This disclosure relates generally to medical devices and related methods. More particularly, at least some embodiments of the disclosure relate to medical devices, e.g., scopes, including expandable distal portions that allow for larger working channels and/or enhanced lighting, and related methods.
Medical scopes often used in endoscopic procedures, e.g., duodenoscopes, catheters, etc., typically include accessory/working channel(s), irrigation channel(s), suction channel(s), lights, and/or an imager. For various reasons, an outer diameter of such scopes may be constrained to a certain dimension, e.g., 3.5 mm, thereby limiting a surface area of the distal face of the scope. Thus, in order to accommodate the various features on the distal face of the scope, the diameter or width of such features, e.g., a working channel diameter, the size of the lights, etc., is also necessarily limited. As a result, when operating these medical scopes, physicians may be limited to, for example, certain accessories and/or tools that are small enough to extend through the working channel. Similarly, physicians may be limited to, for example, lights or illumination devices that are smaller and/or of lesser capacity than lights or illumination devices that are larger.
Examples of the present disclosure relate to, among other things, medical devices and methods. Each of the examples disclosed herein may include one or more of the features described in connection with any of the other disclosed examples.
According to one aspect, a medical device may comprise a handle including an actuator, a shaft extending distally from the handle, wherein the shaft includes a lumen; and a distal cap, wherein the distal cap includes a body including a first channel, wherein the first channel is in communication with a distal portion of the lumen, a distal face including an opening, wherein the opening is a distal opening of the channel, and an expandable portion coupled to the body, wherein the expandable portion is configured to expand radially outwards from the body and to retract radially inwards towards the body from an expanded position, and wherein the expandable portion includes at least one light.
According to another aspect, the actuator may be in engagement with the expandable portion so that the actuator is configured to control the expansion and the retraction of the expandable portion.
According to another aspect, the expandable portion may be biased towards the retracted position. In the retracted position, an outer diameter of the distal cap may be approximately the same as an outer diameter of a remaining portion of the shaft.
According to another aspect, the distal face may not include any lights.
According to another aspect, a diameter of the opening of the distal face may be about 1.5 mm to 2.0 mm.
According to another aspect, the expandable portion may be coupled to the body via a hinge. The expandable portion may be coupled to a distal end of the body so that the expandable portion covers at least a portion of the opening in the retracted position and exposes an entirety of the opening in the expanded position. The expandable portion may be semi-annular so that in the retracted position a portion of the opening remains exposed. The expandable portion may be transparent. The actuator and the expandable portion may engage one another via an opening wire and a closing wire, wherein a force applied to the opening wire is configured to expand the expandable portion, and wherein a force applied to the closing wire is configured to retract the expandable portion. The body may further include an outer cylinder and an inner cylinder, wherein the outer cylinder encloses at least a portion of the inner cylinder and the inner cylinder may be rotatable about a central longitudinal axis of the body. The outer cylinder may include a first slot and the inner cylinder may include a second slot, wherein the first slot and the second slot are overlaid and the first slot and second slot are configured to receive the expandable portion in the retracted position. The expandable portion may be coupled to the outer cylinder via a hinge and the inner cylinder via a hinge, and a rotational force applied to the rotatable inner cylinder in a first direction may be configured to expand the expandable portion. A rotational force applied to the rotatable inner cylinder in a second direction may be configured to retract the expandable portion into the first slot and the second slot.
According to another aspect, a medical device end cap may comprise a body including a channel, a distal face including an opening, wherein the opening is a distal opening of the channel, a first wing coupled to the body, and a second wing coupled to the body, wherein each of the first wing and the second wing is configured to expand radially outwards from the body to an expanded position and to retract radially inwards towards the body from the expanded position, and wherein each of the first wing and the second wing includes at least one light.
According to another aspect, the first wing may be configured to expand radially outwards in a first radial direction and the second wing may be configured to expand radially outwards in a second radial direction, wherein the first radial direction and the second radial direction are different.
According to another aspect, the distal face may not include any lights.
According to another aspect, one or more of the first wing and the second wing may further include an imaging device.
In another aspect, a method of using a medical device, the medical device including a handle including an actuator, a shaft, and a distal cap including an expandable portion controllable by the actuator, wherein the expandable portion includes at least one light, may comprise delivering a distal end of the shaft and the distal cap into a bodily lumen, positioning a distal end of the shaft and the distal cap adjacent to a target site, actuating the actuator to control the expandable portion of the distal cap to expand the expandable portion of the distal cap, and activating the at least one light.
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.
Reference will now be made in detail to aspects of the present disclosure, examples of which are illustrated in the accompanying drawings. Wherever possible, the same or similar reference numbers will be used through the drawings to refer to the same or like parts. The term “distal” refers to a portion farthest away from a user when introducing a device into a subject (e.g., patient). By contrast, the term “proximal” refers to a portion closest to the user when placing the device into the subject.
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.
Embodiments of the disclosure may solve one or more of the limitations in the art. The scope of the disclosure, however, is defined by the attached claims and not the ability to solve a specific problem. The disclosure, in certain embodiments, is drawn to a medical device, which may be, as an example, any scope (e.g., bronchoscope, duodenoscope, endoscope, colonoscope, ureteroscope, cholangioscope, etc.), including a handle, and a shaft, e.g., a catheter, that extends distally from the handle. As further discussed below, the shaft may include a distal cap including one or more “expandable” features, e.g., features configured to open/close, flare radially outwards, retract radially inwards, etc. in some embodiments, the expandable features do not increase the cross-sectional diameter (or otherwise affect the size) of the distal cap or distal portion of the shaft until expanded, so that the shaft may be of the same diameter during insertion/delivery. Each expandable feature may include a light, an imager, and/or additional scope features. Such a distal cap adds surface area to the distal face of the scope, relative to scopes including the light, the imager, and additional features on the distal face of the scope.
Handle 12 may be coupled to an umbilicus 11 and handle 12 may include an actuator 14, e.g., one or more knobs. Umbilicus 11 extends proximally relative to handle 12. Umbilicus 11 may be coupled to any suitable source, e.g., fluid, suction, electrical, etc., a control system, a display, etc.
Actuator 14 may be coupled to an upper (proximal) portion of handle 12, and may be configured to control articulation of at least a portion of flexible shaft 15, and/or an articulation joint at a distal end of flexible shaft 15, in multiple directions. Actuator 14 may be, for example, one or more rotatable knobs that each rotates about its axis to push/pull actuating elements, e.g., steering wires (not shown). The actuating elements, such as cables or wires suitable for medical procedures (e.g., medical grade plastic or metal), extend distally from a proximal end of device 10 and connect to a distal portion of flexible shaft 15 to control movement thereof. Alternatively, or additionally, a user may operate actuating elements independently of handle 12, for example, via a separate control device. Distal ends of actuating elements may extend through flexible shaft 15 and terminate at an articulation joint and/or a distal cap 150 of flexible shaft 15. For example, one or more actuating elements may be connected to an articulation joint, and actuation of actuating elements may move the articulation joint and/or the distal end of flexible shaft 15 in multiple directions.
Handle 12 may further include one or more additional controls 17, e.g., a button. Although not shown, controls 17 may additionally or alternatively include one or more levers, rotational features, etc., which may be configured to actuate the expansion and/or contraction of the expandable features of distal cap 150, which are discussed in further detail below. For example, controls 17 may be actuated via depressing a button (as shown in
Handle 12 may also include one or more ports 13, 18 for introducing and/or removing tools, fluids, or other materials from the patient. For example, port 13 may be used to introduce an accessory device (not shown), which may be any suitable tool or device for medical purposes. Port 13 may be in fluid communication with a working channel, e.g., a lumen (not shown) of shaft 15. Although not shown, port 13 may be a Y-port. Port 13 may receive any suitable accessory device (e.g., a snare, a net, a basket, a forceps, a grasper, scissors, a clip, a stapler, a needle, a knife, an electrode, a cautery loop, etc.), which may extend distally throughout shaft 15 and towards the distal end of device 10. Port 18 may be connected to umbilicus 11, for example, for introducing fluid, applying suction, and/or coupling wiring for electronic components.
In addition, one or more electrical cables (not shown) may extend from the proximal end of device 10 (e.g., from handle 12 and/or umbilicus 11), through flexible shaft 15, to distal cap 150. The one or more electrical cables may provide power and/or electrical signals to imaging, lighting, and/or other electrical devices at distal cap 150, and may carry imaging signals from one or more imaging devices at distal cap 150 proximally to be processed and/or displayed on a display. Handle 12 is not particularly limited and may be any suitable scope handle configured for handling by an operator, e.g., a physician.
Shaft 15 may include at least one lumen (not shown) for receiving any number of additional devices, e.g., scopes, tools, instruments, cables, or the like, delivering fluid, applying suction, etc. Shaft 15 extends between a proximal end coupled to handle 12 and a distal end coupled to distal cap 150. Shaft 15 is not particularly limited, and may be any suitable flexible shaft configured to traverse bodily lumens during a procedure.
Secondary channels 165 may be in communication with respective lumens of shaft 15, and may be utilized for various purposes. For example, as shown in
Tertiary channels 163 may be in communication with respective irrigation or suction lumens of shaft 15. The diameters of tertiary channels 163 are not particularly limited, and may be any suitable diameters for irrigation or suction purposes. The shape and/or size of tertiary channels 163 is also not particularly limited, and may be, for example, cylindrical, as shown in
Imager socket 167 is not particularly limited, and may be of any shape and size to receive any suitable imaging device, e.g., a camera 351 (shown in
Body 151 and a distal face 157 of body 151 does not accommodate for light features. Rather, as shown in
Body 151 may be defined by a proximal portion 153 and a distal portion 155. As shown in
Distal portion 155 includes distal face 157, which accommodates for various openings associated with each of the channels 161, 163, 165 and imager socket 167 discussed above. As shown in
Distal portion 155 may further include a pair of wings 182, for example, pivotably coupled to second portion 1574. Wings 182 may be semi-annular and convex-shaped, so that when wings 182 are in a closed, retracted position, as shown in
Each of wings 182 include an outer surface 1823 and an inner surface 1821. Light features, e.g., lights 354, may be coupled to inner surface 1821. The light feature is not particularly limited, and may be any suitable light including, but not limited to, LED, fiber optics, etc. The means by which lights 354 are coupled, e.g., adhesives, is not particularly limited, and may be via any suitable means. Moreover, lights 354 may be coupled so that illumination from lights 354 is emitted distally when wings 182 are in an open, expanded position (
Wings 182 may be coupled to second portion 1574 via a hinge or a similarly-functioning feature that allows for wings 182 to transition between a retracted position, as shown in
Each opening wire 324 may extend along an exterior of distal cap 150 (or through side channels (not shown) of distal cap 150), and through the catheter of shaft 15). A distal end of each opening wire 324 may be coupled to outer surface 1823 of wings 182. Thus, a pulling force applied to opening wires 324 (i.e., pulling wires 324 proximally) may transition wings 182 to an expanded position. In some embodiments, each opening wire 324 may be two separate wire strands, each of which is coupled to separate controls 17, so that each wing 182 may be opened separately from the other. In other embodiments, each opening wire 324 may be from a single wire strand coupled to a single actuator of controls 17 or may be coupled to a single drive wire, so that both wings 182 may be opened simultaneously. The expanded position may also be maintained via one or more biasing elements. For example, controls 17 and/or another feature of handle 12 or distal cap 150 (e.g., a detent and/or a lever) may be configured to maintain each of opening wires 324 (or, in other embodiments, the single drive wire) in a tight, held position.
In other embodiments, distal cap 150 may only include a single pair of wires, e.g., wires 322. The wires may extend from a single drive wire strand (not shown) coupled to an actuator of controls 17. In such an embodiment, the default configuration of distal cap 150 may be the retracted position, and the single drive wire may be maintained in a default position by any suitable biasing/locking structure. From the default position, the single drive wire may be translated distally, for example, via a first force applied by the actuator, thereby extending wires 322 against wings 182 and transitioning distal cap 150 into the expanded position. The single drive wire may also be translated proximally towards its default position, via a second force applied by the actuator, thereby retracting wires 322 and wings 182 and transitioning distal cap 150 into a retracted position. Alternatively, the above-discussed biasing structure (or a different biasing structure), e.g., a spring, may return the single drive wire to its default position, thereby returning distal cap 150 into the retracted position.
Referring to
Outer cylinder 253 includes a lumen (not shown) extending between a proximal end and a distal portion of outer cylinder 253 (
Outer cylinder 253 includes a first slot 2532 and a second slot 2534. As shown in
As shown in
Inner cylinder 255 further includes actuating elements (not shown), e.g., rotational wires, gears, knobs, etc., that are configured to rotate inner cylinder 255 when actuated via actuators, e.g., controls 17, present on handle 12, while outer cylinder 253 remains stationary. Thus, said actuating elements may engage and extend between both inner cylinder 255 and controls 17 via any suitable means, for example, to extend and/or retract one or more of wings 282 relative to body 251 of distal cap 250. Controls 17 and/or another feature of handle 12 (e.g., a detent and rotational knob) may be configured to lock/maintain distal cap 250 in an expanded position or retracted position.
Inner cylinder 255 includes a first slot 2556 and a second slot 2558. Slots 2556, 2558 extend around a portion of the circumference of inner cylinder 255. The dimensions of slots 2556, 2558 are not particularly limited, and may be of any suitable width that may accommodate expandable wings 282. Thus, slots 2532, 2534 of outer cylinder 253 and slots 2556 and 2558 of inner cylinder 255 may be overlaid. Slots 2556, 2558 are also spaced apart from one another, along the length of inner cylinder 255, and slots 2556, 2558 are also offset from one another to be in accordance with offset slots 2532, 2534 of outer cylinder 253. For example, slot 2556 may extend around a first portion of the circumference of inner cylinder 255 and slot 2558 may extend around a second portion of the circumference of inner cylinder 255. Although the first portion and the second portion may overlap over a circumference of inner cylinder 255, the first portion and the second portion do not span the same circumferential portions of inner cylinder 255. Inner cylinder 255 is not particularly limited and may be formed of a flexible but torqueable material, e.g., a nitinol tube or hollow drive cable.
Wings 282 are respectively fitted within slots 2532, 2556 and slots 2534, 2558, and wings 282 are configured to expand and retract from the aforementioned slots as discussed in further detail below. While two wings 282 are shown in
Each of wings 282 include a first portion 2822 and a second portion 2824. First portion 2822 may be configured to fit within one of slots 2556, 2558 of inner cylinder 255 and the corresponding slot of outer cylinder 253, when wings 282 are in a retracted position. In some examples, first portion 2822 may be of a partial cylindrical shape, but this disclosure is not limited thereto. First portion 2822 may include a first socket 2821. First socket 2821 is not particularly limited, and may be of any shape and size to receive and retain any suitable imaging device, e.g., camera 351 (
Each of first portion 2822 and second portion 2824 includes a first end 2826, 2828 and a second end (not shown). First end 2826 of first portion 2822 and first end 2828 of second portion 2824 may each have hinge forming features so that first end 2826 and first end 2828 may engage one another via a hinged relationship. A second end of first portion 2822 may also engage an inner surface of outer cylinder 253 defining slots 2532, 2534, so that first portion 2822 may hinge relative to outer cylinder 253. A second end of second portion 2824 may also engage an inner surface of inner cylinder 255 defining slots 2556, 2558, so that second portion 2824 may hinge relative to inner cylinder 255. Thus, in view of such configuration, the rotation of inner cylinder 255, via an actuator, e.g., controls 17 of handle 12, may control the expanding and retracting of wings 282. As inner cylinder 255 rotates in a first direction, e.g., clockwise when viewing from the proximal end of cap 250, first portion 2822 and second portion 2824 may hinge towards one another and hinge away from inner cylinder 255, thereby transitioning into an open, expanded position as shown in
Thus, lights and imaging devices may be coupled to separate aspects of distal cap 250, e.g., wings 282, as opposed to a distal face of distal cap 250, thereby providing additional surface area on the distal face to accommodate for a larger primary channel 2554 (and working channel) and/or additional channels or features (not shown), relative to a device that also accommodates for lights and imaging devices on its distal face. Furthermore, given that lights and imaging devices may be coupled to wings 282, said lights and/or imaging devices may also be larger. This may provide greater illumination and/or imaging relative to a device that also accommodates for lights and imaging devices on its distal face.
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. 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 of U.S. Provisional Patent Application No. 63/371,916, filed Aug. 19, 2022, the entirety of which is incorporated herein by reference.
Number | Date | Country | |
---|---|---|---|
63371916 | Aug 2022 | US |