Patent Publication Number: US-2023141071-A1

Title: Medical device

Description:
The invention relates to a medical device having the features in the preamble of patent claim  1 . 
     Endoscopes are used for minimally invasive surgical procedures on humans and animals as well as cavities which are difficult to access in the art for visual inspection. Depending on the intended use, endoscope tubes with different diameters find application. In bronchoscopy, rigid bronchoscope tubes of stainless steel with wall thicknesses of 0.6 mm are oftentimes used. Diameters in the range of 10 mm with lengths of approximately 400 mm are customary. For placing the frequently used silicone stents, tube diameters of 10-16 mm are required according to the width of a normal larynx. Handling with thicker equipments for stent insertion requires practice and experience. 
     A further problem is that in endoscopy, it is normally not possible to change from a smaller diameter to a larger diameter, or vice versa, without greater effort. For this purpose, it normally requires to completely exchange the endoscope tube including the endoscope head attached thereto and to reattach all the connections arranged therein. In the case of bronchoscopy, the connections involve in particular connections for ventilation of the lung and also connections for measuring the pressure conditions within the endoscope. 
     The invention is based on the object to provide a medical device with an endoscope head which enables the use of different endoscope tubes in a simple manner and to implement the necessary connections with the endoscope head as uncomplicated as possible. 
     This object is achieved by a medical device having the features of patent claim  1 . 
     The dependent claims relate to advantageous refinements of the invention. 
     The medical device includes an endoscope head which is designed to be detachably connected to endoscope tubes. For this purpose, the endoscope head has a longitudinal channel between its proximal end and its distal end. In addition, at least one measuring channel is arranged in the endoscope head. The at least one measuring channel has at least one inner connection opening, which is connected to the longitudinal channel, and at least one outer connection opening, which is arranged on the outside of the endoscope head. The outer connection opening can in particular be arranged laterally. Preferably, the measuring channel in the endoscope head is as short as possible. It therefore preferably runs radially. Preferably, two diametrically arranged, radially extending measuring channels are provided in the endoscope head. 
     The outer connection opening of the at least one measuring channel is connectable to a measurement adapter. The measurement adapter can be detachably coupled to the endoscope head. The measurement adapter serves as link and in particular as quick-action coupling between a measuring instrument, which, for example, is connected via a hose to the measurement adapter and to the endoscope head. The connection of the individual measuring channels is in particular gas-conducting. The invention has the advantage that, even in the case of several measuring channels in the endoscope head, these can be connected to the measurement adapter with a single attachment motion. There is no need to connect each measurement channel individually. As a result, it is possible to prepare the endoscope head in a simple and uncomplicated manner for its application. 
     The measurement adapter should preferably be coupled to the endoscope head in a particularly simple and quick manner and be able to be removed again as easily as well. It can preferably be coupled to the endoscope head via a plug connection. The connection can be realized without tools. The measurement adapter is preferably configured as a U-shaped clamp. In this case, it has two arms which are connected to one another via a spine as a link. Such an U-shaped clamp can be attached laterally onto the endoscope head. The lateral attachment is possible in a particularly simple and rapid manner. A faulty operation or a slipping of the measurement adapter relative to the endoscope head can be precluded through suitable contact surfaces and guide surfaces. 
     The measurement adapter is preferably held on the endoscope head by using a clamping force. For this purpose, at least one of the two arms can be designed to be resilient. In particular, the entire measurement adapter is made of a resilient material, so that both arms can be designed resilient due to the material properties. As an alternative or in addition, the spring force can be built up through an elastic deformation of the spine. The arms are slightly bent apart during lateral attachment onto the endoscope head. Slanted surfaces are preferably arranged on the endoscope head and/or at the free ends of the arms and slide on each other so that the clamp is bent open. When the clamp assumes the final position, the arms spring back and rest in a clamping and sealing manner on the endoscope head. 
     It is considered to be advantageous to make the connection not only clamping, i.e. through force-fitting engagement, but in addition or also as an alternative by a form fit. In the case of correspondingly selected tolerances, a form-fitting connection in attachment direction or in opposition to the attachment direction prevents the measurement adapter from slipping and thus a faulty position, a faulty operation or a falsification of measured values. Provision is therefore made for at least one arm and in particular both arms to have latching projections, by which the measurement adapter can be coupled to the endoscope head in a form-fitting manner. A form fit in attachment direction can already be established by having the spine of a U-shaped clamp contact a contact section of the endoscope head. As a result, the attachment depth can be limited. Lateral guides for one or both arms on the arms and/or on the endoscope head ensure the position of the measurement adapter in longitudinal direction of the endoscope head. 
     The latching projections are located at a distance from the spine. As a result, a predominant embracing of the endoscope head can be ensured in combination with the spring force of the arms. A complete embracing is possible, but not necessarily required. The latching projections are in particular located at the free ends of the arms. When the measurement adapter is attached, the arms are bent slightly apart with their inwardly directed latching projections. The latching projections slide over the outer side of the endoscope head and ultimately snap behind a latching edge, so that the arms spring back, and so that a sufficiently tight connection is established between the measuring channel or the measuring channels in the endoscope head and the measuring channel or measuring channels in the measurement adapter. In principle, it is also possible to use the spring force of the arms only in such a way as to establish in combination with the latching projections a form-fitting connection in the latching position. It is considered to be particularly beneficial to involve a combination of a form-fitting connection for the positional orientation and force-fitting connection for sealing the transition in the region of the outer connection opening. 
     As explained above, the measurement adapter is designed to be arranged in a lateral adapter connection region of the endoscope head, with the measurement adapter being displaceable transversely to the longitudinal channel upon the adapter connection region. The latching projections on the free ends of the arms embrace hereby at least two thirds of the endoscope head with respect to its diameter to thereby provide a secure guidance and fixation of the measurement adapter. 
     Located in the measurement adapter is at least one measuring channel which feeds into the region of the spine of the measurement adapter, in particular in the transition zone to the arms. For this purpose, provision is made in particular for a connection piece in the region of the spine, onto which connection piece in particular a hose can be attached. At least one measuring channel is arranged in one of the arms of the measurement adapter. A measuring channel is preferably arranged in each of the arms of the measurement adapter, which measuring channel can in turn be coupled to a respective outer connection opening of the measuring channel in the endoscope head. Therefore, two connection pieces, which point away from the endoscope head, are preferably located on the spine. Several measuring channels per arm are also possible. 
     The endoscope head is designed to be detachably connected to endoscope tubes. So that the measuring channel in the endoscope head can also be connected to corresponding measuring channels in the endoscope tube, the endoscope tube has to be aligned in the endoscope head in a particular position. This is reliably possible via a form-fitting connection. In addition, a form-fitting connection between the endoscope tube and the endoscope head has the advantage that a force can be exerted on the endoscope tube via the endoscope head, for example in order to turn it into the correct position. Therefore, the endoscope head is advantageously coupled to the endoscope tube in such a way that the connection is non-rotatable. The fixed rotative engagement can be designed in a force-fitting and/or form-fitting manner. Preferably, the connection is a form fit or primarily a form fit. The form fit can be established by combining a male piece with a matching female piece as a counterpart. For this purpose, at least one male piece on the endoscope tube and/or endoscope head can engage with at least one female piece on the endoscope tube and/or on the endoscope head. In the simplest case, it involves one or more tongue-and-groove connections. 
     Such a form-fitting connection can simultaneously determine the attachment depth of the endoscope tube into the endoscope head, so that lateral termination openings of the measuring channels on the endoscope tube correspond with the respective connection openings in the endoscope head. 
     Provision is made in a further refinement of the invention for the endoscope-tube-side male piece or female piece to be formed on an adapter sleeve which can be coupled to a proximal end of the endoscope tube. The adapter sleeve has the necessary form-fitting elements for a rotationally fixed connection with the endoscope head. The adapter sleeve limits the attachment depth of the endoscope tube into the endoscope head and defines the position of the measurement channels. The adapter sleeve also has one or more measuring channels, which can be connected to the measuring channels in the endoscope tubes and can be connected to the measuring channel there through engagement into the longitudinal channel of the endoscope head. 
     Provision is made in a further refinement of the invention for adapter sleeves with diameters that are matched to one another, so that an adapter sleeve with smaller diameter can be mated with an adapter sleeve of greater diameter. The adapter sleeves have force-fitting connections and/or form-fitting connections to one another and to the components with which they come into engagement. Such adapter sleeves ensure that a force can be transmitted from the endoscope head to a connected endoscope tube via the adapter sleeves and in particular via at least two adapter sleeves. In particular, it is possible to connect an endoscope tube of smaller diameter, which is coupled to the smaller adapter sleeve, to the endoscope head via the adapter sleeve serving as an intermediary sleeve. In this way, it is possible to use endoscope tubes of different thickness with one and the same endoscope head, wherein the thickness compensation is realized via the use of suitable adapter sleeves. 
     As an alternative to adapter sleeves which are mated with one another with different diameters, but are each matched to the diameter of the endoscope tube, it is also possible within the scope of the invention to use different adapter sleeves which have a first diameter region for coupling to the longitudinal channel of the endoscope tube and a second, optionally smaller diameter region, for connection to the endoscope tube of differing diameter. 
     In accordance with the configuration of the endoscope tube or endoscope head, the measuring channels are arranged in the adapter sleeves, i.e. in particular diametrically. The length of the measuring channels is as short as possible. The arrangement of the measuring channels is therefore preferably not only diametrically but also radially. 
     The used endoscope involves in particular a bronchoscope. 
    
    
     
       The invention is explained hereinafter with reference to an exemplary embodiment illustrated in schematic drawings. 
         FIGS.  1  and  2    show two different perspective illustrations of one and the same medical device  1  with an endoscope head  2  as a central component. The endoscope head  2  has a longitudinal channel  3  extending vertically in the image plane for receiving an endoscope tube  4 . The endoscope tube  4  is only partially shown.  FIG.  1    shows only the proximal end  5  thereof. The longitudinal channel  3 , which extends from a proximal end  6  to a distal end  7  of the endoscope head  2 , serves to receive the proximal end  5  of the endoscope tube  4 . The diameter of the endoscope tube  4  is significantly smaller than the inner diameter of the longitudinal channel  3 . In order to compensate the diameters, adapter sleeves  8 ,  9  are used, which will be discussed further below. 
     
    
    
     A further component of the device  1  is a measurement adapter  10 . The measurement adapter  10  can be detachably coupled to the adapter head  2  by being attached laterally in the direction of the arrow P 1  onto the substantially cylindrical endoscope head  2 . It can be withdrawn again in the opposite direction. No tool is required for attachment and removal. 
     In addition to the actual longitudinal channel  3 , which serves as a working channel, the endoscope head has connections for ventilation. These connections are provided when the endoscope head is used during bronchoscopy. A first connection  11  serves for jet ventilation. A second connection  12  is provided for common ventilation at lower pressures. The connections  11 ,  12  can alternatively be used. 
     In addition, the endoscope head includes measuring channels  13 ,  14 . The measuring channels  13 ,  14  are arranged diametrically. They are located in the vicinity of the distal end  7 , so that they can be brought into overlap with measuring channels  15 ,  16  in the adapter sleeves  8 ,  9  or can be connected to a measuring channel  17  in the endoscope tube  4 . The measuring channels  13 ,  14  feed into the longitudinal channel  3  and have each an inner connection opening  18  and an outer connection opening  19 . The outer connection opening  19  is located in a lateral adapter connection region  20 . Unlike the remaining outer contour of the substantially cylindrical endoscope head  2 , the adapter connection region  20  is not rounded, but flattened. Since corresponding connection openings  19  are diametrically opposite each other on the outside, the corresponding adapter connection regions  20 ,  21  are also arranged opposite one another. The adapter connection regions  20  are flattened and in this case extend parallel to one another. Via these flattened adapter connection regions  20 , the measurement adapter  10  can be pushed in direction of the arrow P 1 . For this purpose, the measurement adapter is configured as an U-shaped clamp. It has a spine  22  and two arms  23 ,  24  which are connected to the spine  22 . The arms  23 ,  24  are configured in a resilient manner and are designed to come into contact with the adapter connection region  20 ,  21  with their respective contact surfaces  25 ,  26  formed on the inside of the arms, but at least to establish a fluid-conducting, in particular gas-conducting connection to the outer connection openings  19  of the measuring channels  13 ,  14  in the endoscope head  2 . The arms  23 ,  24  have a mutual spacing which is conformed to the distance of the adapter connection regions  20 . 
     For the spring action of the arms  23 ,  24 , a notch  27  is arranged on the outside in the spine  22 . As a result, although the arms  23 ,  24  are able to spring outwards, the spring action is established due to a deformation in the region of the spine  22 . The arms  23 ,  24  themselves do not have to be elastic, but can be. 
     The measuring channels  13 ,  14  from the endoscope head  2  are continued by further measuring channels  28 ,  29  in the measurement adapter  10 . Extending in longitudinal direction of the arms  23 ,  24  are measuring channels  28 ,  29 , respectively. The two measuring channels  28 ,  29  have each connection openings  30 ,  31  in the mutually facing contact surfaces  25 ,  26 . The measuring channels  28 ,  29  are therefore angled within the arms  23 ,  24 . These connection openings  30 ,  31  correspond in the mated position of the measurement adapter  10  with the connection openings  19  on the endoscope head  2 . The measuring channels  28 ,  29  in the measurement adapter  10  feed each into connecting pieces  32 ,  33 , to each of which a hose can be connected in order to tap and evaluate the pressure at the measurement adapter  10 . 
     Sealing means, not shown in greater detail, are able to seal the measurement adapter  10  in the endoscope head  2  in the transition zone between the measuring channels  28 ,  29  of the measurement adapter to the measuring channels  13 ,  14 . Sealing may also be realized via a sufficiently large gap seal, for example by resting the contact surfaces  25 ,  26  in a clamping manner on the adapter connection regions  20 ,  21 . For additional locking, inwardly directed latching projections  35 ,  36  are provided at the free ends of the arms. These involve bead-like thickenings which, in the mated position, engage behind the flattened lateral adapter connection regions  20  on the endoscope head  2  and thereby prevent an unintentional removal of the measurement adapter  10 . 
     The spine  22  is bent and conformed to the outer contour of the endoscope head  2 . It serves as a stop and limits the insertion depth of the measurement adapter  10 . 
     It is an essential prerequisite for a pressure measurement that the measuring channels in the respective components freely extend continuously. For this purpose, it is necessary to align the measuring opening  17  in the endoscope tube  4  in such a way as to be continuously connected to the measuring channel  13 ,  14  in the endoscope head  2 . The exact positioning is ensured by the use of the adapter sleeves  8 ,  9 . In this exemplary embodiment, adapter sleeves  8 ,  9  of different sizes are used by way of example. The greater of the two adapter sleeves  8  has an outer diameter which is conformed to the inner diameter of the longitudinal channel  3 , i.e. can be inserted therein. In addition to the measuring channel  15  arranged there, this adapter sleeve  8  additionally has an inwardly directed radial projection which serves as a male piece  37  for a female piece  38  on the smaller adapter sleeve  9 . The female piece  38  is designed as a radially outer, groove-shaped depression. The female piece  38  does not extend over the entire axial length of the adapter sleeve  9 , so that the attachment depth into the greater adapter sleeve  8  can be limited and also defined by the length of the female piece  38 . The smaller adapter sleeve  9  also has a radially inwardly directed male piece  39  in the form of a radially inwardly pointing longitudinal web. This male piece  39  is intended to engage in a corresponding female piece  40  in the form of a longitudinal notch beginning at the proximal end  5  of the endoscope tube  4 . Here, too, the exact position of the endoscope tube  14  in the smaller adapter sleeve  9  is determined by the length of the male piece  39  or female piece  40 . The endoscope tube  4  can now be inserted together with the smaller adapter sleeve  9  and with incorporation of the greater adapter sleeve  8  into the endoscope head  2 . For alignment and for securing against rotation, the greater adapter sleeve  8  has a female piece  41  in the form of a longitudinal groove extending in the longitudinal direction from its proximal end. This longitudinal groove or this female piece  41  corresponds with a respective web in the form of a male piece  34  ( FIG.  2   ) in the interior of the longitudinal channel  3 . In this way, a fixed rotative engagement of the components relative to one another is ensured. In a manner not shown in greater detail, the arrangement of adapter sleeves  8 ,  9  and endoscope tube  4  can additionally be secured against displacement in the longitudinal direction of the endoscope tube  4 . This can involve a clamping connection which acts on the attached endoscope tube  4  radially from the outside and thereby establishes the connection to the endoscope head  2 . 
     The medical device  1  of  FIG.  1    enables the use of greater endoscope tubes  4  as well. By dispensing with the smaller adapter sleeve  9 , a greater endoscope tube can also be connected directly to the greater one of the adapter sleeves  8  in the same way as shown in  FIG.  1   . 
     REFERENCE SIGNS 
     
         
         
           
               1 —medical device 
               2 —endoscope head 
               3 —longitudinal channel 
               4 —endoscope tube 
               5 —proximal end of  4   
               6 —proximal end of  2   
               7 —distal end of  2   
               8 —adapter sleeve 
               9 —adapter sleeve 
               10 —measurement adapter 
               11 —connection for jet ventilation 
               12 —connection for ventilation 
               13 —measurement channel in  2   
               14 —measurement channel in  2   
               15 —measuring channel in  8   
               16 —measuring channel in  9   
               17 —measurement opening in  4   
               18 —inner connection opening of  13   
               19 —external connection opening of  13   
               20 —adapter connection region at  2   
               21 —adapter connection region at  2   
               22 —spine of  10   
               23 —arm of  10   
               24 —arm of  10   
               25 —contact surface of  23   
               26 —contact surface of  24   
               27 —notch in  22   
               28 —measurement channel in  24   
               29 —measurement channel in  23   
               30 —opening of  28   
               31 —opening of  28   
               32 —connection piece of  28   
               33 —connecting piece of  29   
               34 —male piece in  3   
               35 —latching projection 
               36 —latching projection 
               37 —male piece at  8   
               38 —female piece at  9   
               39 —male piece at  9   
               40 —longitudinal channel at  4   
               41 —female piece at  8   
             P 1 —arrow