ENDOSCOPE WITH ROTARY DRUM AND OPERATING METHOD

Abstract

An endoscope with a rotating drum or a rotation module, in particular for use as a sterile disposable instrument, having an elongate rigid and/or flexible shaft tube which at a distal end mounts the rotating drum, so as to be rotatable about at least one first axis of rotation, an optical imaging system being arranged in the rotating drum, with the at least one first axis of rotation running approximately transversely to a longitudinal axis of the shaft tube and with the endoscope having at least one control line for rotating the rotating drum. Here, the at least one control line of the rotating drum runs on an outer side/outer face of the shaft tube, and is fastened to the rotating drum at at least one lever distance (a) from the at least one first axis of rotation.

Claims

1. An endoscope with a rotating drum or a rotation module, in particular for use as a sterile disposable instrument, having an elongate rigid and/or flexible shaft tube which at a distal end mounts the rotating drum, preferably by means of a bearing fork, so as to be rotatable about at least one first axis of rotation, an optical imaging system being arranged in said rotating drum, the optical imaging system preferably comprising an electronic image recorder and/or an imaging optical unit and/or an illumination device, with the at least one first axis of rotation running approximately transversely to a longitudinal axis of the shaft tube and with the endo scope having at least one control line for rotating the rotating drum preferably by way of a linear movement, wherein the at least one control line of the rotating drum runs on an outer side/outer face of the shaft tube, preferably so as not to restrict a work channel in the interior of the shaft tube and the internal diameter of the shaft tube, and is fastened to the rotating drum at at least one lever distance (a) from the at least one first axis of rotation.

2. The endoscope as claimed in claim 1, wherein the at least one control line is windable along at least one winding curve preferably on the outer circumference of the rotating drum.

3. The endoscope as claimed in claim 1, wherein the at least one control line of the rotating drum is embodied as a supply line for the imaging system, preferably as a flexible printed circuit board or as a cable, for electronic circuits in the interior of the rotating drum.

4. The endoscope as claimed in claim 1, wherein the at least one control line is guided in a recess, preferably with a protective collar, in the outer face of the shaft tube, the recess running parallel to the longitudinal axis of the shaft tube.

5. The endoscope as claimed in claim 1, wherein reset means, preferably in the form of a torsion spring at a bearing point of the rotating drum, are arranged on the rotating drum.

6. The endoscope as claimed in claim 1, wherein the work channel comprises at least one second fluid line, including preferably an air line and/or preferably a liquid feed line and a liquid extraction line in modular fashion.

7. The endoscope as claimed in claim 6, wherein the shaft tube has at least one hole, preferably a plurality of holes, on the circumferential side at a distal end, said hole connecting the at least one second fluid line, preferably the liquid extraction line, to an operation region in order to remove a rinsing fluid from an operation region.

8. The endoscope as claimed in claim 1, wherein the work channel is designed to receive at least one instrument and/or contains at least one instrument.

9. The endo scope as claimed in claim 8, wherein the shaft tube is open on an upper section, the at least one control line being guided on a lower section such that preferably at least one flexible instrument is adjustable/bendable in a direction perpendicular to the longitudinal axis of the shaft tube.

10. The endoscope as claimed in claim wherein the bearing fork is fastened to the shaft tube in a manner pivotable about a second axis of rotation and the work channel is open along the longitudinal axis in a pivoted state of the bearing fork in order to preferably guide the at least one instrument from the work channel into an operation region, the bearing fork preferably being controllable by way of a further control line.

11. The endoscope as claimed in claim 1, wherein the external diameter (d) of the shaft tube is 3 mm to 6 mm.

12. The endoscope as claimed in claim 2, wherein a plurality of control lines are windable on different winding curves along a circumference of the rotating drum, in particular with different distances (a) from the axis of rotation in order to carry out different rotational adjustments of the rotating drum in the case of the same adjustment travel (S) of the at least one control line.

13. A method for operating an endoscope, in particular as claimed in claim 1, so as to control a rotating drum with an imaging system, preferably with an electronic image recorder and/or an imaging optical unit and/or an illumination device, at least one control line on an outer side/outer face of a shaft tube of the endo scope and a work channel in the interior of the shaft tube being arranged in non-restrictive fashion and being fastened to the rotating drum at at least one lever distance (a) from an at least one first axis of rotation and the at least one control line subsequently being pulled or pushed in order to rotate the rotating drum.

14. The method as claimed in claim 13 with an endoscope 3, for cleaning a field of view (β) of the imaging system, including the following steps: rotating the rotating drum from an observation position of an operation region to a cleaning position, in which the field of view (β) is aligned with the distal end of the shaft tube and the work channel, rinsing the imaging system and/or the imaging optical unit and/or the illumination device, and especially in the field of view (β), using a rinsing fluid from at least one second fluid line, removing the rinsing fluid by means of a fluid flow, preferably an air flow, from a further second fluid line, in particular an air line, rotating the rotating drum back into the observation position.

15. The method as claimed in claim 13 with an endoscope, including the following steps: guiding the shaft tube, at least with the distal end thereof, into an operation region, pivoting a bearing fork about a second axis of rotation, at least until the rotating drum exposes the work channel along a longitudinal axis of the shaft tube, guiding the at least one instrument from the work channel, in particular into the medical operation region, pivoting the rotating drum by means of the control line about a first axis of rotation in order to track the at least one instrument in the operation region with a field of view (β) of the imaging system, pivoting the bearing fork about a second axis of rotation in order to move/bend the at least one instrument.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0042] Further advantages and details of the invention arise from the following description of preferred embodiments of the invention and on the basis of purely schematic drawings.

[0043] In detail:

[0044] FIG. 1a: shows a perspective view of an upper side of a distal end of an endoscope having a rotating drum and a control line,

[0045] FIG. 1b: shows a perspective view of a lower side of the endoscope as per FIG. 1a,

[0046] FIG. 2a: shows a side view of the endoscope as per FIG. 1a,

[0047] FIG. 2b: shows a longitudinal section of the endoscope as per FIG. 2a in a plane perpendicular to the first axis of rotation of the rotating drum,

[0048] FIG. 2c: shows a longitudinal section of the endoscope as per FIG. 2b with a liquid line as a control line of the rotating drum,

[0049] FIG. 2d: shows a plan view of the distal end of the endoscope in the longitudinal direction of the endoscope,

[0050] FIG. 3a: shows a longitudinal section of the endoscope as per FIG. 2b with a rotating drum in a cleaning position,

[0051] FIG. 3b: shows a cross section of the shaft tube as per FIG. 3a, perpendicular to the longitudinal axis of the shaft tube,

[0052] FIG. 4a: shows a longitudinal section of the endoscope as per FIG. 2b with a hole for extracting liquid,

[0053] FIG. 4b: shows perspective view of an endoscope as per FIG. 1a with holes for extracting liquid,

[0054] FIG. 4c: shows a cross section of the shaft tube as per FIG. 3b with holes as per FIG. 4a,

[0055] FIG. 5a: shows a longitudinal section of the endoscope as per FIG. 2b with a rotatably mounted bearing fork and an instrument,

[0056] FIG. 5b: shows a longitudinal section of the endoscope as per FIG. 5a with the instrument in a bent state,

[0057] FIG. 6: shows a side view of an endoscope with a pivotable bearing fork as per FIG. 5a with a flexible shaft tube,

[0058] FIG. 7a: shows a perspective view of the endoscope as per FIG. 1a with a handle, and

[0059] FIG. 7b: shows a perspective view of the endoscope as per FIG. 1a.

[0060] The same elements or elements with the same function have been provided with the same reference signs in the figures.

DETAILED DESCRIPTION

[0061] FIG. 1a illustrates an endoscope 10 with a rotating drum 20 on a distal end 14 of an elongate rigid shaft tube 12, wherein the rotating drum 20 is mounted at the distal end 14 of the shaft tube 12 by means of a bearing fork 16 so as to be rotatable about a first axis of rotation 18. An optical imaging system 22, which preferably comprises an electronic image recorder 24, an imaging optical unit 26 and an illumination device 28 as shown in detail in FIG. 2b, is arranged in the rotating drum 20. The rotating drum 20 is illustrated from an upper side 62 of the shaft tube 12, wherein a viewing direction 64 of the imaging system 22 is pivotable through an angle α with respect to the longitudinal axis 30 and the bearing fork 16 does not restrict the viewing direction 64 of the imaging optical unit 26. By pivoting the rotating drum 20, and hence the viewing direction 64, it is possible to cover an angle α of preferably more than 130° and an observation region β′ as per FIG. 2b. By rotating the shaft tube 12 about the longitudinal axis 30, it is possible to extend the observation region β′. With a flexible distal end 14 of the shaft tube 12, as per FIG. 6, the entire operation region around the endoscope 10 is observable.

[0062] The first axis of rotation 18 runs approximately transversely to a longitudinal axis 30 of the shaft tube 12, wherein the endoscope 10, as illustrated in FIG. 1b, has at least one, preferably one, control line 32 on a lower side 63 of the shaft tube 12. This at least one control line 32 is guided on an outer side 36 of the shaft tube 12 and fastened to the rotating drum 20 at a lever distance a from the first axis of rotation 18. The rotating drum 20 is rotatable, preferably by way of a linear movement of the at least one control line 32 parallel to the longitudinal axis 30 of the shaft tube 12.

[0063] As an alternative, or in sections, the shaft tube 12 as per FIG. 6 can also be flexibly equipped, preferably at the distal end 14, with a multiplicity of steering members 82 and can be pivotable by means of control lines, not shown in any more detail, at an outer edge 84 of the steering members 82.

[0064] As shown in FIG. 2b, a work channel 34 in the interior of the shaft tube 12 and preferably the internal diameter of the shaft tube 12 are not restricted by the at least one control line 32.

[0065] The rotating drum 20 preferably has a spherical or cylindrical embodiment, with the rotating drum 20 preferably being flattened in a direction perpendicular to a viewing direction 64 of the imaging system 22 in order to receive the imaging optical unit 26 and the illumination device 28, preferably in the form of two LEDs, in a flattened region 66.

[0066] The at least one control line 32 is preferably windable on at least one winding curve 38 along the outer circumference of the rotating drum 20. Particularly preferably, the at least one control line 32 is windable such that the rotating drum 20 is rotatable from a viewing direction 64 along the longitudinal axis 30 of the shaft tube 12 through at least an angle α of 0° to 180° and hence the viewing direction 64 is alignable in the interior of the shaft tube 12 and a work channel 34. The viewing angle β of the imaging system 22 is preferably 50° to 70°, particularly preferably 60°. As a result, a preferred observation region β′, in which the imaging system with a viewing angle β can record an operation region by pivoting the rotating drum 20 through an angle α, is between −35° and 215°, particularly preferably between −30° and 210°, wherein the angle of the observation region 3′, just like the angle α, relates to a 0° direction along the longitudinal axis 30 of the shaft tube 12. For the purposes of pivoting the rotating drum 20, the at least one control line 32 has an at least partly flexible embodiment, as indicated in FIG. 1b by transverse lines, in order to wind said control line on the at least one winding curve 38 of the rotating drum 20. In this case, the at least one winding curve 38 along the outer circumference can preferably have a circular or oval embodiment.

[0067] Particularly preferably, the at least one control line 32 of the rotating drum 20 forms a supply line for the imaging system 22, which preferably is embodied as a flexible printed circuit board 68 illustrated in FIG. 1b, for supplying electronic circuits in the interior of the rotating drum 20, for example the electronic image recorder 24 and/or an electronically adjustable imaging optical unit 26 and/or the illumination device 28. Particularly when using the flexible printed circuit board 68 as a control line 32, the corresponding winding curve 38 is designed such that the bending radius is greater than 0.5 mm. Alternatively, the imaging system 22 can also be electrically supplied by way of a cable 71, as illustrated in FIG. 2d.

[0068] Furthermore, provision can be made for the at least one control line 32, as illustrated in FIG. 2c and FIG. 2d, to comprise at least one first fluid line 69. Here, this at least one first fluid line 69 is preferably provided in addition to an electronic supply line of the imaging system 22 and is windable on the winding curve 38; see FIG. 2d.

[0069] The at least one control line 32 is guided on the circumference of the rotating drum 20 in interlocking fashion, preferably in a depression 70, as per FIG. 2c and FIG. 2d, so that said control line is protected but at the same time the external diameter of the rotating drum 20 is not increased further, and so injury to tissue in an operation region can also be reduced.

[0070] As illustrated in FIG. 1b, FIG. 2a or FIG. 2b, the at least one control line 32 is guided in a recess 50 on the outer side 36 of the shaft tube 12, with the cutout 50 preferably running parallel to the longitudinal axis 30 of the shaft tube 12 and thus forming a protective collar 52, preferably in the region of the distal end 14 of the shaft tube 12. As a result, the at least one control line 32 is protected and injury of tissue in an operation region as a result of the movable control line 32 is prevented. Preferably, the protective collar 52 prevents the at least one control line 32 from being able to detach from the outer side 36 of the shaft tube 12 in a direction perpendicular to the longitudinal axis 30.

[0071] Preferably a torsion spring 55 as a reset means 54 is arranged in the region of the bearing point 56, as per FIG. 2b, for the purposes of resetting a rotated rotating drum 20, wherein the torsion spring 55 preferably keeps the rotating drum 20 in a cleaning position with an angle α of approximately 180° between the viewing direction 64 and the longitudinal axis 30 of the shaft tube 12.

[0072] Alternatively, the rotating drum 20 is also able to be reset by means of a second control line, not shown, on the upper side 62 of the shaft tube 12, or the control line 32 is guided in dimensionally stable fashion and in the recess 52, like a Bowden cable with a supporting sleeve, such that the control line 32 is also adjustable by means of a compression force.

[0073] Preferably at least one second fluid line 39, preferably an air line 39, 40 and/or preferably a liquid feed line 39, 42 and a liquid extraction line 39, 44, is arranged in the work channel 34 of the shaft tube 12. The air line 39, 40 and the liquid lines 39, 41, 44 are illustrated in FIG. 2b and FIG. 3b. In an observation position of the rotating drum 20, as per FIG. 2b, the at least one second fluid line 39 can be used for back-side cooling/temperature control of the imaging system 22.

[0074] Especially for cleaning the imaging system 22 of endoscopes 10 in a dry operation region, the rotating drum 20 is preferably rotatable into a cleaning position as per FIG. 3a, wherein the rotating drum 20 with the viewing direction 64 is inclined in the direction of the work channel 34. In this cleaning position, contamination is preferably able to be rinsed from the flattened region 66 of the rotating drum 20, and hence the field of view β of the imaging system 22 is cleanable, preferably by means of an air line 39, 40 in combination with the liquid feed line 39, 42. Preferably, the rinsing fluid is a rinsing liquid from the liquid feed line 39, 42 for rinsing the imaging system 22, wherein the rinsing liquid is removable by means of the liquid extraction line 39, 44, and hence a leakage of rinsing liquid into a dry operation region can be minimized. Preferably, the air line 39, 40 is used to remove the rinsing liquid from the imaging system 22 and the flattened region 66 in order to prevent a disturbance in the field of view β of the imaging system 22 by drop formation. Further preferably, the liquid feed line 39, 42 and preferably also the air line 39, 40 can be designed as a spray nozzle in order to improve the cleaning effect.

[0075] Preferably for endoscopes 10 with wet ambient conditions or in a wet operation region, the at least one second fluid line 39 can be used to rinse an operation region in addition to the back-side cooling and the cleaning of the rotating drum 20, in particular in order to rinse the operation region in the viewing direction 64 of the imaging system 22 in an observation position. To this end, a sterile and physiological rinsing fluid is preferably used for a medical application. To remove a rinsing fluid from an operation region, use is preferably made of a liquid extraction line 39, 44 with at least one hole 46 on the circumferential side or a slot-shaped opening 47 at the distal end 14 of the shaft tube 12, as illustrated in FIGS. 4a to FIG. 4c. The holes 46 and the opening 47 connect the liquid extraction line 39, 44, preferably on the lower side 64 of the shaft tube 12, to the operation region. Particularly for a bubble-shaped operation region 78 with tissue 79 to be operated, as per FIG. 4a, it is possible to rinse around the rotating drum 20 in a flow direction 80, wherein the circumferential holes 46 and the opening 47 promote the extraction of the rinsing fluid from the bubble-shaped operation region 78. Preferably only the liquid lines 39, 42, 44 are required for this rinsing use since an air line 39, 40 is preferably not required in a wet operation region and the imaging system 22 is able to be cleaned at the same time as the operation region is rinsed, without needing to be pivoted into a cleaning position in the process.

[0076] As an alternative or in addition thereto, it is also possible for the distance between the rotating drum 20 and the shaft tube 12, and hence the opening 47, to be increased in order to facilitate access to the liquid extraction line 39, 44 in FIG. 4a.

[0077] Furthermore, it is preferable for the shaft tube 12, in particular the bearing fork 16, to also have an opening 47 on the upper side 62 in order to open the shaft tube 12 behind the rotating drum 20 and thus ensure a clear emergence of rinsing fluid, in particular from the liquid feed line 39, 42.

[0078] As illustrated in FIG. 5a, the work channel 34 can be designed to receive an instrument 48 and/or contain an instrument 48 as an alternative or in addition to the at least one second fluid line. This instrument 48 can have a tool 72, for example a cutting tool or a punching tool, at a distal end, which tool is adaptable for the respective medical operation.

[0079] Preferably, the shaft tube 12 is open in a section 60 on the upper side 62 such that an instrument 48, preferably a flexible instrument, is adjustable or bendable past the rotating drum 20 in a direction perpendicular to the longitudinal axis 30 of the shaft tube 12.

[0080] FIG. 5a shows a further preferred embodiment of the endoscope 10, in which the bearing fork 16 is fastened to the shaft tube 12 so as to be pivotable about a second axis of rotation 58 and the work channel 34 is open along the longitudinal axis 30 in a pivoted state of the bearing fork 16 so that preferably a rigid instrument 48 is able to be guided from the work channel 34 into the operation region. The bearing fork 16 is preferably controllable by means of a second control line, not illustrated, or another operating mechanism, preferably an operating mechanism for flexible shaft tubes as is known for example from US 2015/0359420 A1 cited at the outset. As illustrated in FIG. 5b, a flexible instrument 48, in particular, is adjustable with this pivotable bearing fork 16 by means of the rotating drum 20 in the direction of the upper open section 60. Thus, the tool 72 at the distal end of the instrument 48 can be moved into an operation region, with this tool 72 remaining in the field of view β of the imaging system 22 as a result of a simultaneous rotation of the rotating drum 20.

[0081] As an alternative or in addition thereto, the bearing fork 16 can also be connected to the shaft tube 12 by means of a flexible or elastically deformable element, preferably a rubber element, wherein the flexible element develops a passive restoring force in order to pivot the bearing fork 16 about the second axis of rotation 58 and open the work channel 34 for an instrument 48.

[0082] In addition to guiding the instrument 48, the work channel 34 can contain further channels for fluid guidance such that the rotating drum 20 is able to be cooled or cleaned and/or the operation region is able to be rinsed, even if an instrument 48 is used. Thus, the rinse of the operation region advantageously also acts to clean the instrument 48. By way of example, the work channel 34 to guide the instrument 48 can simultaneously be a liquid feed channel 41 and the shaft tube 12 can contain a further liquid extraction channel 44.

[0083] As illustrated in FIG. 6, the pivotable bearing fork 16 can reduce the bending radius of a flexible shaft tube 12, or increase the ability to be curved, even without an instrument, or can facilitate the bending radius of a rigid endoscope, for example in order to even capture a field of view of the imaging system 22 that is covered by the shaft tube 12 itself or in order to be able to see behind corners or obstacles. Thus, if the rotating drum 20 is rotated and the bearing fork 16 is rotated at the same time, the observation region is extended to an angle β′ greater than 180° since the observation region is not restricted by the shaft tube 12 itself. The shaft tube 12 which is flexible at least in sections is configured as per FIG. 6 with a multiplicity of steering members 82 and is pivotable at an outer edge 84 of the steering members 82 by means of further control lines, not illustrated.

[0084] As illustrated in FIG. 7a, the at least one control line 32 is adjustable parallel to the longitudinal direction 30 of the shaft tube 12 by an operator by means of a handle 74 at a proximal end of the shaft tube 12 and a linearly displaceable operating element 76. The handle 74 preferably also transfers an electronic cable guidance to the flexible printed circuit board 68, which preferably as a control line 32 is linearly displaceable by an adjustment travel S in order to rotate the rotating drum 20 at the distal end 14 of the shaft tube 12 in FIG. 7b.

[0085] Preferably, the tool 72 of the instrument 48, as per FIG. 5a and FIG. 5b, is also operable by means of the handle 74.

[0086] The external diameter d of the shaft tube 12 is preferably 3 mm to 6 mm. Such a shaft tube 12 is suitable for a multiplicity of non-invasive medical operations in adult humans. Here, the bearing fork 16 is preferably rounded off at a distal end and the diameter of the rotating drum 20 preferably does not exceed this external diameter d in a direction perpendicular to the longitudinal axis 30 of the shaft tube 12 in order to minimize injury during medical use.

[0087] Preferably, when using a plurality of control lines 32, these are windable on different winding curves 38, not illustrated here, of the rotating drum 20, in particular at different distances a from the axis of rotation 30 in order to carry out different rotational adjustments through an angle α in the case of the same adjustment travel S of the control lines 32 in the longitudinal direction 30 of the shaft tube 12. These different winding curves 38 are also preferable if a small distance a is required but the supply line, in particular as a flexible printed circuit board 68, is limited by a maximum radius of curvature.

[0088] The invention also relates to a method for operating an above-described endoscope, wherein the rotating drum 20 is rotated through an angle α from an observation position as per FIG. 2b to a cleaning position as per FIG. 3a such that the imaging system 22 is aligned with the distal end 16 of the shaft tube 12 and the work channel 34, wherein in this position the at least one second fluid line 39 is used to rinse the imaging optical unit 26 and/or the illumination device 28. During the rinsing procedure, the rotating drum 20 can be pivoted in order, in particular, to clean the field of view β of the imaging system 22. For applications in which no rinsing fluid should penetrate into the operation region, in particular for a dry operation region, the rinsing fluid is preferably removed using a liquid extraction line 39, 44. Following the rinsing with the rinsing fluid, preferably a rinsing liquid, the rotating drum 20 can preferably be dried by means of an air flow from the air line 39, 40 before the rotating drum 20 is pivoted back into the observation position, preferably the previously departed observation position.

[0089] For a dry operation region in particular, it is alternatively often sufficient to clean an imaging optical unit that has steamed up as a result of humidity using an air flow. Here, the use of a rinsing liquid is advantageously not required.

[0090] Furthermore, the invention relates to a method for guiding an instrument 48 from the shaft tube 12, wherein the shaft tube 12, at least the distal end 14 of the shaft tube 12, is initially guided into an operation region. Subsequently, the rotating drum 20 is pivoted by means of the pivotable bearing fork 16 about a second axis of rotation 58, as per FIG. 5a, at least until the rotating drum 20 exposes the work channel 34 along a longitudinal axis 30 of the shaft tube 12. Then, the instrument 48 is pushed out of the work channel 34, in particular in the direction of an operation site. In a next step, the rotating drum 20 is pivoted by means of the control line 32 and about the first axis of rotation 18 in order to track and observe the instrument 48, in particular a tool 72, and the operation region with the field of view β of the imaging system 22. Especially for flexible instruments, the instrument 48 can be bent as per FIG. 5b by pivoting the bearing fork 16 about a second axis of rotation 58. In this method, the bearing fork 16 can be actively pivoted or the bearing fork 16 can be passively pivotable by means of a flexible or elastically deformable element as a result of a cooperation with the instrument.

LIST OF REFERENCE SIGNS

[0091] 10 Endoscope

[0092] 12 Shaft tube

[0093] 14 Distal end of the shaft tube

[0094] 16 Bearing fork

[0095] 18 First axis of rotation

[0096] 20 Rotating drum

[0097] 22 Optical imaging system

[0098] 24 Electronic image recorder

[0099] 26 Imaging optical unit

[0100] 28 Illumination device

[0101] 30 Longitudinal axis of the shaft tube

[0102] 32 At least one control line

[0103] 34 Work channel

[0104] 36 Outer side of the shaft tube

[0105] 38 Winding curve

[0106] 39 Second fluid line

[0107] 40 Second air line

[0108] 42 Liquid feed line

[0109] 44 Liquid extraction line

[0110] 46 Holes in the shaft tube

[0111] 47 Opening in the shaft tube

[0112] 48 Instrument

[0113] 50 Recess

[0114] 52 Protective collar

[0115] 54 Reset means

[0116] 55 Torsion spring

[0117] 56 Bearing point of the rotating drum

[0118] 58 Second axis of rotation

[0119] 60 Open upper section of the shaft tube

[0120] 62 Upper side of the shaft tube

[0121] 63 Lower side of the shaft tube

[0122] 64 Viewing direction of the imaging system

[0123] 66 Flattened side of the rotating drum

[0124] 68 Flexible printed circuit board as a control line

[0125] 69 First fluid line

[0126] 70 Depression on the rotating drum

[0127] 71 Cable

[0128] 72 Tool

[0129] 74 Handle

[0130] 76 Operating element

[0131] 78 Bubble-shaped operation region

[0132] 79 Tissue

[0133] 80 Flow direction

[0134] 82 Steering members

[0135] 84 Outer edge of the steering members

[0136] a Distance between the first axis of rotation and the winding curve

[0137] d External diameter of the shaft tube

[0138] α Angle of the viewing direction of the imaging system

[0139] β Viewing angle or viewing field

[0140] β′ Observation region

[0141] S Adjustment travel