(19)
(11)EP 3 272 294 B1

(12)EUROPEAN PATENT SPECIFICATION

(45)Mention of the grant of the patent:
26.06.2019 Bulletin 2019/26

(21)Application number: 17185923.4

(22)Date of filing:  06.09.2011
(51)International Patent Classification (IPC): 
A61B 10/04(2006.01)
A61B 17/00(2006.01)
A61B 10/02(2006.01)
A61B 1/018(2006.01)
A61B 1/00(2006.01)
A61B 90/00(2016.01)

(54)

HANDLE FOR AN ENDOSCOPIC MEDICAL DEVICE

HANDGRIFF FÜR EINE ENDOSKOPISCHE MEDIZINISCHE VORRICHTUNG

MANCHE POUR UN DISPOSITIF MEDICAL ENDOSCOPIQUE


(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

(30)Priority: 07.09.2010 US 380471 P

(43)Date of publication of application:
24.01.2018 Bulletin 2018/04

(62)Application number of the earlier application in accordance with Art. 76 EPC:
11755534.2 / 2613708

(73)Proprietor: Boston Scientific Scimed, Inc.
Maple Grove, MN 55311 (US)

(72)Inventors:
  • TINKHAM, Brian
    South Boston, MA 02127 (US)
  • DEVRIES, Robert
    Northboro, MA 01532 (US)
  • WEISMAN, Michal
    Palo Alto, CA 94303 (US)
  • RYAN, Shawn
    Upton, MA 01568 (US)
  • BACON, Daniel
    Fitchburg, MA 01420 (US)

(74)Representative: Vossius & Partner Patentanwälte Rechtsanwälte mbB 
Siebertstrasse 3
81675 München
81675 München (DE)


(56)References cited: : 
WO-A1-2008/078499
US-A1- 2006 116 605
US-A1- 2010 179 510
US-A1- 2004 260 199
US-A1- 2009 062 830
  
      
    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

    Background



    [0001] Procedures may be performed with Endoscopic Ultrasound Fine Needle Aspiration ("EUS-FNA") devices to obtain cells or small samples of tissue from, for example, the breast or liver for cytology studies, endoscopy or oncology. As understood by those skilled in the art, biopsy needles enable the capture of samples to facilitate diagnosis and treatment. These biopsy needles are generally connected at their proximal ends to handles including actuation mechanisms. Currently available handles are typically formed as two or more overlapping substantially cylindrical elements with a first element attached to an endoscope and a second larger diameter element overlapping a proximal portion of the first element being used to advance the needle to a target site in a living body. Presently available handles and actuation mechanisms offer insufficient ergonomics and further require that the entire handle be rotated to rotate the needle attached thereto. US2010/0179510 A1 discloses a handle according to the preamble of claim 1.

    Summary of the Invention



    [0002] The present invention is defined by the claims.

    [0003] Herein described is a handle for a medical device comprising a proximal segment defining a proximal lumen extending longitudinally therethrough, the proximal lumen being sized and shaped to receive an endoscopic medical device therein and a medial segment received within a distal portion of the proximal segment, the medial segment having an outer diameter smaller than an inner diameter of the proximal segment and defining a medial lumen extending therethrough open to the proximal lumen in combination with a distal segment received within a distal portion of the medial segment and defining a distal lumen extending therethrough open to the medial lumen, the distal segment having an outer diameter smaller than an inner diameter of the medial segment, wherein the medial segment includes a first movement limiting mechanism limiting movement of an endoscopic medical device inserted through the proximal, medial and distal lumens along an axis of the distal lumen and the medial segment includes a second movement limiting mechanism configured to limit advancement and retraction of an endoscope attached to a distal end of the distal body portion.

    Brief Description of the Drawings



    [0004] 

    Fig. 1 is a first perspective view of a device according to a first embodiment of the invention;

    Fig. 2 is a second perspective view of the device of Fig. 1;

    Fig. 3 is a partial cross-sectional view of the device of Fig. 1;

    Fig. 4 is a perspective view of the device of Fig. 1 in a first operative configuration; and

    Fig. 5 is a perspective view of the device of Fig. 1 in a second operative configuration.


    Detailed Description



    [0005] The present invention, which may be further understood with reference to the following description and the appended drawings, relates to handle for an apparatus for obtaining tissue samples and, more particularly relates to FNA devices. The handles according to the invention may be used in substantially all procedures employing FNA devices further increasing the efficacy of FNA procedures by improving handling of the device via an ergonomic design and also by permitting rotational movement of the endoscope without the need to rotate the entire shaft of the device. Specifically, presently available devices require that the entire endoscope or the entire handle be rotated in order to affect a rotation of the needle at a target site in the body. The exemplary system according to the present invention allows for a selective rotation of only a needle of an FNA device without rotating the entire handle, as will be described in greater detail hereinafter.

    [0006] Devices according to the present invention comprise an FNA device including an ergonomic handle controlling rotation of an FNA device inserted through the device, the handle being connected to an adjustment portion controlling proximal-distal movement of the FNA needle inserted through the FNA device and through an endoscope attached to a distal portion of the device, the endoscope being configured for insertion into a living body in an operative configuration. Specifically, embodiments of the present invention are directed to a handle configured to control rotation of the FNA needle inserted therethrough while bypassing the need to rotate the entire endoscope, as is customary with presently available devices. It is noted that the use of the term distal herein refers to a direction away from a user and toward a target tissue treatment area and the term proximal refers to a direction approaching a user of the device (e.g., a physician) with a proximal portion of the device remaining external to the patient as an endoscope attached to the distal portion is inserted into the body.

    [0007] As shown in Figs. 1-5, an FNA actuation device 100 according to an exemplary embodiment of the present invention comprises an elongated body having a proximal handle portion 102, a central portion 104, a distal portion 106 and an attachment portion 108 located at a distal end thereof, the attachment portion 108 permitting attachment with an endoscope or other device for insertion into a living body in an operative configuration. In an exemplary embodiment, components of the device 100 may be formed of any combination of a polymer, metal or other known material, as known to those of skill in the art. An exemplary material of the device 100 is selected so that, when attached to an endoscope, the elements are permitted to rotate without breaking or cracking, as will be described in greater detail later on. A lumen 110 extends through the device 100 from a proximal end 112 to a distal end 114. The lumen 110 may be substantially circular in cross-section and may be configured to receive a needle, stylet or another medical device therethrough (e.g., electrodes, knives, pincers, etc.), as those skilled in the art will understand. The needle or other medical device may be configured to reflect ultrasound signals, such as for example, an endoscopic ultrasound ("EUS") needle, as those skilled in the art will understand. It is noted, however, that other cross-sectional shapes of the lumen 110 are also envisioned. Inner walls of a portion of the lumen 110 extending through the proximal handle portion 102 comprise radial abutments or a treated surface (not shown) to permit a frictional or mechanical engagement with an outer wall of a needle 103 to be inserted therethrough. The needle 103 may also comprise an abutment, a recess or a treated surface to permit such an engagement. Thus, when inserted through the lumen 110, the needle 103 may be moved proximally and distally relative to the proximal handle portion 102 by application of a sufficient proximally or distally directed force to a proximal end of the needle but may be prevented from being rotated relative thereto. Rotation of the needle 103 can only be facilitated by a rotation of the proximal handle portion 102. Alternatively, as will be understood by those skilled in the art, the shapes of any portion of the needle, stylet or other medical device and a corresponding portion the lumen 110 may be keyed to one another to prevent relative rotation therebetween. The lumen 110 also extends through the central portion 104 and distal portion 106 but is not rotatably fixed thereto. That is, the lumen 110 is rotatable relative to the central portion 104 and the distal portion 106. Specifically, as shown in Fig. 3, the central portion 104 and distal portion 106 comprise a telescoping internal channel 138 configured with first, second and third sections 140, 142, 144 configured to be retractable into one another upon retraction of one or both of the central and distal portions 104, 106. The lumen 110 extends through the telescoping internal channel 138 and is slidable relative thereto so that retraction and expansion of the telescoping internal channel 138 does not cause proximal or distal movement of the lumen 110. Thus, proximal retraction of the distal portion 106 causes the distal portion 106 to be withdrawn into the central portion 106 and retraction of at least the third section 144 into the second section 142. Similarly, when the central portion 104 is retracted into the proximal handle portion 102, as will be discussed in greater detail later on, the outer wall of the central portion 104 slides into a cavity 136 within the proximal handle portion 102. The lumen 110 is slidable relative to the telescoping internal channel 138 so that proximal retraction of the central portion 104 and distal portion 106 does not proximally retract the needle 103 but rather, permits a greater portion of the needle 103 to be exposed at a distal end of the device 100, as shown in Fig. 4. The telescoping internal channel 138 further comprises a lip 146 formed at a proximal end thereof to permit frictional engagement of the telescoping internal channel 138 with an abutment 148 preventing removal of the central portion 104 from the proximal handle portion 102. The lumen 110 extends proximally from the proximal handle portion 102 by a predetermined distance and comprises an opening 118 opening into the lumen 110 to permit insertion of the needle or other device therethrough.

    [0008] The proximal handle portion 102 may be substantially cylindrical in shape and may be formed with an outer diameter greater than that of both the central portion 104 and the distal portion 106. It is further noted that the proximal handle portion 102 may also be formed with a non-circular cross-sectional shape without deviating from the scope of the present invention. The proximal handle portion 102 may be formed with a taper so that its diameter increases toward a central portion thereof with proximal and distal ends of the proximal handle portion 102 having a smaller diameter than that of the central portion. The proximal handle portion 102 further comprises an ergonomic groove 116 formed adjacent a distal end thereof to aid in gripping and manipulation thereof. It is noted that although only a single groove 116 is shown, the proximal handle portion 102 may be formed with any number and variety of grooves or abutments configured to aid in ergonomic handling without deviating from the scope of the present invention. The proximal handle portion 102 may also have a soft grip coating (e.g., thermoplastic elastomer) or another surface modification or coating to aid in handling.

    [0009] The central portion 104 extends distally from the proximal handle portion 102 by a predetermined distance and also has a substantially circular cross-section. A diameter of the central portion 104 in this embodiment may be approximately 13 - 25 mm. The central portion 104, although securely connected to the proximal handle portion 102, remains rotatable relative thereto. That is, rotation of the proximal handle portion 102 and the lumen 110 does not result in a rotation of the central portion 104. In one embodiment of the invention, the proximal handle portion 102 comprises a radial groove (not shown) formed on an inner wall of a distal rim thereof configured to rotatably engage a radial abutment formed on an outer wall of a proximal rim of the central portion 104. Alternatively, any connection may be forged between the proximal handle portion 102 and the central portion 104 without deviating from the scope of the present invention.

    [0010] The central portion 104 further comprises a first mechanism 120 and a second mechanism 122 configured to selectively limit a proximal-distal movement of the distal portion 106 relative to the central portion 104 and movement of the central portion 104 relative to the proximal handle portion 102. Specifically, the first mechanism 120 may be formed as a ring 124 extending around a portion of an outer surface of the central portion 104. The ring 124 may be secured to the central portion 104 and may be held in place by a friction fit or any other suitable attachment means known in the art. In an exemplary embodiment, the ring 124 of the first mechanism 120 may be permanently secured to a distal end of the central portion 104. The ring 124 includes a pair of slots 126 extending substantially perpendicular to a longitudinal axis of the central portion 104 and having a length smaller than a circumference of the ring 124. The slots 126 are configured to permit the device to be locked in a desired configuration. Specifically, a profile of an inner surface of the ring 124 adjacent to the outer surface of the distal portion 106 is non-circular (e.g., elliptical) while a knob 128 of the mechanism 120 includes one or more arms (not shown) which extend from a part of the knob 128 which is located between the ring 124 and the outer surface of the distal portion 106. The arms are sized so that, when the knob 128 is rotated to a first orientation, the arms are located within a space formed between a larger diameter portion of the non-circular inner surface of the ring 124 and the distal portion 106 so that the ring 124 is loosely held around the distal portion 106. Rotation of the knob 128 to a second orientation (e.g., by 90° relative to the first orientation) moves the arms into a smaller space between a reduced diameter portion of the non-circular inner surface of the ring 124 and the distal portion 106 so that the ring 124 is pressed tightly against the distal portion 106 locking the positions of the distal portion 106 and the central portion 104.

    [0011] The distal portion 106 is sized and shaped to be slidably received within the central actuating portion 104 and telescopically extendable therefrom. When the distal portion 106 is manually moved to a desired position (i.e., using markings 107 formed on an outer wall thereof as a guide), the first mechanism 120 is tightened to apply a torque to the distal portion 106 to lock a position thereof. The distal portion 106 also comprises a distal opening 130 through which the distal end 114 of the lumen 110 exits the device 100.

    [0012] The second mechanism 122 provided over the central portion 104 is formed substantially similarly to the first mechanism 120 but comprises a ring 132 slidable along a length thereof to permit advancement of the central portion 104 into and out of the proximal handle portion 102. Thus, the second mechanism 122 may be positioned over a target portion of the central portion 104 using markings 105 as a guide and tightened to lock a position thereof. In this manner, the second mechanism 122 can be positioned so that only a portion of the central portion 104 located proximally of the second mechanism 122 is retracted into the proximal handle portion 102, as shown in Fig. 4. For example, when the window 123 is positioned over the "8" marker at a distal-most position of the central portion 104, substantially the entire length of the central portion 104 can be withdrawn proximally into the proximal handle portion 102, as shown in Fig. 4. Similarly, when the second mechanism 122 is moved to a proximal-most position along the central portion 104 (i.e., so that a window 123 is positioned over a "0" marker), the central portion 104 is prevented from being retracted into the proximal handle portion 102.

    [0013] The attachment portion 108 has a greater diameter than the distal portion 106 and comprises internal threading 134 engaging a threaded outer wall of a proximal end of an endoscope (not shown). The distal end 114 of the lumen 110 may be configured so that, when the attachment portion 108 may be coupled to an endoscope, the lumen 110 aligns with and engages a working channel extending through the endoscope (not shown). Specifically, a proximal end of the endoscope (not shown) may be received within the attachment portion 108 and the attachment portion 108 may be rotated to lockingly engage the threads of the endoscope. In one embodiment, only the attachment portion 108 may be rotated to threadedly engage the endoscope (not shown). In another embodiment, the attachment portion 108 may not be rotatable relative to the distal portion 106 so that, in order to threadedly engage the endoscope, the entire distal portion 106 must be rotated. In another embodiment of the invention, the attachment portion 108 may be configured to permit a luer lock connection with the endoscope.

    [0014] In accordance with an exemplary method of the present application, an endoscope may be attached to the attachment portion 108. The central and distal portions 104, 106 are then manipulated to a desired orientation and the first and second mechanisms 120, 122 are tightened to lock the device 100 in the desired configuration. That is, the distal portion 106 may be extended to a length selected such that, when the needle 103 may be inserted into the lumen 110 and through the endoscope, the needle be movable between a first position in which a distal end of the needle may be located within the endoscope lumen (e.g., substantially adjacent a distal end thereof) and a deployed position in which the needle projects distally beyond a distal end of the endoscope by a desired distance. The needle 103 may then be inserted through the FNA device 100 into the working channel of the endoscope until the proximal end of the needle may be locked in position at a proximal end of the device 100. At this point, the device 100 may be configured so that the needle 103 is in the first position with the distal tip thereof received within the endoscope. In addition, at this point, a stylet is preferably placed in a closed configuration in which it seals a distal opening of the needle as the needle is inserted through non-targeted tissue to the target tissue site. The endoscope is then guided to a target location within the body in a conventional manner and a physician or other user determines (e.g., under visual observation via the endoscope) whether a tissue penetrating distal tip of the needle 103 is in a desired orientation relative to target tissue to be sampled. If not, the physician may rotate the proximal handle portion 102 by a desired angle with the rotation being translated only to the lumen 110 and the needle 103 located therein while the central portion 104, distal portion 106 and the entire length of the endoscope remain substantially unaffected by the rotation. The physician freely rotates the needle 103 by any desired angle until the desired orientation is achieved. The needle 103 may then be moved distally out of the endoscope to extend distally therefrom by the desired distance under the guidance of an imaging device, as those skilled in the art will understand. At this point the stylet is also moved to a tissue receiving configuration in which the distal opening of the needle 103 is open to receive tissue. It is further noted that the needle 103 may subsequently be rotated at any point during the target procedure as deemed necessary by the physician.

    [0015] The present invention has been described with reference to specific exemplary embodiments. Those skilled in the art will understand that various modifications and changes may be made to the embodiments. The specifications are, therefore, to be regarded in an illustrative rather than a restrictive sense.


    Claims

    1. A handle for an endoscopic medical device comprising:

    an elongated body extending from a proximal end (112) to a distal end (114), the elongated body having a distal segment (106), a central segment (104), a proximal segment (102) rotatably coupled to the distal segment (106), and a lumen (110) extending longitudinally therethrough from the proximal end (112) to the distal end (114) and configured to receive the endoscopic medical device therethrough, the distal segment (106) configured to engage an endoscope,

    wherein the endoscopic medical device received within the lumen (110) is rotatable relative to the central segment (104) and the distal segment (106) so that rotation of the proximal segment (102) causes a rotation of the endoscopic medical device without applying torque to the endoscope, characterised in that

    the central segment (104) is telescopically movable into and out of the proximal segment (102), wherein the distal segment (106) is telescopically movable into and out of the central segment (104), and wherein proximal and distal movement of the central and distal segments (104,106) is not translated to the endoscopic medical device received within the lumen (110).


     
    2. The handle of claim 1, wherein the endoscopic medical device is a needle (103), preferably an endoscopic ultrasound needle.
     
    3. The handle of claim 1, further comprising an actuating mechanism on the central segment (104), the actuating mechanism configured to affect proximal and distal movement of the distal segment (106) relative to the central segment (104).
     
    4. The handle of claim 1, wherein an outer diameter of the central segment (104) is smaller than an inner diameter of the proximal segment (102) and wherein an outer diameter of the distal segment (106) is smaller than an inner diameter of the central segment (104).
     
    5. The handle of claim 1, wherein the central segment (104) includes a first movement limiting mechanism (120) configured to limit advancement and retraction of the endoscopic medical device.
     
    6. The handle of claim 5, wherein the first movement limiting mechanism (120) is configured to lock a position of the distal segment (106) relative to the central segment (104).
     
    7. The handle of claim 5 or 6, wherein the central segment (104) includes a second movement limiting mechanism (122) configured to limit movement of the endoscopic medical device.
     
    8. The handle of claim 7, wherein the second movement limiting mechanism (122) is slidably positioned over a target portion of the central segment (104) so that only a portion of the central segment (104) located proximally thereof is retractable into the proximal segment (102).
     
    9. The handle of claim 1, wherein the distal segment (106) is configured to threadedly engage the endoscope, preferably via a luer lock.
     
    10. The handle of any of claims 5 to 9, wherein the first movement limiting mechanism (120) is moveable between a first configuration and a second configuration, the first configuration configured to permit the distal segment (106) to move longitudinally through the central segment (104) to adjust a length of the handle to a desired length, and the second configuration configured to lock the central and distal segments (104, 106) relative to one another to maintain the desired length of the handle.
     
    11. An endoscopy set comprising:

    the handle according to any one of claims 1-10, and an endoscopic medical device,

    wherein a proximal portion of the lumen (110) is keyed to a shape of the endoscopic medical device.


     


    Ansprüche

    1. Griff für eine endoskopische medizinische Vorrichtung, mit:

    einem länglichen Körper, der sich von einem proximalen Ende (112) zu einem distalen Ende (114) erstreckt, wobei der längliche Körper ein distales Segment (106), ein mittiges Segment (104), ein proximales Segment (102), das mit dem distalen Segment (106) drehbar verbunden ist, und ein Lumen (110) aufweist, das sich in Längsrichtung vom proximalen Ende (112) zum distalen Ende (114) durch den Körper erstreckt und dafür konfiguriert ist, die endoskopische medizinische Vorrichtung durch dieses aufzunehmen, wobei das distale Segment (106) dafür konfiguriert ist, mit einem Endoskop in Eingriff zu kommen,

    wobei die im Lumen (110) aufgenommene endoskopische medizinische Vorrichtung relativ zum mittigen Segment (104) und zum distalen Segment (106) drehbar ist, so dass eine Drehbewegung des proximalen Segments (102) eine Drehbewegung der endoskopischen medizinischen Vorrichtung bewirkt, ohne dass ein Drehmoment auf das Endoskop ausgeübt wird;

    dadurch gekennzeichnet, dass

    das mittige Segment (104) teleskopartig in das proximale Segment (102) hinein und aus diesem heraus bewegbar ist, wobei das distale Segment (106) teleskopartig in das mittige Segment (104) hinein und aus diesem heraus bewegbar ist, und wobei proximale und distale Bewegung des mittigen und des distalen Segments (104, 106) nicht auf die innerhalb des Lumens (110) aufgenommene endoskopische medizinische Vorrichtung übertragen wird.


     
    2. Griff nach Anspruch 1, wobei die endoskopische medizinische Vorrichtung eine Nadel (103) ist, vorzugsweise eine endoskopische Ultraschallnadel.
     
    3. Griff nach Anspruch 1, ferner mit einem Betätigungsmechanismus auf dem mittigen Segment (104), wobei der Betätigungsmechanismus dafür konfiguriert ist, proximale und distale Bewegung des distalen Segments (106) relativ zum mittigen Segment (104) zu beeinflussen.
     
    4. Griff nach Anspruch 1, wobei ein Außendurchmesser des mittigen Segments (104) kleiner ist als ein Innendurchmesser des proximalen Segments (102), und wobei ein Außendurchmesser des distalen Segments (106) kleiner ist als ein Innendurchmesser des mittigen Segments (104).
     
    5. Griff nach Anspruch 1, wobei das mittige Segment (104) einen ersten Bewegungsbegrenzungsmechanismus (120) aufweist, der dafür konfiguriert ist, eine Vorschubbewegung und eine Rückziehbewegung der endoskopischen medizinischen Vorrichtung zu begrenzen.
     
    6. Griff nach Anspruch 5, wobei der erste Bewegungsbegrenzungsmechanismus (120) dafür konfiguriert ist, eine Position des distalen Segments (106) relativ zum mittigen Segment (104) zu blockieren.
     
    7. Griff nach Anspruch 5 oder 6, wobei das mittige Segment (104) einen zweiten Bewegungsbegrenzungsmechanismus (122) aufweist, der dafür konfiguriert ist, eine Bewegung der endoskopischen medizinischen Vorrichtung zu begrenzen.
     
    8. Griff nach Anspruch 7, wobei der zweite Bewegungsbegrenzungsmechanismus (122) auf einem Zielabschnitt des mittigen Segments (104) gleitend angeordnet ist, so dass nur ein Abschnitt des mittigen Segments (104), der proximal davon angeordnet ist, in das proximale Segment (102) zurückziehbar ist.
     
    9. Griff nach Anspruch 1, wobei das distale Segment (106) dafür konfiguriert ist, mit dem Endoskop in Gewindeeingriff gebracht zu werden, vorzugsweise über einen Luer-Lock.
     
    10. Griff nach einem der Ansprüche 5 bis 9, wobei der erste Bewegungsbegrenzungsmechanismus (120) zwischen einer ersten Konfiguration und einer zweiten Konfiguration bewegbar ist, wobei die erste Konfiguration dafür konfiguriert ist, zu ermöglichen, dass sich das distale Segment (106) in Längsrichtung durch das mittige Segment (104) bewegen kann, um eine Länge des Griffs auf eine gewünschte Länge einzustellen, und wobei die zweite Konfiguration dafür konfiguriert ist, das mittige und das distale Segment (104, 106) relativ zueinander zu verriegeln, um die gewünschte Länge des Griffs aufrechtzuerhalten.
     
    11. Endoskopie-Set mit:

    einem Griff nach einem der Ansprüche 1 bis 10; und

    einer endoskopischen medizinischen Vorrichtung,

    wobei ein proximaler Abschnitt des Lumens (110) einer Form der endoskopischen medizinischen Vorrichtung formschlüssig angepasst ist.


     


    Revendications

    1. Manche pour un dispositif médical endoscopique comprenant :

    un corps allongé qui s'étend depuis une extrémité proximale (112) jusqu'à une extrémité distale (114), le corps allongé ayant un segment distal (106), un segment central (104), un segment proximal (102) couplé à rotation au segment distal (106), et une lumière (110) qui s'étend longitudinalement à travers eux de l'extrémité proximale (112) à l'extrémité distale (114) et configurée pour recevoir le dispositif médical endoscopique à travers elle, le segment distal (106) configuré pour coopérer avec un endoscope,

    où le dispositif médical endoscopique reçu dans la lumière (110) est capable de tourner par rapport au segment central (104) et au segment distal (106) de sorte que la rotation du segment proximal (102) entraîne une rotation du dispositif médical endoscopique sans appliquer de couple à l'endoscope, caractérisé en ce que le segment central (104) est déplaçable de manière téléscopique dans et hors du segment proximal (102), où le segment distal (106) est déplaçable de manière téléscopique dans et hors du segment central (104), et où le mouvement proximal et distal des segments central et distal (104, 106) n'est pas transmis au dispositif médical endoscopique reçu dans la lumière (110).


     
    2. Manche selon la revendication 1, où le dispositif médical endoscopique est une aiguille (103), de préférence une aiguille à ultrasons endoscopique.
     
    3. Manche selon la revendication 1, comprenant en outre un mécanisme d'actionnement sur le segment central (104), le mécanisme d'actionnement configuré pour affecter le mouvement proximal et distal du segment distal (106) par rapport au segment central (104).
     
    4. Manche selon la revendication 1, où un diamètre externe du segment central (104) est plus petit qu'un diamètre interne du segment proximal (102) et où un diamètre externe du segment distal (106) est plus petit qu'un diamètre interne du segment central (104).
     
    5. Manche selon la revendication 1, où le segment central (104) inclut un premier mécanisme limitant le mouvement (120) configuré pour limiter l'avancement et le retrait du dispositif médical endoscopique.
     
    6. Manche selon la revendication 5, où le premier mécanisme limitant le mouvement (120) est configuré pour verrouiller une position du segment distal (106) par rapport au segment central (104).
     
    7. Manche selon la revendication 5 ou 6, où le segment central (104) inclut un second mécanisme limitant le mouvement (122) configuré pour limiter le mouvement du dispositif médical endoscopique.
     
    8. Manche selon la revendication 7, où le second mécanisme limitant le mouvement (122) est positionné à coulissement au-dessus d'une partie cible du segment central (104) de sorte que seule une partie du segment central (104) située de manière proximale par rapport à celui-ci est rétractable dans le segment proximal (102).
     
    9. Manche selon la revendication 1, où le segment distal (106) est configuré pour coopérer par filetage avec l'endoscope, de préférence par le biais d'un luer lock.
     
    10. Manche selon l'une quelconque des revendications 5 à 9, où le premier mécanisme limitant le mouvement (120) est déplaçable entre une première configuration et une seconde configuration, la première configuration configurée pour permettre au segment distal (106) de se déplacer longitudinalement à travers le segment central (104) pour ajuster une longueur du manche à une longueur souhaitée, et la seconde configuration configurée pour verrouiller les segments central et distal (104, 106) l'un par rapport à l'autre pour maintenir la longueur souhaitée du manche.
     
    11. Ensemble d'endoscopie comprenant :

    le manche selon l'une quelconque des revendications 1-10, et un dispositif médical endoscopique,

    où une partie proximale de la lumière (110) est calée à une forme du dispositif médical endoscopique.


     




    Drawing














    Cited references

    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