and/or operating and/or functional advantages, in particular with regard to the provision of the axial stroke required to actuate the useful element, especially in applications with a comparatively short required stroke length.

The invention solves this problem by providing a functional tube instrument with the features of claim 1. Advantageous developments of the invention are the subject of the subclaims, the wording of which is hereby incorporated by reference into the description. This includes, in particular, all embodiments of the invention resulting from the combinations of features defined by the references in the subclaims.

In the functional hose instrument according to the invention, the operating unit is designed to bend the instrument body in the operating area reversibly from an initial position into a curvature that is more curved than the initial position, which causes a curvature length difference between the sleeve and the core along the curvature that provides the axial stroke. Consequently, when operated by the user, the control unit ensures that the course of the instrument body in the operating area changes between the starting position course and the more strongly curved course of curvature, i.e. the course of the instrument body can be repeatedly changed from the starting position course towards the more strongly curved course of curvature and vice versa, preferably continuously. The terms starting position course and more strongly curved curvature course are therefore to be understood, without loss of generality, as the two opposing end positions of the course of the instrument body in the operating area that can be changed by the user via the control unit. Depending on requirements and application, the starting position course of the instrument body can be straight or already have a curved course that is overall less curved than the curvature course required to provide the desired axial stroke.

The changing curvature of the instrument body in the operating area results in a difference in the curvature length of the sleeve and core in the operating area, which in turn leads to a relative axial displacement of the sleeve and core in the distal functional area, thus providing the desired axial stroke there. The reason for the difference in curvature length is the geometric property that the length of a curved path increases with increasing radial distance from the center of curvature.

Consequently, with the functional tube instrument according to the invention, the user effects the axial stroke for actuating the functional element in the distal functional area by changing the curvature of the instrument body in the operating area by correspondingly actuating the operating unit. By appropriately dimensioning the instrument body and in particular its casing and core, a comparatively sensitive adjustment of the axial stroke for the distal functional element actuation can be achieved with this actuating mechanism, i.e. a relatively large operating travel for the user on the operating unit can be realized, which, in the sense of a reduction, can lead to an axial stroke with a significantly shorter stroke length compared to this operating travel. In addition, the instrument designed in this way can be manufactured with comparatively little effort, and the operating unit that supports this operating mechanism is very comfortable and reliable to use by the user.

Preferably, the core is secured against axial movement relative to the shell in a fixing area located proximally in front of the operating area or in the operating area itself, i.e. it is fixed there to the shell, e.g. by frictional engagement, or together with the shell to a third component in such a way that it cannot move axially relative to the shell or at least not to the extent that the difference in curvature length could be compensated for, which is why the difference in curvature length between core and shell is transferred undiminished or at least partially as an axial stroke to the distal functional area.

In particular, the core can extend centrally in the instrument body or in the casing, at least in those sections in which it does not bear unilaterally against the inner side of a curved section of the instrument body or casing.

Typically, when the control unit is actuated by the user to provide the axial stroke, it places the instrument body, and specifically its shell and core, under tensile stress due to the increased curvature, as the increasing curvature length increases the length of the instrument body in the operating area. In other words, the control unit then acts as a type of clamping unit for the instrument body. In appropriate cases, this allows the instrument body to return automatically from the more strongly curved path to its original position when the user releases the control unit.

In the case of endoscopic functional tube instruments, the useful element can in particular be a flexible distal end region of a guide wire unit, the movement of which between two end positions of different curvature fulfills an associated useful function, or a foldable wire basket acting, for example, as a collecting basket or a foldable wire filter element or a forceps or scissors element or an optical lens or camera or another useful element commonly used in endoscopy technology. A further advantage is that, due to this design and this method of providing the axial stroke, the functional tube instrument according to the invention can be implemented in such a way that the user does not have to secure the instrument body to the control unit against axial movement before using the instrument properly. Instead, it is sufficient to loosely couple the instrument body to the control unit, e.g., by simply passing it through a housing of the control unit. This can simplify handling and increase user comfort.

In a further development of the invention, the sleeve contains a helical spring body made of a round wire material or a flat wire material. This represents an advantageous implementation option for the sleeve. Depending on the requirements and application, a metal or plastic material can be used as the round wire material or flat wire material. The helical spring body provides the desired length stability when bent on the radially inner side, while it can easily stretch on its radial outer side. In alternative designs, the sleeve can also be made of an expandable, elastic, solid sleeve wall material, i.e., tubular material, made of metal or plastic.

In a further development of the invention, the core comprises a solid wire body or a hollow wire body. The term "solid wire body" is generally understood here to mean a wire-shaped element made of solid material, a corresponding metal material or plastic material depending on the need and application. In alternative embodiments, the core can comprise a hollow wire body, i.e. a wire-shaped element made of a hollow material, e.g., a coil spring material or a solid tube wall material, again made of metal or plastic depending on the need and application. This is suitable, for example, for catheter instruments. A medication or contrast agent, or a needle, a mandrel, or similar functional element, can be introduced through the hollow channel of the core.

In a further development of the invention, the curvature comprises one or more arcuate sections. Arcuate sections for increasing the curvature length are advantageous both structurally and functionally. Depending on the required stroke length of the axial stroke, the arcuate section(s) can be formed with a corresponding arc length. The arch shape can be chosen appropriately. A circular arc is generally preferred, but the section(s) can alternatively be elliptical, oval, or irregularly curved.

In a further development of the invention, the curvature comprises one or more full wraps. This measure is suitable for applications that require a correspondingly somewhat larger axial stroke length. Each full wrap, i.e., each complete 360° rotation of the curvature, provides a corresponding portion of the required axial stroke length. In other words, by applying a sufficient number of full wraps of the curvature, any desired axial stroke length can be achieved within a range required in practice for functional hose instruments.

In a further development of the invention, the operating unit has a sleeve fixation in a distal end region that secures the sleeve against axial movement. This prevents the curvature of the instrument body in the operating region from causing a corresponding change in the axial position of the sleeve in the distal functional region and consequently facilitates the positioning of the useful element at the intended location. The additional length of the instrument body in the operating region required for curving is in this case supplied by the proximally positioned part of the instrument body. This applies to both the sleeve and the core if, as mentioned above, the core is fixed in the fixation region relative to the sleeve in an axially movement-proof manner. As desired, only the additional difference in curvature length between the core and sleeve caused by the curvature is then transferred to the distal functional region of the instrument body as an axial stroke.

In a further development of the invention, the operating unit has at least one moving bending body, against whose circumference the instrument body rests in its curvature. This represents a very advantageous implementation for the operating unit in terms of manufacturing technology and functionality. When operating the operating unit, the user in this case moves the moving bending body, whereby the bending body bends the instrument body from its initial position to the desired curvature or, conversely, allows it to return to its initial position. The shape of the circumference of the bending body can be dependent on the desired curvature of the area resting against it. of the instrument body can be suitably selected, e.g. as a circular or elliptical or oval circumferential surface in cross-section, whereby the bending body as a whole can be designed e.g. as a cylindrical body with the corresponding cross-sectional shape.

It should be noted at this point that the term "moved" is generally to be understood in a relative sense, i.e., as a relative movement, in this case of the moving flexure relative to another part of the control unit and, in particular, relative to the instrument body. This does not necessarily require the user to actively move only the moving flexure itself; alternatively, the user can also actively move the other part of the control unit, and with it, the instrument body in the control area, relative to the moving flexure, instead of or in addition to the moving flexure, thereby ensuring the relative movement of the moving flexure relative to the instrument body.

In one embodiment of the invention, the moving bending body is rotatable about its longitudinal axis and winds the instrument body to bring it into its curvature. In this implementation, the bending body thus functions as a kind of winding core for winding and unwinding the instrument body, whereby the instrument body assumes the more pronounced curvature or returns to its original position.

In another embodiment of the invention, the moving bending body rotates on an orbit and entrains the instrument body to achieve its desired curvature. In this embodiment, the bending body acts as a type of carrier body that entrains the instrument body as it rotates on the orbit, thereby bending it into the desired curvature. This represents a functionally and structurally advantageous measure. The orbit can be, for example, a circular, elliptical, or oval path, etc.

In a further embodiment of the invention, the orbit extends around a centric bending body, against whose circumference the instrument body rests in its curvature. Advantageously, in this implementation, the centric bending body also contributes to bending the instrument body into its desired This is advantageous both functionally and structurally for certain applications.

In another embodiment of the invention, the operating unit comprises a first and a second moving flexure body, against whose circumference the instrument body rests along its curvature. These flexure bodies rotate on the orbital path at a distance from one another, i.e., at a distance equal to the angle of rotation, and carry the instrument body along to move it into its curvature. This allows for corresponding applications, with the same angle of rotation of the flexure bodies, to provide a greater stroke length of the axial stroke for the distal useful element than in designs with only one rotating flexure body.

In alternative embodiments of the invention, the operating unit has at least a first and a second moving bending body, which are arranged so as to be translationally movable at different distances transversely to the direction of displacement or pivotally movable at a radial distance from the pivot axis.

In a further embodiment of the invention, the first and second flexures are positioned diametrically opposite each other on the orbit and guide the instrument body between them. This design advantageously enables a comparatively compact design for the control unit for a given, required axial stroke length.

In an alternative further embodiment of the invention, the first and second flexures are spaced apart by an orbit angle of less than 180°, in particular between 80° and 100°, and orbit the central flexure. This design enables the provision of somewhat longer axial stroke lengths while maintaining a relatively small orbit angle of the flexures moving on the orbit.

In another embodiment of the invention, the moving bending body can be pivoted about a pivot axis and carries the instrument body along to adjust its curvature. In this case, the operating unit can, for example, comprise two scissor parts that can pivot relative to one another, with the moving bending body being arranged on one of the two scissor parts. In yet another embodiment of the invention, the moving flexure is translationally movable along a displacement direction and carries the instrument body along to adjust its curvature. For this purpose, the operating unit can comprise, for example, two operating parts that are translationally movable relative to one another or, specifically, housing parts, with the moving flexure being arranged on one of the two housing parts.

In a further embodiment of the invention, the operating unit has two operating parts that can be pivoted relative to one another or moved in translation, on each of which one or more flexural elements are arranged, with a gap being left between two flexural elements of one operating part for the engagement of a flexural element of the other operating part. In this way, when the operating unit is actuated, a flexural element arranged on one operating part can be moved into the gap between two adjacent flexural elements on the other operating part, thereby bending or curving the instrument body from its, for example, straight starting position to its more strongly curved curvature. The flexural elements on the other operating part can also contribute to this. The operating unit thus realized can be relatively compact in design and easy to handle.

In a further embodiment of the invention, the operating unit comprises an operating housing with a housing interior that accommodates the at least one moving bending body and the operating area of the instrument body, wherein the operating housing has an inlet opening into the housing interior and an outlet opening from the housing interior for the instrument body. This represents a very advantageous implementation of the operating unit in terms of manufacturing technology, functionality, and ease of use. The operating housing contains the bending body(s) that bend the instrument body into the desired curvature in its operating area, as well as, if applicable, the orbit for the bending body(s). For this purpose, the instrument body is arranged with its operating area in the operating housing, entering the operating housing via the inlet opening and leaving it again via the outlet opening.

In a further embodiment of the invention, the control housing comprises two relatively rotatable or pivotable or translationally movable Housing parts, wherein the inlet opening and the outlet opening are arranged on one housing part and the at least one moving bending body is arranged on the other housing part. This design of the operating unit can be implemented with relatively little effort and enables the desired operating mechanism, i.e., the change in the curvature of the instrument body in the operating area from its initial position to its more strongly curved curvature, in a convenient and reliable manner.

Advantageous embodiments of the invention are illustrated in the drawings. These and other embodiments of the invention are explained in more detail below. In the drawings:

Fig. 1 is a longitudinal sectional view of a curved portion of an instrument body of a functional tube instrument with a coil spring body made of round wire material as a sheath,

Fig. 2 the view of Fig. 1 for a variant with a coil spring body made of flat wire material as a shell,

Fig. 3 the view of Fig. 1 for a variant with a core of smaller diameter,

Fig. 4 the view of Fig. 2 for a variant with a core of smaller diameter,

Fig. 5A the view of Fig. 3 for a variant with a shell made of solid hose wall material,

Fig. 5B the view of Fig. 5A for a variant with a core made of hollow material,

Fig. 5C the view of Fig. 4 for a variant with spacer sleeve,

Fig. 6 is a longitudinal sectional view of the instrument body of Fig. 1 in an area with core taper, Fig. 7 the view of Fig. 6 for a variant with a multi-part sheath made of flat and round wire material,

Fig. 8 is a longitudinal sectional view of an instrument body corresponding to Fig. 1 from a proximal end to a distal functional area in a starting position,

Fig. 9 the view of Fig. 8 with the instrument body in a curved course in an operating area,

Fig. 10 is a longitudinal sectional view of an instrument body according to Fig. 1 from a proximal end to a distal functional area with the instrument body in a curvature with at least one full winding in an operating area,

Fig. 11 is a longitudinal sectional view offset by 90° from Fig. 10, showing the instrument body in a curved pattern with four full windings in the operating area,

Fig. 12 the view of Fig. 10 for a variant with a wire basket structure as an axial stroke-actuated useful element in a distal end region,

Fig. 13 is a longitudinal sectional view of an instrument body of a functional hose instrument with a wire basket structure as an axial stroke-actuated useful element in a distal functional area with an axial distance to a distal end area,

Fig. 14 is a longitudinal sectional view of an operating unit with a central bending body and a bending body moving around it on an orbit limited to approximately 270°,

Fig. 15 is a cross-sectional view of the control unit of Fig. 14,

Fig. 16 the view of Fig. 15 with the operating area of an instrument body accommodated in the operating unit in the starting position, for easier Recognition of the features of interest here without hatching the cut areas,

Fig. 17 the view of Fig. 16 in a position rotated by 90° of the rotating bending body,

Fig. 18 the view of Fig. 16 in a position rotated by 135° of the rotating bending body,

Fig. 19 the view of Fig. 16 for a variant of the control unit with a fully rotating orbit,

Fig. 20 the view of Fig. 19 in a position rotated by 90° of the rotating bending body,

Fig. 21 the view of Fig. 19 in a position rotated by 270° of the rotating bending body,

Fig. 22 the view of Fig. 19 in a position rotated by 360° of the rotating bending body,

Fig. 23 the view of Fig. 19 for a variant of the control unit with two bending bodies offset by 90° on the orbit around running,

Fig. 24 the view of Fig. 23 in a position rotated by 90° of the rotating bending bodies,

Fig. 25 the view of Fig. 23 in a position rotated by 270° of the rotating bending bodies,

Fig. 26 the view of Fig. 23 in a position rotated by 360° of the rotating bending bodies,

Fig. 27 the view of Fig. 16 for a variant of the control unit with a bending body acting as a winding body, Fig. 28 the view of Fig. 19 for a variant of the control unit with two diametrically opposite bending bodies running on the orbit without a centric bending body,

Fig. 29 the view of Fig. 28 in a position of the bending bodies rotated by 90°,

Fig. 30 the view of Fig. 28 in a position of the bending bodies rotated by 180°,

Fig. 31 the view of Fig. 28 in a position of the bending bodies rotated by 270°,

Fig. 32 the view of Fig. 28 in a position of the bending bodies rotated by 360°,

Fig. 33 the view of Fig. 28 for a variant with revolution counter,

Fig. 34 a schematic side view of a part of an operating unit with axially offset and translationally transversely moved bending bodies as well as distal end clamping pin sleeve fixation,

Fig. 35 the view of Fig. 34 for a variant of the control unit with transverse offset of two of the axially offset bending bodies,

Fig. 36 two views corresponding to Fig. 34 for a variant of the operating unit with a rotationally fixed mounting of a distal end bending body as a sleeve fixation and rotatable mounting of the remaining bending bodies in a starting position and an actuating position, respectively,

Fig. 37 a longitudinal sectional view of an operating unit with axially offset and translationally transversely moved bending bodies as well as distal end clamping pin sleeve fixation in a starting position,

Fig. 38 the view of Fig. 37 with the control unit in an operating position,

Fig. 39 is a sectional view taken along a line L39-L39 of Fig. 37,

Fig. 40 the sectional view of Fig. 39 with the control unit in the operating position, Fig. 41 a schematic side view corresponding to Fig. 34 for a variant of the operating unit with radially offset and pivotally arranged bending bodies in a starting position and

Fig. 42 the view of Fig. 41 with the control unit in an operating position.

As illustrated in various designs and views in Figs. 1 to 42, the functional hose instrument according to the invention comprises a hose-like, elongated instrument body 1, which comprises a flexible sheath 2 and a flexible core 3 extending therein. The instrument body 1 is configured to enable an axial relative movement of the sheath 2 and the core 3 in such a way that an axial stroke AH results at least in a distal functional region 1a of the instrument body for actuating a useful element located there. Furthermore, the functional hose instrument includes an operating unit 4, to which the instrument body 1 is coupled to an operating region 1b proximally upstream of the distal functional region 1a for effecting the axial stroke AH.

The operating unit 4 is designed, when actuated, in particular by a user using the instrument, e.g., a doctor, to reversibly bend the instrument body 1 in the operating area 1b from an initial position profile VA into a curvature profile VK that is more strongly curved than this. A resulting difference in the curvature length of the sleeve 2 and the core 3 along the curvature profile VK provides the axial stroke AH. Preferably, but not necessarily, the core 3 is secured against axial movement relative to the sleeve 2 in a fixing area 1c located proximally in front of the operating area 1b or in the operating area 1b itself, i.e., it is fixed there to the sleeve 2, e.g., by frictional engagement or a welded connection or the like, or together with the sleeve 2 to a third component in such a way that it cannot move axially relative to the sleeve 2, or at least not to such an extent that the difference in curvature length would be compensated for. Consequently, the difference in curvature length between core 3 and shell 2 is preferably transferred substantially undiminished, alternatively partially, as axial stroke AH to the distal functional area 1 a.

The functional tube instrument can be designed in particular for use in medical endoscopy technology, ie as an endoscopic functional tube instrument. As will become apparent to those skilled in the art from the present disclosure of the invention, the instrument can also be used for other purposes where there is a need for a tubular, elongated instrument with which a useful element arranged in a distal region can be actuated by an axial stroke that can be commanded by the user on the control unit in the proximal control area. The exemplary embodiments shown are primarily suitable for corresponding medical guidewires and catheters with a distal useful function. In medical applications of the instrument, the useful element can be, for example, an expandable wire basket or filter, e.g. for capturing and/or removing stone-like deposits or formations such as kidney stones or blood clots to eliminate or prevent thrombosis, scissors, forceps, a camera or other optical component, or a distal guidewire or catheter section that fulfills an associated useful function through variable, controlled bending or curving.

The provision of the axial stroke AH in the distal functional area 1 a by curving or bending the instrument body 1 in the operating area 1 b is illustrated schematically and comparatively in Figs. 8 and 9. Fig. 8 shows the instrument body 1 in the operating area 1 b with its rectilinear starting position VA in this selected example. The sleeve 2 and the core 3 are connected to one another in a force-fitting and/or form-fitting manner in the fixing area 1 c, in this case the proximal end of the instrument body 1, via a fixing proximal end cap 11 and are thereby secured against movement in their mutual axial position. Fig. 9 shows the instrument body 1 with its more strongly curved curvature VK in the operating area 1b. In this example, the curvature VK includes a circular arc-shaped bend of the instrument body 1 in the operating area 1b by a bending angle BW of approximately 300°. This results in the axial stroke AH in the distal functional area 1a, which in this case consists in the core 3 moving axially backward by this amount within the sleeve 2 or the sleeve 2 moving forward by this amount relative to the core 3. This is further illustrated in Figs. 8 and 9 in that a distal end of the core 3 in the initial position VA of the instrument body 1 according to Fig. 8 is located at an axial distance A _R = a _R + AH in front of a distal end of the sleeve 2 which is greater by the axial stroke AH than the distance a _R when the instrument body 1 according to Fig. 9 assumes the more curved curvature VK in the operating area 1 b. The return movement or re-deformation of the instrument body 1 in Operating area 1 b from the more strongly curved curvature profile VK to the starting position profile VA results in the reverse axial relative movement of shell 2 and core 3 by the axial stroke AH in the opposite direction in the distal functional area 1 a.

The axial stroke AH in the distal functional region 1 a results from the fact that along the curvature VK there is a greater curvature or path length for the core 3 than for the sheath 2 and that the sheath 2 and core 3 cannot move axially relative to each other in the proximal fixation region 1 c, or at least not to this extent. It is assumed that, starting from the initial position VA, the material of the sheath 2 cannot be significantly compressed on its radially inner side in the curved VK, but is extensible and can therefore stretch on its radially outer side in the curved VK. This generally applies to all sheath materials used in practice for endoscopic and many other functional tube instruments. For example, in endoscopic functional tube instruments, the sheath 2 often consists of a substantially rigid metal or plastic material or of a helical spring body in which the successive windings in the initial position state, i.e. the initial position profile VA, of the instrument body 1 are in contact with each other.

In corresponding embodiments, the sleeve 2 contains a helical spring body 2f made of a round wire material 2fr, as in the embodiments of Figs. 1, 3, 6 and 8 to 12. In other embodiments, the sleeve 2 contains a helical spring body 2f made of a flat wire material 2ff, as illustrated in Figs. 2, 4, 5C and 13. Fig. 7 shows an embodiment in which the sleeve 2 contains a helical spring body 2f which is formed in the operating region 1b from flat wire material 2ff, to which a section of the helical spring body 2f made of round wire material 2fr adjoins in a distal region. Alternatively, the sleeve 2 is formed from a flexible solid wall material, e.g. an elastic metal tube material, in particular a superelastic metal alloy tube material, or a plastic hose material. Figs. 5A and 5B show such embodiments. Due to the fluid-tight solid-wall design of the sheath 2, these are suitable for catheter instruments, for example. In corresponding implementations, the core 3 contains a solid wire body 3m, as is the case in the embodiments shown with the exception of Fig. 5B. In alternative implementations, the core 3 contains a hollow wire body 3h, as is the case in the embodiment of Fig. 5B. The core 3 can consist of a suitable wire- or tube-like metal and/or plastic material, as required. It is understood that, as further variants, in the embodiments of Figs. 4 and 5A, the solid wire body 3m there can be replaced by a hollow wire body in the manner of the hollow wire body 3h in Fig. 5B. The hollow channel formed by the hollow wire body 3h can be used, for example, for passing through medications or contrast agents and other fluids or needles and similar endoscopic functional elements.

Figs. 6, 7, and 13 illustrate examples in which the core 3 or core wire tapers in the distal direction via one or more frustoconical sections. This can typically serve to reduce the flexural rigidity of the instrument body 1 in this region, e.g., a distal region. Furthermore, this measure can prevent or mitigate the effect of any curvatures of the instrument body 1 in this region on the provision of the desired axial stroke AH for actuating the useful element, if such curvatures occur in this region during use of the instrument, for example, due to a correspondingly curved course of a tissue channel into which the instrument body 1 is inserted.

For a more detailed explanation of the presently used effect of providing axial stroke in the distal functional area 1a through the change in curvature in the operating area 1b of the instrument body 1, reference is made to the exemplary Figs. 1 to 5C. It should be noted at this point that the representation of the instrument and its components in Figs. 1 to 33 is largely not to scale; rather, individual components are shown enlarged compared to others as needed, which serves to facilitate understanding.

In Figs. 1 to 5C, the instrument body 1 is shown with a straight lower part and a curved upper part. In the case of the round wire material 2fr according to Figs. 1 and 3, the successive Windings on the radially inner side of the curvature arc are in mutual contact, whereby the curvature length of the sheath 2 is determined, while on the radially outer side of the curvature the windings move away from each other to stretch the sheath 2. When bent into a full circle, the circumferential length of an associated curved path KH of the radially inner curved side of the casing 2 remains unchanged and corresponds to the axial extent of the casing 2 in the non-curved, straight initial state, since the incompressible spring windings remain in contact there, while a larger circumferential length results for a curved path KK of the core 3, since the radius of curvature of the curved path KK of the core 3 is greater than the radius of curvature of the inner curved path KH of the casing 2 by half a diameter d _K of the core 3 plus half a diameter or wall thickness d _H of the round wire material 2fr of the casing 2. This corresponds to an axial length difference D _L between core 3 on the one hand and casing 2 on the other hand when stretching such a full circle winding into the axially straight course in the amount of D _L = 7T(d _K +d _H )/2. By curving the instrument body 1 from a straight line into a full circle and when stretching it from the full circle into a straight line, this curvature length difference _DL represents the axial stroke AH by which the core 3 and sleeve 2 move axially relative in a distally in front area when they are axially secured against movement in the opposite proximal area. If the instrument body 1 is only bent on a circular arc with a circumferential angular extent of less than 360°, this results in a fraction of the value of the length difference _DL for the full circle as the axial stroke AH, ie AH= _{DL xaB} /360°, with _aB as the circular arc angle.

As is clear from this example, the axial stroke AH occurs fundamentally due to the curvature of the instrument body 1 constructed in this way. The value of the axial stroke AH, i.e. the associated stroke length, depends on the specific circumstances, in particular on the dimensions of the core 3 and the shell 2 and on whether and to what extent the materials involved are compressible. It is understood that for this effect and thus for the provision of the axial stroke AH, it is not absolutely necessary for the instrument body 1 to be bent along a circular path. Rather, any other bending pattern that leads to the required difference in curvature length is suitable. For the example of Fig. 2, the same considerations apply as for the case of Fig.

1 , where in this case the relationship D _L = 7T(d _K /2+b _H ) results for the length difference D _L , since in this case the spring windings of the flat wire material 2ff with wall width b _H lie against one another at their radially inner side edge when the sleeve 2 is bent. For the examples in Figs. 3 and 4 the above considerations for the examples in Figs. 1 and 2 apply analogously. Although in these cases the inner diameter of the sleeve 2 is significantly larger than the outer diameter of the core 3, whereas in the examples in Figs. 1 and 2 the inner diameter of the sleeve 2 is only so much larger than the outer diameter of the core 3 that the desired axial relative movement is possible, when the instrument body 1 is bent the core 3 lies radially inward against the inside of the sleeve 2, since the instrument body 1 is put under tensile stress by the bending.

Furthermore, the above considerations based on Figs. 1 and 2 apply analogously to the example in Fig. 5A. In this example, too, the axial stroke AH occurs for the same reason due to a change in the curvature of the instrument body 1, whereby only the specific value of the stroke length may depend on the material of the casing 2, which may be different from that of the helical spring body 2f, in particular on its compression and/or expansion behavior. This can be determined experimentally, for example, if necessary. The above considerations also apply analogously to implementations in which the core 3 is formed from a hollow wire body, such as the hollow wire body 3h in the case of Fig. 5B.

From the above considerations it can be further seen that the axial stroke AH depends essentially on the difference in the curvature length of the two curvature paths KK and KH of core 3 on the one hand and shell 2 on the other hand. In designs in which the outer diameter of core 3 is significantly smaller than the inner diameter of the shell

2, the axial stroke AH can therefore be increased for the same angle of curvature by providing a spacer sleeve 15 between core 3 and shell 2, which spacer sleeve keeps core 3 at a distance from shell 2 by the amount of its wall thickness d _z , as shown in Fig. 5C for a corresponding variant of the example in Fig. 4. Compared to the example in Fig. 4, in this case the wall thickness d _z of the spacer sleeve 15 additionally contributes to the difference in curvature length between the two curvature paths KK and KH of core 3 and shell 2 and thus to the resulting axial stroke AH. In typical medical endoscopy applications, such as for guide wires and catheters, the diameter of the sheath 2 is usually between a few tenths of a millimeter and a few millimeters, and thus the length difference _DL for the full circle winding and thus the associated axial stroke AH is usually in the order of magnitude of approximately one tenth of a millimeter to one or two or even several millimeters. Consequently, with a relatively large and therefore easily manageable bending movement of the instrument body 1, even very short stroke lengths for the axial stroke AH can be conveniently set by bending the instrument body 1 only along an arc-shaped section by less than 360°. To achieve greater stroke lengths for the axial stroke A, the instrument body 1 can be bent by correspondingly more than 360°. This includes in particular the possibility of bending the instrument body 1 into a plurality of full-circle windings VK _W or several times by 360° and thereby multiplying the stroke length resulting from a single full-circle winding VK _W accordingly.

It should be noted at this point that the core 3 can extend centrally, i.e., centrally or longitudinally, in the instrument body 1 or the casing 2, as shown, at least in those sections in which it does not bear unilaterally against the inner side of a curved section of the instrument body 1 or the casing 2. An off-center positioning of the core 3 in the instrument body 1 or the casing 2 is not absolutely necessary. In corresponding embodiments, the core 3 practically completely fills the interior of the instrument body 1 or the casing 2.

Fig. 12 illustrates the use of the axial stroke AH to actuate a useful element in the form of a foldable wire basket 12 in the distal functional region 1a of the instrument body 1, in this case specifically in a distal end region of the instrument. Fig. 12 shows the instrument with the instrument body 1 in the curvature VK, which is more curved than the straight starting position VA and comprises one or more full circle windings VK _W , whereby the distal end of the core 3 moves back relative to the distal end of the sleeve 2, as explained above with reference to Figs. 8 and 9. This compresses the wire basket 12 formed on the sleeve 2, which thereby expands radially into the position shown.

Fig. 13 shows an embodiment in which a foldable wire basket 13 is attached to the sheath 2 at a position in the distal Functional area 1 a is formed proximally behind a distal end area. To reduce the flexural rigidity, the core 3 is tapered towards the distal end area, with a stabilizing fixation 14 of core 3 and sleeve 2 being provided in the distal direction behind the wire basket 13. By curving the instrument body 1 in the operating area 1 b out of the shown, straight starting position VA, there is in turn an axial return movement of the core 3 relative to the sleeve 2, whereby the core 3 applies a compressive shear force to the sleeve 2 in the proximal direction via the fixation 14, as a result of which the wire basket 13 expands radially into its functional position 13' shown in dashed lines.

In corresponding implementations, the curvature VK of the instrument body 1 in the operating area 1 b includes one or more arcuate sections VK _b , as can be seen, for example, in Figs. 9, 17, 18, 20 to 22, 24 to 26, 29 to 32, 35, 36 and 42.

In corresponding implementations, the curvature VK of the instrument body 1 in the operating area 1 b comprises one or more full windings VK _W , as is the case in the embodiments of Figs. 10 to 12 and possibly also in Fig. 27.

In corresponding embodiments, the operating unit 4 has a sleeve fixation 16 in a distal end region 4a that secures the sleeve 2 against axial movement, as shown in Figs. 34 and 36 to 40. This axial fixing of the sleeve 2 prevents the curvature of the instrument body 1 in the operating region 1b from causing a corresponding change in the axial position of the sleeve 2 in the distal functional region 1a, and consequently facilitates the positioning of the useful element arranged there at the intended location. The additional length of the instrument body 1 in the operating region 1b required for the curvature is in this case supplied by the proximally positioned part of the instrument body 1. This applies both to the sleeve 2 and to the core 3 if the core 3 is fixed in the fixing region 1c relative to the sleeve 2 in a manner that is secured against axial movement. As desired, only the additional difference in curvature length between core 3 and sleeve 2 caused by the curvature of the instrument body 1 in the operating area 1 b from the starting position curve VA to the curvature curve VK is then transferred as axial stroke AH to the distal functional area 1 a of the instrument body 1 . In the embodiments of Figs. 34 and 37 to 40, the sheath fixation 16 includes a clamping pin 18 that is movable between a clamping position 18a (see Figs. 34 and 37) and a release position 18b (see Fig. 38). In the clamping position 18a, it clamps the sheath 2 axially, e.g., to a housing part of the control unit 4; in the release position 18b, it releases the sheath 2, allowing the instrument body to be moved axially, e.g., to insert it into the control unit 4 or remove it from it.

In the embodiment of Fig. 36, the sleeve fixation 16 includes a flexural body 19 held stationary, e.g., on a housing part of the operating unit 4. The sleeve 2 rests against this flexural body when bent by actuating the operating unit 4, frictionally locking it against it to prevent it from sliding along, thereby securing the sleeve 2 in its axial position. This flexural body 19 can, for example, be a rotationally fixed cylindrical body, as shown, against whose outer surface the sleeve 2 rests frictionally.

In advantageous embodiments, the operating unit 4 has at least one moving flexural body 5, against whose circumference the instrument body 1 rests in its curvature VK. This is particularly evident from Figs. 14 to 42. In the examples shown, the moving flexural body 5 is designed as a cylindrical body; alternatively, it can have a different shape as required, e.g., a polygonal shape, an oval or elliptical shape, or a spherical shape. It is understood that in corresponding embodiments, either only one moving flexural body, two moving flexural bodies, or more than two moving flexural bodies can be present, depending on requirements.

In corresponding implementations, the moving bending body 5 is rotatable about its longitudinal axis 5L and serves to wind up the instrument body 1 in the operating area 1b and in this way to bring it into its curvature VK. Fig. 27 shows an example of the operating unit 4 in such a design. The moving bending body 5 in this case forms a winding body _5W , to the circumference of which the instrument body 1 is fixed with a proximal end, expediently by an associated positive and/or non-positive connection. By correspondingly rotating the winding body _5W , the instrument body 1 is Operating area 1b is wound onto or unwound from the winding body 5W. The corresponding curvature VK can accordingly include one or more full windings around the winding body _5W or only an arcuate section with a circumferential angular extent of less than 360°.

In other embodiments, the moving bending body 5 rotates on an orbit 6 and carries the instrument body 1 along with it during this orbital movement to bring it into its curvature VK. Figures 15 to 26 and 28 to 33 illustrate corresponding examples.

In corresponding embodiments, the orbit 6 extends around a centric bending body 7, with the instrument body 1 in the operating area 1b resting in its curvature VK against the circumference of the centric bending body 7. Corresponding embodiments are illustrated in Figs. 14 to 26. The centric bending body 7 can be arranged so as to be rotatable about its longitudinal axis or, alternatively, immobile, as required.

In further embodiments, the moving bending body 5 can be pivoted about a pivot axis 17 and carries the instrument body 1 along for its curvature VK. Figures 41 and 42 show a corresponding embodiment, with Figure 41 showing the initial position of the operating unit 4 and Figure 42 illustrating the movement of the instrument body 1 from this initial position into its curvature VK.

In further advantageous embodiments, the moving bending body 5 is translationally movable along a displacement direction TR and carries the instrument body 1 along for its curvature VK. Figs. 34 to 40 show corresponding embodiments.

It is understood that in further embodiments not shown, several of the aforementioned movement options can be combined for the at least one moving flexural body 5. For example, the moving flexural body 5 can be arranged with combined rotational and translational movement, or with combined pivoting and translational movement, or with combined rotational and circulating movement, etc. In corresponding embodiments, the operating unit 4 has a first and a second moving bending body 5^ 5 ₂ and 5 ₃ , 5 ₄ , against the circumference of which the instrument body 1 rests in its curvature VK, wherein these bending bodies 5-i , 5 ₂ ; 5 ₃ , 5 ₄ revolve on the orbit 6 with a circumferential spacing, ie circumferential angular spacing, and carry the instrument body 1 along in the operating area 1 b for bringing it into its curvature VK. Figs. 26 and 28 to 32 illustrate associated embodiments.

In advantageous embodiments, the first and second flexures 5^ ₅₂ are located diametrically opposite one another on the orbit 6 and guide the instrument body 1 between them. Figs. 28 to 33 illustrate corresponding examples. In these exemplary embodiments, the central flexure 7 is omitted, and the two flexures 5^ ₅₂ rotating on the orbit 6 guide the instrument body 1 between them in its rectilinear starting position VA with touching contact or a close distance.

In corresponding implementations, the first and second flexures 5 ₃ , 5 ₄ are spaced apart by an orbit angle Wa of less than 180° and orbit the central flexure 7. Figs. 23 to 26 show a corresponding example. In this illustrated embodiment, the spacing orbit angle Wa is approximately 90°. Depending on requirements, the orbit angle Wa can have a different value, e.g., between 80° and 90° or between 90° and 100°.

In advantageous embodiments, the operating unit 4 has an operating housing 8 with a housing interior 8a, in which the orbit 6 is located and which accommodates the at least one moving bending body 5 as well as the operating area 1b of the instrument body 1. The operating housing 8 includes an inlet opening 9 for the instrument body 1 into the housing interior 8a and an outlet opening 10 from the housing interior 8a. Figs. 14 to 26, 28 to 33 and 37 to 40 illustrate different variants of the operating unit 4 configured in this way. As can be seen therefrom, the operating housing 8 can, for example, have a relatively flat, disc-like shape, ie a relatively small height extension of the operating housing 8 in the direction perpendicular to the orbit 6 or parallel to a longitudinal axis G of the operating housing 8 marked in Fig. 14 is sufficient. 28 to 33 enables, by omitting the central flexural body 7, a comparatively compact design for the operating unit 4 or the operating housing 8, if required, even in the transverse plane parallel to the plane of the orbit 6. In the exemplary embodiment in Fig. 27, the operating unit 4 also includes the operating housing 8 with the housing interior 8a, wherein in this case the flexural body 5 functioning as the winding body 5 _W is accommodated in the housing interior 8a. In the embodiment according to Figs. 37 to 40, two groups of several, preferably cylindrical, flexural bodies 5 are accommodated in the housing interior 8a, which are translationally movable relative to one another transversely to the rectilinear starting position profile VA of the instrument body 1 from the inlet opening 9 to the outlet opening 10.

In advantageous embodiments, the control housing 8 comprises two housing parts 8b, 8c that are rotatable, pivotable, or translationally movable relative to one another, with the inlet opening 9 and the outlet opening 10 being arranged on one housing part 8b, and the at least one moving flexural body 5 being arranged on the other housing part 8c. In this embodiment, the user can very conveniently operate the control unit 4 by moving the two housing parts 8b, 8c relative to one another, i.e., twisting, pivoting, or shifting them, whereby the respective flexural body(s) 5 move along the orbit 6 and bend or deform the instrument body 1 in its control area 1b located in the housing interior 8a into the more strongly curved curvature profile VK. Through the reverse relative movement, the instrument body 1 can be deformed back into its initial position AV or automatically reaches this state after the bending stress is relieved by the bending body(s) 5. Figs. 14 to 26 and 28 to 33 show corresponding embodiments with housing parts 8b, 8c that are rotatably movable relative to one another. Figs. 37 to 40 illustrate an embodiment in which the two housing parts 8b, 8c are translationally movable relative to one another. Analogously, the embodiment shown schematically in Figs. 41 and 42 can, in a practical implementation, comprise the two housing parts 8b, 8c in a scissor-like pivotable configuration relative to one another.

In advantageous embodiments, the two housing parts 8b, 8c, as in the examples shown, are held together by means of a detachable snap, clip, or locking connection. In this case, the user can For example, insert the body 1 into one of the not yet assembled housing parts 8b, 8c and then snap, clip, or latch the other housing part onto it. By loosening the two housing parts 8b, 8c, the operator can remove or replace the instrument body 1 if necessary.

The two housing parts 8b, 8c can in particular be two housing halves which together form an outer housing of the control unit 4, as is the case in the examples shown.

Figs. 15 to 42 illustrate some exemplary examples for providing the axial stroke AH by continuously changing the curvature length of the instrument body 1 by means of the control unit 4 in different variants of the control unit 4.

In the embodiment of Figs. 15 to 18, the orbit 6 for the rotating flexure 5 around the central flexure 7 is limited to approximately 270°. Fig. 15 shows the operating unit 4 in an initial state without the instrument body 1, wherein the orbital movement of the flexure 5 is symbolized by a rotating arrow PU and some intermediate positions 5' of the flexure on the orbit 6 are indicated by dashed lines. Fig. 16 shows the operating unit 4 with the additionally inserted or extended operating area 1b of the instrument body 1.

Fig. 17 illustrates the situation after the rotating flexure 5 has been rotated out of its initial position by approximately 90° on the orbit 6. This is achieved by the user by correspondingly rotating the housing shells 8b, 8c on the control unit 4. In this usage situation, the rotating flexure 5 has carried the instrument body 1 along so far that the instrument body 1 rests in a quarter circle against the central flexure 7 and in a semicircle against the rotating flexure 5. In addition, an exit bevel 10a of the exit opening 10 of the control housing 8 causes a further curvature of the instrument body 1 by approximately 90°, resulting in an overall angle of curvature of the instrument body 1 of approximately 360°.

Fig. 18 shows the situation when the orbiting flexure 5 was rotated by an angle ß! of approximately 135° from its initial state on the orbit 6. In In this position, the instrument body 1 is positioned at an angle of 135° against the central bending body 7 and then at a circumferential angle of approximately 206° against the circumferential bending body 5. The exit bevel 10a causes a further bend of the instrument body 1 by an angle ß ₂ of approximately 71°. Overall, this results in a total angle of curvature of approximately 412°.

The embodiment of Figs. 19 to 22 is similar to that of Figs. 15 to 18 with the exception that the orbit 6 is not restricted but revolves completely around the central flexure 7. Accordingly, the orbital movement of the orbiting flexure 5 on the orbit 6 is not restricted.

Fig. 19 shows the arrangement in the initial state with the instrument body 1 passing straight through the control housing 8 of the control unit 4 in the control area 1b. Fig. 20 shows the situation with the bending body 5 moved by 90° on the orbit 6, resulting in the same total curvature angle of the instrument body 1 as in the analogous situation explained above in Fig. 17 with a total bend of the instrument body 1 of approximately 360°.

Fig. 21 shows the arrangement with the flexure 5 moving 270° from its initial position along the orbit 6. In this case, the instrument body 1 is positioned at a circumferential angle of approximately 270° against the rotating flexure 5, and at an angle of approximately 270° upstream and 30° downstream against the central flexure 7. Additionally, the instrument body 1 is bent by an angle of approximately 30° by the exit bevel 10a, which is also present in this embodiment. Overall, this results in a total angle of curvature of approximately 600°.

Fig. 22 shows the situation with the bending body 5 rotating once through 360° on the orbit 6. In this case, the instrument body 1 is bent by an inlet bevel 9a 9a at the inlet opening 9 by approximately 35°, then it surrounds the rotating bending body 5 by approximately 215°, the central bending body 7 by 180°, the rotating bending body 5 by another 270°, and the central bending body 7 by another 120°. In addition, there is an additional Bending angle of 30° due to the exit slope 10a. Overall, this results in a total curvature angle of approximately 850°.

The embodiment of Figs. 23 to 26 differs from that of Figs. 19 to 22 by the further, second rotating flexure ₅₄ in addition to the first rotating flexure ₅₃ , wherein the second rotating flexure ₅₄ follows or lags behind the first rotating flexure ₅₃ by the distance angle _Wa of, in this case, 90° in the direction of rotation. Fig. 23 shows the initial state with the instrument body 1 in a straight line with its operating area 1b passing through the operating housing 8.

Fig. 24 shows the situation with the rotating bending bodies 5 ₃ , 5 _{4 moving further by 90° on the orbit 6. In this situation, the instrument body 1 is bent by approximately 180° by the first rotating bending body 5 3 and by approximately 125° by the second rotating bending body 5 4. Furthermore ,} the inclined surfaces also present here at the inlet opening 9 and the outlet opening 10, i.e., the inlet bevel 9a and exit bevel 10a, contribute to a further bending of the instrument body of approximately 35° and approximately 90°, respectively. This results in a total angle of curvature of the instrument body 1 of approximately 430°.

Fig. 25 shows the arrangement after the bending bodies 5 ₃ , 5 ₄ have rotated by 270° on the orbit 6. In this case, the instrument body 1, following the inlet opening 9, has initially been bent by approximately 90° against the central bending body 7, then by 180° against the second rotating bending body 5 ₄ and by 225° around the first rotating bending body 5 ₃ , followed by a further bend of approximately 100° around the second rotating bending body 5 ₄ and a final bend through the exit bevel 10a of approximately 53°. This results in a total curvature of the instrument body 1 of approximately 648°.

Fig. 26 shows the arrangement after a complete rotation of the two bending bodies 5 ₃ , 5 ₄ by 360° on the orbit 6. In this case, the instrument body 1 is bent, starting from the inlet opening 9, first at the inlet slope 9a by approximately 36°, and then successively by the first rotating bending body 5 ₃ by approximately 126°, the central bending body 7 by approximately 90°, the second rotating bending body 5 ₄ by approximately 135°, the first circumferential bending body 5 ₃ by approximately 225°, the second bending body 5 ₄ by 180°, and finally by the central bending body 7 and the exit bevel 10a by another approximately 31° each. This results in a total bending angle of approximately 854°.

In the embodiment of Fig. 27, the instrument body 1, as already briefly mentioned above, is fixed circumferentially by its proximal end to the flexible body 5, which is arranged in the operating housing 8 of the operating unit 4 and can rotate about its longitudinal axis 5L. By rotating the flexible body 5 about its longitudinal axis 5L, the instrument body 1 can be wound onto the circumference of the flexible body 5 in its operating area 1b and thereby bent from its straight initial position VA shown in Fig. 27 into a correspondingly curved course. In this case, the angle of rotation of the flexible body 5 corresponds directly to the total bending angle for the instrument body 1.

28 to 32, as also briefly mentioned above, a first rotating flexure 5T and a second rotating flexure ₅₂ are arranged diametrically opposite one another on the rotating path 6, leaving only a gap between them for the passage of the instrument body 1. Fig. 28 shows the arrangement in the straight initial position VA of the operating area 1b of the instrument body 1, which is introduced into the interior 8a of the operating housing 8 of the operating unit 4 via the inlet opening 9 and led out again from this via the outlet opening 10.

Fig. 29 illustrates the arrangement after a circular movement of the two bending bodies 5-i, _5-2 by 90° on the orbit 6. The two bending bodies 5T, _5-2 carry the instrument body 1 along in its operating area 1b, so that the latter in turn undergoes a curved course with several arcuate curved sections _VKb . Starting from the inlet opening 9, the instrument body 1 is first bent by approximately 45° at the inlet bevel 9a, after which it bears against the second bending body _5-2 and the first bending body 5T by approximately 135° each, before being bent again by approximately 45° at the exit bevel 10a. This results in a total angle of curvature of approximately 360°. Fig. 30 shows the arrangement after a circular movement of the two bending bodies 5^ 5 ₂ by 180° relative to the initial state. The instrument body 1 is bent by the inlet bevel 9a by approximately 45°, then by the second bending body 5 ₂ and the first bending body 5T by approximately 225° each, and finally by the exit bevel 10a by another approximately 45°. This results in a total angle of curvature for the instrument body 1 of approximately 540°.

Fig. 31 shows the arrangement after a circular movement of the two bending bodies 5i, ₅₂ on the orbit 6 by 270°. The instrument body 1 is bent by the inlet bevel 9a by approximately 45° and then successively by the first bending body 5i by 45°, the second bending body ₅₂ by 270°, the first bending body 5i by 270°, the second bending body ₅₂ by approximately 45°, and the exit bevel 10a by approximately 45°. This results in a total angle of curvature for the instrument body 1 of approximately 720°.

Fig. 32 shows the situation after a complete rotation of the two bending bodies 5^ 5 ₂ by 360°. The instrument body 1 is bent by the inlet bevel 9a by approximately 45° and then successively by the first bending body 5T by 225°, the second bending body 5 ₂ by 270°, the first bending body 5i by 180°, the second bending body 5 ₂ by approximately 135°, and the exit bevel 10a by approximately 45°. This results in a total bending angle of the instrument body 1 in its operating area 1b of approximately 900°.

It can be helpful for the user to be informed about the current orbital angle of the bending bodies 5^ 5 ₂ or the curvature state of the instrument body 1 in the operating area 1 b. For example, in designs in which the instrument body 1 can be changed in the operating unit 4, i.e., a different instrument body 1 can be coupled to the operating unit 4, it is useful for the user to know whether the instrument body 1 is exactly or at least approximately in its initial position VA, since such a change of the instrument body 1 is normally easier and therefore preferred in this state. For this purpose, the functional hose instrument in associated designs includes a rotation counter 14, as in the example in Fig. 33. In the example of Fig. 33, the revolution counter 14 includes a counting cam 14a on the circumference of each of the two flexures 5^ 5 ₂ and a counting wheel 14b, which is rotatably mounted on the control housing 8. As soon as one of the counting cams 14a passes the counting wheel, which occurs after each half revolution of the flexures 5^ 5 ₂ on the orbit 6, it rotates the wheel from a current to a next detent position, with an elastic detent element 14c holding the counting wheel 14b in its respective detent position. In this way, the revolution counter 14 in this implementation is able to display the current angle of revolution of the flexures 5^ 5 ₂ or the curvature state of the instrument body 1 to within half a revolution, which is generally sufficient for the user. By appropriately modifying the design of the revolution counter 14, its display accuracy can be increased if necessary. In particular, the rotation counter 14 can, if desired, be implemented in such a way that it immediately detects or indicates when the instrument body 1 has been moved out of its initial position VA, and just as precisely detects when the instrument body 1 has been moved back into its initial position VA. This allows the user to reliably detect whether or not the instrument body 1 is in its initial position VA.

Fig. 34 schematically illustrates an embodiment of the operating unit 4 with two flexural bodies 5 ₅ , 5 ₆ arranged so as to be synchronously movable in translation and three further flexural bodies 5 ₇ , 5 ₈ , 5 ₉ , relative to which the two first-mentioned flexural bodies 5 ₅ , 5 ₆ can be displaced, i.e. moved translationally, along the direction of displacement TR. To make it easier to distinguish, the two first-mentioned flexural bodies 5 ₅ , 5 ₆ are referred to below as the first flexural bodies and the three other flexural bodies 5 ₇ , 5 ₈ , 5 ₉ are referred to as the second flexural bodies. In Fig. 34, the initial state of the relevant operating unit 4 is indicated by dashed lines, the actuated state by solid lines. As can be seen from this, the initial position profile VA of the instrument body 1 in the operating area 1 b is again rectilinear, and along this direction, to which the displacement direction TR is perpendicular, the two first bending bodies 5 ₅ , 5 ₆ and the three second bending bodies 5 ₇ , 5 ₈ , 5 ₉ are arranged in a row spaced from each other. In order to effect the actuating movement of the operating unit 4, the operating unit 4 contains two operating parts (not shown in Fig. 34) which are translationally movable relative to each other, wherein the two first bending bodies 5 ₅ , 5 ₆ are arranged on one control part and the three second bending bodies 5 ₇ , 5 ₈ , 5 ₉ are arranged on the other control part.

The distances or spaces between each two adjacent first or second bending bodies 5 ₅ , 5 ₆ ; 5 ₇ , 5 ₈ , 5 ₉ correspond in the example shown essentially to the outer diameter of the bending bodies 5 ₅ to 5 ₉ , so that during the translational movement of the first bending bodies 5 ₅ , 5 ₆ relative to the second bending bodies 5 ₇ , 5 ₈ , 5 ₉ , as is brought about by the actuation of the operating unit 4, the first bending bodies 5 ₅ , 5 ₆ can enter a respective space between the second bending bodies 5 ₇ , 5 ₈ , 5 ₉ and the middle second bending body 5 ₈ can enter the space between the two first bending bodies 5 ₅ , 5 ₆ . The two first bending bodies 5 ₅ , 5 ₆ take the instrument body 1 in the operating area 1 b in the displacement direction TR, whereby the latter simultaneously also rests against the second bending bodies 5 ₇ , 5 ₈ , 5 ₉ .

In the actuated state, as shown by way of example in Fig. 34 and in which the instrument body 1 assumes its curvature VK in the operating area 1 b, the instrument body 1 rests over half the circumference against the two first bending bodies 5 ₅ , 5 ₆ and the middle second bending body 5 ₈ and over a circumferential angle of 90° against the two outer second bending bodies 5 ₇ , 5 _9. The additional length required for this, ie the difference in length of the instrument body 1 in the operating area 1 b between this curvature VK and the straight initial position VA, comes from the proximally forward area of the instrument body 1 on the right in Fig. 34.

This is because the sleeve fixation 16 at the distal end region 4a of the operating unit 4 prevents the instrument body 1 from being drawn into the operating unit 4 from the distally downstream region of the instrument body 1 when the clamping pin 18 is in its clamping position 18a as shown, into which it can be axially advanced by the user from a rearward release position using a feed force FV. This ensures that a useful element arranged at the distal end region of the instrument body 1 remains at its intended location and is not axially retracted. Only the axial stroke AH resulting from the difference in curvature length of the sleeve 2 and core 3 is transmitted to the distal functional region 1a, since the sleeve fixation 16 or the clamping pin 18 in its clamping position 18a only Shell 2 of the instrument body 1 is fixed to the operating unit 4, while allowing axial movement of the inner core 3.

Since the core 3 is secured against axial relative movement in the proximal fixing area 1c of the instrument body 1 to the sleeve 2, it is retracted together with the sleeve 2 from the upstream proximal section of the instrument body 1 into the operating unit 4 when the instrument body 1 with its operating area 1b is moved from its shorter initial position VA to its longer curvature VK by actuating the operating element 4.

It is understood that in correspondingly modified embodiments, only one or more than two first bending bodies and only one or two or more than three second bending bodies can be provided, which are each arranged at a distance from one another in the longitudinal direction of the instrument body 1 that has been inserted or is to be inserted.

In the example of Fig. 34, on the one hand the first flexural bodies 5 ₅ , 5 ₆ and on the other hand the second flexural bodies 5 ₇ , 5 ₈ , 5 ₉ are each arranged without an offset in the displacement direction TR. Fig. 35 shows a modified embodiment in which the two first flexural bodies 5 ₅ , 5 ₆ are arranged offset from one another in the displacement direction TR by a predeterminable offset length LV. This has the consequence that the first flexural body 5 ₆ , which is displaced rearward with respect to the displacement direction TR, comes into contact with the instrument body 1 with the corresponding offset later than the front first flexural body 5 ₅ when the operating unit 4 is actuated and does not move with its entire diameter into the space between the _two relevant second flexural bodies 5 ₈ , 5 ₉ . In the example shown in Fig. 35, the offset length LV corresponds approximately to the radius of the cylindrical bending bodies 5 ₅ to 5 ₉ , which in this case are all chosen to be of the same size.

The offset arrangement of the first bending bodies 5 ₅ , 5 ₆ in the direction of displacement TR enables particularly sensitive adjustment and modification of the axial stroke AH, since initially only the front first bending body 5 ₅ causes the axial stroke AH and only with further actuation of the control unit 4 does the rear first bending body 5 ₆ contribute to causing the axial stroke AH. Fig. 36 shows a variant of the example in Fig. 34, in which the flexures ₅₅ to _59, with the exception of the distally last second flexure _57, are rotatably mounted on the respective operating part, as symbolized by rotation arrows. When the operating element 4 is actuated, the rotatable flexures ₅₅ , ₅₆ , ₅₈ , ₅₉ can therefore rotate when placed against the instrument body 1 and carried along by the instrument body 1 in the operating area 1b, so that it is not necessary for the instrument body 1 to slide along the contact surface of the respective flexure ₅₅ , ₅₆ , ₅₈ , ₅₉ . The distal last second bending body 5 ₇ , however, is held in a rotationally fixed manner on the operating unit 4 in this embodiment and represents the aforementioned immobile bending body 19 of the sheath fixation 16 formed in this case and consequently functions as an alternative to the clamping pin 18 in the example of Fig. 34. The instrument body 1 can bear against the stationary surface of the rotationally fixed bending body 19 with frictional engagement, wherein the frictional engagement is selected to be large enough to prevent the instrument body 1 with its sheath 2 from sliding along. If necessary, the surface of the rotationally fixed bending body 19 can be designed to increase the frictional engagement, e.g. by roughening.

Fig. 36 illustrates the effect of this sleeve fixation 16. In an upper partial image, the operating unit 4 is shown in its initial state, and in a lower partial image in the actuated state. In the actuated state, the instrument body 1 in the operating area 1b with its curvature VK has a greater length than in the straight initial position state VA, as already explained above with reference to Fig. 34. Due to the fixation of the sleeve 2 by the sleeve fixation 16 at the distal end area 4a of the operating unit 4, the instrument body 1 is retracted by the relevant additional length from its forward proximal area into the operating unit 4, ie the instrument body 1 is retracted by a corresponding length dp from its proximal area. Without the sleeve fixation 16, the retraction of the instrument body 1 into the operating unit 4 for the purpose of providing the additional length for its operating area 1 b would basically also take place from the distally downstream area of the instrument body 1, i.e. the instrument body 1 would then move axially back by a certain length dd at its distal end. The sleeve fixation 16 prevents this distal retraction length dd, i.e. the distal retraction length dd then has the value zero, as illustrated in Fig. 36. This has, as already mentioned, the desired consequence in most applications that the axial position of the Useful element in the distal functional area 1 a of the instrument body 1 does not change when the operating unit 4 is actuated in order to provide the axial stroke AH.

Figures 37 to 40 illustrate in more detail an embodiment of the operating unit 4 which is based on the principle of the embodiment of Fig. 34 and corresponds to this with the modification that a further first bending body 5 ₁₀ is provided and all bending bodies 5 ₅ to 5 ₁₀ are held rotatably on the operating unit 4, as explained above with regard to the bending bodies 5 ₅ , 5 ₆ , 5 ₈ , 5 ₉ of the embodiment of Fig. 36.

In the embodiment of Figures 37 to 40, the operating unit 4 includes two operating parts 4j, ₄₂ that are translationally movable relative to one another along the displacement direction TR, which simultaneously form correspondingly translationally movable housing parts 8b, 8c of the thus formed operating housing 8 of the operating unit 4. The three first flexural bodies ₅₅ , ₅₆ , ₅₁₀ are rotatably mounted on one operating part 4j, and the three second flexural bodies ₅₇ , _{58, 59} are rotatably mounted on the other operating part _42. The rotatable mounting is effected via corresponding axle stubs 20, as can be seen in particular from Figures 39 and 40. In this embodiment shown, the clamping pin 18 is arranged on the operating part 4 ₂ or the housing part 8b formed thereby in the distal end region 4a of the operating unit 4, wherein it is shown in Fig. 37 in its axially advanced clamping position 18a and in Fig. 38 in its axially retracted release position 18b.

When the clamping pin 18 is in its release position 18b, the instrument body 1 can be inserted into the control housing 8 from the inlet opening 9 or the outlet opening 10 and pushed through it, exiting the control housing 8 again at the opposite outlet opening 10 or inlet opening 9. By moving the clamping pin 18 into its clamping position 18a, the instrument body 1 with its casing 2 is then axially fixed to the control housing 8. If the instrument body 1 is to be removed from the control housing 8 and thus from the control unit 4, the clamping pin 18 only needs to be moved back to its release position 18b, after which the control unit 4 can be pulled off the instrument body 1.

The realization of the cover fixation 16 with the clamping pin 18 enables the user to fix the instrument body 1 by simply operating the clamping pin 18 to optionally fixate it to the operating unit 4 and to release this fixation again by moving the clamping pin 18 between its release position 18b and its clamping position 18a. In this and functionally analogous implementations of the sleeve fixation 16, this can be used very advantageously by the user, if necessary, for a convenient and reliable successive advancement or introduction of the instrument body 1 into a cannula, e.g. of a catheter, or directly into a body tissue channel. To do this, the user initially places the operating unit 4 during or after attachment to the instrument body 1 at a certain, not too great distance from the distal end of the instrument body 1 by moving the clamping pin 18 into its release position 18b and moving the operating unit 4 along the instrument body 1 accordingly. He then moves the clamping pin 18 into its clamping position 18a, after which the user can very conveniently hold the instrument body 1 on the operating unit 4 and insert its distal end into an access opening of the cannula or tissue channel and then advance it until the operating unit 4 is close to the access opening. He then moves the clamping pin 18 back to its release position 18b. He can now push the operating unit 4 back on the instrument body 1 by the desired amount. The user then moves the clamping pin 18 back to its clamping position 18a and advances the operating unit 4 by the previously pushed back amount, whereby the instrument body 1 fixed to the operating unit 4 now follows the feed movement and thus moves further into the cannula or tissue channel. This process is repeated until the instrument body 1 has been advanced far enough. Since the user can use the control unit 4, which can be positioned relatively close to the access opening, for advancement in this way, they do not need to directly handle the thin and often relatively smooth, and therefore generally more difficult to handle, instrument body 1. Finally, if necessary, the user can move the control unit 4 to the desired position on the instrument body 1 for subsequent use to provide the axial stroke AH.

The operating part 4 ₂ or housing part 8b has in this exemplary embodiment a U-shaped cross-section, as can be seen from Figs. 39 and 40, and the operating part 4i or housing part 8c forms a cuboid-shaped push-button body, which extends from the open U-side of the operating part 4 ₂ or housing part 8b into the receiving space of the U-shape and is guided in a translationally movable manner along the displacement direction TR.

As can be seen in particular from Fig. 39, the cylindrical bending bodies 5 ₅ to 5 ₁₀ are provided on the circumference with a respective guide groove 21 to facilitate the guidance of the instrument body 1 which comes into contact therewith.

A major advantage of implementing the operating unit 4 according to the embodiments of Figs. 15 to 26 and 28 to 40 is that, prior to normal use of the instrument, the user does not have to laboriously fix the instrument body 1 to the operating unit 4 as a whole, securing it against axial movement, as is usually required with conventional endoscopy instruments of this type. Rather, the user only needs to loosely guide the instrument body 1 through the housing 8 of the operating unit 4 or loosely couple it to the operating unit 4 in another known manner, and, if necessary, simply secure the sleeve 2 to the distal end region 4a of the operating unit 4 using the sleeve fixation 16. In the embodiment of Fig. 27, an axial fixation of the instrument body 1 to the operating unit 4 can also be carried out in a relatively simple manner on the winding body _5W rotating about its longitudinal axis 5L by means of an associated positive and/or non-positive connection.

Figures 41 and 42 schematically illustrate a variant embodiment of the example of Fig. 34, in which the first flexural bodies ₅₅ , ₅₆ , on the one hand, and the second flexural bodies ₅₇ , ₅₈ , ₅₉ , on the other hand, are arranged to be pivotally movable relative to one another about the pivot axis 17, rather than to be translationally movable. The operating parts 4i, ₄₂ and housing parts 8b, 8c, which in this case are arranged to be pivotally movable relative to one another, are only symbolically indicated in Figures 41 and 42 for the sake of simplicity. The first flexures ₅₅ , ₅₆ are arranged at a radial distance on the line connecting their centers to the pivot axis 17 on the operating or housing part 48c, the second flexures ₅₇ , ₅₈ , ₅₉ are arranged at a radial distance on the line connecting their centers to the pivot axis 17 on the operating or housing part ₄₂ , 8b. By pivoting the operating unit 4, as indicated in Fig. 42 by a pivot arrow SP, the first flexures ₅₅ , ₅₆ in turn reach the spaces between two adjacent second flexures ₅₇ , ₅₈ , ₅₉ , and the middle second flexure ₅₈ reaches the space between the two first flexures ₅₅ , ₅₆ . as can be seen from Fig. 42, which in turn schematically shows the control unit 4 with dashed lines in the initial state and with solid lines in the actuated state.

Since the first and second flexures ₅₅ to ₅₉ are each arranged at a radial distance from one another, in this example the pivoting actuation of the operating unit 4 achieves an effect similar to that in the exemplary embodiment of Fig. 35 with the translationally movable and mutually offset first flexures ₅₅ , ₅₆ , after which initially only one of the two first flexures ₅₅ , ₅₆ and only later the other first flexure ₅₆ comes into contact with the instrument body 1 in the operating area 1b and carries it along in its movement. This in turn results in the very sensitive variability or adjustability of the axial stroke AH provided by the actuation of the operating unit 4, as explained above for the exemplary embodiment of Fig. 35.

It is understood that the invention encompasses further embodiments with two or any number of moving bending bodies which are arranged to rotate on an orbit or to be translationally movable or pivotally movable in such a way that when the operating unit 4 is actuated, they act on the instrument body 1 in the operating area 1 b successively one after the other instead of simultaneously bending or curving, which, as mentioned, can increase the sensitivity of the adjustment of the axial stroke AH.

As the illustrated and further embodiments explained above make clear, the invention advantageously provides a functional tube instrument in which a useful element in the distal functional area can be actuated by an axial stroke, which can be effected or adjusted by the user via the control unit in a very sensitive, precise and user-friendly manner, preferably continuously. In particular, for endoscopic functional tube instruments, such as guide wires and catheter instruments, relatively short stroke lengths for the axial stroke in the range of one or a few millimeters or only one or a few tenths of a millimeter can be precisely adjusted with the usual dimensions of such instruments. However, even longer stroke lengths in the range of several millimeters can be easily realized by bending the instrument body to a correspondingly larger overall curvature angle, for example by bending it into several complete Windings of 360° each or by using a suitable plurality of flexures, e.g., capable of translational movement or pivoting movement or of continuously moving in an orbit. As explained above, the axial travel depends on the dimensions of the instrument body, in particular on the wall thickness of the shell and the diameter or wall thickness of the core. So, for example, with the same overall angle of curvature, a greater axial travel results for an instrument with a greater wall thickness of the shell or a larger core diameter.

As a further particular advantage, the invention enables designs of the functional hose instrument in which the user does not need to fix the instrument body to the operating unit in a complex manner to prevent axial movement before using the instrument properly. Rather, it may be sufficient for the user to simply loosely guide the instrument body through a housing of the operating unit or to loosely couple it to the operating unit in another way, which can significantly simplify handling and increase user comfort. If necessary, the sleeve fixation can ensure simple, detachable fixing of the sleeve of the instrument body to a distal end region of the operating unit and thus maintain a constant position of the sleeve in the distal end region of the instrument when the operating unit is actuated in order to generate the desired axial stroke of the core relative to the sleeve.

Claims

Patent claims 1. Functional tube instrument, in particular endoscopic functional tube instrument, with - a tubular, elongated instrument body (1) which has a flexible sheath (2) and a flexible core (3) extending therein and is designed to enable an axial relative movement of the sheath (2) and core (3) and thereby an axial stroke (AH) at least in a distal functional area (1 a) for actuating a useful element, and - an operating unit (4) with which the instrument body (1) is coupled to an operating area (1 b) proximally arranged in front of the distal functional area (1 a) for effecting the axial stroke (AH), characterized in that - the operating unit (4) is designed to bend the instrument body (1) in the operating area (1b) reversibly from an initial position (VA) into a curvature (VK) which is more curved than the initial position and which causes a difference in the curvature length of the casing (2) and the core (3) along the curvature (VK) which provides the axial stroke (AH). 2. Functional tube instrument according to claim 1, further characterized in that - the casing (2) contains a helical spring body (2f) made of a round wire material (2fr) or a flat wire material (2ff) and/or - the core (3) contains a solid wire body (3m) or a hollow wire body (3h). 3. Functional hose instrument according to claim 1 or 2, further characterized in that the curvature (VK) comprises one or more arcuate sections (VK _b ) and/or one or more full windings (VK _W ). 4. Functional hose instrument according to one of claims 1 to 3, further characterized in that the operating unit (4) has in a distal end region (4a) a sheath fixation (16) securing the sheath (2) against axial movement. 5. Functional hose instrument according to one of claims 1 to 4, further characterized in that the operating unit (4) has at least one moving bending body (5), against the circumference of which the instrument body (1) rests in its curvature (VK). 6. Functional tube instrument according to claim 5, further characterized in that - the moving bending body (5) is rotatable about its longitudinal axis (5L) and winds up the instrument body (1) to bring it into its curvature (VK) or - the moving bending body (5) rotates on a circular path (6) and takes the instrument body (1) with it to bring it into its curvature (VK) or - the moving bending body (5) can be pivoted about a pivot axis (17) and takes the instrument body (1) with it to bring it into its curvature (VK) or - the moving bending body (5) is translationally movable along a displacement direction (TR) and takes the instrument body (1) with it to bring it into its curvature course (VK). 7. Functional hose instrument according to claim 6, further characterized in that the orbit (6) extends around a central bending body (7), against the circumference of which the instrument body (1) lies in its curvature (VK). 8. Functional hose instrument according to claim 6 or 7, further characterized in that the operating unit (4) has at least a first and a second moving bending body (5^ 5 ₂ ; 5 ₃ , 5 ₄ ; 5 ₅ , 5 ₆ ), against the circumference of which the instrument body (1 ) rests in its curvature (VK) and which rotate with a circumferential distance on the orbit (6) or are arranged so as to be translationally movable at different distances transversely to the direction of displacement (TR) or pivotally movable at a radial distance from the pivot axis (17) and take the instrument body (1 ) along for bringing it into its curvature (VK). 9. Functional hose instrument according to claim 8, further characterized in that the first and the second bending body (5^ 5 ₂ ) are diametrically opposite one another on the orbit (6) and guide the instrument body (1 ) between them. 10. Functional hose instrument according to claim 8, further characterized in that the first and the second bending body (5 ₃ , 5 ₄ ) are spaced from one another by an orbit angle (Wa) of less than 180°, in particular between 80° and 100°, and run around the central bending body (7). 11. Functional hose instrument according to claim 6, further characterized in that the operating unit (4) has two operating parts (4-i, _4-2 ) which can be pivoted relative to one another or moved in translation, on each of which one or more bending bodies ( _5-5 to _5-9 ) are arranged, wherein between two bending bodies ( _5-8 , _5-9 ) of one operating part ( _4-2 ) a space is left for the engagement of a bending body ( _5-6 ) of the other operating part (4-i, 4-2). 12. Functional hose instrument according to one of claims 5 to 11, further characterized in that the operating unit (4) has an operating housing (8) with a housing interior (8a) which accommodates the at least one moving bending body (5) and the operating area (1 b) of the instrument body (1 ), wherein the operating housing (8) has an inlet opening (9) into the housing interior (8a) and an outlet opening (10) from the housing interior (8a) for the instrument body (1 ). 13. Functional hose instrument according to claim 12, further characterized in that the operating housing (8) comprises two housing parts (8b, 8c) that are rotatable, pivotable, or translationally movable relative to one another, wherein the inlet opening (9) and the outlet opening (10) are arranged on one housing part (8b) and the at least one moving bending body (5) is arranged on the other housing part (8c).