This disclosure relates generally to endoscopic medical devices and methods of use. More particularly, in some embodiments, the disclosure relates to endoscopes and related methods for accessing target sites having space constraints, using, e.g., a flexible steerable shaft such as an articulation joint at a distal end of the endoscope.
Endoscope devices generally include a flexible shaft, a working distal tip, and a flexible steerable shaft joining the working tip and the flexible shaft. The flexible steerable shaft may include a bendable articulation joint. Drawbacks of articulation joints of some conventional endoscopes include, for example, the inability to provide a suitably small bend radius and/or appropriate bend angle for the anatomy being viewed. These drawbacks can prevent the physician from properly visualizing and/or accessing areas of the body during procedures.
Accordingly, it is desirable for the articulation joint to provide an appropriate bend radius and/or bend angle when flexing the articulation joint. This disclosure may solve one or more of these problems or other problems in the art. The scope of the disclosure, however, is defined by the attached claims and not the ability to solve a specific problem.
According to an example, an articulation joint for a medical device may comprise a proximal longitudinal section, a distal longitudinal section, and a locking wire. The proximal longitudinal section may define a lumen therethrough and may have proximal articulation links, each proximal articulation link having a contact surface abutting a contact surface of an adjacent proximal articulation link when the articulation joint is in a straight configuration, to limit bending of the proximal longitudinal section to only a first direction. The distal longitudinal section may be distal to the proximal longitudinal section and may have distal articulation links, wherein the distal longitudinal section is configured to bend in the first direction. The locking wire may extend through the lumen adjacent the contact surfaces of the proximal articulation links, wherein a distal end of the locking wire is fixed to a distal articulation link. Tensioning of the locking wire may prevent bending of the proximal longitudinal section in the first direction and may allow bending of the distal longitudinal section in the first direction.
In other examples, the articulation joint may include one or more of the following features. A gap may be defined between adjacent proximal articulation links, the gap being disposed on a side of the proximal longitudinal section opposite a side having the contact surfaces. A spring may connect adjacent proximal articulation links along surfaces of the adjacent proximal articulation links between the contact surfaces and the gap. A plurality of the distal articulation links may be distal of the locking wire, such that tensioning of the locking wire does not straighten or bend the plurality of the distal articulation links. The locking wire may be arranged in a zig-zig pattern within the lumen. The distal longitudinal section may bend in a second direction, a third direction, and a fourth direction. A pair of gaps may be defined between adjacent distal articulation links. The articulation joint may comprise actuation elements extending through the lumen and operable to control bending of the articulation joint. The actuation elements may comprise four wires for controlling bending of the articulation joint in the first direction, a second direction, a third direction, and a fourth direction. The articulation joint may comprise actuation holes coupled to each of the proximal articulation links and the distal articulation links, wherein the actuation elements extend through the actuation holes. The articulation joint may comprise springs defining the actuation holes. The locking wire may extend through at least one of the actuation holes. At least one of the actuation holes may accommodate the locking wire and one of the actuation elements. A maximum combined bending of the proximal longitudinal section and the distal longitudinal section in the first direction when the locking wire is not tensioned may be approximately 180 degrees, and a maximum combined bending of the proximal longitudinal section and the distal longitudinal section in the first direction when the locking wire is tensioned may be approximately 90 degrees. The proximal longitudinal section may be straight when the locking wire is tensioned.
In other examples, an articulation joint for a medical device may comprise a proximal longitudinal section, a distal longitudinal section, a locking wire, a first wire and a second wire. The proximal longitudinal section may define a lumen therethrough and may have proximal articulation links, each proximal articulation link having a flat contact surface abutting a flat contact surface of an adjacent proximal articulation link when the articulation joint is in a straight configuration, to limit bending of the proximal longitudinal section to only a first direction. The distal longitudinal section may be distal to the proximal longitudinal section and may have distal articulation links, wherein the distal longitudinal section is configured to bend in the first direction and a second direction opposite the first direction. The locking wire may extend through the lumen adjacent the contact surfaces of the proximal articulation links, wherein a distal end of the locking wire is fixed to a distal articulation link, and tensioning of the locking wire prevents bending of the proximal longitudinal section in the first direction and allows bending of the distal longitudinal section in the first direction. The first wire and the second wire may each extend through the lumen, the first wire for controlling bending of the distal longitudinal section in the first direction, and the second wire for controlling bending of the distal longitudinal section in the second direction, wherein each of the first wire and the second wire extends distally past the distal end of the locking wire.
In other examples, the articulation device may include one or more of the following features. The distal longitudinal section may be configured to bend in a third direction and a fourth direction opposite the third direction, and the articulation joint further may comprise a third wire and a fourth wire each extending through the lumen, the third wire for controlling bending of the distal longitudinal section in the third direction, and the fourth wire for controlling bending of the distal longitudinal section in the fourth direction, wherein each of the third wire and the fourth wire extends distally past the distal end of the locking wire. The locking wire may be arranged in a zig-zig pattern within the lumen.
In other examples, an articulation joint for a medical device may comprise a proximal longitudinal section, a distal longitudinal section, and a locking wire. The proximal longitudinal section may define a lumen therethrough and may have proximal articulation links, each proximal articulation link having a contact surface abutting a contact surface of an adjacent proximal articulation link when the articulation joint is in a straight configuration, to limit bending of the proximal longitudinal section to only a first direction. The distal longitudinal section may be distal to the proximal longitudinal section and may have distal articulation links, wherein the distal longitudinal section is configured to bend in the first direction and a second direction opposite the first direction. The locking wire may extend through the lumen adjacent the contact surfaces of the proximal articulation links, wherein a distal end of the locking wire is fixed to a distal articulation link, and tensioning of the locking wire prevents bending of the proximal longitudinal section in the first direction, allows bending of the distal longitudinal section in the first direction, and retains the proximal longitudinal section in a straight configuration. The proximal longitudinal section and the distal longitudinal section may combine to bend 180 degrees in the first direction when the locking wire is not tensioned. A maximum combined bending of the proximal longitudinal section and the distal longitudinal section in the first direction when the locking wire is tensioned may be approximately 90 degrees.
In other examples, the articulation joint may comprise four wires extending through the lumen and operable to control bending of the articulation joint in the first direction, the second direction, a third direction, and a fourth direction.
The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate various exemplary embodiments and together with the description, serve to explain the principles of the disclosed embodiments.
Both the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of the features, as claimed. As used herein, the terms “comprises,” “comprising,” “having,” “including,” or other variations thereof, are intended to cover a non-exclusive inclusion such that a process, method, article, or apparatus that comprises a list of elements does not include only those elements, but may include other elements not expressly listed or inherent to such a process, method, article, or apparatus. In this disclosure, relative terms, such as, for example, “about,” “substantially,” “generally,” and “approximately” are used to indicate a possible variation of ±10% in a stated value or characteristic.
Referring to
Referring to
Distal ends of actuating elements 12 extend through flexible shaft 20 and terminate at articulation joint 50 (at or near a distal end of articulation joint 50) and/or tip 30. For example, one or more actuating elements 12 may be connected to articulation joint 50 and one or more other actuating elements 12 may be attached to tip 30. As will be explained herein, actuation of actuating elements 12 may control articulation joint 50, tip 30, and/or elements attached to tip 30, such as an end effector (not shown). A distal end of locking wire 60 may extend through the flexible shaft 20 and terminate at articulation joint 50 (at a midpoint along joint 50, as will be described further herein). In addition, one or more electrical cables (not shown) may extend from the proximal end of endoscope 10 to tip 30 and may provide electrical controls to imaging, lighting, and/or other electrical devices on tip 30, and may carry imaging signals from tip 30 proximally to be processed and/or displayed on a display. Handle 40 may also include ports 44, 46 for introducing and/or removing tools, fluids, or other materials from the subject. Port 44 may be used to introduce tools. Port 46 may be connected to an umbilicus for introducing fluid suction, and/or wiring for electronic components.
As shown in
With continued reference to
With reference to
Articulation joint 50 will be further described with reference to
First, second, and third link sections 52, 54, 56 are formed of a first link type 50a, a second link type 50b, and a third link type 50c, respectively (see
As further shown in
As shown in
As shown in
Referring specifically to the first link section 52, the end surface 51 may include a flat contact surface 53. The flat contact surface 53 may be flat, or planar, in a plane perpendicular to the longitudinal axis A, such as depicted in
Opposite the flat contact surface 53, each link of the adjacent links 50a may include a gap G. Accordingly, on first side 58a of first link section 52, end surface 51 of one link 50a is spaced from end surface 51 of an adjacent link 50a. The end surface 51 approaches end surface 51 of the adjacent link 50a as articulation joint 50 bends toward first side 58a, closing the gap G when articulation joint 50 is completely bent toward first side 58a, as shown in
As described above, springs 24 connect adjacent links 50a on only two sides, e.g., the third side 58c and the fourth side 58d. In other words, the springs 24 may be disposed between the flat contact surface 53 and the gap G. The springs 24 maintain contact between the adjacent links 50a on the third side 58c and the fourth side 58d. In addition, springs 24 are tightly wound coiled springs with no spaces between adjacent coils when the spring is in a straight configuration. For this reason, links having a first link type 50a in first link section 52 are incapable of bending toward the third side 58c or the fourth side 58d. According to an embodiment, therefore links 50a of first link section 52 bend in a single direction, e.g., toward first side 58a. It will therefore be appreciated that the adjacent links 50a of the first link section 52 may be considered partial articulation links.
Referring now to the second link section 54 and the third link section 56, as shown in
Further, springs 24 are attached to all four sides (58a, 58b, 58c, 58d) of second link section 54 and third link section 56. The springs 24 are attached to adjacent links at offset positions, however. For example, three adjacent links 100 (see
Referring back to
Referring to the articulation joint 50 as a whole, adjacent links in each of first, second, and third link sections 52, 54, 56 are capable of bending with respect to each other in at least one direction. The angle at which adjacent links may bend and the spacing between these adjacent links may be equal to a smallest bend radius at which imaging wires and other components are capable of bending and remaining functional. For example, a largest bend angle B of adjacent links spaced apart by 0.3 inches to 0.7 inches is approximately 20 degrees to 40 degrees, preferably approximately 25 degrees to 35 degrees at a 0.4 inch to 0.6 inch spacing between adjacent links, and more preferably approximately 30 degrees at a 0.5 inch spacing between adjacent links.
Referring to
The first, second, and third gaps G, H, I allow articulation joint 50 to bend an amount equal to bend angle B multiplied by the number of total gaps. For example, if bend angle B is 30 degrees and there are seven total gaps on first side 58a, articulation joint 50 may bend 210 degrees from longitudinal axis A and allow tip 30 to point toward an entry point of endoscope 10 into the subject. The size of gaps G, H, and I may be varied to achieve a desired bend angle. For example, gap H and the three gaps I may be made smaller so that the bend angle between the adjacent links defining those gaps is about 22.5 degrees. In that case, the total angle of bend of joint 50 caused by those gaps is 90 degrees. It will also be understood that the bend angles are merely examples, and the bend angle of each different gap may be different for a gap type, e.g., each different gap G from the plurality of gaps G may have a different bend angle.
According to an example, third gaps I on second side 58b allow adjacent links to bend at a same angle B as first gaps G. However, that angle associated with third gaps I on second side 58b is not limited to angle B and may be any angle that optimizes the bend angle of articulation joint 50. As shown in
As described hereinabove, articulation or bending of the articulation joint 50 may be controlled by actuation elements 12. In particular, the articulation joint 50 may include four actuation elements, which may control bending of the articulation joint 50 in four directions. For example, by tightening/tensioning the articulating element 12 extending along the second side 58b and loosening the articulating element 12 extending along the first side 58a, the articulation joint 50 may bend toward the second side 58b, as depicted in
Referring still to
The locking wire may be disposed adjacent the flat contact surfaces 53, e.g. along the second side 58b and terminate inside link 50b′ at point 62. Accordingly, the locking wire 60 may selectively prevent articulation about the flat contact surfaces 53, e.g. toward the first side 58a, when pulled taught. The movement of the second link section 54 and the third link section 56 may be unaffected by the locking wire 60. In other words, when the locking wire 60 is tightened/tensioned, the configuration of the articulation joint 50 depicted in
A method of using the endoscope 10 may include inserting the endoscope 10 into a subject's mouth and guiding the tip 30 and articulation joint 50 into a stomach of a subject via an esophagus of the subject. The articulation joint 50 may then be actuated by moving or rotating the actuating device 42 and/or 43. As described hereinabove, moving or rotating the actuating devices 42 and 43 may tighten or loosen the actuating elements 12 which may, in turn, actuate (bend) the articulation joint 50. In particular, the method may include actuating the articulation joint 50 such that the tip 30 faces the fundus, or the top of the subject's stomach (e.g., such that the articulation joint 50 is arranged as depicted in
The user of the endoscope 10 may then, in some examples, desire to view portions of the GI tract distal to the stomach, for example the duodenum. The user may first straighten the articulation joint 50 (the configuration shown in
As will now be appreciated, the above-described endoscope 10 and the above-described exemplary method of use may enable visualization of the stomach and the duodenum with a single device, i.e. the endoscope 10. This may be easier and faster than using a first device, such as a gastroscope, to view the stomach and a second device, such as a duodenoscope, to view the duodenum.
It will be apparent to those skilled in the art that various modifications and variations can be made to the disclosed device without departing from the scope of the disclosure. For examples, the configuration of gaps and links and the bend angles may be altered to suit any medical device. It will be understood that the bend angles, sizes of each gap, and/or the number of gaps and links are not limited to the examples described herein. Other embodiments of the disclosure will be apparent to those skilled in the art from consideration of the specification and practice of the invention disclosed herein. It is intended that the specification and examples be considered as exemplary only, with a true scope and spirit of the invention being indicated by the following claims.
This application claims the benefit of priority under 35 U.S.C. § 119 from U.S. Provisional Application No. 63/490,782, filed Mar. 17, 2023, which is incorporated by reference herein in its entirety.
Number | Date | Country | |
---|---|---|---|
63490782 | Mar 2023 | US |