Abstract:
The invention relates to a tube assembly for an endoscope comprising a disposable tube that surrounds a working channel and preferably also a flushing channel and fixing means for fixing the disposable tube to the endoscope. Said fixing means have a fixing unit which is used to fix the disposable tube on the distal end of the endoscope in a rotationally and axially fixed manner. The endoscope fixing means also have a guide device which is used to displaceably fix the disposable tube on respective sections of the endoscope that are at a distance from the distal end of said endoscope.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
       [0001]    This application is a continuation of U.S. patent application Ser. No. 12/526,967 filed Apr. 26, 2010, which is the U.S. national phase of PCT/EP2008/001238 filed Feb. 18, 2008, which claims priority of German Patent Application DE 10 2007 008 099.0 filed Feb. 19, 2007. 
     
    
     FIELD OF THE INVENTION 
       [0002]    The invention relates to the field of endoscopy, in particular to a hose arrangement for fastening to an endoscope. 
       BACKGROUND OF THE INVENTION 
       [0003]    In many sub-areas of medicine, in particular in gastroenterology, endoscopy is a widespread and successful method in the diagnostics and in the treatment of a plurality of diseases. It has proven expedient in this respect to provide imaging endoscopes with hose arrangements which have a passage or a plurality of passages, for example for the guidance of equipment. However, conventional hose arrangements of the aforesaid type frequently prove impractical since the fastening means for the connection of the endoscope to the hose arrangement are frequently designed in a voluminous manner and/or hinder the operation of the endoscope. Furthermore, the arrangement of the passages is frequently designed in a very specialized manner so that a corresponding hose arrangements has to be selected for each application. 
       SUMMARY OF THE INVENTION 
       [0004]    It is therefore the object of the invention to provide a hose arrangement for an endoscope which enables a reliable and space-saving fastening to the endoscope. The fastening of the endoscope should moreover be simple to effect. 
         [0005]    This object is satisfied by the features of claim  1 . 
         [0006]    The hose arrangement in accordance with the invention for an endoscope includes at least one disposable hose which surrounds a working passage. The hose arrangement furthermore includes endoscope fastening means for the fastening of the disposable hose to an endoscope. The endoscope fastening means have a fixing device by which the disposable hose can be rotationally fixedly and axially fixedly attached to the distal end of the endoscope. The endoscope fastening means furthermore have at least one guide device by which the disposable hose can be displaceably fastened to a respective section of the endoscope spaced apart from the distal end of the endoscope. 
         [0007]    In other words: the connection between the endoscope and the hose arrangement in accordance with the invention is established by endoscope fastening means which include a fixing device, on the one hand, and a guide device, on the other hand. The fixing device establishes a fixed connection between the endoscope and the hose arrangement, whereby relative movements between the distal end of the endoscope and the hose arrangement are suppressed. It is hereby ensured that an outlet opening of the working passage arranged in the environment of the fixing device always maintains its position relative to the distal end of the endoscope in the use of the endoscope and in particular also on a curvature of the endoscope (e.g. due to an actuation of a Bowden cable). A defined position of a lateral or axial opening of the working passage relative to the distal end of the endoscope is thus ensured, which is important, for example, for the suction of secretions or for a taking of a sample by means of biopsy forceps guided through the working passage, if an observation by means of the endoscope should simultaneously take place. 
         [0008]    In contrast, the guide device allows a relative movement between the endoscope and the hose arrangement. This enables compensation movements in the longitudinal direction (longitudinally displaceable fastening) and/or in the peripheral direction of the hose arrangement (rotationally movable fastening) which are necessary due to bends or curvatures occurring during use along the unit of the endoscope and the hose arrangement. Furthermore, the fastening of the endoscope is simplified since a force-transmitting fixation as a rule only takes place at one point of the endoscope—namely at its distal end. 
         [0009]    In accordance with an advantageous further development, the disposable hose additionally surrounds at least one flushing passage, with the hose arrangement having an outlet opening of the flushing passage which is arranged offset to distal with respect to the fixing device for the distal end of the endoscope. The hose arrangement furthermore has an opening of the working passage which is likewise arranged offset to distal with respect to the fixing device. It is thus ensured, for example, that an optical system located at the distal end of the endoscope can always be reliably flushed by means of a flushing liquid guided through the flushing passage. The hose arrangement in this case therefore surrounds at least two passages, a working passage and a flushing passage. The outlet opening of the flushing passage and the opening of the working passage are arranged in a section of the hose arrangement which projects beyond the fixing device for the distal end of the endoscope in the distal direction of the hose arrangement, whereby an efficient flushing of an optical system arranged at the distal end of the endoscope is possible by means of a flushing liquid emerging from the outlet opening of the flushing passage. In addition, activities carried out by means of the working passage can be monitored visually by the endoscope. 
         [0010]    Advantageous embodiments of the invention are set forth in the dependent claims, in the description and in the drawings. 
         [0011]    In accordance with an embodiment of the hose arrangement in accordance with the invention, it includes a single disposable hose at which the working passage and, optionally, the flushing passage are formed. 
         [0012]    Alternatively, the disposable hose can also have a reception passage for the reception of an inner hose, with the flushing passage optionally being formed at the disposable hose and the working passage being formed at the inner hose. In this case, the inner hose is longitudinally displaceable and/or rotatable within the reception passage and thus relative to the fixing device for the distal end of the endoscope. 
         [0013]    A further alternative embodiment of the hose arrangement includes a disposable hose with a reception passage for the reception of an inner hose, with both the working passage and the flushing passage (where present) being formed at the inner hose. The inner hose is also longitudinally displaceable and/or rotatable within the reception passage and thus relative to the fixing device for the distal end of the endoscope in this variant. 
         [0014]    The different variants allow the provision of respective ideal disposable hoses, with the variants including an inner hose having additional degrees of freedom with respect to the positioning of the distal end of the hose arrangement. If the position of the outlet opening of the flushing passage is also of significance for the examination, it can be advantageous that the flushing passage is also made at the at least longitudinally displaceable inner hose. The variant with a single disposable hose in contrast enables the choice of larger cross-sectional surface of the working passage and/or of the flushing passage with a given diameter of the disposable hose and with given minimal hose wall thicknesses. 
         [0015]    The hose arrangement can include a closure cap which is fixedly connectable to the distal end of the disposable hose or of the inner hose. The hose arrangement is thus in at least two parts in the axial direction. The closure cap can close at least one axial opening of the disposable hose or of the inner hose. Such a closure cap can be manufactured cost-effectively—for example as an injection molded part of plastic—and enables additional possibilities to adapt the hose arrangement to the respectively present needs. 
         [0016]    It is preferred if the closure cap is fixedly connected to the fixing device, is in particular made in one piece with the fixing device. As already explained above, a rotationally fixed and axially fixed connection is present between the fixing device and the endoscope. If the fixing device is now fixedly connected to the closure cap, it is particularly reliably ensured that the closure cap is not lost in endoscopic examinations and/or treatments. In addition, the relative position of the closure cap with respect to the optical system of the endoscope is thereby fixedly defined, which can be advantageous for different examination/treatment methods. 
         [0017]    In a further development of the closure cap, the outlet openings of the flushing passage and/or the opening of the working passage are formed at the closure cap. 
         [0018]    Provision can be made with advantageous embodiments of the hose arrangement in accordance with the invention with or without closure cap that the opening of the working passage and/or the outlet opening of the optionally present flushing passage are arranged laterally, whereby a flushing of the optical system of the endoscope is, for example, made possible by means of flushing fluid supplied via the flushing passage. The flushing passage is preferably arranged for this purpose, among other things—with respect to a cross-section of the hose arrangement between the working passage and the endoscope fastening means. 
         [0019]    The disposable hose or the inner hose can include a closure element which is connectable to the distal end of the disposable hose and which closes at least one of the laterally arranged openings. For example, a hollow-cylindrical—i.e. tubular—closure element can be introduced into the disposable hose or into the inner hose which admittedly does not close the hose in the axial direction, but blocks a lateral outlet opening of the flushing passage and/or a lateral opening of the working passage. 
         [0020]    In accordance with an embodiment, the optionally present flushing passage is arranged laterally offset in a cross-section of the hose arrangement—with respect to a connection line between a longitudinal axis of the disposable hose and a longitudinal axis of the endoscope fastening means. The hose arrangement can have two or more flushing passages instead of a single flushing passage. The outlet openings of the flushing passages can be arranged offset to one another in the axial direction of the hose arrangement. A relative offset of the outlet openings in the radial direction or in the peripheral direction can be provided additionally or alternatively. The flushing passages are in particular arranged symmetrically—with respect to the above-named connection line. 
         [0021]    In accordance with an embodiment of the hose arrangement in accordance with the invention, the guide device includes a plurality of holding elements which are arranged spaced apart from one another along the length of the disposable hose since a throughgoing guide device, i.e. an uninterrupted guide device, is not necessary in a number of cases. A guide device including a plurality of holding elements additionally allows an easier introduction of the endoscope into the guide device and means low friction forces to be overcome in operation on a relative movement of the endoscope and the disposable hose. Two to three substantially identical holding elements can in particular be provided, for example with an endoscope length of 35 cm. With an endoscope length of 75 cm, three to five holding elements can, for example, be provided; with an endoscope length of 100 cm, for example five to seven holding elements. 
         [0022]    It is preferred if the guide device has at least one substantially hollow-cylindrically shaped loop. Such loops are easy to produce or shape, but simultaneously also ensure a reliable guidance of the hose arrangement. 
         [0023]    The guide device and/or the fixing device can be made as a fastening element in one piece which surrounds the disposable hose and the endoscope and which has a disposable hose receiver and an endoscope receiver which are defined by a restriction and/or a web which is arranged between the disposable hose receiver and the endoscope receiver. 
         [0024]    The fixing device can be designed such that a force-transmitting connection, in particular a friction-locked connection, is established between the disposable hose and the endoscope. An advantageous aspect of the fixing device includes a cuff open at both sides in the axial direction. 
         [0025]    In accordance with an embodiment of the hose arrangement, the disposable hose has at least one reinforcement element. The reinforcement element is curvable since it primarily serves for the stabilization of the cross-section of the passages which would, for example, be squeezed together on a pronounced curvature of the disposable hose and less for the stabilization of the longitudinal axis of the hose arrangement although this aspect can also be used in especially configured cases. The stiffness of the cross-section of the reinforcement element and the elasticity with respect to forces perpendicular to the longitudinal axis of the reinforcement element can be selected in accordance with the demands. 
         [0026]    The reinforcement element is in particular arranged in a distal region of the hose arrangement which is arranged offset to proximal relative to the outlet opening of the optionally present flushing passage since the most pronounced curvatures are to be expected here with a corresponding actuation of the endoscope. However, additional reinforcement elements can also be provided in further critical regions of the hose arrangement. 
         [0027]    The invention also relates to a hose arrangement system which includes a plurality of similar disposable hoses or inner hoses of the explained kind and furthermore at least one closure cap and a closure element of the explained kind, with at least one axial opening of the disposable hose or of the inner hose being closable by connection of the closure cap to one of the disposable hoses or inner hoses, and with at least one laterally arranged opening of the disposable hose or of the inner hose being closable by connection of the closure element to another of the disposable hoses or inner hoses. The working passage of the respective disposable hose or inner hose thus selectively has a lateral or an axial outlet opening. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0028]    The invention will be described in the following purely by way of example with reference to advantageous embodiments and to the drawings. There are shown: 
           [0029]      FIG. 1   a  a schematic representation of an embodiment of the hose arrangement in accordance with the invention; 
           [0030]      FIG. 1   b  a view of the hose arrangement of  FIG. 1   a  rotated by 90°; 
           [0031]      FIG. 1   c  a section through the hose arrangement of  FIG. 1   a  along a line AA; 
           [0032]      FIG. 1   d  a section through a fixing cuff of the hose arrangement along the line BB in  FIG. 1   b;    
           [0033]      FIG. 2   a  a schematic representation of a further embodiment of the hose arrangement in accordance with the invention; 
           [0034]      FIG. 2   b  a view of the hose arrangement of  FIG. 2   a  rotated by 90°; 
           [0035]      FIG. 2   c  a schematic representation of an embodiment of an inner hose; 
           [0036]      FIG. 2   d  an enlarged view of the distal end of the inner hose of  FIG. 2   c ; 
           [0037]      FIG. 3   a  a schematic representation of a further embodiment of the hose arrangement in accordance with the invention; 
           [0038]      FIG. 3   b  a schematic sectional view of an embodiment of a closure cap with a fixing device; 
           [0039]      FIG. 3   c  a perspective view of the closure cap of  FIG. 3   b ; 
           [0040]      FIG. 4   a  a schematic sectional view of a further embodiment of a closure cap with a fixing device; 
           [0041]      FIG. 4   b  a perspective view of the closure cap of  FIG. 4   a ; 
           [0042]      FIG. 5   a  a schematic representation of an embodiment of the hose arrangement in accordance with the invention with a reinforcement element; 
           [0043]      FIG. 5   b  a section through the hose arrangement of  FIG. 5   a  along a line CC; 
           [0044]      FIG. 5   c  an endoscope with a hose arrangement in accordance with the invention in a curved arrangement; 
           [0045]      FIGS. 6   a  and  6   b  a respective longitudinal section of an embodiment of the hose arrangement in accordance with the invention with a closure piece; 
           [0046]      FIGS. 7   a  and  7   b  a respective cross-section of an embodiment of the hose arrangement in accordance with the invention with two flushing passages arranged offset and symmetrical or with one flushing passage arranged offset; 
           [0047]      FIGS. 8   a  to  8   c  different embodiments of the fixing device and/or of the guide device in a respective cross-sectional view. 
       
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS 
       [0048]      FIGS. 1   a  and  1   b  show a hose arrangement  10  having a flexible disposable hose  11 , with  FIG. 1   b  representing a view rotated about a longitudinal axis  12  by 90° with respect to  FIG. 1   a . The hose arrangement  10  has a distal end  14  and a proximal end  16 . In a distal region of the hose arrangement  10  close to the distal end  14 , a fixing cuff  26  is fastened to the disposable hose  11 . The fixing cuff  26  is arranged further proximal than an opening  18  and an outlet opening  20  so that the distal end of an endoscope (not shown) to be introduced into the fixing cuff  26  is in visual contact with the openings  18 ,  20  applied to the side at the disposable hose  11 —with respect to the longitudinal axis  12 . The opening  18  and the outlet opening  20  are in contact with a working passage  22  or an optional flushing passage  24  (shown in  FIG. 1   c ) of the disposable hose  11 . As can be seen clearly from  FIGS. 1   a  and  1   b , the outlet opening  20  of the flushing passage  24  is arranged offset at a small distance to distal with respect to the fixing cuff  26 . Flushing liquid can be sprayed onto the optical system of the endoscope to clean it and, for example, to remove disturbing secretion due to the spatial proximity and the slit-like shape of the outlet opening  20  thus acting as a nozzle. Alternatively to this, air can also be guided through the flushing passage  24  in order to not only blow free the optical system of the endoscope, but also to blow up the hollow space to be examined by air insufflation so that a wall, for example of the stomach or of the esophagus can be observed better. 
         [0049]    The opening  18  of the working passage  22  is offset further to distal than the outlet opening  20  relative to the fixing cuff  26 . Since it is also arranged on the side facing the fixing cuff  26  with respect to the longitudinal axis  12  of the disposable hose  11 , it is, for example, possible to suck off secretion or other substances in the region directly in front of the endoscope. 
         [0050]    Guide loops  28  are attached to the disposable hose  11  of the hose arrangement  10  beside the fixing cuff  26 . They are arranged at regular intervals, with this only representing a specific embodiment. 
         [0051]      FIG. 1   c  illustrates the design of the hose arrangement with reference to a cross-section along the line AA of  FIG. 1   a . The cross-section of the disposable hose  11  can be seen in the upper part of  FIG. 1   c . The disposable hose  11  includes—as already addressed above—the working passage  22  and the optional flushing passage  24 . For the better use of the cross-sectional surface of the disposable hose  11 , neither the working passage  22  nor the flushing passage  24  are made as circular. in the embodiment of the hose arrangement  10  shown, the working passage  22  has a substantially larger cross-sectional surface than the flushing passage  24 . Depending on requirements, a division deviating from this can be selected. The cross-section of the working passage  22  can be described in simplified terms by a combination of a section of an arc of a circle with a part of a trapezoid with rounded corners. The deviation from a circular cross-section of the working passage  22  with a given outer diameter of the disposable hose  11  permits a more efficient passing through of liquid or pieces of fabric. In addition, a piece of equipment with a circular cross-section can be moved more easily in a working passage  22  shaped in this manner since the contact surface to the inner walls of the working passage  22  is smaller than in the case of a circular cross-section and less friction thus occurs. 
         [0052]    The side walls of the disposable hose laterally bounding the working passage  22  are in particular made relatively thick, for example, with respect to the wall section of the disposable hose  11  disposed opposite the flushing passage  24 . A collapse of the working passage  22  is hereby prevented on a curvature of the disposable hose  11  by means of the endoscope (cf.  FIG. 5   c ). 
         [0053]    The cross-sectional shape and size of the flushing passage  24  is optimized such that a sufficient supply of flushing liquid can always be delivered for the cleaning of the optical system of the endoscope with an ideal utilization of the cross-sectional surface of the disposable hose  11 . The flushing passage  24  is disposed between the working passage  22  and the guide loops  28 , i.e. on a line which connects the longitudinal axis  12  of the disposable hose  11  and a longitudinal axis  12 ′ extending parallel thereto which extends along the longitudinal axes of the guide loops  28  and of the fixing cuff  26 . 
         [0054]    The lower part of the image in  FIG. 1   c  is taken up by the cross-section of one of the guide loops  28 . It has a circular cross-section which serves for the reception of the endoscope. The endoscope can in particular be moved in the longitudinal direction within the guide loop  28 . The guide loops  28  thus serve to hold the disposable hose  11  of the hose arrangement  10  in the lateral direction in close spatial proximity to the endoscope, but not to connect them firmly to one another. This is the task of the fixing cuff  26 , as already explained above. The guide loop  28  is adhesively bonded to the disposable loop, as indicated by the adhesive connection  30 . The type of the connection can, however, be freely selected; for example, a weld connection or a shrink connection is alternatively possible. A one-piece embodiment of the disposable hose  11  and of the guide loops  28  is also conceivable. The same applies accordingly to the fixing cuff  26 . 
         [0055]      FIG. 1   d  shows a cross-section through the fixing cuff  26  along the line BB of  FIG. 1   b . It can be clearly recognized that the inner diameter of the fixing cuff  26  is smaller at distal than at proximal. The fixing cuff  26  preferably comprises an elastic material so that the region of the fixed cuff  26  with a reduced internal radius is widened by the introduction of the distal end of the endoscope  26 . A friction-locked connection thereby arises between the fixing cuff  26 —which is fixedly connected to the disposal hose  12 —and the endoscope. A reliable fixing is thus ensured. 
         [0056]    At the proximal end of the disposable hose  11 , the working passage  22  and the flushing passage  24  are connected to separate connection hoses  32  which serve for the supply/removal of liquids and/or parts of fabric. 
         [0057]    The flushing passage  24  can also be omitted in the embodiment in accordance with  FIGS. 1   a  to  1   d , in particular for applications of the hose arrangement  10  in the ear-nose-and-throat field (ENT). In this case, the outlet opening  20  shown in  FIGS. 1   a  and  1   b  is omitted. 
         [0058]    A somewhat modified embodiment of the hose arrangement  10  is shown in  FIGS. 2   a  and  2   b . The two embodiments are similar in many aspects, in particular with respect to the cross-sectional shape of the hose arrangement  10 . There is coincidence with respect to the fixing cuff  26  and the outlet opening  20  in this distal region. The opening  18  of the working passage  22  is, however, not attached at the side, but is rather aligned axially with respect to the longitudinal axis  12 . In other words, the distal end of the disposable hose  11  is cut-off perpendicular to the longitudinal axis  12 . On the one hand, this embodiment can also be used in the present form, for example, for the sucking off of substances. On the other hand, this embodiment is, however, in particular suitable for the guidance of equipment shafts through the working passage  22 . This in particular applies when the flushing passage  24  with the outlet opening  20  is omitted. Optionally, the working passage  22  can, however, similar to the embodiment shown in  FIGS. 1   a  and  b  also be used when an inner hose  34  is used which is guided through the working passage  22 . 
         [0059]    Such an inner hose  34  is shown in  FIG. 2   c . It is connected to a connection hose  32  at its proximal end  16 . The distal end  16  of the inner hose  34  is similar to the tip of the embodiment of the hose arrangement  10  shown in  FIGS. 1   a  and  1   b . The inner hose  34  thus has a laterally arranged elongate hole which represents the opening  18 . The opening  18  of the inner hose  34  is shown in more detail in  FIG. 2   d , with the dashed line symbolizing the wall thickness of the inner hose  34 . The opening  18  is dimensioned such that it has the largest possible width in a direction perpendicular to the longitudinal axis  12  so that relatively large pieces of tissue or secretion lumps can also be sucked off. 
         [0060]    The advantage of this embodiment in combination with the use of the inner hose  34  lies in the fact that the opening  18  can be positioned by rotating and pushing the inner hose  34  to and fro almost as desired relative to the fixing cuff  26 —and thus relative to the endoscope. For example, with an unchanged position of the disposable hose  11  or of the endoscope, a larger region of the examination area can thus be achieved with the opening  18 . The treating physician is thus given flexible equipment. 
         [0061]    A further embodiment of the hose arrangement  10  is shown in  FIG. 3   a . It shows a disposable hose  11  which is provided with guide loops  28  and a fixing cuff  26 . The proximal guide loop  28  has a much larger longitudinal extent than the distal guide loop  28  of the above-treated embodiments. A further difference to the embodiments shown in  FIGS. 1   a  and  1   b  and  2   a  and  2   b  lies in the fact that the distal end of the disposable hose  11  terminates flush with the distal end of the fixing cuff  26 . A closure cap  36  (e.g.  FIG. 3   b ) can be introduced into the distal end of the disposable hose  11  which in this case includes a working passage  22  and optionally a flushing passage  24 . Embodiments can also be provided in which the closure cap  36  is pushed onto the disposable hose  11  or is otherwise connected to it. 
         [0062]    A sectional view through the distal end  14  of the hose arrangement  10  is shown in  FIG. 3   b . The disposable hose  11  has a working passage  22  and a flushing passage  24 . A connection sleeve  38  is plugged into the working passage  22  and is in turn pushed onto the closure cap  36 . The connection sleeve  38  and the closure cap  36  can also be made in one piece. 
         [0063]    The closure cap  36  has a groove  40 . If the closure cap  36  is connected to the disposable hose  11 , this groove  40  forms the outlet opening  20  of the flushing passage  24 . Furthermore, the closure cap  36  has a passage  42  which is connected to the working passage  22  and which includes a laterally arranged opening  18 . Functionally, and with respect to the arrangement of the openings  18 ,  20  of the passages  22 ,  24 , the embodiment of the hose arrangement  10  shown in  FIG. 3   b  is therefore similar to the embodiment shown in  FIGS. 1   a  and  1   b.    
         [0064]    The fixing cuff  26 , which rotationally fixedly and axially fixedly connects an endoscope  44  to the closure cap  36  and thus to the disposable hose  11  is furthermore an integral component of the closure cap  36 . 
         [0065]    The detailed representation of the distal end  14  of the hose arrangement  10  illustrates the spatial proximity of the openings  18 ,  20  to the distal end of the endoscope  44 . Flushing liquid can be efficiently sprayed through the outlet opening  20  onto the optical system of the endoscope to clean it. In contrast, secretion or the like can be sucked off simply through the opening  18  in the visual field of the optical system of the endoscope. 
         [0066]    The closure cap  36  is a component which is simple to manufacture and which can, for example, has different variations of the shapes and orientations of the openings  18 ,  20 . The openings  18 ,  20  can also be arranged at different sides. The inner hose  34  can likewise be provided with such a closure cap, both in the embodiment of the inner hose  34  with only one working passage  22  and in the embodiment of the inner hose  34  with a working passage  22  and a flushing passage  24 . 
         [0067]    A perspective view of such a closure cap is shown in  FIG. 3   c . The closure cap  36  of  FIG. 3   c  has two connection webs  46  which connects the fixing cuff  26  to the part of the closure cap  36  containing the openings  18 ,  20 . The position of the connection webs  46  relative to the other elements of the closure cap  36  is indicated in  FIG. 3   b  by dashed lines extending obliquely to the longitudinal axes  12 ,  12 ′. 
         [0068]    The flushing passage  24  with the outlet opening  20  and  40  respectively can also be omitted in the embodiments in accordance with  FIGS. 3   a  to  3   c . 
         [0069]    A somewhat different embodiment of a closure cap  36  is illustrated by  FIG. 4   a . In this embodiment, the closure cap  36  is pushed onto the disposable hose  11  so that a connection sleeve  38  can be omitted. The remaining design of the closure cap  36  is similar to that of the embodiment shown in  FIG. 3   b.    
         [0070]      FIG. 4   b  shows a perspective view of the embodiment of the closure cap  36  shown in  FIG. 4   a . The groove  40  forming the outlet opening  20  of the flushing passage  24  is in turn arranged at the distal end of the fixing cuff  26  so that the groove  40  cannot be seen in the shown perspective in accordance with  FIG. 4   b . 
         [0071]    An advantageous modification of the hose arrangement  10  is shown in  FIG. 5   a . The essential features of the distal end  14  of the hose arrangement  10  such as the opening  18 , the opening  20  of the optional flushing passage, the fixing cuff  26  and the guide loop  28  have already been described in detail above. The embodiment shown, however, additionally has a spiral spring  48  which is embedded in the disposable hose  11  as can be seen from  FIG. 5   b .  FIG. 5   b  shows a section perpendicular to the line CC of  FIG. 5   a . 
         [0072]    The spiral spring  48  extends over a section of the distal region of the hose arrangement  10  which is offset to proximal relative to the outlet opening  20  of the flushing passage  24 . It is curvable, that is elastically flexible perpendicular to the longitudinal axis  12 , with its cross-sectional shape only changing insignificantly on a bending. It is thereby achieved that with a curvature of the hose arrangement  10 , the passages  22 ,  24  are not compressed, whereby, for example, the removal/supply of liquid and/or fabric would be suppressed. 
         [0073]    Such a reinforcement element in the form of a spiral spring  48 —with other reinforcement elements also being able to be used—is particularly advantageous in situations where the endoscope is brought into inversion. In this state, the endoscope  44  is greatly curved so that the optical system of the endoscope looks “backward” toward proximal (see  FIG. 5   c ). The hose cross-section of the disposable hose  11  would be squeezed together without the spiral spring  48 . The supply of, for example, flushing liquid, would thus be interrupted. The same supporting effect can, for example, be achieved by a spiral spring surrounding the disposable hose  11  section-wise. 
         [0074]    It moreover becomes clear with reference to  FIG. 5   c  that the guide loops  28  should permit a relative movement between the endoscope  44  and the disposable hose  11 . If the connection between the guide loops  28  and the endoscope  44  were fixed and if no longitudinally displaceable movement were permitted, high stretch loads would arise in the longitudinal direction in the disposable hose  11  or in the endoscope  44  due to the different curvature radii of the disposable hose  11  and of the endoscope  44 , which could damage the disposable hose  11 , on the one hand, and, on the other hand could also cause a collapse of the cross-sections of the passages  22 ,  24  or could cause damage to the Bowden cables of the endoscope  44 . 
         [0075]      FIG. 6   a  shows the distal end  14  of an embodiment of the hose arrangement  10 . The working passage  22  and the optional flushing passage  24  of the disposable hose  11  are not shown since their arrangement is of subordinate importance for the aspect to be described in the following. The arrows D, E indicate that both the flushing passage  24  and the working passage  22  are connected to a region in front of the endoscope  44  by the lateral openings  20  and  18  of the disposable hose  11 . The distal end  14  of the hose arrangement  10  is closed by a closure piece  36   a.  The two openings  18 ,  20  offset to one another in the longitudinal direction of the disposable hose  11  are, however, not closed by the closure piece  36   a.    
         [0076]      FIG. 6   b  shows another embodiment of the hose arrangement  10  which, however, makes use of the same disposable hose  11  as the embodiment shown in  FIG. 6   a . The cap-like or plug-like closure piece  36   a  of  FIG. 6   a  has here been replaced by a hollow-cylindrical closure piece  36   b  which leaves the axial opening at the distal end  14  of the disposable hose  11  open. The closure piece  36   b  closes the lateral working passage opening  18  so that the working passage  22  is now connected to a region in front of the distal end  14  of the hose arrangement  10 . The optionally present lateral outlet opening  20  of the flushing passage  24  is still open. 
         [0077]    This shows by way of example that different hose arrangement configurations can be realized by the design of the closure piece  36   a,    36   b  without a different embodiment of the disposable hose  11  having to be used. The allows a cost-effective manufacture of the two different configurations (disposable hose  11  as the same part) and also enables the use of endless product for a disposable hose  11  which can be manufactured cost-effectively. 
         [0078]    Differing from  FIGS. 6   a  and  6   b , the closure pieces  36   a,    36   b  can also be designed so that they are pushed onto the disposable hose  11 —not plugged as in  FIGS. 6   a  and  6   b —or are fastened thereto in a different manner. Corresponding closure pieces  36   a,    36   b  can also be used in embodiments of the hose arrangement  10  with an inner hose  34 . 
         [0079]    The hose arrangement  10  in accordance with the invention can have more than one flushing passage  24 , as is shown in  FIG. 7   a . This embodiment has two flushing passages  24 ,  24 ′ which are not arranged directly between the working passage  22  and the fixing device—here a fixing cuff  26 ′ with a cross-section sectionally different from a circle. In a cross-section perpendicular to the longitudinal extent of the hose arrangement  10 , the flushing passages  24 ,  24 ′ are offset laterally relative to a connection line FF between the longitudinal axis  12  of the disposable hose  11  and the longitudinal axis  12 ′ of the fixing cuff  26 ′. They are arranged symmetrically at both sides of the connection line FF. 
         [0080]    The offset arrangement of the flushing passages  24 ,  24 ′ reduces the extent of the hose arrangement  10  in a direction parallel to the connection line FF. In addition, the disposable hose  11  can have a smaller wall thickness in such an aspect for a specific diameter of the working passage  22  (lumen). 
         [0081]    The outlet openings  20  of the flushing passages  24 ,  24 ′ do not have to coincide in the longitudinal direction of the hose arrangement  10  or lie in a common cross-sectional plane, but can rather be arranged as desired to be able to flush different regions—possibly also independently of one another. 
         [0082]    An example for an embodiment having a single offset flushing passage  24  is shown in  FIG. 7   b . The region of the flushing passages  24 ′ of  FIG. 7   a  was attributed to the working passage. This region can, for example, be utilized for the guidance of a further thin hose or of working means/instruments. 
         [0083]      FIGS. 8   a  to  8   c  show different embodiments of a fastening element by which the guide loops  28  and/or the fixing cuff  26 ,  26 ′ can be provided. The fastening element is substantially formed by a one-piece band  50  which is simple to manufacture and which surrounds both the disposable hose  11  and the endoscope  44 . The band  50  can be connected releasably or fixedly to the disposable hose  11 . 
         [0084]    The term “band” is not intended to suggest that the band  50  has to be flexible, for example in the manner of an elastic band. It can in this respect also, for example, be a relatively rigid plastic component. 
         [0085]    If the band  50  is acting as a fixing cuff  26 ,  26 ′, it fixes the endoscope  44  rotationally fixedly and in the axial direction. If it only serves for the guidance of the endoscope  44 , it is made such that the endoscope  44  can move relative to the disposable hose  11 . 
         [0086]      FIG. 8   a  shows a simple variant of the band  50 . It forms a single loop  54  in which the disposable hose  11  and the endoscope  44  are arranged. The loop  54  substantially has the shape of a “0”. 
         [0087]    In contrast to this, the band  50  of  FIG. 8   b  has a waisting  52  by which two loops  54 ,  54 ′ are defined so that the band  50  forms a shape similar to an incomplete “8”. In other words, the restriction is not complete in the middle region of the band  50 , whereby a connection is present between the two loops  54 ,  54 ′. The disposable hose  11  is arranged in the loop  54 , whereas the loop  54 ′ receives the endoscope  44 . 
         [0088]    The advantage of the waisted band  50  is that a mutual twisting of the disposable hose  11  and of the endoscope  44  is prevented. Such a twisting in particular creates problems on an inversion of the endoscope  44 . 
         [0089]      FIG. 8   c  shows a band  50  with a waisting  52  whose loops  54 ,  54 ′ are separated from one another by a web  53 , whereby the shape of an “8” is formed. The web  50  can also only have the web  53  so that the outer contour of the band  50  corresponds to a “0”, as in the case of the embodiment of the band  50  shown in  FIG. 5   a .