Abstract:
An operating device is provided which includes an instrument insertion conduit, having a distal end connectable to the operating channel input of a handle of an endoscopic probe, the proximal end of the instrument insertion conduit forming an instrument input for the operating device, a suction assembly comprising a suction conduit communicating with the insertion conduit and a control device for selectively connecting the suction conduit to a pump, to suck out fluids through the operating channel, and a connecting conduit putting the suction conduit into communication with the insertion conduit, and the length of which is such that when the operating device is fixed on the handle, the suction control device is positioned close to the control means located in a proximal part of the handle.

Description:
FIELD OF THE INVENTION 
   This invention relates to the domain of flexible endoscopic probes for medical purposes of the fibrescope or videoendoscope type provided with an operating channel, an instrumentation input and a suction control. 
   It is particularly applicable to the domain of medical endoscopy, and more particularly to bronchoscopy. 
   BACKGROUND OF THE INVENTION 
   “Endoscopy” usually means a visual examination made inside an obscure cavity using an “endoscope”, a “fibrescope”, or a “videoendoscope”. 
   The term “fibrescope” usually denotes a flexible endoscopic probe that is inserted into an obscure cavity so that a user can firstly observe a target located inside the cavity through a lens, and secondly modify the orientation of the distal end of the probe inside the cavity. To achieve this, a fibrescope naturally integrates an optical device, an illumination device and a mechanical device. The mechanical device of a fibrescope is composed of an articulated distal tip deflection, a control handle and four cables located inside a flexible cylindrical duct connecting the control handle to the articulated distal tip deflection. The fibrescope handle is provided with two manually controlled devices one of which acts on the pair of cables activating the orientation of the tip deflection in one plane, and the other acting on the other pair of cables activating the orientation of the tip deflection in a plane perpendicular to the previous plane. The optical device of a fibrescope is composed of an objective placed in the distal face of an end piece fixed to the distal end of the tip deflection, an optical transport system for the image output by the distal objective, the transport system being composed of a flexible beam of ordered optical fibers passing in sequence through the articulated tip deflection, the flexible duct and then in the handle and connecting the lens to the distal objective, and a lens with a dioptric adjustment fixed to the control handle that the user can use to observe the magnified image of the target located in front of the distal objective of the fibrescope and transmitted through the image optical transport system. The illumination device of a fibrescope is composed of a beam of unordered optical fibers passing in sequence in the articulated tip deflection, in the flexible duct, in the handle, and then in an umbilical cable fixed to the control handle. The distal end of the beam of fibers, housed in the distal face of the end piece fixed to the distal end of the articulated tip deflection, illuminates the observed target when its proximal end housed in an illumination end piece integrated into the connection device forming the proximal end of the umbilical cable, is connected to a light generator. Under these conditions, use of the fibrescope described above requires the joint use of a light generator. 
   The term “videoendoscope” usually denotes a flexible endoscopic probe that, when inserted in an obscure cavity, enables a user firstly to observe a target on the screen of a video monitor located inside the cavity and secondly to modify the orientation of the distal end of the probe inside the cavity. To achieve this, a videoendoscope naturally comprises an imagery device, an illumination device and a mechanical device. The illumination device and the mechanical device of a videoendoscope are identical to devices of the same nature integrated into a fibrescope and described above, in all respects. The imagery device of a videoendoscope comprises mainly the following elements:
         an optoelectronic device housed in the distal end piece fixed to the distal end of the articulated tip deflection and comprising an objective housed in the distal face of said end piece, a color CCD sensor on the photoelectric substrate on which the real image of the observed target output by the objective is formed, and an interface microcircuit designed to correct electrical signals received or generated by the CCD sensor;   a multiconductor electrical cable routed in sequence through the articulated tip deflection, the flexible duct, the control handle and then the umbilical cable fixed to the control handle, the distal end of said cable being electrically fixed to the interface microcircuit of the distal optoelectronic device, while its proximal end is electrically fixed to a multipin connection socket integrated into the connection device forming the proximal end of the umbilical cable;   a video processor for synchronization of the electrical power supply of the distal optoelectronic device, processing of the electrical signal generated by the optoelectronic device, and outputting a video signal that is directly useable on a color monitor; the video processor with a panel of control keys enables the user to adjust the video image parameters, a video output connector that will be connected to a video monitor, and a multipin connector that will be connected to a multipin connection socket integrated into the connection device forming the proximal end of the umbilical cable of the videoendoscope.       

   Under these conditions, operation of the videoendoscope described above requires joint use of a video monitor and a light generator, the light generator often being associated with the video processor of the videoendoscope in the same box. 
   Fibrescope or videoendoscope type flexible endoscopic probes concerned by this invention and that will be used particularly for medical applications such as bronchoscopy, also have an operating channel composed of a flexible cylindrical pipe that passes firstly in the articulated tip deflection, in the flexible cylindrical duct, then in the distal part of the control handle of the endoscopic probes. The operating channel, the distal end of which is located on the distal face of the distal end piece of the endoscopic probes, is used to carry out all or some of the following operations:
         introduction of a flexible instrument such as a clamp, an electrical surgical knife, or laser fiber, that the user can use to take physical action on the target located in front of the distal objective of the flexible endoscopic probe;   suction of tissue debris at the target generated by the work done above;   distribution of a liquid medicine product at the target.       

   These various operations can only be implemented if an operating device comprising the following elements is integrated into flexible endoscopic probes intended for this type of applications:
         the flexible operating channel mentioned above;   a suction input fixed to the control handle and that will be connected to a suction pump through an external flexible pipe;   a control valve usually fixed to the control handle to enable the user to connect a suction input to the proximal end of the operating channel;   an instrument input fixed to the control handle and directly connected to the proximal end of the operating channel, the instrument input usually being provided with a removable silicone cap to seal the input and also to enable entry of a flexible instrument or the conical end piece of a syringe containing a product that will be injected into the operating channel.       

   The architecture of the operating device of flexible endoscopic probes that enable use of the above mentioned operations must satisfy ergonomic constraints and disinfection constraints at the same time. 
   Ergonomic constraints relate to access to functions for “suction control” and for the introduction of instrument(s) that must be located on the control handle so as to facilitate the operator&#39;s work. 
   Disinfection constraints apply equally well to fixed elements in the operating device integrated into the endoscopic probe, and removable elements external to said device. Said removable elements such as the suction control valve and the sealing cap, must be either disposable, or they must be removable so that they can be cleaned by brushing before being disinfected by immersion in a disinfecting bath, or even better by putting into the autoclave. It must be easy to clean fixed elements in the operating device such as the operating channel and the various connecting pipes rigidly fixed into the control handle, using cylindrical brushes before the endoscopic probe is fully immersed in a disinfection bath. 
   Flexible endoscopic probes for medical purposes enabling use of a suction control and an instrumentation input, in practice are based on two types of architecture. 
   The first architecture routinely used in flexible endoscopic probes enabling use of a suction control and an instrumentation input concerns probes like that shown in  FIG. 1 , in which the control handle  1  comprises two distinct accesses  41  and  45  to the operating channel  9  connected through a tubing  12 ,  13  integrated into the handle  1 . The first of these accesses  41 , located at the distal end of the control handle  1 , applies to the instrument input. The second access  45 , located at the proximal part of the handle  1 , is fitted with a removable external suction assembly F, and includes the suction control  30  and a suction tubing  10  comprising a connection end piece to an external suction pump. This type of operating device was described by the Japanese Company OLYMPUS in U.S. Pat. No. 5,299,561 and U.S. Pat. No. 5,840,015. Another operating device of the same type was described by the Japanese Company OLYMPUS in U.S. Pat. No. 5,257,773 and U.S. Pat. No. 5,322,263. This type of device has also been used in fibrescopes in the FB series and videoendoscopes in the EB series made by the Japanese Company PENTAX, and fibrescopes in the 40 and 160 series made by the Japanese Company OLYMPUS. The implantation of the instrument input  41  and the suction control  30  of the suction device F at the ends of the control handle  1  of the flexible endoscopic probes based on this type of architecture, has an undeniable advantage in terms of ergonomy. 
   It is more ergonomic to use one hand to hold the handle  1  of the probe and possibly manipulate the suction control  30  of the suction assembly F, and to use the other hand to manipulate the operating instrument inserted into the instrument input  41  that is not close to the suction control  30 . 
   However, integration of an internal tubing  12  and  13  into the control handle  1  to connect two inputs  41  and  45  to the operating channel  9  is undoubtedly a handicap in terms of ease of cleaning and disinfection. 
   It is very difficult, if not impossible, to disassemble this internal tubing  12 ,  13  from the handle to clean it. In this case, cleaning is usually done inside the control handle at the risk of leaving impurities in the Y branch formed by tubings  13 ,  12 ,  9 , a location at which tissue debris are particularly likely to collect. 
   The second of these architectures concerns endoscopic probes like that described in  FIG. 2 , in which the control handle is provided with a single unique access to the operating channel, this access being equipped with an external operating device E 1 , that may be fully or partially removable depending on the models, and including the instrument input, the suction control and the connection end piece to an external suction pump. This type of operating device was described by the Japanese Company OLYMPUS in U.S. Pat. No. 4,198,958, U.S. Pat. No. 4,469,090 and U.S. Pat. No. 4,561,428. Another operating device of this type was described by the Japanese Company OLYMPUS in U.S. Pat. No. 4,736,732 and U.S. Pat. No. 4,794,913. This type of device has also been used in bronchoscopes in the FBS series made by the Japanese Company MACHIDA and in bronchoscopes in the 20 series made by the Japanese Company OLYMPUS. 
   Direct access to the operating channel that characterizes flexible endoscopic probes based on this type of architecture has an undeniable advantage in terms of the ease of cleaning and disinfection, since the external operating device can easily be disassembled from the handle of the endoscope. 
   However, this single piece removable operating device E 1  is not very ergonomic to use, due to the proximity of the instrument input and the suction control. 
   SUMMARY OF THE INVENTION 
   The purpose of this invention is to make a removable operating device for a flexible endoscopic probe with a preferably medical purpose and provided with a single unique access to the operating channel  9 , this operating device needing to be easily removable, ergonomic to manipulate and it should satisfy disinfection constraints required by users. 
   This objective is achieved by providing an operating device designed to be removably fixed onto an endoscopic probe handle including an internal operating channel having an input opening up in a distal part of the handle, said operating device comprising:
         a means for inserting operating instruments, including an instrument insertion conduit having a distal end which comprises means for connecting the instrument insertion conduit to the operating channel input, and a proximal end which forms an instrument input for the operating device, and   a suction assembly comprising a suction conduit communicating with the insertion conduit and a control means for selectively connecting the suction conduit to a pump, to suck out fluids through the operating channel.       

   According to the invention, this operating device comprises a connecting conduit putting the suction conduit into communication with the insertion conduit, and having a length such that when the operating device is fixed on an endoscopic probe handle, the suction control means is positioned close to the control means of said handle located in a proximal position of said handle. 
   This operating device is then removable from the endoscope handle  1 , for example so that it can be sterilized, and is also ergonomic to use since the suction control  30  is sufficiently close to the control means of the endoscope so that it can be manipulated with the same hand as the endoscope control means. 
   Advantageously, the length of the connecting conduit is of the order of the thickness of several fingers of a hand. 
   Preferably, the connection means of the insertion conduit are designed so as to removably fix the operating device on the handle. 
   According to one embodiment of the invention, this operating device comprises an additional attachment means located at the suction assembly, designed to cooperate with complementary attachment means provided on the proximal part of the handle. 
   The connecting conduit  16  is preferably made of a rigid material. 
   According to another embodiment of the invention, the suction control means is a removable valve that can adopt at least one open configuration enabling fluid to pass between the operating channel and a suction tubing itself connected to the suction pump, and a closed configuration preventing passage of the fluid to the suction tubing. 
   According to another embodiment of the invention, the suction assembly comprises a cylindrical part installed so as to slide freely inside the suction conduit, and comprising a closed axial channel and a lateral orifice connecting the outside of the cylindrical part to the inside of the closed axial cylindrical channel, the cylindrical part closing the inlet to the suction tubing in the closed configuration, the side orifice being in the open configuration facing the suction tubing inlet. 
   Preferably, the cylindrical part is pushed into the closed configuration by elastic return means. 
   According to another embodiment of the invention, the suction conduit of the suction assembly is selectively connected by the control means to an injection tubing used for selective injection of fluids from the injection tubing to the operating channel. 
   Advantageously, the means for inserting operating instruments is provided with a cap for closing off the insertion conduit. 
   Preferably, this operating device is essentially made from a sterilisable material intended for medical purpose, such as stainless steel. 
   Advantageously, this operating device is made so that it should be disposable. 
   The invention also relates to a fibrescope and a videoendoscope equipped with the operating device defined above. 
   One preferred embodiment of the invention will be described below, as a non-limitative example, with reference to the appended drawings. 
   BRIEF DESCRIPTION OF THE DRAWINGS 
     FIG. 1 , briefly mentioned above, is a cross-sectional view of an endoscope handle and its partially removable operating device according to prior art. 
     FIG. 2 , briefly described above, is a cross-sectional view of an endoscope handle and its completely removable operating device according to prior art. 
     FIG. 3  is a cross-sectional view of an endoscope handle and an operating device according to the invention. 
     FIG. 4  is a cross-sectional view of a variant of the operating device according to the invention, shown in  FIG. 3 . 
     FIG. 5  is a profile view of a control handle for a videoendoscopic probe equipped with the operating device according to the invention. 

   DETAILED DESCRIPTION 
     FIG. 1  illustrates a control handle  1  of a fibrescope according to prior art designed for medical purposes, provided with two distinct accesses  41  and  45  to the operating channel  9  and an external operating device also representative of prior art in this subject. 
   Like all flexible endoscopic probes designed for medical purposes and equipped with an operating channel, this fibrescope is provided with a control handle  1  fixed to the distal end of a flexible umbilical cable  7  and the proximal end of a flexible duct  3  used particularly for housing the flexible operating channel  9 , the proximal end of which opens up into the distal part  2  of the control handle  1 . 
   The various devices commonly integrated into this fibrescope are well known to those skilled in the art, and have deliberately not been shown in  FIG. 1  for reasons of clarity. These elements are integrated into the distal part of the flexible duct  3  (objective, illumination window, output from the operating channel, articulated tip deflection, etc.), in the flexible duct  3  (lighting fiber harness, ordered image fibers harness, tip deflection control cables, etc.), in the control handle  1  (tip deflection control device, etc.), in the proximal part  4  of the handle (ocular lens, dioptric adjustment device controlled by the ring  5 , etc.), in the flexible umbilical cable  7  (lighting fibers harness, etc.) and in the proximal end of the umbilical cable (connection end piece to a light generator, etc.). 
   The distal part  2  of the control handle  1  of the fibrescope illustrated in  FIG. 1  is provided with a first oblique lateral socket  40  in which a cylindrical channel  41  is formed in which the conical shaped proximal end  42  forms the instrumentation input to the fibrescope and in which the distal end C is connected to the proximal end of the operating channel  9  through a rigid cylindrical tubing  12  fixed housed in the distal part  2  of the control handle. The proximal end of the socket  40  is provided with an external shoulder  43  used to put a sealing cap  20  made of a flexible plastic material into position. The cap is provided with a circular crossing orifice  21  that can be closed off by a cylindrical shutter  22  fixed to a sealing cover  23  elastically connected to the cap. 
   The control handle  1  of the fibrescope illustrated in  FIG. 1  is also provided with a second lateral socket  44  in which a cylindrical channel  45  is formed, with its proximal end forming the suction input of the fibrescope to which the suction assembly F is connected, and the distal end of which is connected to the distal end of the tubing  12  through a rigid cylindrical tubing  13  housed fixed in the distal part  2  of the control handle. The proximal part of the socket  44  is provided with an external thread  46  intended to connect the suction assembly F of a removable external operating device. 
   Therefore, the operating device comprises a suction assembly F comprising a tube  55 , the distal end of which is provided with an axial circular orifice  56 , and the proximal part of which contains an axial cylindrical channel  57 . The tube  55  of the suction assembly F is fixed to a rigid lateral suction tubing  10 , the distal end of which opens up into the cylindrical channel  57  also called the suction conduit. The distal end of the tube  55  is fixed to a loose ring  59 , the distal part of which is provided with an internal thread used to fix the operating device onto the control handle  1  by screwing the ring onto the external thread  46  formed around the second socket  44 . The proximal part of the tube  55  is provided with an external thread  58  used to fix the valve mechanism  30  described below onto said tube. 
   This removable valve mechanism  30  consists of a cylindrical part  31  housed free to slide in the suction conduit  57  formed in the proximal part of the tube  55  of the operating device. The distal part of the cylindrical part  31  is provided with a closed axial channel  34  which is generally cylindrical, and a lateral circular orifice  35  opening up into the proximal end of the closed channel  34 . The proximal part of the cylindrical part  31  is provided with a proximal end  33  in the form of a push button, an external cylindrical shoulder  32  and a loose ring  37 , the proximal edge of which rests on the proximal face of the shoulder  32  and the distal part of which is provided with an internal thread to screw the ring  37  onto the external thread  46  formed around the proximal part of the tube  55  of the operating device. A helical spring  36  housed between the proximal edge of the tube  55  and the distal face of the shoulder  32  holds the valve mechanism  30  in a rest position characterized by closing the distal end of the suction tube  10 . Manual action on the proximal end  33  of the valve mechanism brings the lateral orifice  35  facing the distal end of the suction tube  10 , so that the suction tube  10  can be connected to channel  45  formed in the socket  44 . 
     FIG. 2  illustrates the structure of a handle  1  of a fibrescope used for medical purposes provided with a single and unique access  48  to the operating channel  9  in the proximal position, and an external operating device E 1  representing prior art in the subject. 
   Like all flexible endoscopic probes for medical purposes equipped with an operating channel  9 , this fibrescope is provided with a control handle  1  fixed to the distal end of a flexible umbilical cable  7  and the proximal end of a flexible duct  3  used particularly for housing the flexible operating channel  9 , the proximal end of which opens up into the distal part  2  of the control handle  1 . 
   The various devices usually integrated into this fibrescope are well known to those skilled in the art and are deliberately not shown in  FIG. 2 , for reasons of clarity. These elements are integrated into the distal part of the flexible duct  3  (objective, illumination window, output from the operating channel, articulated tip deflection, etc.), in the flexible duct  3  (lighting fiber harness, ordered image fibers harness, tip deflection control cables, etc.), in the control handle  1  (tip deflection control device, etc.), in the proximal part  4  of the handle (ocular lens, dioptric adjustment device controlled by the ring  5 , etc.), in the flexible umbilical cable  7  (lighting fibers harness, etc.) and in the proximal end of the umbilical cable (connection end piece to a light generator, etc.). 
   The control handle  1  of the fibrescope illustrated in  FIG. 2  is provided with an oblique lateral socket  47  in which a cylindrical channel  48  is formed, the distal end of which is connected to the proximal end of the operating channel  9  through a rigid cylindrical tubing  14  housed in the distal part  2  of the control handle. The proximal part of the socket  47  is provided with an external thread  49  that will be used for connection of an external operating device E 1 . 
   The operating device E 1  is in the shape of a Y, in which the main branch is located along the prolongation of the line of the socket  47  and contains the instrumentation channel, and the oblique lateral branch contains the suction channel. The main branch of the operating device E 1  comprises a tube  60  in which a cylindrical channel  61  is formed with its conically shaped proximal end  63  forming the instrumentation input. The proximal end  63  of the tube  60  is provided with an external shoulder  65  used to put the sealing cap  20  described above with reference to  FIG. 1  into position. The distal end of the tube  60  is fixed to a loose ring  64 , the distal part of which is provided with an internal thread used to fix the operating device E 1  onto the control handle  1  by screwing the ring  64  onto the external thread  46  formed around the socket  47 . The oblique lateral branch of the operating device E 1  consists of a tube  66  rigidly fixed to the tube  60 ; and the distal end of which contains an axial channel  67  opening up into the distal end  62  of the channel  61  formed in the tube  60 . The proximal part of the tube  66  is provided with an external thread  69  used to screw the ring  37  of the cap mechanism  30  described above with reference to  FIG. 1 , and previously inserted into the cylindrical channel  68  formed in said proximal part, onto the tube. The tube  66  is also fixed to a rigid lateral suction tubing  10 , for which the distal end opens up into the cylindrical channel  68 . 
     FIG. 3  illustrates the structure of a fibrescope for medical purposes provided with a single and unique access  51  to the operating channel  9  and provided with an external operating device according to this invention. 
   Like all flexible endoscopic probes for medical purposes equipped with an operating channel, this fibrescope is provided with a control handle  1  fixed to the distal end of a flexible umbilical cable  7  and the proximal end of a flexible duct  3  used particularly for housing the flexible operating channel  9 , the proximal end of which opens up in the distal part  2  of the control handle  1 . 
   The various devices usually integrated into this fibrescope are well known to those skilled in the art and are deliberately not shown in  FIG. 3 , for reasons of clarity. These elements are integrated into the distal part of the flexible duct  3  (objective, illumination window, output from the operating channel, articulated tip deflection, etc.), in the flexible duct  3  (lighting fiber harness, ordered image fibers harness, tip deflection control cables, etc.), in the control handle  1  (tip deflection control device, etc.), in the proximal part  4  of the handle (ocular lens, dioptric adjustment device controlled by the ring  5 , etc.), in the flexible umbilical cable  7  (lighting fibers harness, etc.) and in the proximal end of the umbilical cable (connection end piece to a light generator, etc.). 
   The distal part  2  of the control handle  1  of the fibrescope illustrated in  FIG. 3  is provided with an oblique lateral socket  50  in which a cylindrical axial channel  51  is formed, the distal end of which is connected to the proximal end of the operating channel  9  through a rigid cylindrical tubing  15  fixed housed in the distal part  2  of the control handle. The proximal part of the socket  50  is provided with an external thread  52  that will be used to connect the external operating device E 2  according to this invention. 
   The distal part of the operating device E 2  comprises a means of insertion A composed of a cylindrical part  70  in which an instrument insertion conduit  71  is formed, the flared proximal end  73  of which forms the instrument input. The proximal end  73  of the cylindrical part  70  is provided with an external shoulder  74  used to put the sealing cap  20  described above with reference to  FIG. 1 , into place. The cylindrical part  70  is also rigidly fixed to a rigid lateral connecting conduit  16 , for which the distal end opens up in the instrument insertion conduit  71 . The distal end C of the cylindrical part  70  of the insertion means A is fixed to a loose ring  75 , for which the distal part is provided with an internal thread used to fix the operating device E 2  onto the distal part  2  of the control handle  1  by screwing the loose ring  75  onto the external thread  52  formed around the proximal part of the socket  50 . 
   The proximal part of the operating device E 2  is formed from a tube  76 , the distal end of which is provided with a circular orifice  77  in which the proximal end of the rigid connecting conduit  16  is rigidly housed. The proximal part of the tube  76  is provided with an external thread  79  used to screw the ring  37  of the valve mechanism  30  described above with reference to  FIG. 1 , after being inserted in the cylindrical suction duct  78  formed in the proximal part, onto said tube. The tube  76  is also rigidly fixed to a rigid lateral suction tubing  10 , the distal end of which opens up into the cylindrically shaped suction conduit  78 . The distal part of the tube  76  is provided with an external lateral pin  80  provided with a shoulder that is inserted into a slit formed on the control handle  1  for this purpose, to fix the distal part of the operating device E 2  and the control handle  1 . 
     FIG. 4  illustrates another version of the operating device E 3  according to this invention, used in cooperation with the same valve mechanism to simultaneously manage functions for suction and injection of a liquid contained in a perfusion pack connected to the operating device E 3  through a flexible pipe, into the operating channel  9 . The use of such of a device in bronchoscopy provides a means of carrying out “alveolar washing” operations. 
   The operating device E 3  illustrated in  FIG. 4  is the same as that described with reference to  FIG. 3  except that the structure of its proximal part formed by a tube  76  rigidly fixed firstly to a rigid lateral suction tubing  10 , the proximal end of which opens up into the proximal part of the suction conduit  78  in the shape of a cylindrical channel, formed in the tube  76 , and also a rigid lateral injection tubing  11 , the proximal end of which opens up in the suction conduit  78 . 
   When the valve mechanism  30  is at rest, this type of operating device E 3  prevents any communication between the suction tube  10  and the connecting conduit  16 , and also prevents any communication between the injection tube  11  and the connecting conduit  16 . 
   When the user activates the valve mechanism  30  by sliding the sliding cylindrical part  31  into a first open position, the device enables communication between the suction tube  10  and the connecting conduit  16  and prevents any communication between the liquid injection tube  11  and the connecting conduit  16 . 
   When the user activates the valve mechanism  30  by sliding the sliding cylindrical part  31  into a second open position, the device prevents communication between the suction tube  10  and the connecting conduit  16  and allows communication between the liquid injection tube  11  and the connecting conduit  16 . 
   Therefore, obviously provided that the instrumentation input  73  is closed off by the sealing cap  20 , it is observed that this type of operating device E 3  effectively enables the user to simultaneously manage fluid suction and/or liquid injection into the operating channel  9 , using a single control means  30 . 
     FIG. 5  illustrates the external appearance of the control handle  1  of a videoendoscopic probe equipped with the operating device E 3  described above with reference to  FIG. 4 . 
   The distal part  2  of the control handle is provided with a socket  50  housing the access channel to the operating channel and is rigidly fixed to the proximal end of the flexible duct  3  of the videoendoscope, the distal end of this duct containing various elements (such as the articulated tip deflection, illumination window, output from the operating channel, optoelectronic device, etc.) well known to those skilled in the art, and mentioned above. The control handle  1  is fixed to the distal end of an umbilical cable  7 , the proximal end of this cable containing various elements (such as the connection end piece to a lighting generator, connector to a video processor, etc.), also well known to specialists in the subject and also mentioned above. 
   The control handle  1  is provided with a control lever  8  used to control the orientation of the distal tip deflection of the videoendoscopic probe and a proximal part  4  equipped with keys  6  used to remote control some functions of the video processor connected to the proximal end of the umbilical cable  7 . 
   The external operating device E 3  described above with reference to  FIG. 4  is fixed to the control handle  1  by screwing the loose ring  75  fixed to the distal end  70  of the device onto the socket  50 . 
   The proximal part  82  of the operating device E 3  is provided with an air suction inlet  10 , a liquid injection inlet  11 , and a valve mechanism  30  fixed to the proximal part  32  by screwing the ring  37  fixed to the valve mechanism  30  onto the proximal part. 
   The connecting conduit  16  connects the distal end  70  of the operating device E 3 , this distal end being equipped with the sealing ring  20  described above with reference to  FIG. 1 , to the proximal end  82  of the device.