Manually actuated function hose instrument and operating device therefor

A manually actuated function hose instrument has a hose-shaped function part and a wire-shaped function part extending in the latter, wherein the two function parts are axially movable relative to each other in order to exert a useful function at a distal section remote from a proximal end section. An associated operating device, which has two operating parts, is arranged at the proximal end section of the function parts. A fixing part is provided which serves for the external fixing of the operating device and with which the second operating part is coupled in an axially relatively movable manner, and/or the second operating part is connected non-releasably to the proximal end section of the hose-shaped function part and contains an operating ring with a circumferential finger recess as operating area.

BACKGROUND AND SUMMARY OF THE INVENTION

The invention relates to a manually actuated functional hose instrument with a hose-shaped functional part and with a wire-shaped functional part extending in the latter, wherein the two functional parts are axially movable relative to each other in order to perform a useful function at a distal section remote from a proximal end section, and the invention also relates to an associated operating device. The operating device has a first operating part, which is connected to the proximal end section of the wire-shaped functional part and has an operating head at the proximal end of the wire-shaped functional part, and a second operating part, which is connected to the proximal end section of the hose-shaped functional part and has an operating area lying at an axial distance in front of the operating head.

In the present context, a hose-shaped functional part is to be understood generally as any elongate hose or tube structure that has a hollow channel for the passage of the wire-shaped functional part. In the present context, a wire-shaped functional part is to be understood as any elongate component that is received in the hollow channel of the hose-shaped part so as to be axially movable relative thereto and that is made of a solid or hollow metal or plastic material.

Manually actuated functional hose instruments of this kind are customary, for example, in the field of endoscopic medicine, especially in the form of stone-catching basket instruments with a deployable wire basket for collecting stones or the like in tissue spaces, and similar instruments such as wire filter instruments, wire loop instruments and collecting net instruments. In these known uses, a deployable element such as the wire basket, a wire filter, a wire loop or a collecting net is typically arranged at the distal end of the wire-shaped functional part, and, by moving the wire-shaped functional part axially back and forth relative to the hose-shaped functional part surrounding it, this element is collapsed and drawn into the distal end of the hose-shaped functional part or is moved out of the latter and deployed.

A similar use concerns guide wire units for catheter instruments, where the wire-shaped functional part is a so-called tension wire, and the hose-shaped functional part is a hose surrounding the latter, which hose is connected to the tension wire in the distal area. By axial relative movement of tension wire and hose, a distal section of the guide wire unit can be deformed in a desired manner, e.g. bent, or a slotted distal section of the hose-shaped functional part can be axially shortened and in this way opened out like a wire basket.

Laid-open specification US 2005/0113862 A1 discloses a guide wire unit of this kind, in which the hose has, in the proximal end section, an area that is elastically compressible in the axial direction by means of a slit, and which guide wire unit has, in its proximal end section, an operating device. The latter comprises a first operating part, which acts with an operating head on the proximal end of the tension wire, and a second operating part, which is connected to the hose in front of the elastic area thereof. The second operating part has a grip sleeve with a screw clamp, by means of which it can be clamped firmly on the hose. The operating head has a blind bore, into which the proximal end of the wire-shaped functional part, with the proximal end of the hose surrounding the latter, is placed to the rear of the elastic area. A guide sleeve, formed integrally on the operating head and protruding axially in the distal direction, surrounds the proximal end section of wire-shaped functional part and hose-shaped functional part and is guided telescopically and axially movably in the grip sleeve.

It is an object of the invention to provide a manually actuated functional hose instrument of the type mentioned at the outset, which permits comparatively simple, ergonomic and reliable operation by one hand, and an operating device suitable therefor.

The invention achieves this object by providing an operating device which comprises a first operating part, which is connected to the proximal end section of the wire-shaped functional part and has an operating head at the proximal end of the wire-shaped functional part and a second operating part, which is connected to the proximal end section of the hose-shaped functional part and has an operating area lying at an axial distance in front of the operating head. According to a first aspect of the invention, a fixing part is further provided which serves for the external fixing of the operating device and to which the second operating part is coupled in a mutually axially movable manner. According to another aspect of the invention, the second operating part is connected non-releasably to the proximal end section of the hose-shaped functional part and has an operating ring with a circumferential finger recess as an operating area. The invention further provides a manually actuated functional hose instrument equipped with an operating device according to the invention.

The operating device according to the invention thus comprises a fixing part, to which the second operating part is coupled in an axially movable manner, and/or an operating ring with circumferential finger recess as second operating part, which is connected non-releasably to the hose-shaped functional part. Both measures, individually or in combination, ensure that the functional hose instrument can be operated comfortably and reliably, particularly using one hand, with the operating head being actuated by the thumb of one hand and the operating ring being held between two fingers, e.g. between index finger and middle finger, or between middle finger and ring finger, the fingers in question being placed in the finger recess of the operating ring. The finger recess serves as operating area and prevents the operating ring from accidentally slipping through the space between the two fingers holding it. The non-releasable connection, e.g. a bonded or welded connection, holds the operating ring securely on the hose-shaped functional part, without adversely affecting the axial mobility of the wire-shaped functional part in the hose-shaped functional part. The desired axial relative movement between wire-shaped functional part and hose-shaped functional part can be achieved very easily by actuation of the operating head using a thumb.

The fixing part allows the operating device to be fixed to an external component, e.g. to an endoscope in the case of a corresponding medical endoscopy instrument. The second operating part can be moved axially relative to the fixing part, e.g. by corresponding actuation of the operating ring. Thus, for example in the case of a medical functional hose instrument, such as a stone-catching basket instrument or the like, inserted into an endoscope channel, the hose-shaped functional part, and possibly also the wire-shaped functional part in synchrony therewith, can be moved axially back or forth in the endoscope channel.

In a development of the invention, the first operating part is connected to the wire-shaped functional part for rotation therewith and is movable in rotation with respect to the second operating part. This measure makes it possible to rotate the wire-shaped functional part relative to the hose-shaped functional part, preferably freely in rotation without any limit on the rotation angle, by turning the first operating part correspondingly relative to the second operating part and, therefore, to the hose-shaped functional part connected non-releasably to the latter. This can also still be done by one-handed operation. Alternatively, the user can use his other hand for this purpose.

In a development of the invention, the first operating part is guided telescopically on the second operating part by means of guide sleeves that are suitably guided one inside the other. This permits an advantageous and reliable actuation of the two operating parts relative to each other, in order to obtain the desired axial relative movement of the two functional parts. In another embodiment, a helical spring is provided, which acts in the axial direction between the two operating parts and which surrounds the proximal end section both of the wire-shaped functional part and also of the hose-shaped functional part and bears at one end on the operating head and at the other end on the guide sleeve of the second operating part. Thus, in a manner that is advantageous in terms of design and function, the two functional parts can be pretensioned by pressure or tension into an end position of their axial relative mobility, for example, in the case of a medical stone-catching basket instrument, into a starting position with the catching basket drawn into the hose-shaped functional part.

In a development of the invention, using two guide sleeves suitably guided one inside the other, a telescopic guidance of the second operating part on the fixing part is provided. In this way, the second operating part, and with it the hose-shaped functional part, can be moved axially back or forth in a functionally reliable manner relative to the fixing part, either with or without the first operating part and the wire-shaped functional part. In another embodiment, an elastic pretensioning element is provided, which acts in the axial direction between the fixing part and the second operating part, e.g. in the form of a corresponding helical spring. In this way, the hose-shaped functional part can be pretensioned with pressure or tension into a desired axial end position relative to the fixing part.

In a development of the invention, the fixing part has an attachment means for releasable mounting on an endoscope. This permits an advantageous use of the manually actuated functional hose instrument for endoscopic applications.

In a development of the invention, the first operating part is connected releasably to the wire-shaped functional part. It is thus possible, if need be, to release the first operating part from the wire-shaped functional part. This can be advantageous, for example in endoscopic applications, in order to be able to pull the first operating part, together with the second operating part and the hose-shaped functional part, proximally from the wire-shaped functional part.

The manually actuated functional hose instrument according to the invention advantageously has an operating device according to the invention for effecting the axial relative movement of hose-shaped functional part and wire-shaped functional part for the purpose of effecting the corresponding useful function. In particular, the instrument can be a stone-catching basket instrument, a wire filter instrument, a wire loop instrument or a collecting net instrument for endoscopic applications, as are known per se to a person skilled in the art. If so desired, the operating device can also be retrofitted on an otherwise conventional functional hose instrument.

DETAILED DESCRIPTION OF THE DRAWINGS

The operating device shown inFIG. 1serves for the manually actuated operation of a functional hose instrument that has a hose-shaped functional part1and a wire-shaped functional part2extending in the latter in a mutually axially movable manner, which parts are shown inFIG. 1by their proximal end section. The axial relative mobility of the hose-shaped functional part1, hereinafter also referred to in short as the hose, and of the wire-shaped functional part2, hereinafter also referred to in short as the functional wire or tension wire, serves to perform a useful function at a distal section of the instrument remote from the proximal end section; this does not necessarily have to be the distal end section, and instead it can also be a section of the two functional parts1,2that lies between the proximal end section and a distal end section. Hose1and functional wire2can be made of any suitable solid or hollow plastic or metal materials, as are known per se to a person skilled in the art for the intended use of the particular functional hose instrument. Depending on the requirements, the hose1can be more flexible or stiffer than the functional wire2.

The operating device shown has a first operating part3, which is connected rigidly and non-releasably to the functional wire2, and a second operating part4, which is connected rigidly and non-releasably to the hose1. The first operating part3has an operating head3a, which directly adjoins a proximal end2aof the functional wire2, it being connected to the latter in a non-releasable manner, e.g. by a bonded or welded connection. The first operating part3further comprises an operating head guide sleeve3b, which is integrally formed on the operating head3aand protrudes axially from the latter in the distal direction, i.e. to the left inFIG. 1. The second operating part4has an operating ring4a, and an operating ring guide sleeve4bwhich, together with the operating head guide sleeve3b, forms a guide means of the telescopic type, by means of which the two operating parts3,4are guided on each other in a mutually axially movable manner. Furthermore, the two operating parts3,4are thereby freely rotatable with respect to each other about their common longitudinal center axis. The operating head guide sleeve3bprotrudes in the proximal direction, i.e. rearward, from the operating ring guide sleeve4b, such that the operating head3ais located at an axial distance behind the operating ring4a.

At its distal face5, the operating ring guide sleeve4bis provided with a central bore6, through which the two functional parts1,2are guided. On the inner edge of its bore6, the operating ring guide sleeve4bis connected fixedly and non-releasably to the hose1, e.g. by a bonded or welded connection. At its proximal face7, the operating ring guide sleeve4bis connected fixedly to the operating ring4a, preferably by means of operating ring4aand operating ring guide sleeve4bbeing produced as a one-piece component.

Furthermore, the operating device shown has a fixing part9, which serves for the external fixing of the entire operating device, i.e. for fixing the latter on an external component, for example on an endoscope component in the case of a medical use of the functional hose instrument in endoscopy. The fixing part9has an attachment part9a, in the example shown a conventional Luer connector, and a fixing part guide sleeve9bthat extends axially from the attachment part9ain the proximal direction. Correspondingly thereto, the second operating part4has another and outer operating ring guide sleeve4c, which coaxially surrounds the inner operating ring guide sleeve4bto form an annular gap10. The fixing part guide sleeve9bcooperates with the outer operating ring guide sleeve4cto form a guide means of the telescopic type for guiding the second operating part4on the fixing part9in a mutually axially movable manner. The fixing part guide sleeve9bis received in the annular gap10between inner and outer operating ring guide sleeve4b,4c.

As is shown, the operating ring4ahas, on its outer periphery, a circumferential and semicircular recess11which functions as a finger recess and thus contributes to an ergonomic and reliable actuation of the operating device by a user. This can be done preferably, or as far as possible, using one hand, with the user positioning the operating ring4abetween two neighboring fingers, which he places in a respective area of the finger recess11, e.g. between index finger and middle finger, or between middle finger and ring finger, after which he presses the operating head3awith his thumb and thus moves the first operating part3with the functional wire2relative to the second operating part4with the hose1. Compared to illustrative embodiments of the invention in which the second operating part does not have any such finger recess, the illustrative embodiments with finger recess ensure a better hold of the second operating part by two neighboring fingers of one hand. Alternatively to the circumferentially extending finger recess mentioned, it suffices, in alternative illustrative embodiments of the invention, to design the finger recess in the form of two circumferentially opposite recess areas of a suitably modified operating ring, in which recess areas the two neighboring fingers can be placed.

Preferably, one or more elastic pretensioning elements are present, in order to ensure that the mutually axially movable components are kept pretensioned in an axial end position by pressure or tension, from which end position they can then be moved by active user actuation. For this purpose, in the example shown inFIG. 1, a first helical compression spring12is provided between first and second operating parts3,4, and a second helical compression spring13is provided between second operating part4and fixing part9. The first helical compression spring12surrounds the proximal end section both of the functional wire2and also of the hose1, by extending in an annular gap between the hose1and the operating head guide sleeve3b, and it bears axially at one end on the distal face5of the inner operating ring guide sleeve4band at the other end on the operating head3a. In this way, the helical compression spring12pretensions the first operating part3with pressure into an extended position of its telescopic guide on the second operating part4, i.e. into a position in which the functional wire2is drawn back relative to the hose1. Analogously, the other helical compression spring13pretensions the second operating part4with pressure into an extended position of its telescopic guide on the fixing part9, in which position it surrounds the two associated guide sleeves9b,4cand bears axially at one end on the attachment part9aand at the other end on the operating ring4a.

The end positions, into which the respective components of the operating device are pretensioned by the two helical compression springs12,13, are defined by suitable limit stops of the telescopic guide sleeves. In particular, the drawn-back end position of the first operating part3is defined by a corresponding limit stop14of the distal end section of the operating head guide sleeve3bon the proximal end section of the inner operating ring guide sleeve4b, and the pushed-back end position of the second operating part4relative to the fixing part9is defined by a corresponding limit stop15of the proximal end section of the fixing part guide sleeve9bon the distal end section of the outer operating ring guide sleeve4c.

Hereinafter, the advantageous operation of a manually actuated functional hose instrument equipped with the operating device fromFIG. 1is discussed in more detail in connection withFIGS. 2 to 8, which depict typical operating situations. A medical stone-catching basket instrument is taken here as an example of a manually actuated functional hose element. It will be appreciated, however, that the invention similarly covers any other manually actuated functional hose instruments which are intended for medical and non-medical uses and which are equipped with such an operating device. Examples of medical uses that may be mentioned here are, in particular, wire filter instruments, wire loop instruments and collecting net instruments.FIGS. 2 to 8also depict, by way of example, the situation where the functional hose instrument or stone-catching basket instrument is fixed, via the attachment part9aof the fixing part9of the operating device, to a proximal end of an endoscope channel16, of which only a short section is represented schematically in each ofFIGS. 2, 3, 5 and 7and which can be formed, for example, by an endoscope tube with a proximal endoscope attachment part.

FIG. 2shows the functional hose instrument or stone-catching basket instrument in a starting position in the endoscope channel16, which position corresponds to the pretensioned position of the operating device as shown inFIG. 1. To make matters clearer, the pretensioning spring elements12,13have been omitted in the views inFIGS. 2 to 8. In the starting position inFIG. 2, a catching basket17arranged at the distal end of the functional wire2is in a collapsed state and drawn back into the distal end section of the hose1.

By pressing on the operating head3a, e.g. with the thumb, while securely holding the operating ring4ain the one-handed operation described above, it is possible for the functional wire2to be pushed forward relative to the hose1into the functional position shown inFIG. 3, as a result of which the wire basket17moves out from the hose1and automatically deploys. This functional end position can be defined, for example, by the operating head3acoming into abutment against the operating ring4aor the corresponding operating ring guide sleeve4band/or by the operating head guide sleeve3bcoming into abutment with its distal face against the distal end area5of the corresponding operating ring guide sleeve4b. For this purpose, the course of the axial relative mobility between the two operating parts3,4corresponds at least to the axial length by which the wire basket17is to move out of the hose1. The detail view inFIG. 4shows more clearly the position of the operating device, which corresponds to the functional position of the stone-catching basket instrument according toFIG. 3.

FIGS. 5 and 6illustrate a situation in which the entire stone-catching basket instrument, i.e. hose1and tension wire2, is pushed forward in the endoscope channel16, for example in order to collect a stone farther away from the distal end of the endoscope channel16. To do this, the user pushes the second operating part4with operating ring4adistally forward onto the fixing part9.FIGS. 5 and 6show, in particular, the instrument in a position in which the telescopic guide has in this way been pushed together by slightly more than half between second operating part4and fixing part9. The first operating part3is thus also moved forward synchronously with the second operating part4and, in the corresponding end position, is held pretensioned on the second operating part4. Hose1and tension wire2, with catching basket17drawn at the distal end into the hose1, are therefore moved forward synchronously in the endoscope channel16until the distal end of the instrument has reached a desired position in front of the endoscope channel16.

In this instrument position, the user can then deploy the catching basket17by holding the operating ring4asecurely and pressing on the operating head3auntil the catching basket17has emerged from the distal end section of the hose1, as has been explained above with reference toFIG. 3.FIGS. 7 and 8show the instrument in this pushed-forward state with automatically deployed catching basket17. As is clear fromFIG. 8, the operating head3ain this position, compared to the situation inFIG. 6, is located in its position adjacent to the operating ring4ain accordance withFIG. 4.

In the position with the catching basket17deployed as inFIG. 3orFIG. 7, the user is able to collect a stone or a similar tissue particle. If need be, the user can rotate the catching basket17in order to make collecting the stone or particle easier. For this purpose, the first operating part3, which is connected rigidly to the functional wire2and therefore also rotates therewith, simply has to be rotated via its operating head3aor guide sleeve3b. The user is also generally able to do this by the one-handed operation described. If need be, the user can use his other hand to rotate the first operating part3. As has already been mentioned above, the first operating part3is held freely rotatably on the second operating part4. It will be noted that, during this rotation movement, the functional wire2rotates in the hose1, which in this case does not have to rotate too. Problems associated with a rotation movement of the hose1in the endoscope channel16, for example increased frictional effects, etc., can thus be avoided.

As soon as the stone or particle has been collected, the user releases the pressure on the operating head3a, as a result of which the latter is pressed back by means of the associated helical compression spring12. In this way, the tension wire2is moved back relative to the hose1, and the catching basket17is drawn partially into the hose1until it has been closed together to such an extent that it securely encapsulates the collected stone or particle. In this position, the entire instrument can then be withdrawn, along with the collected stone, from the tissue channel in question.

FIG. 9shows a variant with a modified first operating part3′, specifically a modified operating head3′a, the operating device inFIG. 9otherwise corresponding in design and function to that inFIGS. 1 to 8, and the same reference signs have been chosen inFIG. 9for identical or functionally equivalent components, such that reference may be made in this respect to the above discussion of the operating device inFIGS. 1 to 8. The operating device inFIG. 9differs from the one inFIGS. 1 to 8in that the connection of operating head3′aand functional wire2is releasable. For this purpose, the operating head3′ahas an operating head sleeve18and a locking screw19, which is screwed into a radial bore20of the operating head sleeve18. The operating head sleeve18surrounds the proximal end area of the functional wire2, the operating head guide sleeve12protrudes from the distal front end of the operating head sleeve18, and the proximal front end of the latter terminates substantially flush with the proximal end2aof the functional wire2, which proximal end is hemispherical in this example. When the locking screw19is tightened, the operating head3′ais clamped on the proximal end area of the functional wire2. The instrument is actuated by pressing, e.g. with the thumb, on the proximal front end of the operating sleeve18, in which case the exposed hemispherical end2aof the functional wire2is also available as operating surface.

The releasable connection of operating head3′aand functional wire2has advantages, for example in the case where the stone-catching basket instrument has collected a stone in the distal wire basket, but it turns out that the stone is too big to be able to be removed by pulling the instrument out of the endoscope channel. In this case, in the instrument equipped with the operating device ofFIG. 9, the clamping connection of the first operating part3′ on the functional wire2can be released by loosening the tightening screw19. After the fixing of the operating device on the endoscope channel has been undone by correspondingly releasing the attachment part9a, the entire operating device with the first operating part3′, second operating part4and fixing part9, and with the hose1fixed on the second operating part4, can be pulled back proximally and off of the functional wire2. If need be, the releasable connection of first operating part3′ and functional wire2can of course also be used to remove only the first operating part3′, for which purpose the telescopic connection of the guide sleeves4b,12between the first operating part3′ and the second operating part4is additionally uncoupled.

The above illustrative description of the operation of a medical stone-catching basket instrument makes clear that, by virtue of the operating device according to the invention, a suitably equipped functional hose element can be actuated very advantageously by hand, preferably and as far as possible by just one hand. For this purpose, the user holds the operating ring4abetween two neighboring fingers and actuates the operating head3awith the thumb. By moving the operating ring4aaxially back and forth relative to the fixing part9, it is possible for the entire instrument, i.e. the hose-shaped functional part and the wire-shaped functional part, to be moved back and forth synchronously relative to an external component on which the instrument is fixed by its fixing part. By pressing on the operating head3awhile keeping the operating ring4asecure, the user can perform a desired useful function in the distal section of the instrument. In any case, he does not need help from another person for any part of the operation of the instrument.

It will be appreciated that the advantageous effects and properties explained above for the operation of a medical stone-catching basket instrument apply in the same way for the operation of other manually actuated functional hose instruments that are equipped with the operating device according to the invention.