ENDOSCOPIC DEVICE AND METHODS OF USE THEREOF
20220079419 · 2022-03-17
Inventors
- Jeremy STARKWEATHER (Englewood, CO, US)
- Christen SPRINGS (Englewood, CO, US)
- John WYNNE (Englewood, CO, US)
- Jason YLIZARDE (Englewood, CO, US)
- Amir GOVRIN (Englewood, CO, US)
- Doron KATZIR (Englewood, CO, US)
Cpc classification
A61M25/0147
HUMAN NECESSITIES
A61B1/0052
HUMAN NECESSITIES
A61B1/0057
HUMAN NECESSITIES
A61B1/273
HUMAN NECESSITIES
International classification
A61B1/00
HUMAN NECESSITIES
Abstract
The disclosure provides for an endoscopic device and method for manipulating the endoscopic device. The endoscopic device includes a tube assembly and a slider mechanism connected to the cylindrical body for control of the endoscopic device. The tube assembly has a cylindrical body with a proximal end and a distal end and a plurality of openings extending from the proximal end to the distal end of the cylindrical body. The slider mechanism includes a tip deflecting mechanism and a rotation assembly having a planetary gear system.
Claims
1. An endoscopic device comprising: a tube assembly comprising: a cylindrical body having a proximal end and a distal end and comprising a plurality of openings extending from the proximal end to the distal end of the cylindrical body; and a slider mechanism connected to the cylindrical body, the slider mechanism comprising: a rotation assembly; and a tip deflecting mechanism.
2. The endoscopic device of claim 1, wherein the rotational assembly comprises a planetary gear system.
3. The endoscopic device of any one preceding claim, wherein the rotation assembly further comprises a knob having an outer surface and an inner surface.
4. The endoscopic device of claim 3, wherein the planetary gear system comprises a ring gear on the inner surface of the knob.
5. The endoscopic device of any one of claims 2-4, wherein the planetary gear system comprises at least two planet gears.
6. The endoscopic device of any one of claims 3-5, wherein the knob comprises a plurality of recessions on the outer surface of the knob.
7. The endoscopic device of any one of the preceding claims, wherein the slider mechanism is configured to rotate at least 360° around the cylindrical body.
8. The endoscopic device of any one of the preceding claims, wherein the slider mechanism is configured to translate toward the distal end or toward the proximal end of the cylindrical body.
9. The endoscopic device of any one of the preceding claims, wherein the endoscopic device comprises a catheter operatively connected to the slider mechanism.
10. The endoscopic device of claim 9, wherein the tube assembly further comprises at least two ports fluidly connected to the catheter.
11. The endoscopic device of any one of the preceding claims, wherein the endoscopic device is a cholangioscope.
12. The endoscopic device of any one of the preceding claims, wherein the endoscopic device further comprises a control assembly comprising a video processor.
13. The endoscopic device of claim 12, wherein the control assembly further comprises an endoscope attachment.
14. The endoscopic device of claim 12 or 13, wherein the control assembly further comprises a light source.
15. The endoscopic device of one of claims 12-14, wherein the control assembly further comprises a wireless transceiver.
16. The endoscopic device of one of claims 12-15, wherein the control assembly further comprises a battery.
17. The endoscopic device of any one of the preceding claims, wherein the tip deflecting mechanism is a switch, a lever, or at least one button.
18. The endoscopic device of any one of the preceding claims, wherein the tip deflecting mechanism is powered.
19. The endoscopic device of any one of the preceding claims, wherein the tube assembly and the control assembly are detachably connected with a locking mechanism.
20. The endoscopic device of any one of claims 1-18, wherein the tube assembly and the control assembly are integrally connected.
21. A method of manipulating the endoscopic device of any one of claims 1-20, comprising inserting the endoscopic device comprising a catheter through a working channel of an endoscope.
22. The method of claim 21, further comprising rotating the rotation assembly around the cylindrical body to rotate the catheter of the endoscopic device.
23. The method of claim 21 or 22, further comprising translating the slider mechanism toward the distal end or toward the proximal end of the cylindrical body to extend or retract the catheter, respectively.
24. The method of any one of claims 21-23, further comprising engaging a tip deflecting mechanism, wherein the tip deflecting mechanism is a switch, a lever, or at least one button.
25. The method of claim 24, wherein the tip deflecting mechanism is powered.
26. The method of any one of claims 21-25, further comprising activating a light source in the control assembly and acquiring a video signal from the distal tip of the catheter.
27. The method of claim 26, further comprising processing the video signal with the video processor and transmitting the video signal to an external display.
28. The method of claim 27, wherein the video signal is transmitted wirelessly using a wireless transceiver.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0015] The description will be more fully understood with reference to the following figures, which are presented as variations of the disclosure and should not be construed as a complete recitation of the scope of the disclosure, wherein:
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DETAILED DESCRIPTION
[0039] The disclosure may be understood by reference to the following detailed description, taken in conjunction with the drawings as described below. It is noted that, for purposes of illustrative clarity, certain elements in various drawings may not be drawn to scale.
[0040] For purposes of this description, “distal” refers to the end extending into a body and “proximal” refers to the end extending out of the body.
[0041] For purposes of this description, “endoscopic device” refers to medical devices extending into the interior of a hollow organ or cavity of the body. An endoscopic device may be used for flexible endoscopy. In some variations, an endoscopic device may include a mechanical manipulation controller capable of controlling the endoscopic device with 360° rotation and advancement and retraction capabilities.
[0042] A “planetary gear system”, or epicyclic gear train, includes at least two gears arranged so that the center of one gear revolves around the center of the other. A carrier connects the centers of the two gears and rotates to carry the planet gear around the sun gear. The planet gear may rolls on the inside of the pitch circle of a fixed, outer ring gear, sometimes called an annular gear.
[0043] For purposes of this description “connected to” includes two components being directly connected or indirectly connected with intervening components.
[0044] Disclosed herein are endoscopic devices having an intuitive handle assembly for manipulating the endoscopic device and methods of use thereof. The disclosed device and method for manipulation provide a simpler and more intuitive way of navigating the tip of a catheter associated with the endoscopic device. For example, the endoscopic device may provide for single handed, rotational manipulation of the device. Also disclosed herein are endoscopic devices that are single use and do not require capital equipment. For example, the endoscopic device may include an integrated microprocessor, light source, and/or power source which eliminate the need for endoscopic capital equipment. In other examples, the endoscopic device may include minimal capital equipment that is smaller and more portable than standard endoscopic capital equipment. The endoscopic device may connect to or work in conjunction with another endoscope, thus allowing a “plug-and-play” adaptation to existing endoscopes. Thus, the endoscopic device may be adaptable to be used with existing endoscopes without any additional equipment.
[0045] As seen in
[0046]
[0047] The endoscope attachment may be directly coupled to the entry port of the larger endoscope channel. The endoscope attachment may further provide a seal at the entry port to prevent bodily fluids leaving the endoscope and maintain positive or negative pressure in the lumen of the endoscope. In some variations, the endoscope attachment 118 may be a screw fit attachment, a snap fit attachment, a press fit attachment, or a compression fit attachment, without limitation.
[0048] As seen in
[0049] The slider mechanism 104, as further seen in
[0050] The rotation assembly 106 includes, but is not limited to, a knob 122 having an outer surface and an inner surface and a planetary gear system 124. As seen in
[0051] In a variation, the planetary gear system 124 is a double-pinion planetary gear system. In this variation, the planetary gear system includes two meshed planet gear sets between the sun gear and the ring gear. An arm of the carrier may hold an outer planet gear and an inner planet gear at different radii from the sun gear centerline, and allow the individual planet gears to rotate with respect to each other. For example, the planetary gear system in
[0052] The size of the planetary gear system 124 may vary based on the size of the cylindrical body. In some variations, the size of the gears in the planetary gear system varies with the application of the endoscopic device. In general, the relationship between the gears in a double-pinion planetary gear system may be represented by Eqn. 1.
r.sub.r=r.sub.s+2.Math.r.sub.pi+2.Math.r.sub.po, Eqn. 1
where: r.sub.r is the ring gear radius, r.sub.s is the sun gear radius, r.sub.pi is the inner planet gear radius, and r.sub.po is the outer planet gear radius. In a variation, the inner planet gear and the outer planet gear are the same size. In another variation, the inner planet gear and the outer planet gear are different sizes.
[0053] The ring gear may have a radius ranging from about 2 mm to about 20 mm. In a variation, the ring gear may have a diameter of at least 4 mm. In a variation, the ring gear may have a diameter of at least 6 mm. In a variation, the ring gear may have a diameter of at least 10 mm. In a variation, the ring gear may have a diameter of at least 20 mm. In a variation, the ring gear may have a diameter of at least 30 mm. In a variation, the ring gear may have a diameter of at least 40 mm.
[0054] In a variation, the planet gears 128 are held stationary and the ring gear 130 is used as an input. If there is one planet gear between ring gear and the sun gear, the ring gear and the sun gear will rotate in opposite directions. For example, if the ring gear is turned clockwise, then the sun gear will turn counterclockwise. The double-pinion planetary gear system reverses the relative rotation directions of the ring and sun gears. Therefore, meshed planet gear sets in the double-pinion planetary gear system allow the rotation of the ring gear to be in the same direction as the rotation of the sun gear. Therefore, when the ring gear is rotated, the sun gear will rotate in the same direction. In one variation, the rotation assembly includes a double-pinion planetary gear system such that rotation of the ring gear results in rotation of the sun gear, and anything attached thereto, in the same direction. For example, in some variations, a catheter may be attached to the sun gear so that the catheter is rotated based on the rotation of the ring gear. The ring gear, the sun gear, and the planet gears may rotate up to 360°.
[0055] In a variation, the planetary gear system 124 may rotate up to 360°. In a variation, the planetary gear system 124 may rotate less than 360°. In a variation, the planetary gear system 124 may rotate less than or equal to 180°. In a variation, the planetary gear system 124 may rotate less than or equal to 90°. In a variation, the planetary gear system 124 may rotate less than or equal to 45°. In some examples, the planetary gear system 124 may rotate 45°-90°, 90°-180°, or 180°-360°.
[0056] The planetary gear system may further include stops for preventing further rotation of the gears in one direction. This may prevent or reduce bending or restriction of the lumina/catheter as the rotation assembly is rotated. In some variations, the stops may include one or more fixed stops 133 and a rotating stop 135, for example, as seen in
[0057] The planetary gear system 124 may increase or decrease rotation from the knob to the catheter at a ratio ranging from 4:1 to 1:4. Using a ratio for increased rotation allows for smaller rotations of the knob to translate to larger rotations of the catheter for ease of use and minimizing movement, allowing for one hand manipulation of the device. In a variation, the planetary gear system 124 may increase rotation from the knob to the catheter at a 4:1 ratio. In a variation, the planetary gear system 124 may increase rotation from the knob to the catheter at a 3:1 ratio (ex. 120° of knob rotation equals 360° of catheter rotation). In a variation, the planetary gear system 124 may increase rotation from the knob to the catheter at a 2:1 ratio. In a variation, the planetary gear system 124 may match rotation from the knob to the catheter at a 1:1 ratio. Using a ratio for decreased rotation allows for larger rotations of the knob to translate to smaller rotations of the catheter for improved resolution or sensitivity. In a variation, the planetary gear system 124 may decrease rotation from the knob to the catheter at a 1:2 ratio. In a variation, the planetary gear system 124 may decrease rotation from the knob to the catheter at a 1:3 ratio. In a variation, the planetary gear system 124 may decrease rotation from the knob to the catheter at a 1:3 ratio. In a variation, the planetary gear system 124 may decrease rotation from the knob to the catheter at a 1:4 ratio.
[0058] In a variation, the sun gear may be located inside the cylindrical body and the ring gear may be located outside the cylindrical body. The arms of the carrier may then extend through corresponding openings in the cylindrical body to connect the planet gears to the sun and ring gears. This arrangement allows for the slider mechanism to be pushed up and down the cylindrical body in a linear motion and still transfer rotary motion from the outside to the inside of the tube assembly. In some variations, the knob is integral with or connected to the planetary gear system. The inner surface of the knob may engage the planetary gear system and the outer surface of the knob may allow for the user to adjust or manipulate the planetary gear system. For example, the planetary gear system may include a ring gear on the inner surface of the knob, as seen in
[0059] As seen in
[0060] The slider mechanism 104 is also configured to translate toward the distal end or toward the proximal end of the cylindrical body 110. The translation of the slider mechanism provides for advancement or retraction of a catheter connected to the slider mechanism. The slider mechanism is able to translate along the cylindrical body because the openings 112 on the cylindrical body 110 extend the length of the cylindrical body and align with the arms 134 of the carrier 132 in the rotation assembly 106. Therefore, by way of the openings, the planet gears can engage with the ring gear on the inner surface of the knob while also allowing the entire slider mechanism to translate. In some variations, the slider mechanism may be moved along the length of the cylindrical body without rotating the rotation assembly. In other variations, the slider mechanism may be moved along the length of the cylindrical body while rotating the rotation assembly.
[0061] As seen in
[0062] The tip deflecting mechanism may include but is not limited to a switch, a lever, or at least one button. In a variation, a lever tip deflecting mechanism may have at least a first position corresponding to the catheter tip in a straight configuration and a second position corresponding to the catheter tip in a deflected configuration. In a variation, a switch tip deflecting mechanism may have at least a first position corresponding to the catheter tip in a straight configuration and a second position corresponding to the catheter tip in a deflected configuration. In a variation, a button tip deflecting mechanism may have at least a first button corresponding to the catheter tip in a straight configuration and a second button corresponding to the catheter tip in a deflected configuration. In some variations, the tip deflecting mechanism may include at least one button, at least two buttons, or at least three buttons.
[0063] In a variation, the tip deflecting mechanism may be non-powered. For example, the tip deflecting mechanism may be mechanically operated. The tip deflecting mechanism may be a non-powered lever. In another variation, the tip deflecting mechanism may be powered or motorized. For example, the tip deflecting mechanism may include gearing and a power source or access to a power source. In some examples, the power source for the motor for the tip deflecting mechanism may be within a control assembly, either integrated with or external to the tube assembly. A powered tip deflecting mechanism may provide more control and precise movement of the wire and therefore provide more control and precise movement of the distal tip of the catheter. The tip deflecting mechanism may be a powered lever, powered switch, or powered button. The tip deflecting mechanism may further include a sensor configured to measure the degree of deflection of the tip of the catheter. The sensor may be configured to determine the location of the distal tip or how much the distal tip has deflected in relation to a straight configuration. For example, the sensor may measure the movement of gears in a powered tip deflecting mechanism that may then be converted to the movement of the distal tip of the catheter. In a variation, the tube assembly may further include an indicator operatively connected to the sensor to provide information on the location of the distal tip of the catheter or the amount of change in the deflection of the distal tip. In one variation, the indicator may be a display.
[0064] The endoscopic device 100 may further include a catheter 120 operatively connected to the slider mechanism 104. In a variation, the distal end of the catheter may then be manipulated by operation of the slider mechanism. In a variation, the catheter may include at least two lumina that extend longitudinally along the catheter.
[0065] Referring to
[0066] As seen in
[0067] As seen in
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[0069] The size and shape of the lumina in the catheter may vary depending on the number of lumina and the arrangement within the catheter. For example, the lumina may have a circular, oval, square, rectangular, curved, star-shaped, or irregular cross-sectional shape. Different lumina for electrical channels, working channel, and/or irrigation channels can have different shapes or the same shapes. The addition of one or more pull wire channels may change the size of the electrical channels, working channel, and/or irrigation channels. In a variation, the working channel may have a diameter of greater than 1.5 mm. In a variation, the working channel may have a diameter of at least 1.8 mm. In a variation, the working channel may have a diameter of at least 1.9 mm. In a variation, the working channel may have a diameter of at least 2 mm. For example, the working channel may be 20%-50% larger than a working channel in a standard endoscopic device (usually 1.2 mm). In a variation, the working channel may be 20% larger that a working channel in a standard endoscopic device. In a variation, the working channel may be 30% larger that a working channel in a standard endoscopic device. In a variation, the working channel may be 40% larger that a working channel in a standard endoscopic device. In some variations, the endoscopic device is a cholangioscope. In a variation, the working channel may be 50% larger that a working channel in a standard endoscopic device. In a variation, the working channel may be 60% larger that a working channel in a standard endoscopic device. In a variation, the working channel may be 70% larger that a working channel in a standard endoscopic device. A larger working channel may allow for larger and a wider variety of therapeutic and diagnostic devices or accessories to be placed within the working channel. The working channel 142 may provide for access for therapeutic probes at the tip of the catheter including, but not limited to forceps, laser probes, Electrohydraulic Lithotripsy (EHL) probes, or Radiofrequency Ablation (RFA) probes. In one example, the working channel of a catheter used with a cholangioscope may be about 50% larger than the working channel on standard cholangioscope catheters (i.e. SpyGlass™). The larger working channel may have capacity for 60% larger biopsy forceps or provide improved suction for ductal clearance.
[0070] The catheter 120 may have an outer diameter of at least 3 mm. In a variation, the catheter may have a diameter of at least 3.5 mm. In a variation, the catheter may have a diameter of at least 4 mm. In a variation, the catheter may have a diameter of at least 4.5 mm. In a variation, the catheter may have a diameter of at least 5 mm. In other variations, the catheter size may range from about 5 French to about 15 French. In a variation, the catheter may have a diameter of at least 5 French. In a variation, the catheter may have a diameter of at least 7 French. In a variation, the catheter may have a diameter of at least 10 French. In a variation, the catheter may have a diameter of at least 11 French. In a variation, the catheter may have a diameter of at least 13 French. In a variation, the catheter may have a diameter of at least 15 French. In another variation, the catheter may have a diameter of less than or equal to 10 French. The size of the catheter may be selected based on the use of the endoscopic device and where it will be used in the body.
[0071] Referring to
[0072] Referring to
[0073] In a variation, the catheter 120 may further include a light source 146 at its distal end to provide light for the camera 144. The catheter may include at least one light source or at least two light sources. In one variation, the light source may be an LED located at the distal end of the catheter. In another variation, the light source 146 may be two LEDs at the distal end of the catheter, as seen in
[0074] The endoscopic device 100 may be used for flexible gastrointestinal endoscopy. Non-limiting examples of endoscopic devices include a laryngoscope, an esophagoscope, esophagogastroduodenoscope, an enteroscope, a colonoscope, a duodenoscope, a cholangioscope, a rectoscope, or a proctoscope. In one variation, the endoscopic device is a cholangioscope. In one example, the cholangioscope may be used in endoscopic retrograde cholangiopancreatography (ERCP) or intraductal endoscopy and cholangiopancreatography (IECP). The endoscopic device may or may not include video imaging capabilities.
[0075] As seen in
[0076] In some variations, the control assembly 116 also includes a light source. The light signal from the light source in the control assembly may then be transmitted to the distal end of the catheter with optical fibers. In other variations, the light source may be at the distal end of the catheter or may be located external to the endoscopic device. In some variations, the control assembly 116 may further include a power source. For example, the power source may be a battery. The battery may be disposable or rechargeable. In other variations, the control assembly may be powered by an external power source. For example, the control assembly may be powered through a USB connection. The control assembly may also be connected to an endoscope attachment 118. The endoscope attachment 118 may be configured to fit within a portion of the working channel of a larger endoscope
[0077] The control assembly and the tube assembly may be fluidly connected such that a catheter may pass through the control assembly and into the tube assembly. In a variation, the tube assembly 102 and the control assembly 116 may be detachably connected. For example, as seen in
[0078] Further provided herein is a method of manipulating the endoscopic device by inserting the endoscopic device with a catheter through a working channel of an endoscope. The method may further include rotating the rotation assembly around the cylindrical body to rotate the catheter of the endoscopic device. In some variations, the rotation assembly may rotate up to or including 360°. In some variations, the rotational assembly may rotate up to or including 180°. In some variations, the rotational assembly may rotate up to or including 90°. In some variations, the rotational assembly may rotate up to or including 60°. This can depend on the number of stops and/or pull wires, which can rotate the catheter up to or including 360°.
[0079] In some variations, the rotational assembly may rotate up to or including 200° clockwise and counterclockwise. In some variations, the rotational assembly may rotate up to or including 100° clockwise and counterclockwise. In some variations, the rotational assembly may rotate up to or including 70° clockwise and counterclockwise.
[0080] The method may further include translating the slider mechanism toward the distal end or toward the proximal end of the cylindrical body to extend or retract the catheter, respectively. The method may further include engaging a tip deflecting mechanism to deflect the tip of the catheter. The movement of the slider mechanism (rotation, advancement and/or retraction, and tip deflection) provides for intuitive, single handed manipulation of a catheter associated with the endoscopic device and provides greater control of the catheter over existing devices.
[0081] The method may further include activating a light source in the control assembly or at the distal tip of the catheter and acquiring a video signal from a camera at the distal tip of the catheter. The method may further include flushing the distal end of the catheter with an irrigation fluid. This may clear the area in front of the camera to provide a clearer video image. The method may further include processing the video signal from the camera with a video processor in a control assembly and transmitting the video signal to an external display. The video signal may be transmitted wirelessly using a wireless transceiver. The transmission of the video signal may allow the user to view the anatomy at the distal end of the catheter in real time. This may provide feedback for further manipulation of the catheter with the tube assembly of the endoscopic device.
[0082] It should be noted that the endoscopic device represents a single variation for endoscopy, and claimed subject matter is not limited to any particular variation. For example, an endoscopic device may be used in association with other endoscopic devices or catheter manipulation mechanisms and advanced into body cavities, including but not limited to the esophagus, colon, or biliary ducts of a human patient, animal patient. Other variations may involve the use of other types of probing devices that may be used to view or probe objects in internal structures of living organisms and/or mechanical apparatuses, and the claimed subject matter is not limited in this respect.
[0083] Having described several variations, it will be recognized by those skilled in the art that various modifications, alternative constructions, and equivalents may be used without departing from the spirit of the invention. Additionally, a number of well-known processes and elements have not been described in order to avoid unnecessarily obscuring the present invention. Accordingly, the above description should not be taken as limiting the scope of the invention.
[0084] Those skilled in the art will appreciate that the presently disclosed variations teach by way of example and not by limitation. Therefore, the matter contained in the above description or shown in the accompanying drawings should be interpreted as illustrative and not in a limiting sense. The following claims are intended to cover all generic and specific features described herein, as well as all statements of the scope of the present method and system, which, as a matter of language, might be said to fall therebetween.