WO2011154006A1

WO2011154006A1 - An endoscope for use in connection with various tools

Info

Publication number: WO2011154006A1
Application number: PCT/DK2011/050200
Authority: WO
Inventors: Anita SCHØNING
Original assignee: Innovative Medico Products Aps
Priority date: 2010-06-08
Filing date: 2011-06-07
Publication date: 2011-12-15
Also published as: DK201070253A

Abstract

The invention relates to an endoscope for use in connection with different tools for the treatment of humans or animals, which endoscope comprises a passage for conveyance of a manoeuvring cable, said passage being, at the end intended for being conveyed into the patient, provided with a bore 4 having a larger diameter than the diameter of the passage for conveyance of the manoeuvring cable, wherein the endoscope is, at the end intended for being conveyed into the patient, provided with a number of elongate bulges 3 extending longitudinally on the outside of the endoscope, at least on a stretch until a distance from the end of the endoscope. The bulges 3 may accommodate one or more passages 2 or the like for light, liquid flush, air / oxygen, navigation camera or the like. At the end of the endoscope intended for being inserted into the patient, the endoscope may have a releasable module 1.

Description

An endoscope for use in connection with various tools

The invention relates to an endoscope for use in connection with various tools in the treatment of humans or animals.

Prior art

In recent years it has become increasingly common to perform examinations and / or surgical interventions by means of a kind of telescope. The advantage of using an examination and / or treatment telescope is that it is necessary to make only such incision in the patient that there is room for inserting the examination and / or treatment telescope through the incision made. It is also possible to use one of the natural orifices in the body for introducing the apparatus, eg by endoscopy, in particular when examining the digestive tract, optionally through the oesophagus, or when examining the digestive tract through the rectum.

In connection with the taking of samples through such examination and / or treatment telescope (in the following designated "an endoscope"), the so- called biopsy forceps are known that are a comparatively thin and long, pliable object, primarily consisting of an external cable that extends throughout the length of the forceps, in which external cable an internal maneuvering cable can be conveyed that connects an operating handle in the outer end of the biopsy forceps to a set of jaws at the end of the forceps that is taken through the endoscope. By influencing the operating handle, the jaws are moved in such a manner that it is possible to excise a piece of tissue and pull the tissue out along with the biopsy forceps. Such biopsy forceps are often of a length of between 1.5 and 2 m. When introducing biopsy forceps into the endoscope, it must be introduced a small distance at a time, in case of the known equipment, ie often about 5 cm. That means that the medical doctor performing the examination with his one hand has to introduce the biopsy forceps 5 cm at a time and, after having carefully taken a tissue sample, still with his one hand, while the other hand keeps the jaws of the forceps closed around the tissue sample or the biopsy via the operating handle, he has to withdraw the biopsy forceps from the endoscope again. That is a time-consuming process which is often uncomfortable to the patient being examined / treated, since not all examinations / treatments take place under sedation. It is not uncommon that, for one single sample collection, the biopsy forceps must be moved about 1.4 m into the patient and out again, ie two times 1.4 m. In case of some examinations it is necessary to collect as much as ten samples for subsequent analyses. It is therefore very inconvenient to have to insert biopsy forceps through the endoscope ten times entailing movement of the forceps along a distance of two times 1.4 m inside the patient. WO2008101497 A1 teaches an endoscope wherein, at the end conveyed into the patient, room is made for arrangement of a tool at the end of a manoeuvring cable, which tool may have outer dimensions that are larger than the bore diameter of the passage provided for the manoeuvring cable in the longitudinal expanse of the endoscope.

It is the object of the invention to provide an endoscope for sample collection or treatment, whereby, at the end of the endoscope conveyed into the patient, a bore is provided which is sufficiently wide for accommodating a tool having outer dimensions that are larger than the bore diameter of the passage provided for the manoeuvring cable in the longitudinal expanse of the endoscope. Thereby it is possible to arrange tools of various sizes at the end of the manoeuvring cable.

In an endoscope, apart from passages for sucking and flushing and a mini- camera for diagnosis and navigation, there is also a passage for the insertion of the biopsy forceps. That passage has a diameter of about 2.8 mm, and the diameters of the existing biopsy forceps are typically 2.4 mm, which provides a gap when the biopsy forceps are inserted into the endoscope.

Therefore, obviously, it is not possible to increase the diameter of the biopsy forces to a high degree, since, in that case, the insertion into the endoscope will become more cumbersome, entailing moreover that it will be considerably more time-consuming to convey the biopsy forceps through the endoscope and into the patient. In that the endoscope is provided with an opening at that end of the endoscope which is inserted into the patient, which opening is sufficiently large for accommodating a tool which is larger than the diameter of the passage for conveying the manoeuvring cable through the endoscope, it is possible to use tools in connection with the endoscope, which tools may have such size that it is possible to collect several tissue samples and to store the tissue samples in the tool until the sampling is finished.

This object is accomplished according to the invention in that the passages that are usually provided in the endoscope at the end intended for being introduced into the patient are provided with a number of elongate bulges that extend longitudinally on the outside of the endoscope, at least on a stretch until a distance from the end of the endoscope to the effect that the passages that are usually used for suction, flushing, light, navigation camera, etc., can be arranged in such bulges. Thereby it is possible to expand the diameter of the opening at the end of the endoscope.

In that, at the end of the endoscope intended for being inserted into the patient, a releasable module is provided, it is accomplished that such module can be substituted by another module in an easy manner, which provides the option that a module suitable for insertion of the endoscope with another kind of tool or a module with a bore corresponding to the tool to be used can be mounted at the end of the endoscope.

In that the releasable module is releasably attached to the end of the endoscope by means of some kind of standard socket, which socket comprises connection to one or more of the elements selected from the group of light, liquid, air, oxygen, camera, sensor, or vacuum, it is easy and expedient to replace the module. In that the tool that can be coupled to the manoeuvring cable comprises one or more of the following tools: magnet, camera, gripper claw, vacuum extractor with vacuum supply, biopsy tool with collection container for tissue samples, it is possible to alternate between or to select a tool to the effect that it is possible to use an endoscope according to the invention whichis targeted for different concrete tasks.

In that the bore at the end of the passage for conveyance of the manoeuvring cable is shaped like a kind of cross, there is room in the material for providing passages or the like for suction, flushing, light, navigation camera, etc.

Those passages may typically have an elliptic or an oval cross-section or an approximation thereof.

By positioning the bulges facing the arms of the cross it is accomplished that it is possible to form passages with larger cross-sections than otherwise possible, since more material is provided in that space.

In that, at the end of a cable, coupling means are provided for replaceably retaining a tool for use in connection with the cable, a convenient manner of switching between different tools is provided and so is the option of mounting or dismounting the selected tool prior to and following use of the endoscope. Examples of different tools include tools for collecting tissue samples or tools for performing surgical interventions. Tools for removing foreign matter may also be concerned, eg by means of some kind of gripper or jaws, by means of vacuum or by means of a magnet.

The extreme end of the endoscope may be configured as a module to the effect that the extremity of that end of the endoscope which is intended for being conveyed into a patient may be replaced depending on which task is to be performed and on the size of the tool to be used.

The bulges provided at the end of the endoscope can advantageously be further used as a kind of guide fins facilitating the guidance of the endoscope in position in a treatment or examination position.

In the following, the invention will be described in further detail with reference to the drawing, wherein: Figure 1 shows a module with bulges for an endoscope being conveyed into the patient, said module being seen from the side;

Figure 2 shows the module of figure 1 , seen in a perspective view;

Figure 3 shows the module of figures 1 and 2, seen from the coupling end;

Figure 4 shows an embodiment of a module for the endoscope, wherein the module is seen from the insertion end;

Figure 5 shows an alternative embodiment of a module for the endoscope, wherein the module is seen from the insertion end; and

Figure 6 shows yet an embodiment of a module for the endoscope, wherein the module is seen from the introduction end. Now, convenient embodiments of the invention will be described. The apparatus which is primarily used for collecting tissue samples and the like in the context of the use of some kind of examination or treatment telescope 1 , in the following designated an endoscope. The endoscope is used in the treatment of humans or animals and comprises a kind of manoeuvring unit in the form of a cable or the like, said cable comprising at least one internal part and at least one external part that can be moved relative to each other to the effect that a tool (not shown) arranged at the end of the cable which is, via the endoscope 1 , conveyed into a patient can be operated by influencing one or more operating handles arranged at the end of the cable situated at the end of the endoscope 1 from where it is operated. Apart from a passage for the operating cable or the sampling cable that, in combination with the tool, constitute a biopsy cable or biopsy forceps, an endoscope 1 of this type often comprises one or more passages 2 intended for being used for sucking or flushing liquid or the like. At the end 1 of the endoscope, more specifically the end intended for being inserted into the patient, a camera may be provided to the effect that it is possible to see how the endoscope 1 is to be moved during insertion and how the tool is to be moved in order for it to be directed to its site of use.

A biopsy sample may be concerned that has to be collected on the right site, or a foreign body may be concerned that is to be collected and removed. At the end of the cable where the sample is to be collected, coupling means (not shown) are provided, which coupling means may be of ordinary type. The most important in this context is that a tool can be arranged at the end of the cable in such a manner that it is easy to substitute if, in some scenario or other, there is a need for securing another type of tool to the cable; and that the tool can be retained on the cable in a reliable manner without being capable of dislodging in use. To provide space for a larger tool and for more passages, eg in the form of service passages through which it is possible to insert a camera, oxygen supply, water supply eg for flushing, and suction for removing liquid, there is, in accordance with the invention, provided a number of elongate bulges 3 at the end of the endoscope.

The bulges 3 are arranged at the end of an endoscope which is intended for being conveyed into the patient, and the bulges 3 are preferably configured as a number of elongate bulges 3 that extend in the longitudinal direction on the outside of the endoscope, at least on a stretch until a distance from the end of the endoscope.

Thus, the bulges 3 may be configured to accommodate one or more passages 2 in the form of service passages or the like for light, liquid flush, air / oxygen, navigation camera, or the like.

The endoscope may be configured such that, at the end of the endoscope intended for being conveyed into the patient, a releasable module 1 is provided.

The module may be releasably attached to the end of the endoscope by means of a kind of standard socket 6, which socket 6 comprises connection to one or more of the elements selected from the group of light, liquid, air, oxygen, camera, sensor, or vacuum.

The module 1 is further secured to the endoscope by means of a union nut (not shown) or the like capable of engaging with a recess 7 or the like in the module. The essential aspect of the attachment is that the module 1 is attached to the endoscope in a simple and reliable manner.

The endoscope may be provided with a tool that can be coupled to the manoeuvring cable, which tool comprises one or more of the following tools: magnet, camera, gripper claw, vacuum extractor with vacuum supply, biopsy tool with collection container for tissue samples.

The endoscope may be provided with a bore 4 at the end of the passage for passage of the manoeuvring cable, said bore 4 being configured as a kind of cross.

The endoscope may also be configured such that, in the transition between the arms 5 of the cross, passages 2 are provided.

The passages 2 may have an elliptic or oval cross-section or an approximation thereof.

According to a further embodiment, the bulges may be arranged facing the arms 5 of the cross.

According to a further embodiment of the endoscope, coupling means for exchangeable attachment of a tool for use in connection with the manoeuvring cable may be provided at the end of the manoeuvring cable.

According to one embodiment, the end of the endoscope is configured as an exchangeable module 1 to the effect that it is possible to substitute the module 1 for another module 1 having the configuration which is adapted to the tool to be used in a given situation or treatment. Thereby it is possible to substitute the end of the endoscope for another module 1 having more or fewer passages 2. Figures 3 - 6 show end views of a module 1 for positioning at the end of an endoscope. It is in the nature of things that those end views may also indicate how an endoscope may appear from the end without having to be provided with a module 1.

The tool useable in connection with the endoscope in the context of collecting biopsy samples may advantageously be of the type capable of collecting and containing several tissue samples at one time. This is advantageous since the endoscope of the module 1 has, by virtue of a bore 4, the requisite space for being able to accommodate such tool.

At the end of the endoscope or at the end of the module 1 , there is thus a bore 4 or an opening which has a larger cross-section than the passage for the manoeuvring cable. The bore 4 or the opening may be circular or it may be configured as a cross. Optionally the arms 5 of the cross may be wider at the centre of the cross than at the end of the arms 5.

The passages 2 of the endoscope may be configured in the bulges 3 or in the material facing the bulges 3 to the effect that the extra material added to the endoscope or module 1 in the form of bulges 3 provides space for the passages 2, see eg figure 4 and figure 6.

According to an embodiment as set forth in figure 5, passages 2 are provided in the material between the arms 5 in the cross constituting the bore 4 in the endoscope or module 1 and passages 2 in the material in the bulges 3.

From figure 5 it will appear that the bulges 3 are arranged facing the arms 5 in the cross constituting the bore 4, but the bulges 3 may also be arranged such that passages 2 in the bulges 3 are arranged to face the passages 2 that are arranged between the arms 5 in the cross. The number of bulges 3 need not correspond to the number of arms 5 in the cross constituting the bore 4. A further advantage of the bulges 3 is that they serve as a kind of guide fins making it easier to convey the endoscope into position during the examination.

Bulges 3 may have different lengths depending on how far the bore 4 extend in the longitudinal direction of the endoscope or the module 1.

According to an embodiment as shown in figure 6, the bulges 3 may be configured to be wider to the effect that it is possible to have two or more passages 2 situated in each bulge 3. Thus, it is also possible to arrange passages 2 with oval, elliptic, or similar cross-section in such wider bulges 3.

Claims

C l a i m s

1. An endoscope for use in connection with different tools in the treatment of humans or animals, which endoscope comprises a passage for conveyance of a manoeuvring cable, said passage being, at the end intended for being inserted into the patient, provided with a bore having a larger diameter than the diameter of the passage for conveyance of the manoeuvring cable, characterised in that the endoscope is, at the end intended for being conveyed into the patient, provided with a number of elongate bulges (3) that extend longitudinally on the outside of the endoscope at least on a stretch until a distance from the end of the endoscope.

2. An endoscope according to claim 1 , characterised in that the bulges (3) accommodate one or more passages (2) in the form of service passages or the like for light, liquid flush, air / oxygen, navigation camera or the like.

3. An endoscope according to claim 1 or 2, characterised in that, at the end of the endoscope intended for being inserted into the patient, a releasable module (1 ) is provided.

4. An endoscope according to claims 1 , 2, or 3, characterised in that the releasable module (1 ) is releasably secured to the end of the endoscope by means of a kind of standard socket (6), which socket (6) comprises a connection to one or more of the elements selected from the group of light, liquid, air, oxygen, camera, sensor, or vacuum.

5. An endoscope according to claims 1 , 2, 3, or 4, characterised in that a tool capable of being coupled to the manoeuvring cable comprises one or more of the following tools: magnet, camera, gripper claw, vacuum extractor with vacuum supply, biopsy tool with collection container for tissue samples.

6. An endoscope according to claims 1 , 2, 3, 4, or 5, characterised in that the bore (4) at the end of the passage for conveyance of the manoeuvring cable is shaped as a kind of cross.

7. An endoscope according to claim 6, characterised in that, in the transition or the gap between the arms (5) of the cross, passages (2) are formed.

8. An endoscope according to claim 7, characterised in that the passages (2) have an elliptic or an oval cross-section or an approximation thereof.

9. An endoscope according to one or more of claims 1 - 8, characterised in that the bulges (4) are arranged facing the arms (5) of the cross.

10. An endoscope according to one or more of claims 1 -9, characterised in that, at the end of a cable, coupling means are provided for replaceable attachment of a tool for use in connection with the cable.