Patent Application
20100056867
The present invention relates to apparatus for minimally invasive procedures and particularly to valves of minimally invasive probes.
Minimally invasive probes, such as endoscopes, are used for many surgical procedures, in order to reduce the trauma in full scale surgical operations. Endoscopes may include in their small diameter a plurality of separate apparatus, including, for example, two or more of viewing, suction and irrigation apparatus. In order to reduce costs and prevent mistakes due to misunderstandings between members of a medical staff, it is advantageous that a single physician controls operation of all the apparatus of the endoscope. Such single operator control requires proper human engineering of the controls of the endoscope.
U.S. Pat. No. 4,852,551 to Opie et al., the disclosure of which is incorporated herein by reference, describes a contamination-free endoscope pinch valve for use with a disposable endoscope sheath. The valve is located on a handle of the endoscope and is actuated by pushing a button. The valve includes a spring that biases the valve in a specific state.
U.S. Pat. No. 6,666,818 to Dhindsa, the disclosure of which is incorporated herein by reference, describes an endoscope valve assembly that is releasably attached to the endoscope handle. The valve is biased in an upper position by a spring. A latch is used to keep the valve in the open position until it is released by the user.
An aspect of some embodiments of the present invention relates to an endoscope tube valve mounted on the handle of an endoscope, which valve has at least two stable states (i.e., states in which the valve does not apply force urging the valve to leave the state, e.g., by a biasing spring). The at least two states optionally include states in which the level of blocking of the tube is different. In some embodiments of the invention, the at least two states include at least one state in which flow through the tube is at least partially blocked (for example, substantially entirely blocked) and at least one state in which flow through the tube is not blocked by the valve. Alternatively or additionally, the at least two states include a first stable state in which the open cross section of the tube is at least twice or even at least four times the open cross section in a second stable state.
In some embodiments of the invention, the valve does not have any state in which the valve itself applies a force which urges the valve into a different state. The use of a valve which does not have a preferred state allows simpler control of the valve by a physician.
In some embodiments of the invention, gravitational forces on the valve are not strong enough to change the functional state of the valve (i.e., the level of blocking of the tube), in at least one or even two of the functional states of the valve.
In some embodiments of the invention, in one or more of the stable states, the valve applies a retaining force when an attempt is made to remove it from the stable state. Thus, leaving the stable state requires application of at least a predetermined force. Optionally, the retaining force feature is activated by the movement of the valve into the stable state, without requiring an additional latching act by a human operator of the valve.
In some embodiments of the invention, the valve comprises a pinch valve. Optionally, the valve is an integral part of the endoscope, while the tube is part of a disposable sheath attached to the endoscope.
There is therefore provided in accordance with an exemplary embodiment of the invention, an endoscope, comprising a handle, an insertion tube, adapted for insertion into a patient, connected to the handle, at least one valve, mounted on the handle, for controlling flow through one or more channels, which valve has at least two stable states, wherein in the stable states the valve does not apply a force to leave the state.
Optionally, the at least one valve controls the flow through a channel, which belongs to a sheath covering the insertion tube. Optionally, the at least one valve includes a niche adapted to receive a channel to be controlled by the valve. Optionally, in at least one of the stable states it is required to apply at least a predetermined force to leave the state.
Optionally, the valve comprises a pinch valve. Optionally, in at least one of the stable states, the valve applies a force which counters exiting the state. Optionally, the movement of the valve into the stable state such that it does not exit the state does not require additional acts beyond bringing the valve to the position of the stable state. Optionally, the valve comprises a base and a handle which rotates around a pivot attached to the base. Optionally, the handle comprises a pinching roller adapted to block the flow through the one or more channels.
Optionally, the handle includes a plurality of valves mounted thereon. Optionally, substantially all the possible states of the valve are stable. Optionally, the valve has at least five different stable states.
There is further provided in accordance with an exemplary embodiment of the invention, an endoscope, comprising a handle, an insertion tube, adapted for insertion into a patient, connected to the handle, at least one valve, mounted on the handle, for controlling flow through at least two channels, which valve includes a member moveable between at least two states, the member limiting the flow through a first channel in a first one of the states and limiting the flow through a second channel in a second one of the states.
Optionally, the member has a third state in which it does not block the flow in any of the channels. Optionally, the member does not have a state in which it blocks two or more of the channels at once. Optionally, the endoscope comprises a cystoscope. Optionally, the member comprises a roller. Optionally, the member moves between states by rotation. Optionally, the member moves between states by linear movement.
Exemplary non-limiting embodiments of the invention will be described with reference to the following description of the embodiments, in conjunction with the figures. Identical structures, elements or parts which appear in more than one figure are preferably labeled with the same or similar number in all the figures in which they appear, and in which:
A valve 200 mounted on handle 104 is used to control the flow through a channel of a sheath covering endoscope 100, as described below. Alternatively to mounting only a single valve 200 on handle 104, a plurality of identical or different valves may be mounted on handle 104, for example for water, suction and/or air channels. The use of non-identical valves, for example having different form factors, reduces the chances of a physician from getting mixed up between the valves.
Lever 204 optionally includes a pinching element, such as a pinching roller 220 which presses on tubes 130 within niche 216, when lever 204 is rotated in a first direction. In some embodiments of the invention, lever 204 includes two extensions 222 and 224 which are pressed down by the physician alternately in order to change the state of the valve (e.g., between closed and open states). Lever 204 is optionally of a size which is convenient for use by physicians, for example, by pressing with the thumb or other finger of the physician.
In use, one or more channels to be controlled by valve 200 are passed through slot 214 into niche 216. When the physician wants to block the passage through the channel, extension 222 is pushed down, causing lever 204 to rotate around pivot 206 and thus push pinching roller 220 against the channel. In order to open the channel, the physician presses extension 224 downwards, thus causing pinching roller 220 to move away from the channel in niche 216 and allow flow through the channel.
Alternatively or additionally to using the ball detent, the movement of lever 204 around pivot 206 has a constant friction, which requires a physician to apply a force of at least a predetermined level in order to move lever 204. The friction force is optionally larger than any force on the valve due to gravity, resilience of tube 130 and/or pressure in tube 130. In this embodiment, substantially all states of the valve are stable.
Further alternatively or additionally, lever 204 is rotatable around pivot 206 until a maximal rotation point of a closed state, in which pinching roller 220 is pushed beyond a maximal compression point of channel tube 130. At this state, the release of lever 204 from the closed state requires applying force, to further compress channel tube 130 before it is released.
Further alternatively or additionally, any other retention mechanism holds valve 200 in one or more of the stable states. In some embodiments of the invention, different types of retention mechanisms are used in holding valve 200 in at least two different stable states. In other embodiments, the same type of retention mechanism (e.g., friction) is used to hold valve 200 in a plurality of different stable states.
A set screw 250 optionally holds pivot 206 in place and hence keeps lever 204 and base 202 in an assembled state.
Pinching roller 220 is optionally mounted rotateably on a shaft 236 of lever 204, so that pinching roller 220 does not damage channel tube 130 when it is pressed against the tube. Alternatively, for simplicity, pinching roller 220 is an integral part of lever 204 and is not a roller, but rather an appendage of lever 204.
Moving bar 404 optionally includes a handle 406 which is used by a physician to move bar 404.
In some embodiments of the invention, moving bar 404 includes one or more protrusions 416, which fit into respective notches 418 in base 402. The fitting of protrusions 416 into their respective notches 418, prevents inadvertent movement of bar 404 out of its current state. That is, in order to take switch 400 out of its closed stable state, at least a minimal force is required. In some embodiments of the invention, base 402 includes only a single set of one or more notches corresponding to protrusions 416. For example, the set of notches may be used for keeping the channel tube 130 in a state which prevents flow, against the resistance of the tube 130. Alternatively, base 402 includes a plurality of sets of notches 418, for example for a closed state, in which no flow passes through tube 130, a half closed state and an open state. In some embodiments of the invention, a same threshold force is defined for moving switch 400 out of the stable state. Alternatively, different states have different threshold forces required for moving them out of their stable state.
The protrusions 416 are optionally elastically and/or spring loaded on bar 404, so as to allow easy entrance into and release from notches 418. Alternatively or additionally, the movement of bar 404 is damped, for example by a friction or hydraulic force, to prevent undesired inadvertent movement.
In some embodiments of the invention, valve 400 is mounted on handle 104 (
Valves 200 and 400 may be used for a single channel tube 130. Alternatively, valves 200 and/or 400 may be used for a plurality of channel tubes which need to be opened and closed together. Further alternatively, the valves may be used with a pair of tubes, a first tube of which must be closed when the second tube is closed. The channel tubes are positioned such that in a half closed state, the first tube is closed while the second tube remains open. In a fully closed state, both of the tubes are closed.
In other embodiments of the invention, a valve is designed to receive two tubes in two different niches. A lever or bar may be moved to press on one or the other of the tubes but not on both tubes together. In some embodiments of the invention, at any time, one of the tubes is closed for flow. Alternatively, the valve has three states, a state in which both tubes are open and states in which one of the tubes is closed and the other is open.
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It will be appreciated that the above-described apparatus and methods may be varied in many ways. It should also be appreciated that the above described description of methods and apparatus are to be interpreted as including apparatus for carrying out the methods, and methods of using the apparatus.
The present invention has been described using non-limiting detailed descriptions of embodiments thereof that are provided by way of example and are not intended to limit the scope of the invention. It should be understood that features and/or steps described with respect to one embodiment may be used with other embodiments and that not all embodiments of the invention have all of the features and/or steps shown in a particular figure or described with respect to one of the embodiments. Variations of embodiments described will occur to persons of the art. Furthermore, the terms “comprise,” “include,” “have” and their conjugates, shall mean, when used in the claims, “including but not necessarily limited to.”
It is noted that some of the above described embodiments may describe the best mode contemplated by the inventors and therefore may include structure, acts or details of structures and acts that may not be essential to the invention and which are described as examples. Structure and acts described herein are replaceable by equivalents which perform the same function, even if the structure or acts are different, as known in the art. Therefore, the scope of the invention is limited only by the elements and limitations as used in the claims.
This application claims the benefit under 119(e) of U.S. provisional patent application 60/634,117, filed Dec. 8, 2004, the disclosure of which is incorporated herein by reference.
| Filing Document | Filing Date | Country | Kind | 371c Date |
|---|---|---|---|---|
| PCT/US05/44650 | 12/8/2005 | WO | 00 | 11/9/2009 |
| Number | Date | Country | |
|---|---|---|---|
| 60634117 | Dec 2004 | US |
