Disposable endoscopy cannula with integrated grasper

An endoscopic system includes an integrated grasper device passing through a device lumen in the cannula. The grasper device has distal end forming two jaw portions that are biased to remain in an open position if unconstrained. The grasper has arch shaped portions that push against the inner surface of the device lumen when the grasper is retracted. To close the jaws of the grasper the grasper is retracted proximally until the arch shaped portions engage the opening of the device lumen. Further retraction causes the grasper jaws to close through engagement with the device lumen inner surface. The endoscopy system can include a single-use, removable cannula having a camera module on its distal tip. A re-usable portion can include the hand piece and display screen.

FIELD

This patent specification generally relates to grasping devices for use with endoscopic surgical procedures. More particularly, some embodiments relate to surgical grasping devices and methods configured for use with portable endoscopes having a disposable cannula.

BACKGROUND

There are many medical procedures which require a tissue or other object in a human cavity to be grasped while under view of an endoscopy device. Examples of procedures include stent removal, foreign body removal, hysteroscopy endometrium biopsy, and removal of polyps.

The subject matter described or claimed in this patent specification is not limited to embodiments that solve any specific disadvantages or that operate only in environments such as those described above. Rather, the above background is only provided to illustrate one exemplary technology area where some embodiments described herein may be practiced.

SUMMARY

According to some embodiments, a disposable, single-use endoscope including a permanently mounted, integrated grasper operated under video control, comprises: a shaft having a manually operated grasper control movable relative to the shaft, a cannula extending distally from the shaft and having a working channel, and a grasper at a distal portion of the working channel; wherein: said grasper is permanently secured to said cannula and to said manually operated grasper control to move relative to the cannula with movement of the control relative to the shaft, between a retracted position at in which the grasper is within the working channel and an extended position at which the grasper protrudes distally from the channel; said grasper comprises a pair of resilient jaw portions with distal portions that are biased to move away from each other toward and to an open position as the grasper moves distally relative to the cannula toward and to its extended position; and said working channel acts on the grasper to move said distal portions of the resilient jaws toward each other and to a closed position as the grasper moves proximally relative to the cannula toward and to its retracted position.

According to some embodiments, the endoscope can further comprise one or more of the following: (a) said grasper further includes arch shaped portions from which said jaws extend distally, wherein said arch shaped portions are configured to engage an inside wall of said working channel and move the jaws toward and to said closed position as the grasper moves proximally relative to the cannula; (b) said distal portions of the jaws terminate distally in claw portions that face each other when the grasper is in its extended position and engage each other when the grasper is in its retracted position; (c). a combination with multiple-use handle, wherein the cannula includes an imaging module at a distal portion thereof and the handle includes a video screen and electronics coupled with said imaging module to control the imaging module and to cause said screen to display images taken with said imaging module; (d) in combination with said multiple-use handle of claim, wherein each of the endoscope and the handle comprises respective mechanical and electrical connectors that releasably mate mechanically with each other to form an integral unit of an endoscope and handle and to form an electronic connection between said video screen and electronics and said imaging module; (e) in combination with said multiple-use handle, wherein said mechanical and electrical connectors mate by relative motion in a direction parallel to a length of said shaft; (f) in combination with said multiple-use handle, wherein said mechanical and electrical connectors mate by relative motion in a direction transverse to length of said shaft; (g). said grasper control comprises a manually operated collar movable along a length of said shaft; (h) said grasper control comprises a manually operated tab movable along a length of said shaft; (i) said cannula is configured to rotate relative to a portion of said shaft; (j). further including a first proximal port coupled for fluid flow with a proximal portion of said working channel; (k) said cannula further includes a lumen in addition to said working channel and a second proximal port coupled for fluid flow with a proximal portion of said lumen and distal ports, for two-directional flow along a length of said cannula; (l) further including a mechanism that releasably locks the grasper in at least one of its extended and retracted position, wherein said mechanism comprises a window at a proximal portion of the cannula, a spring tab secured to said shaft and biased to engage said window when aligned therewith and thus lock said grasper against movement relative to the cannula, and a manually operated release button selectively engaging said tab to move it out of engagement with said window and thus release the grasper and cannula for relative movement therebetween; and (m). said mechanism is configured to releasably lock the grasper in its extended position.

According to some embodiments, a disposable, single-use endoscope with a cannula that includes a permanently mounted, integrated surgical tool operated under video control, comprises: a shaft having a manually operated control movable relative to the shaft, a cannula extending distally from the shaft and having a working channel and a surgical tool at a distal portion of the working channel; wherein: said surgical tool is permanently secured to said manually operated control to move relative to the cannula with movement of the control relative to the shaft, between a retracted position at which the tool is within the working channel and an extended position at which the tool protrudes distally from the channel; and said tool comprises one of: (i) a grasper comprising a pair of resilient jaw portions with distal portions biased to move away from each other and toward and to an open position as the grasper moves distally relative to the cannula toward and to its extended position wherein said working channel acts on the grasper to move said distal portions of the resilient jaws toward each other and to a closed position as the grasper moves proximally relative to the cannula toward and to its retracted position; and (ii) an injection needle for injecting medication into tissue.

According to some embodiments, the endoscope described in the immediately preceding paragraph further includes one or more of the following: (a) said tool comprises said grasper; and (b) said tool comprises said injection needle.

According to some embodiments, a method comprises: providing a disposable, single-use endoscope with a cannula that includes a permanently mounted, integrated surgical tool; inserting the endoscope in tissue or a tissue cavity or passage while the surgical tool is in a retracted position inside a working channel of the cannula, while observing the insertion path on a video screen mechanically secured releasably to the cannula, which screen receives images sent from an imaging module at a distal end of the cannula; selectively moving manually operated control relative to a shaft forming a proximal portion of the cannula to thereby move the tool toward and to an extended position at which the tool protrudes distally from the channel while observing the motion of the tool out of the working channel; wherein said tool is one of a grasper and an injection needle; and carrying out one of the steps of: (a) grasping tissue with a pair of resilient jaw portions of said grasper that are biased away from each in the extended position of the grasper by manually moving said control relative to the shaft to thereby move the grasper toward and to its retracted position into said working channel to thereby engage the jaws with an inner wall of the working channel and move them toward each into the working channel (FIG.6D); and (b) injecting medication into tissue with said injection needle and thereafter manually moving said control relative to the shaft tot hereby move the needle toward its retracted position in the working channel.

The method can carry our step (a) or step (b).

As used herein, the grammatical conjunctions “and”, “or” and “and/or” are all intended to indicate that one or more of the cases, object or subjects they connect may occur or be present. In this way, as used herein the term “or” in all cases indicates an “inclusive or” meaning rather than an “exclusive or” meaning.

As used herein the terms “surgical” or “surgery” refer to any physical intervention on a patient's tissues and does not necessarily involve cutting a patient's tissues or closure of a previously sustained wound.

DETAILED DESCRIPTION

A detailed description of examples of preferred embodiments is provided below. While several embodiments are described, it should be understood that the new subject matter described in this patent specification is not limited to any one embodiment or combination of embodiments described herein, but instead encompasses numerous alternatives, modifications, and equivalents. In addition, while numerous specific details are set forth in the following description in order to provide a thorough understanding, some embodiments can be practiced without some or all of these details. Moreover, for the purpose of clarity, certain technical material that is known in the related art has not been described in detail in order to avoid unnecessarily obscuring the new subject matter described herein. It should be clear that individual features of one or several of the specific embodiments described herein can be used in combination with features of other described embodiments or with other features. Further, like reference numbers and designations in the various drawings indicate like elements.

FIGS.1A-1Bare top and side views, respectively, of an endoscopy system having a cannula with an integrated grasper device, according to some embodiments. Endoscopy system100is configured to be handheld by hand piece140and includes a semi-rigid cannula120having an integrated grasper device160disposed at its distal tip110. Imaging and illumination modules are included on distal tip110. An electrical cable (not shown) is positioned within cannula120and supplies control signals and power to the camera and LED illumination modules on distal tip110, and also transmits video image and still image data from the camera module to the hand piece140and display150for viewing by an operator. In the example shown, hand piece140includes control buttons142and144which can be configured for power on/off and image capture, respectively.

According to some embodiments, hand piece140includes a third button148that is configured as an exposure and/or lighting control button. Button148can be configured as a toggle button which circulates through a number of states, for example four states, setting the LED illumination levels and system exposure control parameters. According to some embodiments, hand piece140includes a rechargeable battery146as well as electronics for video capture, processing and display on display150.

The cannula120is connected proximally to a fluid hub130including in this example fluid port132. A syringe or other fluid supply device (for example as inFIG.9A) can be used to supply (or withdraw fluid) such as saline through a fluid lumen within cannula120through port132. According to some embodiments, an additional proximal port (for example as inFIG.9A) can be connected to the device lumen and device port for infusing or withdrawing fluid from the organ or tissue into which the distal tip110is inserted. According to some embodiments, the outer diameter of cannula120is about 4.85 mm. According to some other embodiments, the outer diameter of cannula120can be made smaller, for example 4.65 mm. Proximal to the fluid hub130is a shaft168and a collar170. According to some embodiments, the collar170is fixed to the proximal portion of grasper160such that it can be used to retract and extend the grasper160relative to the cannula120, as will be shown and described further herein. When the operator moves collar170in the proximal direction the grasper160moves in a similar or identical proximal direction. A syringe (FIG.9A) can be used to supply fluid, such as saline, through a fluid lumen within cannula120via fluid port132. According to some embodiments, the working length L of cannula120including distal tip110is between 250 mm and 300 mm.

According to some embodiments, the system100is formed of a single use portion102and a multiple use portion104. The portions102and104are connectable and separable via a mechanical and electrical connector (shown inFIG.3C). According to some embodiments, the cannula120is semi-rigid. The cannula120is stiff enough so it does not collapse when actuating the grasper device160. On the other hand, cannula120is flexible enough such that it can bend while it passes through curved anatomy such as male urethra or female cervix. The distal end of cannula120can be curved upwards at location108as shown inFIG.1B. According to some embodiments, the upward bend is at least 15 degrees. According to some further embodiments, the upward bend is about 25 degrees. According to some embodiments, cannula120is configured to rotate about its longitudinal axis relative to handle140, as indicated by arrow122. A suitable rotation mechanism is described below in connection withFIG.9E.

FIG.1Cis a top view showing further detail of the distal tip of a grasper device integrated into an endoscopy system having a disposable cannula, according to some embodiments. The distal tip of grasper160is shown protruding from distal end of tip110. The distal tip of grasper160is formed of two opposing jaw portions162and164. According to some embodiments, the jaw portions162and164are made of metal. At the distal ends of jaw portions162and164are opposing claw portions172and174, respectively. Opposing claw portions172and174are configured to grasp and securely hold tissue (or other object) when the jaw portions162and164are actuated towards each other. Jaw portions162and164also include arch-shaped portions182and184, respectively, that are shown just protruding distally from device channel (or working channel) opening116. According to some embodiments, arch-shaped portions182and184are shaped such as they are pulled back into the opening116, a force is generated to force the claw portions172and714to close towards each other, as shown by the dotted arrows. According to some embodiments, the grasper160is dimensioned such that the distance d from the camera module on the distal tip to the claw portions172and174allows for clear visualization of tissue or other object being grasped. According to some embodiments, the distance d is 15 mm. According to some embodiments, the grasper jaw portions162and164are made of a memory-type metal or non-metal material. According to some embodiments, jaw portions162and164are made of spring steel or nitinol alloy. According to some embodiments, the claw portions172and174when fully opened (i.e. arch portions are not engaged with opening116) are at least 5 mm apart. According to some embodiments, claw portions172and174are shaped to “scoop” tissue when grasper160is configured to be used as a biopsy device.

FIG.2is a top view of an endoscopy system having cannula with an integrated grasper device, according to some further embodiments. The endoscopy system200is similar or identical to system100shown inFIGS.1A-Cand elsewhere herein, except that in this case cannula120is configured with two separate fluid lumens which are fluidly connected to two separate proximal fluid ports232and234. One of the lumens is configured as a device lumen where the grasper or needle resides. According to some embodiments, one of the separate fluid lumens can be shared with the electrical cable (not shown) that supplies control signals and power, and transmits image data as described, supra. According to some other embodiments, neither of the two separate fluid lumens is used to carry the electrical cable.

FIGS.3A-3Care perspective views showing further details of an endoscopy system having cannula with an integrated grasper device, according to some embodiments. InFIG.3B, further detail of the distal tip110is shown. In particular, the view ofFIG.3Bshows the camera module330and two LEDs332and334that are positioned below the device opening116. According to some embodiments, tip piece310of distal tip110is arranged such that the device channel opening116through which the grasper device160(or other built-in device, such as an integrated needle) is above, or on top, of the camera module330rather than below the camera module. The location of the device opening116is slightly more distal than the surface of camera module330, which allows for a better view by the camera module330of the grasper claw portions172and174, or other tool tip components in cases when another type of tool device is used. The slight distal positioning of opening116can be achieved by a slight forward (or distal) angle of the upper portion of the front face the tip piece310, as can also be seen inFIGS.5A,5B and5D.

According to some embodiments, the grasper160is positioned within a lumen or “working channel” formed inside cannula120. The device lumen or working channel can be off-center within the cross-section of the cannula120, as is shown with working channel516inFIG.5E. In cases where the cannula has a bend such as shown inFIGS.1B and3Aat location108, the grasper160(or needle) and working channel can be positioned within the cannula on the concave side of the curved cannula. Positioning an otherwise straight grasper160or other tool within the working channel on the concave side of the bend (above center in this case), the natural spring-like stiffness of the grasper or other tool (e.g. a needle as shown inFIGS.11A-11B) will tend to force the grasper or tool back towards the center, or downward in this case, when exiting the device channel opening116. The effect is that the grasper160or other tool will be pushed slightly toward the camera axis or toward the center of the camera field of view, making for better imaging and viewing of the tool by the operator. In cases where the shaft of the tool has a matching bend (such as shown inFIG.4A), the bending amount can be made less than (i.e. more straight) than the bending of the cannula, which will have the same or similar effect of pushing the distal tip of the tool slightly toward the camera axis or toward the center of the camera field of view.

Also visible inFIG.3Bare two distal fluid ports320and520that are positioned on either side of device opening116. According to some embodiments, the two distal fluid ports320and520are fluidly connected to proximal fluid port132inFIG.1B, or to one of the proximal fluid ports232or234inFIG.2.

FIG.3Cis a perspective view showing further detail with respect to connecting and separating single use portion102and multiple use portion104. In particular, connector340on multiple use portion104and connector342on single use portion102are configured to make both electrical and mechanical connections between units104and102.

FIGS.4A-4Dare diagrams illustrating further detail of a grasper tool configured for use through the working channel of a cannula of an endoscopy system, according to some embodiments.FIG.4Ais a side view of grasper device160showing a main shaft420being bent at location408. As described supra, the bending amount at location408can be made less than (i.e. straighter) than the bending of the cannula120, such that the distal tip of the grasper160is pushed slightly toward the camera axis or toward the center of the camera field of view. According to some embodiments, the main shaft20is not pre-bent at all and is completely straight prior to insertion or after removal from cannula120.FIG.4Bis a top view of grasper device160, whileFIG.4Cis a more detailed top view of the distal tip of grasper160. Various dimensions are shown for this example device.FIG.4Dshows a cross section view along A-A′ ofFIG.4B. The shaft420of grasper160is shown formed of two layers422and424. According to some embodiments, the layers422and424of shaft420, arch-shaped portions182and184, jaw portions162and164, and claw portions172and174are made of two pieces of the same material, or a single piece of material folded at the proximal end. According to some embodiments, the two pieces of material can be joined or welded at one or more locations426along the shaft420as shown inFIG.4B. According to some embodiments, the material is a type of memory metal or memory metal alloy or a non-metal material configured to bias the jaws portions162and164to be spread apart such as shown inFIG.4C. This allows for the claw portions172and174of grasper device160to be closed and opened solely by translating its position axially relative to the device channel opening116(shown inFIGS.10and3B) as is shown in greater detail inFIGS.6A-6D. In this way, the grasper device160can be relatively simple, low cost, and robust when compared to more complex arrangements such as those that include scissor-like actuation structures. According to some embodiments, each piece422and424has a cross-sectional dimension of 0.5 mm thick and 1.5 mm wide, such that the overall cross-sectional dimension of the shaft420is 1 mm by 1.5 mm.

FIGS.5A-5Eare diagrams illustrating further detail of a distal tip piece and cannula for an endoscopy system having a disposable cannula with a working channel configured to accept a grasper device, according to some embodiments.FIG.5Ais perspective view of distal tip piece310. According to some embodiments, the distal tip piece310is formed as a separate piece and is bonded to the distal end of cannula120during assembly. InFIG.5A, the camera module and LEDs are not shown for clarity. Visible are camera distal opening530and LED distal openings532and534. Also visible inFIG.5Aare distal fluid ports320and520. According to some embodiments, the device channel516and device channel opening116can also be used as a fluid channel and fluid port, respectively.

FIG.5Bis a side view of distal tip piece310. According to some embodiments, the maximum outer diameter of tip piece310and cannula120is 6.0 mm. In the example shown, the dimensions of the outer diameter of tip piece310can be 5.6 mm in cases where the cannula outer diameter is about 4.85 mm. According to some embodiments, the tip piece310can have an outer diameter of 5.1 mm in cases where the cannula outer diameter is about 4.65 mm. Also visible inFIG.5Bis the angled upper distal face portion510which as described supra, provides for positioning of the device opening to be slightly more distal than the surface of camera module, which allows for a better view by the camera module of the grasper claw portions, or other tool being deployed. According to some embodiments, the face portion510is angled distally by about 25 degrees or 30 degrees.

FIG.5Cis a front view of distal tip piece310. In this view the camera module330and LEDs332and334are shown inserted in openings530,532and534(which are shown inFIG.5A), respectively. The diameter of the device channel opening116can be 2.0 mm in cases where the outer diameter of piece310is 5.6 mmm, and can be 1.6 mm in cases where the outer diameter of piece310is 5.1 mm.FIG.5Dcross-section view along B-B′ ofFIG.5C. The proximal opening512is dimensioned to accept and be bonded with the distal end of cannula120. The inner diameter of opening512can be 4.85 mm in cases where the outer diameter of the cannula is 5.6 mm, and can be 4.65 mm in cases where the outer diameter of the cannula is 5.1 mm.

FIG.5Eis a cross section view of cannula120. The device channel (or working channel)516is visible and is used to carry the grasper device160or another tool. Also visible are the fluid lumens522and524, and cable lumen526. According to some embodiments, fluid lumens522and524are fluidly attached to proximal fluid port132,232or234(shown inFIGS.1B and2) and to distal fluid ports320and520. The cable lumen526is used to carry the electrical cable(s) used by the camera module and LEDs. According to some embodiments, device channel516having an inner diameter of 2.0 mm provides adequate fluid flow capacity when the grasper shaft420(shown inFIG.4D) has a dimension of 1 mm by 1.5 mm.

FIGS.6A-6D and7A-7Dare two sets of diagrams illustrating a process of opening, closing, and retracting a grasper device from an endoscopy system, according to some embodiments.FIGS.6A-6Dillustrate the grasper160in different positions relative to the distal tip110whileFIGS.7A-7Dshow the relative positions of the collar170configured to control grasper160and shaft168.FIGS.6A and7Ashow the grasper and collar positions, respectively, when the grasper jaw portions162and164, and claw portions172and174in an “open” position. In this position, the arch shaped portions182and184protrude distally from the device opening116as can be seen inFIG.6A. The collar170is shown in a distal position relative to shaft168as shown inFIG.7A. The collar170is mounted or otherwise securely directly or indirectly attached to a proximal end of main shaft420(shown in dashed outline) of the grasper device. While the grasper160is in the distally protruded position from the distal opening116as shown inFIGS.6A and7A, the biased shape of the grasper device maintains the jaw portions162and164and claw portions172and174apart from each as shown.

FIGS.6B and7Bshow the grasper and collar positions, respectively, when the grasper being moved proximally relative to the distal device opening116as indicated by dashed arrow620inFIG.6B. This is accomplished by the operator manually sliding collar170proximally along shaft168as shown by dashed arrow720inFIG.7B. In the position shown inFIGS.6B and7B, the proximal ends of arched shaped portions182and184are just beginning to engage with edge of distal opening116. This engagement will tend for force the claw portions172and174towards each other, as shown by dashed arrows622inFIG.6B. Note that due to the distanced between the device opening116and claw portions172and174, the camera module330having a wide-field of view (depicted by dotted lines730) has a good view of claw portions172and174and any tissue (or object) that might be the target of being grasped (not shown).

FIGS.6C and7Cshow the grasper and collar positions, respectively, when the grasper claws securely clamped towards each other. InFIG.6C, it can be seen that the arched portions182and184are shown retracted proximally of distal device opening116. InFIG.7Cthe collar170is shown in a more proximal position relative to shaft168than inFIG.7B. The arched portions182and184are forced together with the device channel (either within tip piece310or working channel516of cannula120(shown inFIG.5E). Portions182and184being held together forces the claw portions172and174to be in a closed position and any tissue (or other object) that might be being grasped (not shown) is securely held by the claw portions.

FIGS.6D and7Dshow the grasper and collar positions, respectively, when the grasper device160retracted even more proximally than inFIG.6C. InFIG.6D, the claw portions182and184are shown nearly flush with the distal face of opening116. InFIG.7Dthe collar170is shown retracted fully proximally along shaft168.

FIG.8is a block diagram illustrating the operation of using an endoscopy device with an integrated grasper, according to some embodiments. In block810, the endoscope (e.g. endoscopy device100shown inFIGS.1A,1B and3A) is inserted into the target cavity while the grasper is retracted (e.g. in the position shown inFIG.7D). Examples of target cavities include the bladder and uterus, although the endoscopy device and integrated grasper can be configured for insertion into and in operation with other cavities in the human body. In block812the endoscope is translated or rotated to approach the target. In block814the tab or collar (e.g. collar170shown inFIGS.1A-B,2,3A,3C and7A-7D) at the proximal end of the cannula is pushed distally. Pushing the tab or collar distally causes the grasper or needle to protrude out of the distal tip of the cannula. The grasper jaw opens after emerging from the distal cannula (such as shown inFIG.7A). In block816, under direct view of camera images being shown on the integrated display (e.g. display150shown inFIGS.1A-B,2, and3A), the claw portions of the grasper (e.g. portions172and174shown inFIGS.10,3B,4Cand6A-6D) are positioned around the target while advancing the cannula. In block818the grasper is retracted back into the cannula which forces the jaw to close and grab the target securely, such as shown inFIGS.6C and6D. According to some embodiments, applications for using the endoscopy device with integrated grasper include, without limitation: stent removal, foreign body removal, hysteroscopy and endometrium biopsy. According to some embodiments, pushing the tab or collar distally can have the opposite effect and cause the grasper or needle to retract and pulling the tab or collar proximally can cause the grasper or need to extent.

FIG.9Ais a perspective view showing an endoscopy system having cannula with an integrated grasper device, according to some further embodiments. In this case the single-use portion902is configured to be mounted and unmounted with multiple use portion904. According to some embodiments, multiple use portion904is similar or identical to the multiple use portions shown and described in the commonly assigned incorporated applications. The single-use portion902and reusable portion904attach mechanically primarily via mating mechanical connectors920and922, as shown by the dotted arrow. Electrical connection is made via separate mating electrical connectors910and912. Instead of collar170sliding along shaft168of single use portion102(shown inFIGS.1A,1B and3A), inFIG.9A, tab970is provided that is configured to slide along shaft968as shown by the dashed arrow. Tab970is attached to the proximal end of the grasper device160. An additional fluid port932is provided that is fluidly connected to the device channel (e.g.516inFIG.5E) through which grasper160is positioned. Also shown inFIG.9Ais a fluid line962and syringe960which can be attached to fluid port932. The syringe960can be used to draw fluid samples (and tissue particles suspended therein) back through the distal device opening (116), device channel (516), port932and into syringe960. A second syringe964and fluid line966, or other fluid delivery device, can be attached to fluid port132to provide in-flow fluid via ports320and520at distal tip110(shown inFIG.3B). According to some embodiments, the two fluid ports132and932can provide “continuous inflow/out flow” operation. According to some embodiments, fluid or tissue debris can be withdrawn from the target cavity through port932while in-flow fluid (such as saline) is provide via port132. In this way, inflow fluid distention and pressure can be controlled during the procedure. According to some embodiments, the in-flow and out-flow can be reversed between ports132and932such that port932is used for fluid in-flow (via device opening116) and port132is used for fluid (and tissue) out-flow via distal ports320and520.

The remaining components of the single use portion902are similar or identical to single use portion102and components thereof shown inFIGS.1A,1B,3A,3B,4A-4D,5A-5D and6A-6D. It is understood that single use portion902could be substituted for single use portion102in any descriptions or depictions of portion102herein. It is also understood that multiple use portion904could be substituted for multiple use portion104in any descriptions or depictions of portion104herein. For example, it is understood that hand piece140includes two buttons configured for power on/off as well as optionally a third button configured as an exposure and/or lighting control button, as described, supra.

FIGS.9B-9Dare side, top and bottom views, respectively, of a single-use portion of an endoscopy system with an integrated grasper device, according to some further embodiments. According to some embodiments, the working length L of cannula120including distal tip110is between 250 mm and 300 mm. According to some embodiments, the working length L is 275 mm and the distance d, where the grasper160is fully distally protruded, is 15 mm.

FIG.9Eis an exploded view showing further details of a single-use portion of an endoscopy system with an integrated grasper device, according to some further embodiments. At the distal end, distal tip piece310, camera module330and LEDs332and332are shown. Electrical cable972is shown which is connected at its distal end to camera module330and LEDs332and332. Grasper160, including its elongated shaft420, is also shown. Grasper160and cable972are positioned in separate lumens (516and526, respectively, shown inFIG.5E) within cannula120. At the proximal end of cannula120, hub130is shown which has an inner cavity in fluid communication with fluid port932. According to some embodiments, the device channel516of cannula120has an opening (e.g. by “skiving”) within hub130to provide fluid communication between the device channel and fluid port932. A silicone seal990is provided to prevent fluid leakage proximally of hub130. The seal990has two openings through which cable972and shaft420of grasper160pass. The second fluid port132is in fluid communication with fluid hub housing980. The cavity within housing980is in fluid communication with the fluid lumens of cannula120(lumen522and lumen524shown inFIG.5E), for example by an opening (e.g. by “skiving”). The proximal end of hub980is sealed with silicone seal992, which also has two openings through which cable972and shaft420of grasper160pass. Grasper end piece994can be a machined metallic piece that is bonded (e.g. by welding) to the proximal end of shaft420. End piece994, in turn, is securely mounted to slider piece974which includes tab970. Slider piece974also includes spring tab1020which is shown inFIGS.10A-10Dand described in further detail, infra. Slider piece974is dimensioned to slide within shaft housing968. According to some embodiments, elastomer ring996is provided to add additional frictional resistance to the sliding actuation of the slider piece974and grasper160. A rotation socket984fits into shaft housing968proximal to the slider piece974. The socket984accepts slotted axle piece986to allow for rotation of socket piece984, shaft housing968, slider piece974, and all of the components located distally of axle piece986as shown by arrows122(and also shown inFIGS.1A-1B,2,3A,9A-9D and11A) relative to multiple-use portion140. According to some embodiments, rotation is confined to, slightly less than 180 degrees in either direction to avoid excessive torsional stress on cable972.

FIGS.10A-10Dare a set of diagrams illustrating a process of opening, closing, and retracting a grasper device from an endoscopy system, according to some embodiments.FIGS.10A-10Dare similar toFIGS.7A-7Dexcept that tab970is actuated instead of collar170. In particular, the positions of tab970shown inFIGS.10A,10B,100and10Dcorrespond to the positions of grasper160shown inFIGS.6A,6B,6C and6D, respectively. Note that in the example shown, single use portion902is configured with only one fluid port (132) instead of two fluid ports (e.g.132and932as shown inFIGS.9A-9E). In such cases fluid port132can be configured as fluidly communicating with the side fluid lumens522and524and distal fluid ports320and520(shown inFIGS.5E and5A, respectively). According to some embodiments, device channel (516shown inFIG.5E) is not fluidly attached to any proximal fluid port. According to some other embodiments, an alternative proximal fluid port934can be configured to be fluidly attached to the device channel to provide a total of two proximal fluid ports.

According to some embodiments, the shaft968also includes a releasable locking mechanism as well. In the position shown inFIG.10A, a spring tab1020protrudes through distal window1034. The shape of tab1020has a square shaped proximal edge1040that engages the square shaped proximal edge of window1034which effectively “locks” or prevents retraction or proximal movement of grasper160relative to the cannula120(shown elsewhere). When the operator wishes to retract the grasper (or needle), the lock release button1030is depressed which forces the spring tab1020inwards though the window1034. In the depressed state, the spring tab1020is no longer “locked” by the distal window1034and the actuation tab970can then be moved rearwards or proximally relative to the housing of shaft968which causes the grasper (or needle) to retract. According to some embodiments, the spring tab1020can be shaped with square edges on both proximal and distal sides which will allows for the grasper (or needle) to be releasably locked in the both the retracted position (shown inFIGS.10D and6D) and protruded position (shown inFIGS.10A and6A). In such cases, the lock release button1030is used to unlock the tab1020in either position to allow actuation of the grasper (or needle). For further details of a possible configuration of spring tab1020and the locking mechanism(s) see, e.g. U.S. Ser. No. 15/462,331, one of the commonly assigned incorporated applications.

FIGS.11A-11Bare perspective diagrams of an endoscopy system having cannula with an integrated needle, according to some embodiments. The needle1160could be used, for example, in surgical procedures to inject fluid such as a drug into the patient's tissues. Shown is single use portion1102configured with needle1160positioned in the working channel of the cannula120(e.g. working channel516inFIG.5E). In the example shown, fluid port132is configured as fluidly communicating with the side fluid lumens522and524and distal fluid ports320and520(shown inFIGS.5E and5A, respectively). Proximal fluid port934next to sliding tab970is configured to be fluidly attached to the central channel1162of needle1160.

Apart from substituting needle1160for grasper160and the configuration of fluid port934described supra, the rest of the single use portion1102is the same or similar to single use portions902and102shown and described elsewhere herein. According to some embodiments, the needle1160is positioned within working channel516(shown inFIG.5E) which is off-center and on the concave side of the bend portion108of the cannula120. Positioning an otherwise straight needle1160within the working channel on the concave side of the bend (above center in this case) the natural spring-like stiffness of the needle1160will tend to force of needle back towards the center, or downward in this case, when exiting the device channel opening116. The effect is that the distal tip of needle1160will be pushed slightly toward the camera axis or toward the center of the camera field of view, making for better imaging and viewing of the tool by the operator.

Although the foregoing has been described in some detail for purposes of clarity, it will be apparent that certain changes and modifications may be made without departing from the principles thereof. It should be noted that there are many alternative ways of implementing both the processes and apparatuses described herein. Accordingly, the present embodiments are to be considered as illustrative and not restrictive, and the body of work described herein is not to be limited to the details given herein, which may be modified within the scope and equivalents of the appended claims.