Patent Publication Number: US-2019191973-A1

Title: Endoscopic vacuum controller

Description:
RELATED APPLICATIONS 
     This application is a divisional of U.S. application Ser. No. 13/001,127, filed Jun. 28, 2011, which is a national stage filing under 35 U.S.C. § 371 of International Patent Application No. PCT/US2008/008104, filed Jun. 27, 2008. The entire contents of these applications are incorporated herein by reference in their entirety. 
    
    
     BACKGROUND OF INVENTION 
     1. Field of Invention 
     The present invention relates to a vacuum controller for use with an endoscope. 
     2. Discussion of Related Art 
     An endoscope is a medical instrument that can be inserted into the body cavity or organ of a patient for performing various surgical procedures. An endoscope may include an optics system to allow a user to view the body cavity or organ. A working or biopsy channel typically extends along the entire length of the endoscope to allow passage of various instruments, and/or tools into a patient. 
     An endoscope includes an elongated, flexible shaft within which extends the channels and instrumentation. A control handle is conventionally provided at the proximal end of the shaft for holding and manipulating the endoscope through the patient. One or more controls may be provided on the handle for operating various features of the endoscope. One or more ports are conventionally provided on the handle to provide access to the working or biopsy channel. 
     For some endoscopic surgical procedures, it may be desirable to draw a vacuum in or near the body cavity or organ of the patient. A fluid conduit may be coupled to a vacuum source to draw a vacuum through a channel of the endoscope or through an external tube. 
     SUMMARY OF INVENTION 
     In one illustrative embodiment, an endoscopic vacuum controller includes a housing having a vacuum inlet, a vacuum outlet configured to be coupled to a vacuum source, and a vacuum passage fluidly coupling the vacuum inlet to the vacuum outlet. The vacuum controller also includes an actuator supported by the housing and configured to interrupt a flow of fluid through the vacuum passage, and an indicator supported by the housing. The indicator is configured to provide an indication that a predetermined vacuum level is being drawn at the vacuum inlet. 
     In another illustrative embodiment, an endoscopic vacuum controller includes a housing having a vacuum inlet, a vacuum outlet configured to be coupled to a vacuum source, and a vacuum passage fluidly coupling the vacuum inlet to the vacuum outlet. The vacuum controller also includes an actuator supported by the housing and configured to control the flow of fluid through the vacuum passage from the vacuum inlet to the vacuum outlet, and an indicator supported by the housing. The indicator is configured to provide an indication that a predetermined vacuum level is being drawn at the vacuum inlet. The vacuum controller further includes a connector to detachably couple the housing to an endoscope shaft. 
     In a further illustrative embodiment, an endoscopic vacuum controller includes a housing having a vacuum inlet, a vacuum outlet configured to be coupled to a vacuum source, and a vacuum passage fluidly coupling the vacuum inlet to the vacuum outlet. The vacuum controller also includes actuation means supported by the housing for interrupting a flow of fluid through the vacuum passage, and indication means supported by the housing for indicating that a predetermined vacuum level is being drawn at the vacuum inlet. 
     In yet another illustrative embodiment, a method of providing a vacuum in an endoscopic procedure is provided. The method includes an act of (a) detachably connecting an endoscopic vacuum controller to an endoscope shaft, where the vacuum controller includes a housing having a vacuum inlet, a vacuum outlet configured to be coupled to a vacuum source, and a vacuum passage fluidly coupling the vacuum inlet to the vacuum outlet. The method further includes acts of (b) actuating the vacuum controller to draw a vacuum through the vacuum passage from the vacuum inlet to the vacuum outlet, and (c) determining whether a predetermined vacuum level is being drawn within the housing with an indicator supported by the housing. 
     Various embodiments of the present invention provide certain advantages. Not all embodiments of the invention share the same advantages and those that do may not share them under all circumstances. 
     Further features and advantages of the present invention, as well as the structure of various embodiments of the present invention are described in detail below with reference to the accompanying drawings. 
    
    
     
       BRIEF DESCRIPTION OF DRAWINGS 
       In the drawings, each identical or nearly identical component that is illustrated in the various figures is represented by a like numeral. For purposes of clarity, not every component may be labeled in every drawing. 
       Various embodiments of the invention will now be described, by way of example, with reference to the accompanying drawings, in which: 
         FIG. 1  is perspective view of an endoscopic vacuum controller according to one illustrative embodiment; 
         FIG. 2  is an exploded assembly view of the endoscopic vacuum controller of  FIG. 1 ; 
         FIG. 3  is a top view of the endoscopic vacuum controller of  FIG. 1 ; 
         FIG. 4  is a bottom view of the endoscopic vacuum controller of  FIG. 1 ; 
         FIG. 5  is a cross-sectional view of the endoscopic vacuum controller taken along line  5 - 5  shown in  FIG. 3 ; 
         FIG. 6  is a cross-sectional view of an endoscopic vacuum controller with the actuator shown in an open position according to another illustrative embodiment; 
         FIG. 7  is a cross-sectional view of the endoscopic vacuum controller shown in  FIG. 6  with the actuator shown in a closed position; 
         FIG. 8  is a first end view of an endoscopic vacuum controller taken along line  8 - 8  shown in  FIG. 3 ; 
         FIG. 9  is a second end view of an endoscopic vacuum controller taken along line  9 - 9  shown in  FIG. 3 ; 
         FIG. 10  is a perspective view of an endoscopic vacuum controller of  FIG. 1  detachably coupled to an endoscope shaft; 
         FIG. 11  is an exploded assembly view of an endoscopic vacuum controller housing according to one illustrative embodiment; 
         FIGS. 12A-12C  illustrate an actuator according to one illustrative embodiment; 
         FIGS. 13A-13B  illustrate cross-sectional views of the endoscopic vacuum controller taken along line  13 A- 13 A in  FIG. 7  and line  13 B- 13 B in  FIG. 6 ; 
         FIGS. 14A-14C  illustrate a diaphragm for movably coupling an indicator to the housing of an endoscopic vacuum controller according to one illustrative embodiment; and 
         FIGS. 15A-15B  illustrate an endoscopic vacuum controller that employs an actuator according to another illustrative embodiment. 
     
    
    
     DETAILED DESCRIPTION 
     The present invention is directed to an endoscopic vacuum controller that facilitates drawing a vacuum during an endoscopic procedure. It should be appreciated that the vacuum controller may be configured in any of numerous ways, and that the present invention is not limited to the particular devices and techniques described below. 
     The vacuum controller may be configured to be coupled to a vacuum source and may control when a vacuum is drawn during an endoscopic procedure. It may be desirable to draw a vacuum during an endoscopic procedure for a variety of reasons. For example, when suturing tissue, a vacuum may be used to capture the tissue within a suction port of a tissue fastening device. Once the tissue is captured within the suction port, the tissue fastening device may be used to fasten the captured tissue with one or more sutures. In another endoscopic procedure, a vacuum may be drawn to assist in the removal of material from the surgical site. It should be appreciated that the vacuum controller of the present invention is not limited for use with a particular type of endoscopic procedure or device. 
     The vacuum controller may include a housing having an inlet and an outlet, where the outlet is configured to be coupled to a vacuum source. A vacuum passage may extend through the housing and fluidly couple the vacuum inlet to the vacuum outlet. 
     The vacuum controller may include an actuator configured to control the flow of fluid through the vacuum passage. As set forth in more detail below, in one embodiment, the actuator may be configured to allow and interrupt the flow of fluid through the passage. The actuator may include a switch that is actuatable between an open or on position to allow a vacuum to be drawn through the vacuum passage and a closed or off position to prevent a vacuum from being drawn through the vacuum passage. 
     The vacuum controller may include an indicator configured to provide an indication of the vacuum level being drawn through the vacuum passage. In one embodiment, the indicator may be configured to present a visual indication as to whether or not a particular vacuum level is being drawn at the controller inlet. In this respect, the vacuum controller may provide hospital or medical personnel with a ready indication as to when a predetermined vacuum level is reached for performing a surgical procedure. If the predetermined vacuum level has been reached, the user may proceed with the endoscopic procedure. If the predetermined vacuum level has not been reached, the user may wait to perform the procedure. 
     The amount of vacuum that may be drawn from a vacuum source may vary based on numerous factors. In a hospital setting, a vacuum source may be provided by a wall outlet. The indicator on the vacuum controller may alert the user that the current vacuum level in the vacuum passage is or is not sufficient for a particular endoscopic procedure. 
     When employed in an endoscopic suturing procedure, the level of vacuum may be indicative of the amount of tissue captured by the suturing device. When the amount of vacuum is below a predetermined vacuum level, it may indicate that the amount of tissue captured by the suturing device is insufficient for continuing with the procedure. The indicator may alert the hospital or medical personnel to delay performing the endoscopic suturing procedure until the predetermined vacuum level is reached. 
     The vacuum controller may include a connector to detachably couple the vacuum controller to an endoscope shaft. Such an arrangement may facilitate the operation of the vacuum controller and the manipulation of the endoscope by the surgeon or endoscopist. The connector may be configured to slidably couple the vacuum controller to the endoscope shaft to allow adjustment of the vacuum controller along the length of the endoscope shaft while the vacuum controller remains coupled to the endoscope shaft. This may permit the user to more readily adjust the position of the vacuum controller relative to the endoscope shaft during an endoscopic procedure. In one illustrative embodiment, the vacuum controller is clipped onto the exterior of the endo scope shaft. It should be appreciated, however, that the vacuum controller may not include a connector and may thus remain detached from the endoscope shaft. 
     Turning now to the drawings, it should be appreciated that the drawings illustrate various components and features which may be incorporated into one or more embodiments of the present invention. For simplification, several drawings may illustrate more than one optional feature or component. However, the present invention is not limited to the specific embodiments disclosed in the drawings. It should be recognized that the present invention encompasses one or more embodiments which may include only a portion of the components illustrated in any one figure, and/or may also encompass one or more embodiments combining components illustrated in multiple different drawings, and/or may also encompass one or more embodiments not explicitly disclosed in the drawings. 
       FIG. 1  illustrates a perspective view of one embodiment of an endoscopic vacuum controller  10 . In this illustrative embodiment, the vacuum controller  10  includes a housing  20  having a vacuum inlet  22  and a vacuum outlet  24  configured to be coupled to a vacuum source (not shown). In one embodiment, the outlet  24  is configured to be coupled to a vacuum source via conduit  70 , such as a tube. The inlet  22  may be configured to be coupled to a conduit  72 , such as a tube, to draw a vacuum from the vacuum source to the endoscopic tool. In one embodiment, the inlet  22  is configured to draw a vacuum through the vacuum controller  10  and to an endoscopic tool and/or a desired location, such as, for example, near the distal end of an endoscope. 
     The housing  20  includes a passage  26  (see  FIGS. 5-7 ) which fluidly couples the vacuum inlet  22  to the vacuum outlet  24 . An actuator  40  is supported by the housing  20  and, as discussed in more detail below, may be configured to control the flow of fluid through the passage  26  from the inlet  22  to the outlet  24 .  FIG. 2  illustrates an exploded assembly view of the vacuum controller  10  shown in  FIG. 1 , and  FIGS. 3 and 4  illustrate top and bottom views of the vacuum controller  10  according to one embodiment. 
     In one embodiment, the actuator  40  is configured to interrupt a flow of fluid, such as air, through the vacuum passage  26 . As shown in  FIGS. 5-7 , in one embodiment, the actuator  40  includes a switch that is actuatable to an open or on position (see  FIG. 6 ) to allow a vacuum to be drawn through the passage  26  and to a closed or off position (see  FIGS. 5 and 7 ) to prevent a vacuum from being drawn through the passage  26 . In one illustrative embodiment, the switch includes a protrusion  42  that is arranged to block the passage  26  when actuated to the closed position. The protrusion  42  may include a wedge-shaped rib outwardly extending from the bottom surface of the actuator  40 . 
     As shown in  FIGS. 6-7 , in one embodiment, at least a portion of the vacuum passage  26  is compressible. In this embodiment, the actuator  40  is arranged to compress a portion of the passage  26 , when actuated to a closed position, to block and prevent the flow of fluid through the passage  26 . In one illustrative embodiment, a portion of the vacuum passage  26  is formed with a compressible tube  28  which is configured to be compressed by the actuator  40  in the closed position (see  FIG. 7 ). The actuator  40  and the compressible tube  28  may operate similar to a pinch valve. In one embodiment, the tube  28  may be an integral portion of the conduit  70  configured to couple the fluid outlet  24  of the vacuum controller  10  with the vacuum source. In another embodiment, the tube  28  may be separate from the conduit  70  and the two components may be selectively coupled together. 
     As shown in  FIGS. 5-7 , the actuator  40  may be pivotally supported by the housing  20  to pivot between an open or on position (see  FIG. 6 ) to a closed or off position ( FIGS. 5 and 7 ). In one embodiment the actuator  40  is configured as a toggle switch and pivots approximately 30° between the open and closed position. In another embodiment, the actuator  40  is configured to pivot approximately 45° between the open and closed position. In another embodiment, it is also contemplated that the actuator  40  may be configured to pivot less than 30° or greater than 45° as the invention is not so limited. As shown in greater detail in  FIGS. 12A-12C , in one embodiment, the actuator  40  pivots about an axle  48 . 
     Although the above mentioned embodiments include a pivoting actuator  40 , it should be appreciated that the invention is not so limited, as non-pivoting actuators are also contemplated. For example, in one embodiment, the actuator  40  may be supported by the housing  20  and may be configured to move linearly between an open position and a closed position to control the flow of fluid through the vacuum passage  26  from the inlet  22  to the outlet  24 . 
     It should also be appreciated that, in one embodiment, the actuator  40  may be configured to control the flow of fluid through the passage  26  from the inlet  22  to the outlet  24  without interrupting the flow of fluid through the passage  26 . For example, the actuator  40  may move between an open position and a partially open position. In the open position, the actuator may be configured to allow a vacuum to be drawn through the passage  26  and in the partially open position, the actuator  40  may be configured to reduce fluid flow through the passage  26 . 
     In one illustrative embodiment, the vacuum controller  10  includes a lock configured to maintain the actuator  40  in the closed position. In this embodiment, the vacuum controller  10  may remain in a closed position, preventing a vacuum from being drawn through the vacuum passage  26 , until the user actuates the actuator to its open position. In one embodiment, the user actuates the actuator to an open position to allow a vacuum to be drawn through the passage  26  by manually pressing down on the top surface  44  of the actuator remote from the protrusion  42 . 
     In one embodiment, the vacuum controller  10  may include a lock configured to maintain the actuator in the open position. In this embodiment, the vacuum controller  10  may remain in an open position, allowing a vacuum to be drawn through the vacuum passage  26 , until the user actuates the actuator to its closed position. 
     In one illustrative embodiment, the vacuum controller includes a locking detent positioned on at least one of the switch actuator  40  and the housing  20 . In the embodiment illustrated in  FIGS. 12A-12C  and  FIGS. 13A-13B , the detent is positioned on the actuator  40 . In this embodiment, a pair of detents  46  are provided, one on each side of the actuator  40 . As shown in  FIGS. 13A-13B , the detents  46  engage a locking feature on the housing  20  to bias the actuator  40  to the closed position. In one illustrative embodiment, the detents  46  engage tapered walls  34  which bias the actuator  40  to the closed position. In another embodiment, the detents  46  may engage one or more ribs formed on the housing  20 , as the invention is not limited in this respect. 
     As mentioned above, in one embodiment, the vacuum passage  26  includes a compressible tube  28  and the actuator  40  may be configured to compress the tube to block the passage  26  in the closed position. When compressed, the tube  28  may exert a force against the actuator  40  that biases the switch  40  toward its open position (see  FIG. 6 ). In one illustrative embodiment shown in  FIG. 13A , the detents  46  engage a shelf or flange  50  to counteract the force exerted by the tube  28  against the actuator  40  and maintain the vacuum controller  10  in its closed position. 
     It should be appreciated that in one embodiment, the detent may be located on the housing  20  and the detent may be configured to engage with a portion of the actuator  40 , as the invention is not so limited. Other types of locks apparent to one of ordinary skill in the art are also contemplated by the present invention to maintain the switch actuator in the open position and/or the closed position. 
     Another illustrative embodiment of an actuator  40  is shown in  FIGS. 15A-15B . In this embodiment, the actuator  40  includes a valve arrangement that is configured to extend within the vacuum passage  26 . In the illustrative embodiment, the valve includes a valve stem  100  with a sealing member  102  provided on the distal end of the valve stem. The valve stem is coupled to the actuator so that actuation of the actuator moves the valve stem relative to the passage.  FIG. 15A  illustrates the actuator  40  in a closed position which prevents a vacuum from being drawn through the passage  26 . In this embodiment, the valve stem  100  extends into the passage  26  so that the sealing member  102  engages with a portion of the walls of the passage  26  to prevent the flow of fluid through the passage  26 . 
       FIG. 15B  illustrates the actuator  40  in an open position to allow a vacuum to be drawn through the vacuum passage  26 . In this embodiment, the actuator  40  pivots such that the valve stem  100  and the sealing member  102  do not interfere with the flow of fluid through the vacuum passage  26 . 
     In one embodiment, additional sealing members  106 , such as o-rings, are provided to maintain a vacuum within the passage  26 . It should be appreciated that in other embodiments, the actuator may be configured differently as the invention is not so limited. 
     As mentioned above, the vacuum controller  10  may include an indicator  60  supported by the housing  20  that is configured to provide an indication that a predetermined vacuum level is being drawn at the vacuum inlet  22 . The predetermined vacuum level may vary based upon the type of endoscopic procedure to be performed. In one embodiment, it may be desirable to achieve a high vacuum level, and approaching the highest vacuum (approximately 29 inHg) may be desirable. 
     In one embodiment, the predetermined vacuum level is approximately 18 inHg. In another embodiment, the predetermined vacuum level is approximately 20 inHg, and in another embodiment, the predetermined vacuum level is approximately 24 inHg. As discussed in greater detail below, the indicator  60  may be calibrated based upon the desired predetermined vacuum level. 
     As shown in  FIGS. 5-7 , in one embodiment, the indicator  60  is biased to a first position relative to the housing  20 . The indicator  60  may be movable from the first position to a second position relative to the housing to indicate that the predetermined vacuum level is being drawn at the vacuum inlet  22 . In one illustrative embodiment, the indicator  60  may include a pin that is slidably supported by the housing  20  between the first position and the second position. The movement of the indicator from the first position to the second position enables the user to readily determine whether or not a predetermined vacuum level is being drawn at the inlet  22 . 
     In one illustrative embodiment, a spring  62  biases the indicator  60  to the first position. In one illustrative embodiment, the spring  62  is a helical spring which extends into the vacuum passage  26  and is positioned below the indicator  60 , such that the indicator  60  rests on the top of the spring  62 . It should be appreciated that in other embodiments, other types of springs may be employed. 
     As shown in  FIGS. 5 and 7 , in one embodiment, the indicator  60  is configured to protrude outwardly from a surface  18  of the housing  20  in the first position when an insufficient vacuum level is present at the inlet  22 . In the embodiment illustrated in  FIG. 6 , the indicator  60  is configured to be substantially flush with the surface  18  of the housing  20  in the second position to indicate the predetermined vacuum level is being drawn at the vacuum inlet  22 . It should be appreciated that in other embodiments, the first and/or second positions of the indicator  60  may differ as the invention is not so limited. For example, in one embodiment, the indicator  60  may be substantially flush with a surface  18  of the housing in the first position, and in the second position, the indicator  60  may be recessed with respect to the surface  18  of the housing  20 . In another embodiment, the indicator  60  may protrude outwardly from a surface  18  of the housing in both the first and second position. 
     In one illustrative embodiment, the indicator is movably coupled to the housing by a diaphragm  64 . One embodiment of a diaphragm is depicted in  FIGS. 14A-14C . In this embodiment, the diaphragm  64  has an annular shape with a substantially circular outer diameter  66  configured to be coupled to the housing  20  and a substantially circular inner diameter  68  configured to be coupled to the indicator  60 . 
     The diaphragm  64  may be made of a flexible material such that the diaphragm  64  moves based upon the pressure within the passage  26 . If the vacuum controller  10  is disconnected from a vacuum source and/or if the actuator  40  is positioned in a closed position to prevent a vacuum from being drawn through the vacuum passage  26 , the pressure within the vacuum passage  26  will be substantially the same as the pressure outside of the housing  20 , which may for example be approximately atmospheric pressure. The diaphragm  64  may be configured to be substantially planar in shape when the pressure within the vacuum passage  26  is substantially the same as the pressure outside of the housing  20 . When the vacuum controller  10  is coupled to the vacuum source and when the actuator  40  is positioned to allow a vacuum to be drawn through the vacuum passage  26 , the diaphragm is drawn inwardly towards the vacuum passage  26  due to the reduced pressure within the vacuum passage  26 . 
     As mentioned above, the indicator  60  may be coupled to the inner diameter  68  of the diaphragm  64  such that the inward movement of the diaphragm  64  also moves the indicator  60  inwardly towards the vacuum passage  26 . This movement of the indicator  60  relative to the housing  20  provides an indication of the reduced pressure within the passage  26 . In one embodiment, when the vacuum level within the passage  26  reaches a predetermined vacuum level, the diaphragm  64  and indicator  60  move inwardly such that the top of the indicator  60  is flush with a surface  18  of the housing  20 . 
     As shown in  FIGS. 5 and 14C , in one embodiment, the diaphragm  64  may include a lip  90  extending about its outer diameter  66 . The lip  90  may be configured to engage with portions of the housing  20  to retain the diaphragm  64  within the housing  20 . In one embodiment, the housing  20  has a conical relief  92  (see  FIG. 5 ) configured to receive the diaphragm  64  in a nesting arrangement to prevent over stressing the diaphragm  64  as the diaphragm  64  moves inwardly toward the passage  26 . One or more seals may be provided to seal the housing  20  and the passage  26  around the indicator  60  and diaphragm  64 . 
     The indicator  60 , diaphragm  64  and/or spring  62  may be calibrated based upon the desired predetermined vacuum level at the vacuum inlet  22 . In one embodiment the indicator  60 , diaphragm  64  and spring  62  are calibrated such that the predetermined vacuum level is between approximately 17-19 inHg. In this respect, the size, shape and materials of the indicator  60 , diaphragm  64  and spring  62  may be chosen based upon the level of vacuum needed for a particular endoscopic surgical procedure. For example, variables such as the spring constant of the spring  62 , the size and/or diameter of the indicator  60  and the diaphragm material may all affect the movement of the indicator  60  when a vacuum is drawn through the passage  26 . The greater the spring constant, the greater the vacuum will be required to move the indicator from the first position to the second position against the resistance of the spring  62 . The more flexible the diaphragm  64  material, the less the vacuum will be required to move the indicator  60  from the first position to the second position. The greater the cross-section and/or diameter of the indicator  60 , the greater the amount of vacuum will be required to move the indicator  60  from the first position to the second position. The greater the height of the indicator  60  the greater the amount of vacuum will be required to move the indicator inwardly such that the indicator is flush with a surface  18  of the housing  20 . 
     It should be appreciated that a determination of the vacuum level at the inlet  22  may be substantially equal to the vacuum level at the desired vacuum location, such as near the distal end of an endoscope. Because there may be a distance separating the inlet  22  from the desired location for the vacuum, there may a time delay for the two locations to reach an equilibrium such that the vacuum level at the inlet  22  is substantially equal to the vacuum level at the desired location. 
     Other types of indicators are also contemplated by the present invention. For example, the present invention may include other types of visual indicators, as well as audio indicators. It should be appreciated that the indicator may be made in a variety of ways, as the invention is not limited in this respect. 
     In one illustrative embodiment, the vacuum controller  10  includes a connector configured to detachably couple the housing  20  to an endoscope shaft. As shown in  FIGS. 4-10 , the connector may include a pair of rigid arms  30  with a recess  32  formed between the arms to receive at least a portion of an endoscope shaft  99 . The size and shape of the recess  32  may vary depending upon the size and shape of the endoscope shaft  99  to which the vacuum controller  10  is to be attached. In the embodiment illustrated in  FIGS. 4-10 , the connector is integrally formed with the housing  20 . It is to be appreciated, however, that the connector may be separately formed and thereafter coupled to the housing  20  in a manner apparent to one of ordinary skill in the art. 
     In one illustrative embodiment, the recess  32  is substantially C-shaped. It should be appreciated that in other embodiments, the recess  32  may be shaped differently, and may for example be rectangular or irregularly shaped as the invention is not so limited. The recess  32  may be configured to be slightly smaller than the outer diameter of the endoscope shaft to provide an interference fit between the recess  32  and the endoscope shaft  99 . In this regard, the endoscope shaft  99  may include a compressible outer covering which may be pinched by the arms and positioned within the recess  30 . 
     During an endoscopic procedure, it may be desirable for a user to adjust the position of the vacuum controller relative to the endoscope shaft. In one embodiment, the connector is configured to slidably couple the housing to an endoscope shaft  99  to allow adjustment of the housing  20  along the length of the shaft while the housing remains coupled to the endoscope shaft. In the illustrative embodiment, the arms  30  are configured to be slidably couple the controller to the endoscope shaft  99  that is positioned within the recess  32 . 
     As shown in  FIG. 11 , in one embodiment, the housing  20  includes a top outer shell  80  and a bottom outer shell  82  that enclose an inner housing  84 , where the vacuum inlet  22 , the vacuum outlet  24  and the vacuum passage  26  are provided with the inner housing  84 . In this embodiment, the top outer shell  80  includes a first opening  95  to accommodate the actuator  40  and a second opening  97  to accommodate the indicator  60 . In one embodiment, the connector is provided on the bottom outer shell  82  to detachably couple the housing  20  to the endoscope shaft  99 . In one embodiment, a plurality of fasteners  86  (see  FIG. 2 ) fasten the top outer shell  80  to the bottom outer shell  82  to enclose the inner housing  84 . 
     Aspects of the present invention are also directed to methods of providing a vacuum in an endoscopic procedure. An endoscopic vacuum controller  10  may be detachably connected to an endoscope shaft  99 , where the vacuum controller includes an inlet  22 , an outlet  24  and a passage  26  fluidly coupling the inlet and outlet. The vacuum controller may be actuated to draw a vacuum through the passage from the inlet  22  to the outlet  24 . A determination of whether a predetermined vacuum level is being drawn at the inlet may be made with an indicator  60  supported by the housing  20 . In one embodiment, the vacuum controller may be slid along at least a portion of the length of the endoscope shaft  99  to allow adjustment of the vacuum controller along the length of the shaft. 
     The types of materials used to manufacture the vacuum controller  10  of the present invention may vary as the invention is not limited in this respect. In one embodiment, the top and bottom outer shell  80 ,  82  may be made of a polycarbonate plastic and may be configured to ergonomically fit within a user&#39;s hand. In one embodiment, the inner housing  84  may be made of a clear polycarbonate so that the compressible tube  28  forming a portion of the vacuum passage  26  may be bonded to the inner housing  84 . In one embodiment, the compressible tube  28  is made of a silicone and the tube  28  and the inner housing  84  may be bonded together with a UV curable adhesive. In one embodiment, the tube  28  is formed of a material that is resistant to creeping over time. This may be desirable if the vacuum controller is maintained in the closed position where the protrusion  42  on the actuator  40  may be pressing down on the compressible tube to pinch the vacuum passage  26  closed. The tube  28  may be made of a flexible material that is able to withstand the vacuum levels within the passage  26  without collapsing. 
     In one embodiment, the indicator  60  is made of an injection molded plastic. The top surface of the indicator  60  may have the same color as the top outer shell  80  and the sides of the indicator may have a different or contrasting color to allow a user to more readily visually determine when the indicator  60  is flush with the top surface  18  of the housing  80  to indicate that a predetermined vacuum level is being drawn at the inlet  22 . 
     In the first position, the indicator  60  may extend out from the top surface  18  of the housing  20  approximately 0.1 inch. In one embodiment, an interference fit may be used between the indicator  60  and the inner diameter  68  of the diaphragm  64 . In one embodiment, the outer diameter of the indicator  60  is slightly greater than the inner diameter  68  of the diaphragm  68 , and the difference between the two diameters may, for example, be approximately 0.025 inches. 
     In one embodiment, the diaphragm  64  may be made from a flexible material, such as a silicone, and may have a durometer of approximately 20 A. In one embodiment, the outer diameter  66  of the diaphragm  64  is approximately 0.75 inches and the thickness of the diaphragm is approximately 0.020 inches. 
     In one embodiment, the spring  62  that biases the indicator  60  to the first position relative to the housing  20  may be a helical spring with a spring rate of approximately 2 lbs/inch. The spring may be fabricated of stainless steel wire having a diameter of approximately 0.016 inches. 
     As shown in  FIGS. 1-2 , in one embodiment, additional components may be coupled to the vacuum controller  10  to facilitate drawing a vacuum during an endoscopic procedure. In one embodiment, a female luer  74  and a male luer  76  are provided to couple the outlet conduit  70  to a vacuum source (not shown). Similarly, a female luer  94  and a male luer  96  may be provided to couple the inlet conduit  72  to the vacuum inlet  22  of the housing  20 . In one illustrative embodiment, a needleless injection site  98  may be coupled to the conduit  72  with a male luer  78 . 
     It should be understood that the foregoing description of various embodiments of the invention are intended merely to be illustrative thereof and that other embodiments, modifications, and equivalents of the invention are within the scope of the invention recited in the claims appended hereto.