ENDOSCOPE WITH ENHANCED STEERING WIRE ARRANGEMENT

Abstract

An endoscope including at least one operating element, a steerable deflecting element located at the distal end, an endoscope tip, and a steering wire having a first portion, a second portion and an intermediate portion, wherein the intermediate portion is attached to the deflecting element or to the endoscope tip, operation of the at least one operating element to apply a drag force to the first portion moving the endoscope tip in a first direction, and operation of the at least one operating element or another operating element to apply a drag force to the second portion moves the endoscope tip in a second direction different from the first direction, and/or wherein the intermediate portion of the steering tie element is at least in part received in a clearance provided at/in a distal end portion of the deflecting element and/or at/in the endoscope tip.

Claims

1-17. (canceled)

18. An endoscope comprising: at least one operating element; an insertion tube having a proximal end and a distal end; a steerable deflecting element located at the distal end of the insertion tube, the deflecting element being steerable; an endoscope tip distally arranged at the deflecting element; and a first steering wire having a first portion, a second portion and an intermediate portion between the first portion and the second portion, wherein a proximal end of the first portion and/or a proximal end of the second portion are attached to the at least one operating element, wherein the intermediate portion is attached to the deflecting element and/or to the endoscope tip, wherein operation of the at least one operating element to apply a drag force to the first portion of the first steering wire moves the endoscope tip in a first direction, and wherein operation of the at least one operating element or another operating element to apply a drag force to the second portion of the first steering wire moves the endoscope tip in a second direction different from the first direction.

19. The endoscope of claim 18, wherein the first direction is perpendicular to the second direction.

20. The endoscope of claim 18, wherein the first portion and the second portion of the first steering wire are angularly offset to each other by an angle of about 90°.

21. The endoscope of claim 18, wherein the first portion and the second portion of the first steering wire are angularly offset to each other by an angle of about 180°.

22. The endoscope of claim 18, wherein the endoscope further comprises a second steering wire having a first portion, a second portion and an intermediate portion.

23. The endoscope of claim 22, wherein the at least one operating element includes a first operating element and a second operating element, wherein the first operating element is connected to the first portion of the first steering wire and to the first portion of the second steering wire, and wherein the second operating element is connected to the second portion of the first steering wire and to the second portion of the second steering wire.

24. The endoscope of claim 23, wherein by operating the first operating element the endoscope tip is selectively moved in the first and/or a third direction, wherein by operating the second operating element the endoscope tip is selectively moved in the second and/or a fourth direction, and wherein the first direction, the second direction, the third direction and the fourth direction are different from each other.

25. The endoscope of claim 24, wherein the first direction and the third direction are in a first plane, and wherein the second direction and the fourth direction are in a second plane, and wherein the first plane is perpendicular to the second plane.

26. The endoscope of claim 24, wherein the intermediate portion is held in position by frictional forces between the intermediate portion and the deflecting element.

27. The endoscope of claim 24, further comprising a resin material provided on, to stiffen, the intermediate portion.

28. The endoscope of claim 24, wherein the intermediate portion comprises a crimp.

29. The endoscope of claim 18, wherein the intermediate portion of the first steering wire is at least in part received in a clearance provided at/in a distal end portion of the deflecting element and/or at/in the endoscope tip.

30. The endoscope of claim 29, wherein the clearance consists of a recess, a depression, a groove, an opening or a combination thereof.

31. The endoscope of claim 29, wherein the clearance is provided in a radial direction in a circumferential surface of the deflecting element, and/or in an axial direction in an axial surface of the deflecting element.

32. The endoscope of claim 31, wherein a distal segment of the deflecting element comprises the circumferential surface and/or the axial surface.

33. The endoscope of claim 29, wherein the clearance is provided by at least one through hole extending through the deflecting element in the radial direction, wherein the intermediate portion is threaded through the through hole.

34. The endoscope of claim 33, wherein the intermediate portion is threaded from radially inside to radially outside or vice versa.

35. The endoscope of claim 33, wherein a distal segment of the deflecting element comprises the at least one through hole.

36. The endoscope of claim 29, wherein the clearance is curved in the direction of the intermediate portion.

37. An endoscope comprising: at least one operating element; an insertion tube having a proximal end and a distal end; a steerable deflecting element located at the distal end of the insertion tube, the deflecting element being steerable; an endoscope tip distally arranged at the deflecting element; and at least one steering wire having a first portion, a second portion and an intermediate portion between the first portion and the second portion, wherein a proximal end of the first portion and/or a proximal end of the second portion are attached to the at least one operating element, wherein the intermediate portion is attached to the deflecting element and/or to the endoscope tip, and wherein the intermediate portion of the steering wire is at least in part received in a clearance provided at/in a distal end portion of the deflecting element and/or at/in the endoscope tip.

38. An endoscope comprising: at least one operating element; an insertion tube having a proximal end and a distal end; a steerable deflecting element located at the distal end of the insertion tube, the deflecting element being steerable; an endoscope tip distally arranged at the deflecting element; and a first steering wire having a first portion, a second portion and an intermediate portion between the first portion and the second portion, a proximal end of the first portion and/or a proximal end of the second portion of the first steering wire being attached to the at least one operating element; and a second steering wire having a first portion, a second portion and an intermediate portion, wherein the intermediate portion is attached to the deflecting element and/or to the endoscope tip, wherein operation of the at least one operating element to apply a drag force to the first portion of the first steering wire moves the endoscope tip in a first direction, and wherein operation of the at least one operating element or another operating element to apply a drag force to the second portion of the first steering wire moves the endoscope tip in a second direction different from the first direction, the first direction being perpendicular to the second direction.

Description

BRIEF DESCRIPTION OF THE FIGURES

[0058] Further features and advantages of the present disclosure result from the following exemplary and non-limiting description of the figures. These are only schematic in nature and only serve to understand the present disclosure:

[0059] FIG. 1 shows a perspective view of an example of a deflecting element for an endoscope according to the disclosure,

[0060] FIG. 2 shows the deflecting element of FIG. 1 in a perspective view from a different viewing direction,

[0061] FIG. 3a shows a schematic top view of a first arrangement of the steering wires,

[0062] FIG. 3b shows a schematic top view of a second arrangement of the steering wires,

[0063] FIG. 4a shows a perspective view of an example of a deflecting element of an endoscope according to the disclosure, wherein the steering wire is not in its final position,

[0064] FIG. 4b shows a perspective view of the example of FIG. 4a, wherein the steering wire is in its final position,

[0065] FIG. 4c shows a sectional view of the example of FIGS. 4a and 4b, wherein the steering wire is in its final position,

[0066] FIG. 5a shows a perspective view of an example of a deflecting element of an endoscope according to the disclosure, wherein the steering wire is not in its final position,

[0067] FIG. 5b shows a perspective view of the example of FIG. 5a, wherein the steering wire is in its final position,

[0068] FIG. 5c shows a sectional view of the example of FIGS. 5a and 5b, wherein the steering wire is in its final position,

[0069] FIG. 6a shows a top view of an example of a deflecting element of an endoscope according to the disclosure,

[0070] FIG. 6b shows a side view of the example of FIG. 6a,

[0071] FIG. 6c shows a perspective view of the example of FIGS. 6a and 6b,

[0072] FIG. 6d shows a perspective view of the example of FIGS. 6a, 6b and 6c from a different viewing direction,

[0073] FIG. 7 shows a perspective view of an example of a deflecting element of an endoscope according to the disclosure, wherein the steering wire has been omitted,

[0074] FIG. 8 shows a perspective view of the example of FIG. 7 with steering wire,

[0075] FIG. 9 shows a perspective view of the example of FIGS. 7 and 8 with steering wire from a different viewing direction,

[0076] FIG. 10 shows an enlarged detail of FIG. 9,

[0077] FIG. 11 shows a systematic view of an endoscope according to the disclosure,

[0078] FIG. 12 shows a steering wire connection schema, and

[0079] FIG. 13 shows another steering wire connection schema.

DETAILED DESCRIPTION

[0080] To begin with, FIG. 11 shows the endoscope 100 of the present disclosure in its substantially complete structure.

[0081] Accordingly, the endoscope 100 is preferably a single use endoscope (duodenoscope) and comprises a connector unit 120 for connecting the endoscope 100 with a (separate) supply unit, which may also be referred to as a base unit, for at least one operating resource (for example, electric power, water, etc.). The endoscope 100 further comprises a supply line 140 located proximal (in the direction toward the user) to/at the connector unit 120. The supply line 140 is for supplying said at least one operating resource from the connector unit to an endoscope handle 130 which is designed to be held by a user and - in accordance with the manual actuations of several manipulators 131 at the handle 130 by the user - from the handle 130 to a distal (direction away from the user/direction toward the patient) endoscope tip/head 132, which is intended to be inserted into a patient’s body cavity and which is located at the distal end of an endoscope shaft 133 which shaft 133 is mounted at its proximal end to the handle 130 and into which the supply line is extended. Furthermore, the endoscope shaft 133 comprises at least one so-called working channel 134 extending along the endoscope shaft 133 and having an opening in the tip 132 such that a surgical instrument can be shifted through the working channel 134 to extend beyond the tip 132 into a distal and/or radial direction. Furthermore, between the distal end of the endoscope shaft (insertion shaft) 133 and the endoscope head (tip) 132 a so-called deflecting element 1 is provided, which can be manually actuated for actively moving/tilting the tip 132 relative to the endoscope shaft 133. Here, the endoscope shaft is made flexible but it can also be made stiff.

[0082] FIG. 1 shows a perspective view of an example of such a deflecting element 1 for an endoscope according to the disclosure. The deflecting element 1 comprises a number of essentially plate- or ring-shaped segments, of which three segments 2a, b, c are shown. The deflecting element 1 is terminated at its distal end by a distal end segment 3. The segment 2a proximal to the distal end segment 3 is connected to the proximal end of segment 3 by a first hinge 4 and a second hinge 5. It is further connected to the proximally adjacent segment 2b by a third hinge 6 and a fourth hinge 7. At the distal side of the segment 3 there is attached a tip/head or a tip housing (shown in FIG. 11) of the endoscope.

[0083] The hinges 4, 5, 6, 7 are each made integrally from a same material as the segments 2 and allow the connected segments 2 to bend relative to the adjacent segments 2 in a bending plane defined by the concerning hinges 4, 5, 6, 7. As it is shown in the figures, the hinges 4, 5, 6, 7 are angularly offset to each other by 90°, such that the bending plane defined by the first hinge 4 and the second hinge 5 is perpendicular to the bending plane defined by the third hinge 6 and the fourth hinge 7. Therefore, the deflecting element 1 can bend/tilt in any direction perpendicular to the longitudinal direction 8 of the endoscope. Each segment 2, 3 has a ring-like form, such that all the segments 2, 3 together form the hollow tubular/cylindrical deflecting element 1 having a central channel 9 inside for receiving a surgical instrument and/or conduits (not shown in the figures) as fluid conduits, electrical conduits and/or optical conduits.

[0084] The endoscope further comprises a first steering tie element (first wire) 10 and a second steering tie element (second wire) 11, which in the following are referred to as the first steering wire 10 and the second steering wire 11. Each of the first and the second steering wires 10, 11 has a first portion 12, a second portion 13 and an intermediate portion 14 located between the first portion 12 and the second portion 13. In the following the first portion 12 may be referred to as the first branch 12, while the second portion 13 may be referred to as the second branch 13. It is not concretely shown in the figures, that a proximal end of the first branch 12 and a proximal end of the second branch 13 are attached to an operating element (as shown in FIG. 11) of the endoscope. The intermediate portion 14 is attached to the deflecting element 1 (additionally or alternatively it may be attached to the endoscope tip). As can be taken from the figures, when either the first branch 12 or the second branch 13 of the same steering wire are alternately objected to a pull force for bending the deflecting element 1 and moving the tip, the intermediate portion 14 is loaded by a pull force in its longitudinal direction, i.e. loaded by tensile stress. Therefore, a friction force is generated between the intermediate portion and the contact surface of the deflecting element 1 in the longitudinal direction of the steering wire.

[0085] By operating the operating element a drag force (pulling force) is introduced, for example, exclusively into the first branch 12 or exclusively into the second branch 13 for bending the deflecting element 1 and for moving the endoscope tip. In particular, by operating the operating element so as to apply the drag force (exclusively) into the first branch 12 of the first steering wire 10 the endoscope tip is moved in a first direction. By operating the operating element so as to apply a drag force (exclusively) into the second branch 13 of the first steering wire 10 the endoscope tip is moved in a second direction. By operating the operating element so as to apply the drag force exclusively into the first branch 12 of the second steering wire 11 the endoscope tip is moved in a third direction. By operating the operating element so as to apply a drag force exclusively into the second branch 13 of the second steering wire 11 the endoscope tip is moved in a fourth direction. Evidently, the first direction, the second direction, the third direction and the fourth direction are different from each other.

[0086] FIGS. 1, 2 show an example of the disclosure, wherein the intermediate portion 14 of the first steering wire 10 and the intermediate portion 14 of the second steering wire 11 are each received in a clearance 15, here in form of a groove 15, which is provided in a radial direction in a circumferential (outer) surface 16 of the deflecting element 1.

[0087] More concretely, each segment 2a to 2c of the deflecting 1 is provided with at least four axial throughholes A to D oriented in the longitudinal direction of the endoscope and being distanced from each other in the circumference direction by 90°, respectively such that the through holes A and C are located opposite to each other and B and D are located opposite to each other. Furthermore, the through holes B and C are in line with the hinges 4 and 5, respectively, wherein the through holes A and D are in line with the hinges 6 and 7, respectively. The first branch 12 of the first steering wire 10 is fed through the through holes B in the distal direction, is then bent at the most distal axial surface of the distal segment 3 into the intermediate portion 14 which is finally bent into the second branch 13 being fed through the through holes A back in the proximal direction. In the same way, the second branch 12 of the second steering wire 11 is fed through the through holes C in the distal direction is then bent at the most distal axial surface of the distal segment 3 into the intermediate portion 14 and is finally bent into the second branch 13 being fed through the through holes D back in the proximal direction. This design corresponds to the above-mentioned connection schema I.

[0088] Furthermore, as can be seen especially in FIGS. 1 and 2, the distal (end) segment 3 comprises connection portions / sockets (having no reference signs) for connecting the endoscope tip to the deflecting 1.

[0089] FIGS. 4a, 4b, 4c, 5a, 5b and 5c show an example (improvement of the embodiment according to FIGS. 1 and 2), wherein the intermediate portions 14 of the first steering wire 10 and the intermediate portion 14 of the second steering wire 11 are each received in a clearance 17, here in form of a groove 17, which are provided in an axial direction in an axially distal end surface 18 of the deflecting element 1, especially of the distal (end) segment 3. It is shown in the figures that the clearance 15, 17 are provided at and in a distal end portion of the deflecting element 1, i.e. the distal segment 3 of the deflecting element 1. Additionally, or alternatively the clearance 15, 17 may be provided at / in the endoscope tip (not shown in FIGS. 4a to c). In the example of FIGS. 4a, 4b and 4c the clearance 17 is provided in the distal segment 3, wherein a side wall of a tip housing of the tip provides a side of the clearance 17, while in the example of FIGS. 5a, 5b and 5c the clearance 17 is provided at the distal segment 3, here by a bridging part 26.

[0090] More concretely, according to the embodiment of FIGS. 4a to c, the distal axial end surface of the distal segment 3 of the deflecting element 1 comprises two arc-shaped grooves 17 (of about 90° circumferential length) connecting the through holes A with B and C with D, respectively such that the intermediate portions 14 of each steering wire 10, 11 are substantially completely accommodated therein as shown especially in FIG. 4b. Therefore, the clearances 15, 17 surround / encapsulate the intermediate portions 14 for a certain angular area, which enhances the generation of frictional forces (in the longitudinal direction of the respective steering wire) between each intermediate portion 14 and its contact surface of the deflecting element 1 in case a pulling force is applied to (only) one of the branches 12, 13.

[0091] As already stated above, the clearances 15, 17 are not necessarily formed by the arc-shaped grooves in the distal segment 3 but can also be provided by the bridging part 26 as shown in the FIGS. 5a to c. In this case an additional design element (namely the bridging part 26) is integrally formed with the distal segment 3 having a bracket-like shape and bridging the circumferential distance between the through holes A and B as well as C and D, respectively.

[0092] While in any of figures the first branch 12 and the second branch 13 are shown in an angular displacement of 90° (when seen in circumferential direction), alternatively they may be arranged in an angular displacement of 180°, see also FIGS. 3a and 3b, which further enlarges the area of contact between the intermediate portions 14 and the deflecting element 1 and therefore enhances the generation of frictional forces. FIG. 3a shows an example of a 180°-arrangement, wherein the intermediate portions 14 of the first steering wire 10 and the second steering wire 11 do not directly cross the central channel 9 of the deflecting element 1, but are wound around it in an arc-like manner, thereby entangling the deflecting element 1. It is an advantage of this arrangement that the central channel 9 is not covered / crossed by the steering wires 10, 11, but is left free, such that there is free space for any duct or conduit connecting functional unit in the tip with a base unit or supply of the endoscope. Alternatively and as shown in FIG. 3b, the intermediate portions 14 of the first steering wire 10 and the second steering wire 11 may directly cross the central channel 9 of the deflecting element 1. In any of the shown possibilities, the steering wires 10, 11 each forms two (serial) 90° bends (from the longitudinal direction 8/ the first branch 12 into the circumferential direction / the intermediate portion 14 and from the circumferential direction / the intermediate portion 14 into the longitudinal direction 8 / the second branch 13), such that the intermediate portion 14 (thereby achieving substantially an U-shape) runs along the (circumferential) periphery of the deflecting element 1 (especially the distal segment 3). It is shown in the figures, that the clearance 15 as well as the clearance 17 is curved in the direction of the intermediate portion 14, which further enhances the generation of frictional forces.

[0093] As already stated above, the first branch 12 and the second branch 13 are each guided by the segments 2a to c and 3 of the deflecting element 1. Each segment 2a to c and 3, therefore, comprises a number of openings (through holes) 19 arranged in the longitudinal direction 8 and are distinguished in the above mentioned pairs of through holes A and B as well as C and D. These segment openings / through holes 19 arranged one upon the other in the longitudinal direction 8 and together provide a passage for one branch 12, 13 of the steering wires 10, 11. Said passage extends in the longitudinal direction 8 from proximal to distal.

[0094] FIGS. 6a to 6d show a further example, wherein a clearance 20 is provided by a number of through holes 20 extending through the distal segment 3 of the deflecting element 1 in a circumferential and/or radial direction (perpendicular to the longitudinal direction 8) thereby forming a kind of loops or eyes for receiving the intermediate portion 14 of the respective steering wires 10, 11. In other words, the intermediate portion 14 of each, the first steering wire 10 and the second steering wire 11, is threaded through each through hole 20 from radially inside to radially outside or vice versa along the circumferential direction between two longitudinal through holes 19, thereby increasing the friction effect between the steering wire and the deflecting.

[0095] FIGS. 7 to 10 show a further example of the present disclosure. Accordingly, the steering wires 10, 11 and especially their intermediate portions 14 are connected to the endoscope tip/head and more concretely to a receiving element / casing for/of the endoscope tip/head which receiving element represents the distal segment 3 of the deflecting 1. However, it is also possible that the distal segment 3 is a simple final segment of the deflecting 1 at which a separate endoscope head is distally fixed.

[0096] As shown especially in FIGS. 9 and 10, the distal segment 3 comprises a number of longitudinally (axially) extending through holes 19 at/in a circumferential wall thereof (only two through holes 19 for one single steering wire, being defined as first axial passage and second axial passage, are shown in FIGS. 9 and 10 wherein, however four through holes 19 for two steering wires are provided) leading to the respective through holes 19 at the proximal neighboring segment 2a and distally ending radially inside the segment 3. Furthermore, when seen in the circumferential direction both axial through holes 19 (first and second axial passages) as shown in the figures are distanced from each other by an angle of about 90°. Between the two axial through holes 19 (first and second axial passages) two radially extending through bores / radial openings 22, 23 are provided being separated from each other in the circumferential direction thereby generating a separation wall 30 in between.

[0097] Finally, as can be seen especially in the FIGS. 7 and 8 the distal segment 3 has an outer axially extending (first) groove/channel 25 starting from the proximal end surface of the distal segment 3 and ending at the one 23 of the two radial openings wherein both radial openings 22, 23 are linked by an outer circumferentially extending (second) groove/channel 24.

[0098] The steering wires 10, 11 can be attached to the deflecting element 1 by performing the following steps which steps are shown in the FIGS. 7, 8 and 10 on the basis of only one of the two steering wires 10, 11: [0099] Step 1: bending the steering wires 10, 11 thereby forming the first branch 12, the second branch 13 and the intermediate portion 14 which intermediate portion 14 can be divided into a first and second steering wire parts 14a, 14b and a middle steering wire section 14c. [0100] Step 2: arranging the middle steering wire section 14c between the first opening 22 and a gap 21 generated between the two neighboring segments 2 and 2a on the internal side of the deflecting element 1, (i.e. in the central channel 9), [0101] Step 3: drawing the first steering wire part 14a through the gap 21 between the bending segments 2a, 3 to the external side of the deflecting element 1 [0102] Step 4: drawing the second steering wire part 14b through the first radial opening 22 to the external side of the deflecting section 1 [0103] Step 5: placing the first steering wire part 14a in the first outside groove 25 and drawing the first steering wire part 14a through the second radial opening 23 to the internal side of the deflecting element 1, (i.e. into the central channel 9), [0104] Step 6: placing the second steering wire part 14b into the second outside groove 24 and drawing the second steering wire part 14b through the second radial opening 23 to the internal side of the deflecting element 1, (i.e. into the central channel 9), [0105] Step 7: inserting the first branch 12 into the opening 19 (first passage) for the first branch 12 and threading the first branch 12 through all openings 19 of all segments 2, 3 of the deflecting element 1 from distal to proximal, [0106] Step 8: inserting the second branch 13 into the opening 19 (second passage) for the second branch 13 and threading the second branch 13 through all openings 19 of all segments 2, 3 of the deflecting element 1 from distal to proximal.

[0107] To summarize the gist of the present disclosure, it refers to an endoscope, in particular single use endoscope, comprising at least one operating element, an elongated insertion tube / insertion hose having a proximal end and a distal end, a steerable deflecting element 1 located at the distal end, an endoscope tip distally arranged at the deflecting element 1, and at least one steering tie element 10, 11 having a first portion 12, a second portion 13 and an intermediate portion 14 between the first portion 12 and the second portion 13, wherein at least one of a proximal end of the first portion 12 and a proximal end of the second portion 13 is / are attached to the at least one operating element, wherein the intermediate portion 14 is attached to the deflecting element 1 or to the endoscope tip, such that by operating the operating element a drag force can be applied via the steering tie element 10, 11 to the deflecting element 1 for moving the endoscope tip, wherein by operating the at least one operating element so as to apply a drag force to the first portion 12 of the steering tie element 10, 11 the endoscope tip is moved in a first direction and that by operating the at least one operating element so as to apply a drag force to the second portion 13 of the steering tie element 10, 11 the endoscope tip is moved in a second direction, wherein the first direction and the second direction are different from each other and/or wherein the intermediate portion 14 of the steering tie element 10, 11 is at least in part received in a clearance 15, 17, 20, 22, 23, 24, 25, in particular in a recess, a depression, a groove, an opening or a combination thereof, which clearance 15, 17, 20, 22, 23, 24, 25 is provided at / in a distal end portion of the deflecting element 1 and/or at / in the endoscope tip.

TABLE-US-00001 Reference signs: 1 2, 2a,b,c 3 4 5 6 7 8 9 10 11 12 13 deflecting element segment distal end segment first hinge second hinge third hinge fourth hinge longitudinal direction central channel first steering tie element, first steering wire second steering tie element, second steering wire first portion, first branch second portion, second branch 14 14a 14b 14c 15 16 17 18 19 20 21 22 23 24 25 26 30 100 120 130 131 132 133 134 140 intermediate portion first steering wire part of intermediate portion second steering wire part of intermediate portion middle steering wire section of intermediate portion clearance, groove circumferential surface clearance, groove axial surface opening clearance, through hole gap clearance, radial opening clearance, radial opening second outside groove first outside groove bridging part separation wall endoscope connection unit control handle operating elements endoscope head endoscope shaft working channel supply line