(19)
(11)EP 2 941 174 B1

(12)EUROPEAN PATENT SPECIFICATION

(45)Mention of the grant of the patent:
04.12.2019 Bulletin 2019/49

(21)Application number: 13700971.8

(22)Date of filing:  07.01.2013
(51)Int. Cl.: 
A61B 1/005  (2006.01)
(86)International application number:
PCT/DK2013/050002
(87)International publication number:
WO 2014/106511 (10.07.2014 Gazette  2014/28)

(54)

AN ARTICULATED TIP PART FOR AN ENDOSCOPE

GELENKIGER SPITZENTEIL FÜR EIN ENDOSKOP

PARTIE POINTE ARTICULÉE POUR ENDOSCOPE


(84)Designated Contracting States:
AL AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HR HU IE IS IT LI LT LU LV MC MK MT NL NO PL PT RO RS SE SI SK SM TR

(43)Date of publication of application:
11.11.2015 Bulletin 2015/46

(73)Proprietor: Ambu A/S
2750 Ballerup (DK)

(72)Inventors:
  • JACOBSEN, Morten
    DK-2970 Hørsholm (DK)
  • QVIST, Troels Nicolaj
    DK-4000 Roskilde (DK)

(74)Representative: AWA Denmark A/S 
Strandgade 56
1401 Copenhagen K
1401 Copenhagen K (DK)


(56)References cited: : 
KR-A- 20120 056 363
US-A1- 2007 249 896
US-A- 4 580 551
US-A1- 2010 217 082
  
      
    Note: Within nine months from the publication of the mention of the grant of the European patent, any person may give notice to the European Patent Office of opposition to the European patent granted. Notice of opposition shall be filed in a written reasoned statement. It shall not be deemed to have been filed until the opposition fee has been paid. (Art. 99(1) European Patent Convention).


    Description


    [0001] The present invention relates to endoscopes, and more specifically to an articulated tip part for an endoscope.

    [0002] Endoscopes are well known devices for visually inspecting inaccessible places such as human body cavities. Typically, the endoscope comprises an elongated insertion tube with a handle at the proximal end as seen from the operator and visual inspections means, such as a built in camera, at the distal end of the elongated insertion tube. Electrical wiring for the camera and other electronics such as LED lighting run along the inside of the elongated insertion tube from the handle to the tip at the distal end. Instead of using cameras, endoscopes may also be fibre-optic, in which case the optical fibres run along inside of the elongated insertion tube.

    [0003] In order to be able to manoeuvre the endoscope inside the body cavity, the distal end of the endoscope may comprise a section with increased flexibility, e.g. an articulated tip part allowing the operator to bend this section. Typically this is done by tensioning or slacking pull wires also running along the inside of the elongated insertion tube from the articulated tip part to a control mechanism of the handle. Furthermore, a working channel may run along the inside of the insertion tube from the handle to the tip, e.g. allowing liquid to be removed from the body cavity or allowing the insertion of surgical instruments or the like into the body cavity.

    [0004] US-A-4911148 discloses a fibre-optic endoscope with an articulated tip part. The articulated tip part is an integrally moulded member with cut-out progressively increasing in size towards the distal end. The cut-outs are provided in one side only, thus only allowing the bending of the articulated tip in one direction. The articulated tip comprises a central working channel. The pull wire and the fibre-optic cables are located in lumens arranged in the wall part of the articulated tip part.

    [0005] US-A-2004/0199052 discloses a camera endoscope with an articulated tip part. The articulated tip comprises a central lumen. Though not clearly described, a working channel appears to be arranged in this central lumen. All cables except the pull wires are also arranged in this central lumen. The pull wires are located in lumens arranged in the wall part of the articulated tip part.

    [0006] US-A-4580551 discloses an articulated tip part for a fibre-optic endoscope. The cross-section of the articulated tip part comprises several lumens. In one of the lumens a tube for air or water is provided. This tube is comparatively narrow and will not be able to serve as a working channel as such.

    [0007] An articulated tip part for an endoscope with the features of the preamble of claim 1 is known from US2010217082.

    [0008] Based on the above prior at it is an object of the present invention to 5 provide an improved articulated tip part for an endoscope.

    [0009] The invention is defined in claim 1. Preferred embodiments are defined in dependent claims 2 to 10.

    [0010] The present invention will now be described in greater detail based on non-limiting exemplary embodiments, and with reference to the drawings on which:

    Fig. 1 shows an endoscope with an articulated tip part according to an embodiment of the invention at the distal end of the insertion tube,

    fig. 2 shows details of the articulated tip part at the distal end of the insertion tube,

    figs. 3 to 7 show various views of a first embodiment of the articulated tip part according to the invention, and

    figs. 8 to 12 show various views of a second embodiment of the articulated tip part according to the invention.



    [0011] Referring first to fig. 1, an endoscope 1 is shown. The endoscope is disposable, and not intended to be cleaned and reused. The endoscope 1 comprises an elongated insertion tube 12. At the proximal end of the insertion tube 12 an operating handle 13 is arranged. The operating handle 13 has a control lever 14 for manoeuvring an articulated tip part 3 at the distal end of the insertion tube 12 by means of pull wires 15 (visible in fig. 2 only). The control lever 14 is secured by means of a removable securing clip 16 to be removed before use.

    [0012] Turning now to fig. 2 details of the distal end of the insertion tube 12 with the articulated tip part 3 is shown, i.e. details from in the circle marked II in fig. 1. Some parts, such as an external sheath normally covering the articulated tip part 3, have been removed for clarity. The articulated tip part 3 comprises a number of segments 4, 5, 6. More specifically a distal end segment 4, a proximal end segment 6 (not visible in fig. 2) and a number of intermediate segments 5. In the illustrated embodiments, the number of intermediate segments 5 is eight, but the skilled person will understand that the precise number is less important. The distal end segment 4 comprises a camera 17, light emitting diodes 18 as well as a tube 9. The tube 9 extends inside the insertion tube 12 all the way from the distal end segment 4 of the articulated tip part 3 to the operating handle 13, so as to form a working channel. The working channel may via a suction port on the handle (not visible) be connected to a standard external suction, e.g. wall suction present in hospital environment by means of an attached tube. The external suction may be activated by means of a push-button 20 on the operating handle.

    [0013] One embodiment of the articulated tip part 3 is shown in figs. 3 to 7 without any attached parts. It can be seen that there is one distal end segment 4 one proximal end segment 6 and eight intermediate segments 5. The segments 4, 5, 6 are interconnected by means of flexible hinge members 10, 10'. As can be seen the individual thickness of the flexible hinge members 10, 10' vary from one to the next, increasing in thickness from the distal end towards the proximal end of the articulated tip part 3, i.e. from left to right in fig. 3. By comparison with fig. 4, it can also be seen that flexible hinge members 10, 10' interconnecting intermediate segments are arranged in a plane corresponding to the first diameters of the cross-sections of said two adjacent segments.

    [0014] The flexibility of the articulated tip part 3 is thus higher at the distal end of the articulated tip part 3 than at the proximal end of the articulated tip part 3. The intermediate segments 5 generally have the same cross-section, which generally correspond to the end view of fig. 4. That is to say a generally circular cross-section with four passages 8, 21, 22. The first passage 8 is circular and adapted to engage and support the outer wall of a tube 9 forming the working channel. This first passage is relatively large, and the centre 7 of the cross-section of the intermediate segments actually lies within the first passage 8. In a second embodiment of the articulated tip member 3 shown in figs. 8 to 12 this is even more pronounced. Cf. fig. 9. The second passage 21 is adapted to accommodate the electrical supply wires for the camera 17 and the light emitting diodes 18, signal wires for the camera 17 etc. The camera 17 and the light emitting diodes 18 are mounted on a small circuit board to which the supply and signal wires are connected. The last two passages are pull wire passages 22 for guiding the pull wires 15. As can be seen in fig. 4 the two pull wire passages 22 are arranged symmetrically opposite each other on either side of the plane in which the hinge members 10, 10' extend. That is to say, symmetrically opposite each other on a second diameter orthogonal to and on either side of the first diameter in each of said intermediate segments 5. At his location plenty of material surround the guide passages 22, thus giving good support for the pull wires 15 when tensioned. The ends of the pull wires are secured in the distal end section as well as connected to the control lever 14 in the operating handle 13. Thus by manipulating the control lever 14 the pull wire may be tensioned on one side of the plane of the hinge members 10, 10' and slacked on the other, thus allowing the articulated tip member 3 to bend in a desired direction.

    [0015] As can best be seen from fig. 5 three hinge members 10, 10' interconnect the intermediate segments 5. The location of these hinge members 10, 10' as seen in an end view correspond to the outer walls of the intermediate segments 5 and the wall formed between the circular passage 8 and the second passage 21. There is thus two outer hinge members 10 and one central hinge member 10' interconnecting two intermediate segments 5. By having not only the outer hinge members 10 but also the central hinge member 10' allows the tube 9 forming the working channel to be supported on either side between two intermediate segments, thereby reducing the tendency of the tube 9 to kink or collapse between the intermediate segments 5, where unlike in the passages 8 it is not tightly accommodated and supported by the wall of the first passage 8.

    [0016] The extra central hinge member 10' in also advantageous in another way. Were there only the lateral hinge members 10, the articulated tip member would be less resistant to torsions. More importantly there would be the risk that one or both would be compressed and two adjacent intermediate segments 5 thereby pre-bent in an undesired direction with respect to each other by external forces from e.g. the body cavity. If just one lateral hinge member 10 or even both leads to pre-bending in this uncontrolled manner, the tension from the pull wires 15 might further bend two intermediate segments 5 in the opposite direction of what is expected and desire by the operator. Having the extra central hinge member 10' mitigates this.

    [0017] The proximal end segment 6 has a number of recesses or cut-outs 23 in the surface. These cut-outs aid in securing the articulated tip member 3 to the insertion tube 12 of the endoscope 1. The distal end segment 4 also has a number of cut-outs, preferably through holes 24. These help securing the camera 17, light emitting diodes 18, the end of the tube 9 etc. when these are moulded-in by means of plastic material, e.g. in a process similar to the one described in WO-A-2010/066790 incorporated herein by reference. This is particularly important when, as preferred, the articulated tip part 3 is moulded as a one-piece polypropylene member, which has good bending properties, but relatively poor adhesive properties.

    [0018] As indicated above, figs. 8 to 12 illustrate a different embodiment of the articulated tip part 3. The difference from the first embodiment is mainly that it is adapted for a larger working channel. Consequently many parts are the same and need no repeated explanation. For the same reason corresponding reference numerals have been used. It will be noted that because the diameter of the passage 8 is larger in order to accommodate and support a larger diameter tube 9, the intermediate segments 5 as well as the distal end segment 4 and the proximal segment 6 have been made shorter as compared to the overall diameter of the cross-section of the intermediate segments 5. More specifically the outer diameter of the cross-section of the intermediate segments 5 of the first embodiment is about 4 mm and the inner diameter of the tube 9 forming the working channel about 1.2 mm, whereas in the second embodiment the outer diameter of the cross-section of the intermediate segments 5 is about 5 mm and the inner diameter of the tube 9 forming the working channel is about 2.5 mm. Furthermore the cut-outs and through holes 24 of the distal end segment 4 differ in order to better accommodate both the camera and the working channel in the distal end surface of the endoscope.

    [0019] Both of the embodiments, however, have in common the feature of intermediate segments with first passages 8, adapted to accommodate and in particular support the outer wall of the tube 9 forming the working passage. That is to say, the outer diameter of the tube 9 corresponds essentially to the inner diameter of the passage 8 in the intermediate segments 5. This in turn allows the use of a working canal made from a tube, which does not have the same flexibility all the way from the operating handle 13 to the distal end of the endoscope 3. Rather, the tube 9 providing the working channel may comprise a first proximal section and a second distal section along the length thereof, wherein the second section has a higher degree of flexibility than the first section. Preferably, the material for both the first proximal section and the second distal section is polyurethane but with different flexibility.


    Claims

    1. An articulated tip part (3) for an endoscope (1) where the articulated tip part (3) comprises a distal end segment (4), a proximal end segment (6) and a number of intermediate segments (5) arranged between the distal end segment (4) and the proximal end segment (6), each intermediate segment (5) having a generally circular cross-section with a centre (7) and comprising a passage (8), having an inner diameter corresponding to the outer diameter of a tube (9) providing a working channel of the endoscope (1) through which tools can be inserted and/or fluid can be withdrawn so as to accommodate and support an outer wall (11) of the tube (9), characterized in that, each of said intermediate segments (5) comprises a further passage adapted for accommodating electrical wires, adjacent intermediate segments (5) are connected via flexible hinge members (10, 10') arranged in a plane corresponding to first diameters of the cross-sections of said two adjacent segments (5) wherein some of the flexible hinge members (10, 10') are adapted to engage and support the outer wall (11) of the tube (9) providing said working channel of the endoscope (1).
     
    2. An articulated tip part (3) according to claim 1, wherein the passage (8) is off-set with respect to said centre (7).
     
    3. An articulated tip part (3) according to claim 2, wherein said centre (7) lies within said passage (8).
     
    4. An articulated tip part (3) according to any one of the preceding claims wherein each of said intermediate segments (5) comprises a further passage adapted for accommodating electrical wires.
     
    5. Articulated tip part (3) according to any one of the preceding claims, wherein the individual thickness of the flexible hinge members (10, 10') decreases from one to the next in the direction from the proximal end segment (6) to the distal end segment (4).
     
    6. Articulated tip part (3) according to any one of the preceding claims, wherein pull wire passages (22) are arranged symmetrically opposite each other on a second diameter orthogonal to and on either side of the first diameter in each of said intermediate segments (5).
     
    7. An articulated tip part (3) according to any one of the preceding claims, wherein the distal end segment (4), the proximal end segment (6) and said number of intermediate segments (5) is provided as a one-piece integrally moulded part.
     
    8. An articulated tip part (3) according to any one of the preceding claims, wherein the surface of at least some of the segments (4, 5, 6) comprises recesses or cut outs.
     
    9. An endoscope (1) comprising an articulated tip part (3) according to any one of the preceding claims.
     
    10. An endoscope (1) according to claim 9, wherein the tube (9) providing the working channel comprises a first section and a second section along the length thereof, wherein the second section has a higher degree of flexibility than the first section.
     


    Ansprüche

    1. Gelenkiger Spitzenteil (3) für ein Endoskop (1), wobei der gelenkige Spitzenteil (3) ein distales Endsegment (4), ein proximales Endsegment (6) und eine Reihe von Zwischensegmenten (5) umfasst, die zwischen dem distalen Endsegment (4) und dem proximalen Endsegment (6) angeordnet sind, wobei jedes Zwischensegment (5) einen allgemein kreisförmigen Querschnitt mit einem Mittelpunkt (7) aufweist und einen Durchgang (8) umfasst, mit einem Innendurchmesser, der dem Außendurchmesser einer Röhre (9) entspricht, die einen Arbeitskanal des Endoskops (1) bereitstellt, durch den Instrumente eingeführt werden können und/oder Flüssigkeit entnommen werden kann, um eine Außenwand (11) der Röhre (9) aufzunehmen und zu unterstützen, dadurch gekennzeichnet, dass jedes der Zwischensegmente (5) einen weiteren Durchgang umfasst, der zur Aufnahme von elektrischen Drähten angepasst ist, benachbarte Zwischensegmente (5) über flexible Scharnierelemente (10, 10'), die in einer Ebene angeordnet sind, die ersten Durchmessern der Querschnitte der zwei benachbarten Segmente (5) entsprechen, miteinander verbunden sind, wobei einige der flexiblen Scharnierelemente (10, 10') dazu angepasst sind, die Außenwand (11) der Röhre (9), die den Arbeitskanal des Endoskops (1) bereitstellt, zu kontaktieren und zu unterstützen.
     
    2. Gelenkiger Spitzenteil (3) nach Anspruch 1, wobei der Durchgang (8) bezüglich des Mittelpunkts (7) versetzt ist.
     
    3. Gelenkiger Spitzenteil (3) nach Anspruch 2, wobei der Mittelpunkt (7) in dem Durchgang (8) liegt.
     
    4. Gelenkiger Spitzenteil (3) nach einem der vorhergehenden Ansprüche, wobei jedes der Zwischensegmente (5) einen weiteren Durchgang umfasst, der zur Aufnahme von elektrischen Drähten angepasst ist.
     
    5. Gelenkiger Spitzenteil (3) nach einem der vorhergehenden Ansprüche, wobei die individuelle Dicke der flexiblen Scharnierelemente (10, 10') von einem zum nächsten in der Richtung vom proximalen Endsegment (6) zum distalen Endsegment (4) abnimmt.
     
    6. Gelenkiger Spitzenteil (3) nach einem der vorhergehenden Ansprüche, wobei Zugdrahtdurchgänge (22) symmetrisch gegenüber auf einem zweiten Durchmesser orthogonal zu dem und zu beiden Seiten des ersten Durchmessers in jedem der Zwischensegmente (5) angeordnet sind.
     
    7. Gelenkiger Spitzenteil (3) nach einem der vorhergehenden Ansprüche, wobei das distale Endsegment (4), das proximale Endsegment (6) und die Reihe von Zwischensegmenten (5) als einteiliges, einstückig geformtes Teil bereitgestellt sind.
     
    8. Gelenkiger Spitzenteil (3) nach einem der vorhergehenden Ansprüche, wobei die Oberfläche zumindest einiger der Segmente (4, 5, 6) Aussparungen oder Ausschnitte umfasst.
     
    9. Endoskop (1), umfassend einen gelenkigen Spitzenteil (3) nach einem der vorhergehenden Ansprüche.
     
    10. Endoskop (1) nach Anspruch 9, wobei die Röhre (9), die den Arbeitskanal bereitstellt, einen ersten Abschnitt und einen zweiten Abschnitt entlang ihrer Länge umfasst, wobei der zweite Abschnitt einen höheren Flexibilitätsgrad als der erste Abschnitt aufweist.
     


    Revendications

    1. Partie de pointe articulée (3) pour un endoscope (1) la partie de pointe articulée (3) comprenant un segment d'extrémité distale (4), un segment d'extrémité proximale (6) et un certain nombre de segments intermédiaires (5) agencés entre le segment d'extrémité distale (4) et le segment d'extrémité proximale (6), chaque segment intermédiaire (5) ayant une section transversale généralement circulaire avec un centre (7) et comprenant un passage (8), ayant un diamètre intérieur correspondant au diamètre extérieur d'un tube (9) fournissant un canal de travail de l'endoscope (1) à travers lequel des outils peuvent être insérés et/ou un fluide peut être retiré de façon à recevoir et supporter une paroi externe (11) du tube (9),
    caractérisée en ce que, chacun desdits segments intermédiaires (5) comprend un passage supplémentaire adapté pour recevoir des fils électriques, des segments intermédiaires adjacents (5) sont connectés via des éléments de charnière flexibles (10, 10') agencés dans un plan correspondant aux premiers diamètres des sections transversales desdits deux segments adjacents (5), certains des éléments de charnière flexibles (10, 10') étant adaptés pour engager et supporter la paroi externe (11) du tube (9) en fournissant ledit canal de travail de l'endoscope (1).
     
    2. Partie de pointe articulée (3) selon la revendication 1, le passage (8) étant décalé par rapport audit centre (7).
     
    3. Partie de pointe articulée (3) selon la revendication 2, ledit centre (7) se trouvant à l'intérieur dudit passage (8).
     
    4. Partie de pointe articulée (3) selon l'une quelconque des revendications précédentes, chacun desdits segments intermédiaires (5) comprenant un passage supplémentaire adapté pour recevoir des fils électriques.
     
    5. Partie de pointe articulée (3) selon l'une quelconque des revendications précédentes, l'épaisseur individuelle des éléments de charnière flexibles (10, 10') diminuant d'un élément à l'élément suivant dans la direction allant du segment d'extrémité proximale (6) au segment d'extrémité distale (4).
     
    6. Partie de pointe articulée (3) selon l'une quelconque des revendications précédentes, des passages de fil de traction (22) étant agencés symétriquement opposés l'un à l'autre sur un second diamètre orthogonal au premier diamètre et de part et d'autre de celui-ci dans chacun desdits segments intermédiaires (5).
     
    7. Partie de pointe articulée (3) selon l'une quelconque des revendications précédentes, le segment d'extrémité distale (4), le segment d'extrémité proximale (6) et ledit certain nombre de segments intermédiaires (5) étant fourni sous la forme d'une partie moulée d'une seule pièce.
     
    8. Partie de pointe articulée (3) selon l'une quelconque des revendications précédentes, la surface d'au moins certains des segments (4, 5, 6) comprenant des évidements ou des découpes.
     
    9. Endoscope (1) comprenant une partie de pointe articulée (3) selon l'une quelconque des revendications précédentes.
     
    10. Endoscope (1) selon la revendication 9, le tube (9) fournissant le canal de travail comprenant une première section et une deuxième section le long de la longueur de celui-ci, la deuxième section ayant un degré de flexibilité plus élevé que la première section.
     




    Drawing












    REFERENCES CITED IN THE DESCRIPTION



    This list of references cited by the applicant is for the reader's convenience only. It does not form part of the European patent document. Even though great care has been taken in compiling the references, errors or omissions cannot be excluded and the EPO disclaims all liability in this regard.

    Patent documents cited in the description