ENDOSCOPIC DEVICE REMOVAL SYSTEM AND METHOD

Abstract

Systems and methods are provided for the non-traumatic removal of a variety of devices placed over, or on, endoscopic instruments or endoscopes. A device removal system includes a removal element for gripping the device having a body with a central portion and adjacent gripping arms movably coupled to the central portion. The system further includes an insertion device coupled to the removal element and an expanding instrument. The insertion device has an elongate shaft configured for advancement into an opening or channel within the device to be removed. The expanding instrument is configured for insertion into the insertion device to expand the shaft of the insertion device and obtain a firmer grip on the device, thereby reducing the local pressure applied to any one portion of the device, which reduces the wear and tear on the instrument and minimizes damage to epoxy joints and other sealed areas.

Claims

1. A system for removing a device from an endoscopic instrument, the system comprising: a removal element for gripping the device, the removal element having a body comprising a central portion and first and second gripping arms movably coupled to the central portion; and an insertion device coupled to the removal element and having a projection configured for advancement into an opening within the device.

2. The system of claim 1, wherein the projection is an elongate shaft configured for advancement through an internal channel in the device.

3. The system of claim 2, wherein the elongate shaft is collapsible such that an outer diameter of at least a portion of the elongate shaft is reduced upon advancement into the internal channel of the device.

4. The system of claim 2, further comprising an expanding instrument configured for insertion into the insertion device.

5. The system of claim 4, wherein the insertion device comprises an internal open channel for receiving the expanding instrument.

6. The system of claim 4, wherein the insertion device is expandable upon advancement of the expanding instrument into the internal open channel.

7. The system of claim 4, wherein the insertion device comprises slits along the elongate shaft allowing for expansion of the elongate shaft.

8. The system of claim 1, wherein the first and second gripping arms include ridges on an inner surface.

9. The system of claim 1, wherein the first and second gripping arms include finger gripping elements on an outer surface.

10. The system of claim 1, wherein the insertion device includes ridges on the projection.

11. The system of claim 4, wherein the expanding instrument comprises an elongate shaft having an enlarged distal head.

12. The system of claim 11, wherein the elongate shaft of the expanding instrument terminates in a tapered tip.

13. (canceled)

14. (canceled)

15. A system for removing a device from an endoscopic instrument, the system comprising: a removal element for gripping the device; an insertion device coupled to the removal element and having a projection configured for advancement into an opening within the device; and an expanding instrument configured for insertion into the projection such that the projection expands within the device.

16. The system of claim 15, wherein the projection comprises an elongate shaft configured for advancement through an internal channel in the device.

17. The system of claim 15, wherein the elongate shaft of the insertion device is collapsible such that an outer diameter of at least a portion of the elongate shaft can be reduced upon advancement into the opening of the device.

18. The system of claim 15, wherein the insertion device comprises an internal open channel for receiving the expanding instrument.

19. The system of claim 15, wherein the removal element includes a body comprising a central portion and first and second gripping arms pivotally coupled to the central portion;

20. The system of claim 18, wherein the elongate shaft of the insertion device is expandable upon advancement of the expanding instrument into the internal open channel.

21. The system of claim 16, wherein the insertion device comprises slits along the elongate shaft allowing for expansion of the shaft.

22. The system of claim 19, wherein the first and second gripping arms include ridges on an inner surface.

23. The system of claim 19, wherein the first and second gripping arms include finger gripping elements on an outer surface.

24. The system of claim 15, wherein the insertion device includes ridges on the projection.

25. The system of claim 16, wherein the expanding instrument comprises an elongate shaft having an enlarged distal head.

26. The system of claim 25, wherein the elongate shaft of the expanding instrument terminates in a tapered tip.

27. (canceled)

28. (canceled)

29. (canceled)

30. (canceled)

31. (canceled)

32. (canceled)

33. (canceled)

34. (canceled)

35. (canceled)

36. (canceled)

37. (canceled)

38. (canceled)

39. (canceled)

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0017] The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate several embodiments of the disclosure and together with the description, serve to explain the principles of the disclosure.

[0018] FIG. 1A shows an isometric outer view of a removal system according to the present disclosure in an unfolded configuration;

[0019] FIG. 1B shows an isometric inner view of the removal system of FIG. 1A;

[0020] FIG. 1C shows a top-down view of the removal system of FIG. 1A in a folded configuration;

[0021] FIG. 1D shows an isometric inner view of the removal system of FIG. 1C.

[0022] FIG. 2 is an exploded view of the removal system of FIG. 1A.

[0023] FIG. 3A illustrates a step in a method of removing a device from an endoscopic instrument according to the present disclosure;

[0024] FIG. 3B shows a step of securing the endoscopic device to the removal system by inserting an insertion device; and

[0025] FIG. 3C is an isometric inner view of the removal system and endoscopic device ready to be removed.

DETAILED DESCRIPTION

[0026] This description and the accompanying drawings illustrate exemplary embodiments and should not be taken as limiting, with the claims defining the scope of the present disclosure, including equivalents. Various mechanical, compositional, structural, and operational changes may be made without departing from the scope of this description and the claims, including equivalents. In some instances, well-known structures and techniques have not been shown or described in detail so as not to obscure the disclosure. Like numbers in two or more figures represent the same or similar elements. Furthermore, elements and their associated aspects that are described in detail with reference to one embodiment may, whenever practical, be included in other embodiments in which they are not specifically shown or described. For example, if an element is described in detail with reference to one embodiment and is not described with reference to a second embodiment, the element may nevertheless be claimed as included in the second embodiment. Moreover, the depictions herein are for illustrative purposes only and do not necessarily reflect the actual shape, size, or dimensions of the system or illustrated components.

[0027] It is noted that, as used in this specification and the appended claims, the singular forms “a,” “an,” and “the,” and any singular use of any word, include plural referents unless expressly and unequivocally limited to one referent. As used herein, the term “include” and its grammatical variants are intended to be non-limiting, such that recitation of items in a list is not to the exclusion of other like items that can be substituted or added to the listed items.

[0028] The present disclosure provides a system that enables the precise, predictable and less traumatic removal of a variety of devices used in endoscopic procedures. The devices that can be removed include, for example, endoscopic caps, endoscopic shields, sheaths, optical couplers, lenses, variceal banding devices, endoscopic submucosal resection devices, balloons and other such devices that can be placed on, within, or over an endoscope or other devices used endoscopically, interventionally or in other procedures where an instrument or other device is inserted in a body. The present disclosure is particularly useful for removing devices from endoscopes, such as optical couplers and conductive optical elements that may be removably coupled to the distal end portion of an endoscope. Optical coupling devices suitable for removal by the systems and methods of the present invention, for example, are described in International Application Nos: PCT/US2016/043371, filed Jul. 21, 2016, PCT/US2016/035566, filed Jun. 2, 2016 and U.S. Pat. No. 8,905,921, the entire disclosures of which are incorporated herein by reference for all purposes.

[0029] According to one exemplary embodiment shown in FIGS. 1A-1D, a removal system 100 includes a removal element 20 configured to atraumatically grip and apply force to the outer surface or end of the device being removed, allowing the user to grasp and apply force to the device subject to removal from the endoscope or instrument. The removal element 20 comprises an elongate body 22 having a central portion 24 flanked by adjacent tabs or gripping arms 26a, 26b connected to the central portion 24 at scored areas 28. The scored areas 28 between central portion 24 and gripping arms 26a, 26b enable the gripping arms 26a, 26b to fold or pivot relative to the central portion 24, as shown in FIGS. 1C and 1D. Of course, other configurations are possible. For example, gripping arms 26a, 26b may be pivotally coupled to central portion 24 through a variety of different mechanisms, such as a hinge or other suitable articulation mechanisms.

[0030] On the inner surface 32 of the removal element 20, surface protrusions, such as ridges 36 or other suitable gripping elements, can be provided, as shown in FIG. 1B, to increase the grip and application of force to grasp and remove the device subject to removal. The removal element 20 or any other aspect of the system 100 may include finger grip elements 38 on its outer surface 34, as shown in FIG. 1A, to improve the ergonomic aspects of the system by making it easier to hold and apply force to the system 100. In one embodiment, finger grip elements 38 are protrusions extending outwardly from gripping arms 26a, 26b. These protrusions preferably include a curved inner surface configured for contacting the operator's fingers to allow the operator to hold onto grip elements 38 as removal element 20 is being pulled in the proximal direction (or the direction opposite the curved surfaces).

[0031] According to one aspect of the present disclosure, the system 100 may further include an insertion device 40, as shown in FIG. 2, which may be a collet or other suitable element capable of being inserted into the working channel of an endoscopic shield, an optical coupler, an endoscopic cap or other device subject to removal that includes an internal channel. The insertion device 40 may be attachable to the removal element 20, so that the insertion element is advanced into the internal channel of the device subject to removal. Alternatively, insertion device 40 may be an integral part of removal element 20 (i.e., manufactured together in the same mold). The insertion device 40 preferably comprises an elongate shaft 42 with slits 44 or other suitable cutout or design features that allow the insertion device 40 to collapse or otherwise reduce the diameter of its elongate shaft 42 upon insertion. This allows insertion device 40 to be advanced easily through the internal channel of the device subject to removal. In addition, insertion device 40 will then naturally expand outward within the device to create a friction fit between insertion device 40 and the device to be removed. This friction fit allows the user to apply a force from within the device as it is withdrawn. Applying a force from within the device spreads the application of force so that the force being applied is from the outside of the device (through gripping arms 26a, 26b) and from the inside through insertion device 40. This reduces the local pressure applied to any one portion of the device, which results in a more precise and atraumatic removal.

[0032] It is of course understood that the removal element 20 may be configured to provide a radial pressure or force from the inside of the device to be removed, or it may be used to spread the ends to capture the device to be removed. In other words, the removal element 20 may be used to effectively grab and pull the device away from the instrument or endoscope on which it is attached by spreading the opening end and pulling the device towards the user.

[0033] In alternative embodiments, the insertion device 40 comprises a projection (not shown), such as a knob, flange, lip, extension or other protrusion, that can be inserted into an opening in the device to be removed. In these embodiments, the projection is configured to expand outward upon insertion into the opening to create a friction fit within the device. The projection may, for example, comprise a flexible material that is biased outward by a spring or the natural composition of the material. The user may exert force upon the projection to collapse it and insert it into the opening, whereby it then expands outward to create the friction fit. In one such embodiment, the projection is configured to spread outward upon insertion into the opening such that the projection applies force to the inside proximal surface of the device as it is being withdrawn by the user. In these embodiments, the insertion device 40 may, for example, be used to remove devices that have an opening, but no internal channel therein.

[0034] In some embodiments, the insertion device 40 can have one or more ridges 48 or other surface features or variations on its outer surface to increase the amount of adhesion and grip in the internal channel when the removal system 100 is applied to remove the device. Ridges 48 may, for example, be disposed on the outer or distal surfaces of shaft 42.

[0035] As shown in FIG. 2, an expanding instrument 60 may be provided for use with the removal system 100. According to another aspect of the exemplary embodiment, insertion device 40 may include an opening 46 (see FIG. 3B) leading into an internal channel (not shown) within elongate shaft 42 for receiving expanding instrument 60. In some embodiments, expanding instrument 60 has a larger outer diameter than the inner diameter of the internal channel of insertion device 40 such that expanding instrument 60 expands insertion device 40. In some cases, the outer diameter of expanding instrument 60 is only larger than the collapsed internal dimeter of insertion device 40 (i.e., after it has been inserted into device and collapsed due to the slits 44 on shaft 42). In other embodiments, the expanding instrument 60 may include an enlarged head portion 62 and an elongate shaft 64 extending from the head portion 62. In these embodiments, the enlarged head portion 62 serves to expand insertion device 40 (i.e., the outer diameter of expanding instrument 60 may be equal to or less than the inner diameter of insertion device 40). In all of these embodiments, advancing insertion device 40 through opening 46 and into the internal channel of insertion device 40 increases the diameter of elongate shaft 42 and therefore the amount of resistance and transfer of force when the insertion device 40 is used to remove the device subject to removal.

[0036] The elongate shaft 64 of expanding instrument 60 may terminate in a tip 66. In some embodiments, the tip 66 may be tapered and either blunt or sharp. Tip 66 serves to facilitate advancement of expanding instrument through the internal channel in insertion device 40.

[0037] Referring now to FIGS. 3A-3C, an exemplary method of removing a representative device 200 that is attached onto an instrument or endoscope according to the present disclosure will now be described. Insertion device 40 is advanced through an opening and into the interior of device, as shown in FIG. 3C. Slits 44 allow shaft 42 of insertion device 40 to collapse to facilitate its advancement through the opening of device 200. The gripping arms 26a, 26b of removal element 20 may then be folded onto the device 200, as shown in FIG. 3A. The ridges 36 on the inner surface 32 of the removal element 20 may allow a secure grip when the user applies pressure using the finger grip elements 38 to fold the removal element 20 over the device 200 to be removed. Next, the expanding instrument 60 may be inserted through opening 46 of the insertion device 60, as shown in FIG. 3B. This expands the diameter of the elongate shaft 42 of the insertion device 40 and further secures the device 200 within the removal system, as shown in FIG. 3C. Once the insertion device 60 has been inserted, the user may grip the entire removal system 100 and pull the device 200 away from the instrument or endoscope, thereby removing the device 200 in a precise, predictable and less traumatic manner than current methods.

[0038] The components of the removal system 100 may be made of any medical grade material, including for example, but not by way of limitation, elastomeric materials, rigid materials, combinations of materials to achieve various performance elements that may include both elastic and rigid materials, which may include polypropylenes, PET materials, PTFE materials, thermoplastic elastomers, polycarbonates, acrylics, and any other elastic or rigid medical grade material.

[0039] It is of course understood that the removal system 100 may be sterilized using any acceptable method or may be non-sterile. For example, the removal system 100 may be provided as a disposable or single-use system.

[0040] Hereby, all issued patents, published patent applications, and non-patent publications that are mentioned in this specification are herein incorporated by reference in their entirety for all purposes, to the same extent as if each individual issued patent, published patent application, or non-patent publication were specifically and individually indicated to be incorporated by reference.

[0041] Other embodiments will be apparent to those skilled in the art from consideration of the specification and practice of the embodiment disclosed herein. It is intended that the specification and examples be considered as exemplary only, with a true scope and spirit of the embodiment being indicated by the following claims.