Abstract:
In an endoscope having a proximal end area, a distal end area introducible into the body of a human being, a shaft extending in a longitudinal direction, and an optical device extending through the shaft in the longitudinal direction thereof and movable relative to the shaft, to enable particularly easy and safe handling of the optical device it is proposed that the optical device be fixable in axial direction relative to the shaft in a first position and in at least a second position differing from the first position.

Description:
[0001]     The present disclosure relates to the subject matter disclosed in international application PCT/EP03/12634 of Nov. 12, 2003, which is incorporated herein by reference in its entirety and for all purposes. 
     
    
     BACKGROUND OF THE INVENTION  
       [0002]     The invention relates to an endoscope having a proximal end area, a distal end area introducible into the body of a human being, a shaft extending in a longitudinal direction, and an optical device extending through the shaft in the longitudinal direction thereof and movable relative to the shaft.  
         [0003]     Endoscopes of the kind described hereinabove are used for various purposes when performing minor surgery on the human body. An operating surgeon can view the operating site with the aid of the optical device extending through the shaft. With conventional endoscopes, the optical device is introducible from the proximal end into the shaft and displaceable therein in axial direction. It has proven to be disadvantageous that the optical device can be moved in an uncontrolled manner.  
         [0004]     The object of the present invention is, therefore, to so improve an endoscope of the kind mentioned hereinabove that the optical device is easier and safer to handle.  
       SUMMARY OF THE INVENTION  
       [0005]     This object is accomplished with a generic endoscope, in accordance with the invention, in that the optical device is fixable in axial direction relative to the shaft in a first position and in at least a second position differing from the first position.  
         [0006]     This configuration makes it possible for the optical device to be held in precisely defined positions at least in the longitudinal direction of the shaft. An undesired relative movement between the shaft and the optical device is thereby avoided. By selecting two positions, for example, a diagnosis position and a work position, the optical device can be employed in the desired manner. Thus, for example, in the diagnosis position, it can protrude far beyond the distal end of the endoscope without the distal end of the endoscope or tools arranged thereon impeding a view of the operating site. By transferring the optical device from the diagnosis position to the second position serving, for example, as work position, an optical monitoring of employment of tools arranged on the shaft is rendered possible in a defined manner. In the second position, a free end of the optical device could, however, also be retracted into the shaft to such an extent that the optical device is protected. Owing to the possibility of axially fixing the optical device in two positions relative to the shaft, considerably easier and safer handling of the endoscope is possible.  
         [0007]     The optical device is fixable in axial direction in a particularly simple way when at least one locking device is provided for fixing the optical device in the first position and/or the second position. In particular, the optical device can thereby be fixed automatically upon reaching one of the two predetermined positions. With corresponding design of the locking device, the fixed optical device can also be released again and moved in axial direction.  
         [0008]     The optical device is preferably fixed in circumferential direction relative to the shaft in the first position and/or in the second position. This results in a fully defined position of the optical device relative to the shaft.  
         [0009]     It is expedient for the optical device to be fixable in axial direction and to be freely rotatable about the longitudinal axis of the shaft in a third position. In the third position, the optical device may, for example, be completely retracted into the interior of the shaft, which protects it against outer influences. A free rotatability about the longitudinal axis of the shaft makes it possible for connection lines proceeding from the proximal end of the optical device to be orientated in any chosen way.  
         [0010]     Provision may be made in a preferred embodiment of the invention for the distal end of the optical device to protrude in the first position over the distal end of the endoscope. An operating site which can be viewed by the optical device is thus not restricted by the endoscope or elements arranged thereon.  
         [0011]     In the second position, it is expedient for the distal end of the optical device to project over the distal end of the shaft, and for the distal end of the endoscope to project over the optical device. When the second position is provided in such a way, the distal end of the endoscope which is formed, for example, by tool elements projecting from the shaft can be viewed with the optical device. A movement of tool elements during use is thus optically controllable.  
         [0012]     To enable use of conventional optical devices in conjunction with an endoscope according to the invention, provision may be made for the endoscope to comprise a device for receiving the optical device, for the device for receiving the optical device to be movable relative to the shaft and fixable in axial direction in the first position and/or in the second position and/or in the third position. The at least one position in which the optical device is fixable in axial direction relative to the shaft is now defined by a corresponding configuration of the endoscope and the device for receiving the optical device.  
         [0013]     The optical device is preferably freely rotatable about the longitudinal axis relative to the device for receiving the optical device. In this way, the optical device can be freely rotated and an operating site freely viewed even when the device for receiving the optical device is fixed in axial direction. Furthermore, connection lines proceeding from a proximal end of the optical device can be orientated in any desired way.  
         [0014]     A particularly simple design of the locking device is obtained when the locking device comprises a locking member movable relative to a locking recess, when the locking recess or the locking member is arranged on the optical device or on the device for receiving the optical device, and when the locking member or the locking recess is arranged on a receptacle of the endoscope for the optical device or the device for receiving the optical device. A fixing of the respective position is achieved by the locking member dipping into the locking recess. Conversely, release is achievable in a simple way by the locking member being guided out of the locking recess.  
         [0015]     Provision may be made in accordance with a further preferred embodiment of the invention for the endoscope to comprise an inflow channel for feeding a fluid from the proximal to the distal end area, an outflow channel for conducting a fluid away from the distal to the proximal end area, an inflow connection in flow communication with the inflow channel, and an outflow connection in flow communication with the outflow channel. Owing to this configuration, a fluid can be conducted via the inflow connection from the proximal end to the distal end of the endoscope and issue there, for example, to flush the operating site. At the same time, the fluid or body tissue which has been removed can be conducted away through the outflow channel.  
         [0016]     It is expedient for the inflow connection, the outflow connection and the optical device to be rotatable relative to one another about an axis of rotation extending substantially in the longitudinal direction of the shaft. In this way, connection lines proceeding from the respective connections can be arranged in any chosen position, which also reduces the danger of the connection lines becoming twisted or knotted together.  
         [0017]     Furthermore, it is advantageous for the inflow connection, the outflow connection and the optical device to be rotatable relative to the shaft about the axis of rotation extending substantially in longitudinal direction of the shaft. Owing to this configuration, the shaft can be introduced into the interior of the body and left lying there in a non-rotatable manner. On the other hand, lines proceeding from the inflow connection, the outflow connection or the optical device can be orientated in any chosen way so as not to obstruct the operator or so as to prevent twisting of the lines. Furthermore, owing to the shaft resting in this way within the body, the risk of damage to the interior of the body owing to rotation of the shaft is virtually excluded.  
         [0018]     In order not only to be able to view an operating site with the endoscope but also to be able to actually perform surgery, it is expedient for at least one movable tool to be arranged at the distal end of the shaft. The tool may be, for example, a fixation forceps, scissors or the like.  
         [0019]     It is advantageous for the movable tool to be rotatable relative to the shaft about an axis of rotation extending substantially in the longitudinal direction of the shaft. A relative position of the movable tool relative to a shaft which is stationary within the body can thus be optionally altered.  
         [0020]     Provision may be made in a preferred embodiment of the invention for the tool to comprise at least one jaw part which is mounted for movement relative to the shaft. Scissors or fixation forceps can thus be formed in a simple way.  
         [0021]     To increase a range of action of the tool, it is expedient for at least two jaw parts which are movable relative to each other to be provided. These may, for example, be pivoted outwardly far beyond a cross-sectional area of the shaft and grasp body tissue, in particular, for the removal of septa, polyps or the like, some of which are of larger cross section than the cross section of the shaft introduced into the interior of the body.  
         [0022]     It is advantageous for the at least one movable jaw part to be pivotable relative to the shaft about a pivot axis extending substantially transversely to the longitudinal direction of the shaft. A pivotal movement of the jaw part, in particular, a sideways pivoting of the jaw part, can thereby be implemented in a particularly easy way.  
         [0023]     It is preferable for an actuating device associated with the at least one jaw part to be provided and for the actuating device to be rotatable relative to the shaft. A movement of the jaw part can be brought about with the actuating device. Owing to the rotatability of the actuating device relative to the shaft, a conclusion can be drawn from the position of the actuating device as to the relative orientation of the associated jaw part.  
         [0024]     For example, in order to keep a fixation forceps in a closed position, it is expedient for the actuating device to be lockable in an actuated position of the at least one movable jaw part. Locking is, however, also conceivable in an open position of the jaw parts.  
         [0025]     It is expedient for at least two jaw parts to be provided, which, in a closed position in which the two jaw parts rest against each other, are formed symmetrically in relation to a plane containing the longitudinal axis of the shaft. Irrespective of whether only one or both of the jaw parts are movably mounted on the shaft, a particularly simple design of the endoscope is thereby achieved.  
         [0026]     Preferably, the optical device is arranged in the area of the at least two jaw parts on a side of the stationary jaw part, and the movable jaw part is arranged on that side of the stationary jaw part which faces away from the optical device. The optical device is thus arranged outside the work area of the two jaw parts and cannot get in between these and thereby become damaged. Rather, in this way it is arranged so as to be protected.  
         [0027]     A particularly good protection of the optical device is obtained when the stationary jaw part is concavely curved in the direction pointing towards the optical device. The optical device can thus lie snugly against the concave area of the jaw part. The cross section of the portion of the endoscope introducible into the interior of the body is thereby also minimized.  
         [0028]     Provision may be made in accordance with a further preferred embodiment of the invention for the shaft to have adjacent to the distal end of the endoscope a shaft section which is introducible into the body of a human being, for the axis of symmetry of the optical device in the area of the shaft section to extend parallel to the axis of symmetry of the shaft in the area of the shaft section, and for both axes of symmetry to be spaced from each other. Such an eccentric arrangement of the longitudinal axes of the shaft section and the optical device make it possible for the shaft and, in particular, tools arranged thereon to be rotatable about the optical device. The longitudinal axis of the optical device thus also forms, as a whole, the axis of rotation for the entire portion of the endoscope that is introducible into the interior of a body.  
         [0029]     For use of the endoscope in the field of high-frequency surgery, it is advantageous for an HF connecting device to be provided for connecting the endoscope to a high-frequency generator and for this HF connecting device to be arranged so as to be rotatable relative to the optical device. Connection lines can thus also be arranged in any desired orientation, and twisting of the connection lines is thereby prevented.  
         [0030]     The following description of a preferred embodiment of the invention serves in conjunction with the drawings to explain the invention in further detail. 
     
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       [0031]      FIG. 1  is a partly sectional side view of an endoscope;  
         [0032]      FIG. 2  is an enlarged sectional view of area A in  FIG. 1 ;  
         [0033]      FIG. 3  is a cross-sectional view taken along line  3 - 3  in  FIG. 2 ;  
         [0034]      FIG. 4  is a partly broken open plan view of an endoscope with an optical device in a diagnosis position;  
         [0035]      FIG. 5  is a side view of the end portion of the endoscope shown in  FIG. 4 ;  
         [0036]      FIG. 6  is a plan view similar to  FIG. 4  with the optical device in a work position; and  
         [0037]      FIG. 7  is a plan view similar to  FIG. 4  with the optical device in a retracted position. 
     
    
     DETAILED DESCRIPTION OF THE INVENTION  
       [0038]      FIG. 1  shows an endoscope generally designated by reference numeral  10  with a shaft  12  for introduction into the interior of the body of a human being through an opening of the body. A surgical tool in the form of a fixation forceps  14  is arranged at the distal end of the shaft  12  for rotation about the longitudinal axis of the shaft  12  relative thereto. The fixation forceps comprises a stationary jaw part  16  and a jaw part  17  which is mounted for pivotal movement about a pivot axis  18  extending transversely to the longitudinal axis of the shaft  12 .  
         [0039]     Adjoining a proximal end of the shaft  12  is a handling portion  20  of the endoscope  10 , which comprises a main body  22  rigidly connected to an outer shaft sleeve  13  of the shaft  12 . Extending through the shaft  12  and the main body  22  is an optical channel  24  which widens in the form of a step in the area of the main body  22  in the direction towards its proximal end, thereby forming a ring-shaped stop  26 . Provided in the proximal end area of the main body  22  for rotation around the main body  22  and relative to each other are an inflow connection  28  and an outflow connection  30 , which are in flow communication with an inflow channel  32  and an outflow channel  34 , respectively, which are of lens-shaped cross-section and extend through the main body  22  and the shaft  12 . Also mounted for rotation on the main body  22  is an HF connection  36  which is conductively connected to the two jaw parts  16  and  17  via electric connections, not shown, which extend in the longitudinal direction through the shaft  12 .  
         [0040]     Arranged for rotation about a distal portion of the main body  22  is a grip portion  38  which comprises a stationary branch  40  projecting sideways from the main body  22  and pointing in proximal direction with a thumb opening  20 , and a branch  44  pivotal on the grip portion  38  about a pivot axis  45  extending transversely to the longitudinal axis of shaft  12  relative to the branch  40  with a finger opening  46 . Inserted into a manipulation channel  48  extending through the shaft  12  in the longitudinal direction thereof is a push-and-pull rod  50  whose proximal end is movably mounted on the branch  44  and whose distal end is movably connected to the jaw part  17  via bearing pins  54  protruding at the sides and extending into guide slots  52  of the jaw part  17 . By a pivotal movement of the branch  44  the push-and-pull rod  50  is moved in the longitudinal direction of the shaft  12 , whereby the jaw part  17  is pivoted relative to the jaw part  16 .  
         [0041]     With the locking lever  56  a pivoted position of the branch  44  relative to the branch  40  can be locked, whereby the movable jaw part  17  is held in a desired position, for example, in abutment against the stationary jaw part  16  or in an open position in which it is turned sideways away from the jaw part  16 .  
         [0042]     Inserted into the optical channel  24  at the proximal end is a guide sleeve  58  which rests with its distal end almost at the stop  26 . The guide sleeve  58  is part of an optical adapter  68  via which a connection portion  61  at the proximal end of an optical device  60  is connectable to further optical devices, for example, a camera, a microscope or the like. By means of a connection between the optical adapter  68  and the connection portion  61 , an axial fixing of the two elements is achievable, for example, via a releasable locking connection. A relative axial movement between the guide sleeve  58  and the optical device  60  is thereby prevented in the connected state. If desired, the locking connection may be designed so as to allow rotation of the connection portion  61  relative to the optical adapter  68 .  
         [0043]     The rod-shaped optical device  60  can be pushed in through the guide sleeve  58  from the proximal end of the endoscope  10 . The optical device  60  has an end  64  which is beveled relative to its longitudinal axis  62  and is formed by a surface inclined at an angle of inclination  66  relative to the longitudinal axis  62 .  
         [0044]     As shown in  FIGS. 2, 3  and  6 , the guide sleeve  58  has adjacent to its distal end an annular groove  70 , from which there extends in proximal direction along its outer surface over approximately half of the length of the guide sleeve  58  a flattened portion  74 . Alternatively, as shown in  FIG. 4 , a longitudinal groove  72  may be provided instead of the flattened portion  74 . On the guide sleeve  58  two hollow sphere-type recesses  76  and  78  are spaced from each other in the longitudinal direction and offset through 90° in the circumferential direction. The spacing between recess  76  and recess  78  corresponds approximately to the length of the movable jaw part  17 . The spacing between the recess  76  and the annular groove  70 , on the other hand, is significantly smaller.  
         [0045]     The grip portion  38  is provided with two radial threaded bores  80  and  82  offset in relation to each other through approximately 90° in circumferential direction for guiding the guide sleeve  58 . Inserted into the threaded bore  80  is a threaded pin  84  whose end  88  is designed so as to correspond to the longitudinal groove  72  as shown, for example, in  FIG. 4  or whose flattened end  88  corresponds to the flattened portion  74  as shown, in particular, in  FIG. 3 . Inserted into the threaded bore  82  is a headless screw  90  on which a helical spring  92  is supported in the direction towards the guide sleeve  58  and presses a ball  94  against the guide sleeve  58 . In combination the headless screw  90 , the helical spring  92  and the ball  94  form a ball thrust member via which a locking connection can be made with the two recesses  76  and  78  provided on the guide sleeve  58  and forming locking recesses. The threaded pin  84  is screwed into the threaded bore  80  until the end  88  dips into the longitudinal groove  72  and the guide sleeve  58  is thereby guided in the longitudinal direction thereof. The guide sleeve  58  is fixed in axial direction relative to the grip portion  38  and hence to the shaft  12  when the ball  94  dips into one of the two recesses  76  or  78  or into the annular groove  70 . In the last mentioned case, rotation of the grip portion  38  about the optical adapter  68  is possible.  
         [0046]     Owing to the configuration of the two recesses  76  and  78  and of the annular groove  70 , the optical adapter  68  is fixable in three axial positions relative to the shaft  12 , which will be explained in further detail in conjunction with FIGS.  4  to  7 .  
         [0047]     In the so-called diagnosis position the ball  94  dips into the recess  78 . The end  64  of the optical device  60  protrudes in the diagnosis position somewhat beyond the end of the stationary jaw part  16  in the distal direction. In this way, an operating site can be viewed without the two jaw parts  16  and  17  impeding the view. This is shown in  FIGS. 4 and 5 . In the work position shown in  FIG. 6  the ball  94  dips into the recess  76 . In this position the end  64  of the optical device  60  protrudes somewhat over the optical channel  24  out of the shaft  12 , but not beyond the distal end of the fixed jaw part  16 . In this work position, surgery performed with the jaw parts  16  and  17  can be observed with the optical device  60 .  
         [0048]     When the optical adapter  68  is retracted even further in axial direction, the ball  94  finally dips into the annular groove  70  into which the free end  88  of the threaded pin  84  also dips simultaneously, and rotation of the guide sleeve  58  relative to the grip portion  38  is thereby enabled. In this third position of the optical adapter  68 , the end  64  of the optical device  60  is retracted into the optical channel  24  so that the end  64  is protected.  
         [0049]     In the area of the shaft  12 , the longitudinal axis  62  of the optical device  60  is offset in parallel with the longitudinal axis of the shaft  12 , thereby resulting, in all, in an eccentric rotation of the shaft  12  around the optical device  60 . In the area of the stationary jaw part  16  which, as well as the jaw part  17 , is provided with an elongate transverse opening  96  and  97 , respectively, the optical device  60  fits snugly into a radially outwardly pointing concave recess  98  of the stationary jaw part  16 . The optical device  60  is thus guided on a side of the stationary jaw part  16  facing away from the movable jaw part  17 . Damage to the optical device  60  by the two jaw parts  16  and  17  is thereby avoided.