Abstract:
The present invention includes systems and methods for decreasing the pain and discomfort commonly associated with endoscopic procedures, where such procedures may be performed with lower dosage levels of sedative and analgesic drugs. The invention includes use of an anesthetic collar coupled to an endoscope with a flexible shaft. The anesthetic collar allows lubricants, local anesthetics, dyes, and/or other desirable fluids to be passed through the existing lumen of the flexible shaft into an annulus, where the fluid may be distributed through expulsion pores into the gastrointestinal tract. Utilizing the existing lumens found in endoscopes, the present invention allows those fluids that may reduce the pain and discomfort associated with endoscopies such as, for example, local anesthetics and lubricants, to be distributed in an even fashion throughout the gastrointestinal tract or throughout the length and circumference of the endoscope, where such fluids may reduce the drug level requirements for sedative and analgesic agents. Alternatively, the endoscope may be redesigned for streamlined integration with the anesthetic collar or to accomplish the same function of distributing local anesthetics and lubricants, in an even fashion throughout the gastrointestinal tract or throughout the length and circumference of the endoscope, The invention can also be used with endoscopes without existing lumens.

Description:
CROSS REFERENCE TO RELATED APPLICATIONS 
   This application claims priority under 35 U.S.C. §119(e) to U.S. Provisional Patent Application No. 60/430,055, “Systems and Methods for Providing Gastrointestinal Pain Management,” filed Dec. 2, 2002, which is hereby incorporated by reference. 

   STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT 
   Not Applicable 
   REFERENCE TO A “MICROFICHE APPENDIX” 
   Not Applicable 
   BACKGROUND OF THE INVENTION 
   1. Field of the Invention 
   The present invention relates, in general, to systems and methods of medical pain management and, more particularly, to the management of pain and discomfort associated with endoscopies. 
   2. Description of the Related Art 
   Endoscopy is a term used to describe medical procedures involving the use of an endoscope, where an endoscope is an instrument for examining visually the interior of a bodily cavity or a hollow organ such as the colon, bladder, or stomach. Endoscopic procedures include colonoscopies, esophagogastroduodenoscopies (EGDs), and other visually invasive procedures, where a number of fiber optic and video chip endoscopes have been specifically designed and adapted to particular areas of operation. 
   Colonoscopies and other procedures involving the insertion of an endoscope into the colon of a patient are generally performed using sedation administered intravenously with medications such as benzodiazepine sedatives (Midazolam) and/or opioid narcotic analgesics (Fentanyl). Undesirable effects of IV sedation drugs for a patient may include, among others, respiratory depression, missed work due to time of recovery from drug effect, and anaphylaxis or other allergic reactions. The pain and discomfort of endoscopies are generally attributable to the stimulation of pain sensitive nerve endings found in the mucous membranes of the gastrointestinal tract. In attempts to alleviate the pain and discomfort in the absence of sedatives, oral and rectal local anesthetic sprays have been developed that deliver lidocaine and other local anesthetic agents to a particularly sensitive region. These agents may have only a nominal affect on the pain and discomfort experienced by the patient as the endoscope is driven farther into the gastrointestinal tract. 
   Colonoscopy is a generic term describing the common procedure employed in examining the colon with a fiber optic system which is known as a colonoscope. The colonoscope is also used in removing polyps and other tissue in the colon for diagnostic and other purposes. 
   During an examination, the colonoscope (or endoscope) is driven into the rectum, through the sigmoid colon and the descending colon into the splenic flexure. At this point, the scope must be manipulated through a ninety-degree bend to enter the transverse colon. While colonoscopes generally have a steerable or bendable head, the force necessary to progress the colonoscope across the splenic flexure can only be applied by pushing the colonoscope from outside the anus in a direction at right angles to the desired direction of travel. After the colonoscope has moved through the transverse colon, the colonoscope encounters the hepatic flexure, another ninety-degree turn leading to the ascending colon. To steer the scope down the ascending colon toward the caecum, force applied to the portion of the colonoscope located near the anus of the patient must vector through a minimum of two right angle bends. 
   The manipulations used to move the colonoscope through the rectum and colon may be extremely painful and uncomfortable to the patient due to the nerve endings in the colon located in the mucosal and muscular walls. The principal forces to which these nerves are sensitive are stretching and tension, both of which occur when the relatively rigid colonoscope passes through the colon. In general, the only existing means of relieving the pain and discomfort that result from the stretching, torsion, and friction incurred during a colonoscopy is to provide sedation and analgesia to the patient, an often undesirable alternative since the drug levels required to relieve the discomfort often render the patient unable to cooperate during the procedure. 
   In the past, attempts have been made to make endoscopic devices such as gastric tubes and catheters pass more easily through tubular body structures by coating them with polymers having low coefficients of friction. Such coatings must be bonded to the device, either covalently or by other means. These coatings are subject to wear and eventually can lose their effectiveness, particularly when applied to reusable devices such as colonoscopes and cystoscopes. Permanent coatings also must be able to withstand sterilization and/or disinfecting procedures without losing effectiveness, a difficult technical requirement. 
   Endoscopic devices have also been coated with a petrolatum or water-based lubricant prior to insertion as a means of easing patient discomfort. However, in the case of colonoscopy, these lubricants are often removed from the colonoscope as it is inserted into the rectum and advanced through the anal sphincter. Very little lubricant remains afterwards to ease further manipulation of the colonoscope. Certain existing devices attempt to reduce the amount of lubricant and anesthetic lost during insertion of the colonoscope by employing a syringe or flexible plastic bottle equipped with a long applicator tip to coat the surface of the colonoscope while the colonoscope passes through the rectum. Though such devices may have some effect in reducing the friction coefficient of the colonoscope, much of the lubricant and/or anesthetic may be lost as the colonoscope is pushed farther into the colon. Further, applying the lubricant and/or anesthetic to the colonoscope inside the rectum may make fully coating the scope and fully coating sensitive colon tissue a difficult task. 
   BRIEF SUMMARY OF THE PRESENT INVENTION 
   The present invention includes systems and methods for decreasing the pain and discomfort commonly associated with endoscopic procedures, where such procedures may be performed with lower dosage levels of sedative and analgesic drugs. The decreased requirements for sedative and analgesic drugs allow the patient to remain conscious and able to participate in the procedure. The systems and methods of the present invention further permit the easy sterilization and effective reuse of expensive medical equipment and the delivery of an anesthetic and/or lubricant at a consistent level of effectiveness, concentration, and coverage as the colonoscope is pushed farther into the colon. The invention further comprises systems that deliver the anesthetic and/or lubricant in a consistent manner, where the anesthetic and/or lubricant may be applied to all desired gastrointestinal areas in a comprehensive and effective manner. A less painful endoscopic procedure may diminish the need for heavy sedation thus reducing the likelihood of unintended loss of consciousness during endoscopic procedures that are inherently painful. 

   
     BRIEF DESCRIPTION OF THE DRAWINGS 
       FIG. 1  illustrates one embodiment of an endoscopic scope for use with the present invention; 
       FIG. 2A  illustrates one embodiment of an anesthetic collar with an adapter for delivering fluid to a patient&#39;s gastrointestinal tract in accordance with the present invention; 
       FIG. 2B  illustrates a further embodiment of an adapter for an anesthetic collar in accordance with the present invention; 
       FIG. 3  illustrates one embodiment of an insertion member for insertion into an endoscope in accordance with the present invention; 
       FIG. 4  illustrates a further embodiment of an anesthetic collar for delivering fluid to a patient&#39;s gastrointestinal tract in accordance with the present invention; 
       FIG. 5  illustrates a cross-sectional view of the flexible shaft of an endoscope having a fluid delivery system in accordance with the present invention; 
       FIG. 6  illustrates a cross-sectional view of the flexible shaft of an endoscope having an annulus and a fluid delivery system in accordance with the present invention; 
       FIG. 7  illustrates a further embodiment of an insertion member in accordance with the present invention; and 
       FIG. 8  illustrates one embodiment of a method for delivering fluid endoscopically to a patient in accordance with the present invention. 
   

   DETAILED DESCRIPTION OF THE INVENTION 
     FIG. 1  shows an endoscope  10  having distally a flexible shaft  14  and proximally an operating unit  15 . Flexible shaft  14  comprises a distal section  11 , a bending section  12 , and a flexible section  13 . The bending section  12  may be flexed in all directions by adjusting a control knob  18 , mounted at operating unit  15 . The distal section  11  of flexible shaft  14  may be provided with image receiving windows, light projecting windows, instrument lumens, and/or any other suitable distal element. These image receiving windows (examples of which are shown in  FIGS. 5 and 6 ) may be equipped with an objective lens for a fiberscope, or an image pick-up device for an electronic scope, such as a charge-coupled device (CCD). The image receiving windows receive an image from the distal end of flexible shaft  14 . The received image may be transmitted to operating unit  15  by an image guide of a fiberscope or lead wire of an electronic scope, which may be inserted into flexible shaft  14 , and then transferred through universal cord  19 . A light guide such as an optical fiber, inserted in the bore of light projecting windows (examples of which are shown in  FIGS. 5 and 6 ) may run through operating unit  15  via universal cord  19 , and may be connected to a light source outside. The light source then may project light from the distal end surface of the light guide. 
   Instrument lumens (examples of which are shown in  FIGS. 5 and 6 ) may be connected to an instrument insertion opening  17  at operating unit  15  so that instrument  20  may be inserted through flexible shaft  14 . Instrument  20  may be a snare, forceps, a suction tube, an RF probe, or other suitable instrumentation. Endoscope  10  further comprises delivery nozzle  16 , which may be connected with fluid lumens (examples of which are shown in  FIGS. 4 ,  5  and  6 ). Endoscope  10  illustrates one embodiment of endoscope  10 , however it is contemplated that colonoscopes, EGD scopes, cystoscopes, and other suitable scopes may be used with the present invention. 
     FIG. 2A  illustrates one embodiment of anesthetic collar  25 , where anesthetic collar  25  comprises annulus  26 , lumen  28 , and adapter  29 . Anesthetic collar  25  is adapted for placement on flexible shaft  14 . Annulus  26  may be a band that circumnavigates or partially encircles flexible shaft  14 . Annulus  26  may be constructed from rubber, plastic, composites, and/or any other suitable material that may be safely used within the human body. Annulus  26  is, in one embodiment of the present invention, an enclosed chamber having a hollow core (not shown), external surface  32 , and expulsion pores  27  in external surface  32 . Annulus  26  may include any suitable number of expulsion pores  27 . Expulsion pores  27  may be configured in any suitable way to permit desirable fluid coverage of the gastrointestinal tract. Annulus  26  may be adapted to contain fluid such as, for example, a 0.1% Lidocaine solution, where the fluid may be expelled through expulsion pores  27  into the gastrointestinal tract of a patient. Annulus  26  may be coupled to lumen  28 , where lumen  28  may be any suitable conduit capable of delivering fluid to annulus  26 . Lumen  28  is coupled to annulus  26  in a manner that permits the free flow of fluid from lumen  28  into the hollow core of annulus  26 . 
   In the particular embodiment shown in  FIG. 2A , lumen  28  extends distally from annulus  26  to a distal section  11  of flexible shaft  14 , where lumen  28  is coupled to adapter  29 . Adapter  29 , in one embodiment of the present invention, is adapted to removably couple with an existing lumen of flexible shaft  14 . An example of such a lumen would be an instrument insertion lumen. Adapter  29  may be inserted into the existing lumen, where adapter  29  may be secured by any suitable means such as, for example, a friction fit. Adapter  29  is designed to permit the free transfer of fluid pumped through the existing lumen of flexible shaft  14  into lumen  28  and annulus  26 , where fluid pumped into annulus  26  may then be expelled through expulsion pores  27  into the gastrointestinal tract of the patient. 
   Anesthetic collar  25  may be permanently affixed or detachably coupled to flexible shaft  14 . When detachably coupled, anesthetic collar  25  may be held to flexible shaft  14  by an adhesive, a high friction coefficient, shrink fit, heat shrink tubing, heat shrink fit, threaded section, and/or by any other suitable coupling means. Anesthetic collar  25  allows lubricants, local anesthetics, dyes, and/or other desirable fluids to be passed through the existing lumen of flexible shaft  14  into annulus  26 , where the fluid may be distributed through expulsion pores  27  into the gastrointestinal tract. Utilizing the existing lumens found in endoscopes, the present invention allows those fluids that may reduce the pain and discomfort associated with endoscopies such as, for example, local anesthetics and lubricants, to be distributed in an even fashion throughout the gastrointestinal tract, where such fluids may reduce the drug level requirements for sedative and analgesic agents. Placing anesthetic collar  25  towards the distal end  11  of flexible shaft  14  may allow anesthetic fluids passing through anesthetic collar  25  to take effect as more proximal portions of flexible shaft  14  bend around uncomfortable flexures such as the splenic flexure and come into contact with nerve endings in the gastrointestinal tract. Further, the removable embodiment of the present invention permits the easy removal of anesthetic collar  25  for the sterilization and cleaning of endoscope  10  (FIG.  1 ). Distal end  11  may house any suitable endoscopic component such as, for example, one or a plurality of instrument insertion lumens, light projecting windows, image receiving windows, and fluid lumens. 
   Still referring to  FIG. 2A , anesthetic collar  25  may be placed at any suitable location on flexible shaft  14 . A plurality of anesthetic collars may be used, where multiple collars coupled to an existing lumen of flexible shaft  14  may be used to disperse desirable fluids at a plurality of locations. Fluid may be dispensed through the existing lumen of flexible shaft  14  by a fluid pump, manual injection, or by any other suitable means. Further embodiments of anesthetic collar  25  comprise constructing annulus  26  from a porous material in the absence of expulsion pores  27 , where fluid pumped into annulus  26  may ooze through the porous outer surface. The present invention further comprises designing anesthetic collar  25  with any suitable dimensions, shapes or profiles; adhering anesthetic collar  25  to the distal section  11  of flexible shaft  14 ; providing a plurality of lumens branching from adapter  29  to annulus  26 ; and/or any other suitable configuration in accordance with the present invention. 
     FIG. 2B  illustrates an alternate embodiment of lumen  28  and adapter  29 , where adapter  29  comprises ascending portion  33  and transverse portion  34 . Transverse portion  34  may be substantially collinear with and coupled with an existing lumen of flexible shaft  14  (FIG.  2 A). Ascending portion  33  may connect transverse portion  34  with lumen  28 , where lumen  28  may be integrated with annulus  26  (FIG.  2 A). Ascending portion  33  further comprises an aperture  31 , which may be a slit in ascending portion  33 . In one embodiment of the present invention, adapter  29  is constructed from a pliable material such as a plastic or rubber. Instrument  20  may be passed through an existing lumen of shaft  14 , through transverse portion  34 , and out through aperture  31 . Instrument  20  may push apart the sides of aperture  31  to pass through, however, when instrument  20  is removed, aperture  31  may retain a substantially water tight seal. 
   When the use of instrument  20  is desired to perform polypectomies or other medical procedures, instrument  20  may be inserted into flexible shaft  14  until it protrudes through slit  31 . When instrument  20  is no longer needed, it may be removed from flexible shaft  14 , whereupon aperture  31  may return to a watertight seal. Once instrument  20  has been removed, desirable fluids such as lubricants and local anesthetics may be dispensed through the existing lumen of flexible shaft  14 , through transverse portion  32 , through ascending portion  33 , through lumen  28 , and into annulus  26  (FIG.  2 A). The substantially watertight seal of aperture  31 , when instrument  20  is not present, may allow fluid to be dispensed through annulus  26  rather than simply out the distal section  11  of flexible shaft  14 . The illustrated embodiment of aperture  31  allows for the use of instruments and the delivery of desirable fluids to take place through a single lumen. The illustrated embodiment may take advantage of existing lumens within flexible shaft  14  without compromising a clinician&#39;s ability to insert an instrument at any desirable time. Aperture  31  may be a valve, a flap affixed to a hinge, or any other suitable means of permitting instrumentation to pass through ascending portion  33 . It is further contemplated that fluid may be dispensed through an existing lumen of flexible shaft  14  simultaneously with the use of an instrument inserted through the same lumen. 
     FIG. 3  illustrates one embodiment of an insertion member  35 , where insertion member  35  comprises a lumen  36 , a descending portion  40 , and a band portion  38 . In one embodiment of the present invention, lumen  36  is flexible and may be straightened for insertion into an existing lumen of flexible shaft  14  (FIGS.  1  and  2 A). An example of such a lumen would be an instrument insertion lumen described below with respect to FIG.  5 . Lumen  36  is further designed to extend from a fluid delivery mechanism, such as a fluid pump or manual fluid injection assembly, coupled with proximal end  37 . Insertion member  35  may be driven through an existing lumen in flexible shaft  14  until lumen  36  is able to exit the existing lumen distally and take the form illustrated in FIG.  3 . Descending portion  40  and band portion  38  may be constructed from memory retention material such that descending portion  40  and band portion  38  may take their illustrated shape once they have passed through the distal opening of the existing lumen. The descending portion  40 , for example, may extend proximally with respect to flexible shaft  14 , where band portion  38  may then encircle flexible shaft  14  proximal to distal section  11  (FIG.  1 ). 
   As shown in  FIG. 3 , band portion  38  may further comprise closure  42 . Closure  42  may be any suitable seal or closure means that prevents fluid from escaping from the end of lumen  36 . Band portion  38  further comprises expulsion pores  39 . Fluid pumped through lumen  36  may pass through expulsion pores  39  into the gastrointestinal tract. Lumen  36  may be used to deliver local anesthetics, lubricants, dyes, and/or other desirable fluids. Furthermore, insertion member  35  may be inserted into and removed from the existing lumen of flexible shaft  14  at any time during a medical procedure allowing other instrumentation to be inserted into the existing lumen as needed. The present invention further comprises configuring insertion member  35  with any suitable dimensions and shapes that allow for the efficient and comprehensive delivery of fluids to the gastrointestinal tract. For example, insertion member  35  may include multiple band portions, multiple descending portions, a descending portion having expulsion pores in the absence of a band portion, or any other suitable configuration. 
     FIG. 4  illustrates one embodiment of an anesthetic collar  45 , where anesthetic collar  45  comprises annulus  47  and lumen  49 . Anesthetic collar  45  is adapted for placement on flexible shaft  14  (FIGS.  1  and  2 A). Annulus  47  may be a band that circumnavigates flexible shaft  14  or partially encircles flexible shaft  14 , where annulus  47  may be constructed from rubber, plastic, composites, and/or any other suitable material that may be safely used within the human body. Annulus  47 , in one embodiment of the present invention, is an enclosed chamber having a hollow core (not shown), where the external surface of annulus  47  has expulsion pores  48 . Annulus  47  comprises any suitable number of expulsion pores  48 , which may be configured in any suitable way to permit comprehensive fluid coverage of the gastrointestinal tract. Annulus  47  may be adapted to deliver fluid such as, for example, a 0.1% Lidocaine solution, where the fluid may be expelled through expulsion pores  48  into the gastrointestinal tract of the patient. Annulus  48  may be coupled to lumen  49 , which may be any suitable conduit capable of delivering fluid to annulus  47 . Lumen  49  is coupled to annulus  47  in a manner that permits the free flow of fluid from lumen  49  into the hollow core of annulus  47 . In one embodiment of the present invention, lumen  49  extends from annulus  47  proximally towards operating unit  15  (FIG.  1 ), where lumen  49  may be coupled with, for example, a fluid pump or manual fluid injection assembly. Lumen  49  may be secured to flexible shaft  14  by an adhesive, covered in a sheath, or secured by any other suitable coupling means. 
   Anesthetic collar  45  may be permanently affixed or detachably coupled to flexible shaft  14 . When detachably coupled, anesthetic collar  45  may be held to flexible shaft  14  by an adhesive, by creating a high coefficient of friction, heat shrink tubing, shrink fit, heat shrink, threaded section, and/or by any other suitable coupling means. Anesthetic collar  45  allows lubricants, local anesthetics, dyes, and/or other desirable fluids to be passed through the existing lumen of flexible shaft  14  into annulus  47 , where the fluid may be distributed through expulsion pores  48  into the gastrointestinal tract. 
   The embodiment of  FIG. 4  is well suited for use with an endoscope that does not have an internal lumen available for fluid delivery. Utilizing existing lumens secured to (e.g.,  FIG. 4 ) or found in (e.g.,  FIG. 6 ) flexible shaft  14 , the present invention allows those fluids that may reduce the pain and discomfort associated with endoscopies such as, for example, local anesthetics and lubricants, as well as fluids that may be helpful in diagnosing patients, such as dyes, to be distributed in an even fashion throughout the gastrointestinal tract. Placing anesthetic collar  45  towards the distal section  11  of flexible shaft  14  may allow anesthetic fluids passing through anesthetic collar  45  to take effect and ease patient discomfort as more proximal portions of shaft  14  bend around uncomfortable flexures such as the splenic flexure and come into contact with nerve endings in the gastrointestinal tract. Further, the removable embodiment of the present invention permits the easy removal of anesthetic collar  45  for the sterilization and cleaning of endoscope  10  (FIG.  1 ). 
   Still referring to  FIG. 4 , the present invention comprises placing anesthetic collar  45  at any suitable location on flexible shaft  14  as well as the use of a plurality of anesthetic collars, where multiple collars coupled to an existing lumen of flexible shaft  14  may be used to disperse desirable fluids at a plurality of locations. Fluid may be pumped through the existing lumen of flexible shaft  14  by any suitable means such as, for example, an automatic fluid pump or a manual fluid injection assembly. Further embodiments of anesthetic collar  45  comprise constructing annulus  47  from a porous material in the absence of expulsion pores  48 , where fluid pumped into annulus  47  may ooze through the porous outer surface. The present invention further comprises designing anesthetic collar  45  with any suitable dimensions, adhering anesthetic collar  45  to the distal section  11  of flexible shaft  14 , providing a plurality of lumens coupled to annulus  47 , and/or any other suitable configuration in accordance with the present invention. 
     FIG. 5  illustrates a cross-sectional view of one embodiment of distal end  11  of flexible shaft  14  (as shown in  FIG. 1 ) in accordance with the present invention, where flexible shaft  14  comprises image receiving window  53 , instrument lumen  52 , fluid lumen  54 , light projecting window  56 , and outlet lumens  55 . Lumen  52  may be a multi-purpose instrument lumen, where a clinician may insert instruments such as forceps, biopsy needles, and snares through instrument insertion opening  17  (FIG.  1 ), down lumen  52 , and out through distal section  11  (FIG.  1 ). Fluid lumen  54  comprises a lumen or other suitable fluid delivery means that extends from delivery nozzle  16 , or from any other suitable fluid insertion point, towards the distal section  11  of shaft  14 . Fluid lumen  54  may open at distal section  11  of flexible shaft  14  or may be sealed at any point along flexible shaft  14 . 
   Outlet lumens  55  of flexible shaft  14  may radiate from fluid lumen  54 , may run substantially perpendicular to, or at any suitable angle from, fluid lumen  54 , and may open through outer surface  57 . In one embodiment of the present invention outlet lumens  55  are cylindrical, yet any other suitable lumen form or cross-section capable of fluid delivery is contemplated. The present invention further comprises outlet lumens of any suitable diameter for delivering fluid from fluid lumen  54  to the gastrointestinal tract of a patient. As fluid is pumped through fluid lumen  54 , the fluid will encounter outlet lumens  55 , where fluids may pass through the outlets into the gastrointestinal tract of the patient. In one embodiment of the present invention, outlet lumens  55  extend radially from fluid lumen  54 ; however, any suitable configuration of outlet lumens  55  may be used with the present invention. For example, the outlet lumens (or set of lumens as in  FIG. 4 ) may be positioned serially or longitudinally, where outlet lumens are exposed through outer surface  57  at intervals along the length of flexible shaft  14 . Likewise, flexible shaft  14  may be suitably configured in a number of ways in accordance with the present invention. For example, flexible shaft  14  may have one or a plurality of lumens  52 , one or a plurality of image receiving windows  53 , one or a plurality of fluid lumens  54 , and/or any number of other suitable additions. 
   Fluid lumen  54  allows local anesthetics, lubricants, dyes and/or other suitable fluids to be passed through shaft  14  and into the gastrointestinal tract without comprising instrument lumen  52  and blocking image receiving window  53 . Further, placing outlet lumens  55  towards the proximal end of flexible shaft  14  may allow such fluids to cover a broad surface area of tissue, where as local anesthetics take effect, more proximal portions of shaft  12  may cause less pain and discomfort to the patient as they pass through the gastrointestinal tract. 
     FIG. 6  illustrates a cross-sectional view of a further embodiment of annulus  26  in accordance with the present invention, where annulus  26  circumnavigates flexible shaft  14 . In the illustrated embodiment, flexible shaft  14  comprises image receiving window  61 , instrument insertion lumen  62 , light projecting lumen  68 , fluid lumen  63 , and fluid port  64 . Fluid lumen  63  may be a lumen or other suitable fluid delivery means that extends from delivery nozzle  16  (FIG.  1 ), or from any other suitable fluid insertion point, towards the distal section  11  of shaft  14 . Delivery nozzle  16  may be coupled with any suitable fluid delivery system such as, for example, a fluid pump or a manual fluid injection assembly. Fluid port  64  is an offshoot of fluid lumen  63  that allows fluid to pass from fluid lumen  63  into annulus  26 . Fluid port  64  obviates the need for additional lumens and/or adapters, such as those shown in  FIG. 2A , for example, because annulus  26  (forming part of anesthetic collar  25 ) can be placed directly over fluid port  64  of flexible shaft  14 . Fluid port  64  may have any suitable dimensions or configurations that facilitate the movement of fluid between fluid lumen  63  and annulus  26 . 
   Annulus  26  may be permanently affixed or detachably coupled to shaft  14 , where annulus  26  is aligned with fluid port  64  in order to allow fluid to pass into the hollow core of annulus  26 . Once fluid has passed into annulus  26  from fluid port  64 , the fluid will be expelled from annulus  26  through expulsion pores  66  into the gastrointestinal tract. Fluid port  64  may be located anywhere and at more than one location along the length of flexible shaft  14 , preferably near distal section  11 . 
     FIG. 7  illustrates one embodiment of an insertion member  70 , which comprises lumen  71 , head  72 , and expulsion pores  73 . In one embodiment of the present invention, lumen  71  is flexible and may be inserted into an existing lumen such as, for example, instrument insertion lumen  52  ( FIG. 5 ) of flexible shaft  14  (FIG.  1 ). Lumen  71  is further designed to extend from a fluid delivery mechanism such as, for example, a fluid pump or a manual fluid injection assembly, coupled with proximal end  73 , through an existing lumen in flexible shaft  14  until lumen  71  is able to exit the existing lumen at the distal section  11  of flexible shaft  14 . Insertion member  70  may deliver fluids such as local anesthetics, dyes, and lubricants to the gastrointestinal tract of a patient, where fluid passing through lumen  71  enters head  72  and is expelled through expulsion pores  73 . Head  72  may be a hollow chamber positioned at the distal most point of lumen  71 , however any suitable design that facilitates the comprehensive dispersion of fluids into the gastrointestinal tract is in accordance with the present invention. For example, head  72  may be spherical, elliptical, or have any other suitable form, where one or a plurality of expulsion pores  73  may be positioned in any suitable configuration on head  72 . Insertion member  70  may be constructed from any material suitable for use within the human body, however, the preferred embodiment comprises the construction of insertion member  70  from flexible material such as, for example, plastic, rubber, or composites. 
   The present invention allows clinicians to insert insertion member  70  into flexible shaft  14  at any point during an endoscopic procedure, where insertion member  70  may be used to deliver local anesthetics, lubricants, dyes, and/or other suitable fluids to the gastrointestinal tract. The removable nature of insertion member  70  allows the clinician to extract insertion member  70  if the existing lumen is needed for the insertion of other instrumentation or if the delivery of fluids is no longer needed. The plurality of expulsion pores  73  found on head  72  in one embodiment of the present invention allows fluids to be distributed in a comprehensive manner in order to affect a large surface area of tissue. By affecting a large surface area of tissue, the present invention may effectively lubricate and/or anesthetize such tissue in order to diminish the pain and/or discomfort experienced by the patient during the procedure. 
     FIG. 8  illustrates one embodiment of a method  100  for delivering fluids to the gastrointestinal tract of a patient. Method  100  comprises step  101  for providing an endoscope such as, for example, endoscope  10  (FIG.  1 ), however other suitable scopes may be used. Step  102  of method  100  comprises providing a fluid delivery means, where the fluid delivery means may be anesthetic collar  25  (FIG.  2 A), anesthetic collar  45  (FIG.  4 ), insertion member  35  (FIG.  3 ), insertion member  70  (FIG.  7 ), embodiments of flexible shaft  14  as depicted in  FIG. 5 , embodiments of flexible shaft  14  and annulus  26  as depicted in  FIG. 6 , and/or any other suitable fluid delivery means for providing substantially uniform fluid dispersion. Step  102  further comprises coupling the fluid delivery means to flexible shaft  14  ( FIG. 1 ) when necessary, providing the fluid delivery means, where the fluid delivery means may be an insertion member, and/or otherwise preparing the fluid delivery system. 
   Step  103  of method  100  comprises performing the endoscopic procedure, where the procedure may be, for example, a colonoscopy. Step  103  further includes preparing the endoscope for insertion, inserting the endoscope into the patient, and performing any suitable procedure with the endoscope. Step  103  may include performing the procedure without the administration of fluids. However, query  105  of method  100  may take place before the endoscope is inserted to ensure that fluids may be delivered at any desirable time during the procedure. Query  104  of method  100  comprises ascertaining whether the endoscopic procedure is complete, where procedures may be performed in the total absence of fluid delivery, however, this capability may be present at all times. If the procedure is complete, method  100  may transition to finish  108 , where finish  108  indicates a fully completed procedure including the extraction of the endoscope. If the procedure is not complete, method  100  may transition to step  105 . 
   Step  105  comprises ascertaining whether fluid delivery is desired. If fluid delivery is not desired, method  100  may loop back to step  103 , where the procedure may continue without the additional delivery of fluids. If fluids are desired, method  100  may proceed to step  106 . Step  106  comprises delivering fluids through the fluid delivery means of step  102  into the gastrointestinal tract of the patient. Fluids include, but are not limited to, dyes, local anesthetics, and lubricants. Fluids may also be defined to include gases, where gases may be administered through the fluid delivery means to the gastrointestinal tract of the patient. During fluid delivery, method  100  may continue to perform the endoscopic procedure of step  103 , where fluid delivery in accordance with step  106  may be administered while the procedure is taking place. Query  107  may continually ascertain whether fluid delivery is desired, where method  100  may loop back to step  103  if fluid is no longer desired. 
   The illustrated method allows for fluids to be delivered to the gastrointestinal tract of a patient at any point during a procedure depending on the needs of the clinician. Fluid delivery may further be halted and restarted at any desirable points during the procedure. Such fluids may decrease the pain and/or discomfort commonly associated with a number of endoscopic procedures. Further, fluids such as dyes may be used for diagnostic purposes independent of or in cooperation with pain reducing fluids. The present invention further comprises the delivery of gases, irrigation water, suction, and/or any other feature that may be suitably performed in accordance with the present invention. 
   While exemplary embodiments of the invention have been shown and described herein, it will be obvious to those skilled in the art that such embodiments are provided by way of example only. Numerous insubstantial variations, changes, and substitutions will now be apparent to those skilled in the art without departing from the scope of the invention disclosed herein by the Applicants. Accordingly, it is intended that the invention be limited only by the spirit and scope of the claims as they will be allowed.