Patent Description:
In certain medical procedures, physicians and/or technicians need to control a bronchoscope (or other scope or medical device) and other medical accessory devices. Depending on a patient's position relative to that of the physician's, the physician controlling the device may need to contort and/or twist his/her body into exaggerated positions to navigate the medical device to the desired anatomical position. As a result, physicians may be placed in less than ideal ergonomic positions, and/or the procedure may suffer. <CIT> discloses a medical device.

The invention is defined by the independent claim. According to an example, a medical device may comprise a shaft, a handle including a proximal portion and a distal portion, wherein the distal portion is fixed to a proximal portion of the shaft, and a channel extending from the handle into the shaft, wherein the channel includes a proximal channel and a distal channel, the proximal channel being rotatable relative to the distal channel and aligned with the distal channel throughout rotation of the proximal channel, wherein the proximal portion includes the proximal channel and the distal portion includes the distal channel, wherein the distal portion is rotatable relative to the proximal portion of the handle, and the shaft is configured to rotate with the distal portion of the handle.

In another example, the shaft may surround at least a portion of the distal channel, and the distal channel may be configured to rotate with the shaft and the distal portion of the handle. The distal portion of the handle may be rotatable relative to the proximal portion of the handle in either a clockwise direction or a counterclockwise direction. The rotation of the distal portion of the handle may be limited to a set degree of rotation. The distal portion of the handle may remain stationary relative to the proximal portion of the handle by frictional forces generated between a surface of the distal portion abutting a surface of the proximal portion. The handle may further include a guide, wherein the guide includes a lumen extending along a central axis of the guide, and wherein the lumen is positioned between the proximal channel and the distal channel, and the lumen is aligned with the proximal channel and the distal channel. The guide may be fixed to an inner surface of the proximal portion of the handle. The distal portion of the handle may further include a support along an inner surface of the distal portion of the handle, and the proximal portion of the shaft may be fixed to the support.

In another example, a medical device may further comprise a lock having a first configuration and a second configuration, wherein, in the first configuration of the lock, the distal portion of the handle is stationary relative to the proximal portion of the handle, and, in the second configuration of the lock, the distal portion of the handle is rotatable relative to the proximal portion of the handle. The lock may include a first washer including a pin protruding proximally, wherein the distal channel extends through the first washer via an opening of the first washer, a second washer including a plurality of openings each configured to receive the pin, and a spring coupling a distal surface of the first washer to a base. In the first configuration of the lock, the first washer may be spring-biased towards the second washer so that the pin of the first washer is engaged with one of the plurality of openings of the second washer, and wherein, the second configuration of the lock, the first washer may be spaced proximally from the second washer, compressing the spring, and so the pin is disengaged from all of the plurality of openings. The lock may further include a tube, wherein the tube extends through openings of the first washer and the second washer, wherein the tube sheaths over at least a portion of the distal channel, and wherein the first washer is configured to translate over the tube.

In another example, the medical device may further comprise a first steering wire and a first gyro holding the first steering wire, wherein the first gyro includes a proximal gyro and a distal gyro, and wherein the distal gyro is interlocked with the proximal gyro so that the distal gyro is rotatable about the distal channel or the proximal channel, relative to the proximal gyro. The first steering wire may include a proximal wire and a distal wire, wherein a distal end of the proximal wire is coupled to a first enlargement, and a proximal end of the distal wire is coupled to a second enlargement, wherein the first enlargement is anchored to the proximal gyro and the second enlargement is anchored to the distal gyro. The distal wire may configured to be pulled when the proximal wire is pulled via an actuation device.

According to an example, a medical device may comprise a shaft, a handle connected to a proximal portion of the shaft, and a channel extending from the handle into the shaft, wherein the channel is rotatable relative to the handle, and wherein a side wall of the channel includes an opening at a portion of the channel housed in the handle, wherein the handle defines a lumen in fluid communication with the opening of the channel, and wherein a proximal end of the lumen is configured for fluid communication with a suctioning source. The opening may be sealed from portions of the handle by a first seal and a second seal. The side wall of the channel may include a plurality of circumferentially distributed openings.

According to a non-claimed example, a method of positioning a shaft of a medical device is provided, wherein the medical device further comprises a handle including a proximal portion and a distal portion rotatably attached to the proximal portion, and a channel extending from the second portion into a the shaft, wherein a proximal portion of the shaft is fixed to the distal portion of the handle, may comprise inserting a distal end of a shaft of the medical device into a body of a subject, and after the insertion step, rotating the distal portion of the handle, the shaft, and the channel relative to the proximal portion of the handle.

In another example, the method may further comprise, after the insertion step, unlocking the distal portion of the handle from the proximal portion of the handle, rotating the distal portion of the handle, the shaft, and the channel relative to the proximal portion of the handle, and locking the distal portion of the handle to the proximal portion of the handle.

Reference will now be made in detail to aspects of the disclosure, examples of which are illustrated in the accompanying drawings. Wherever possible, the same or similar reference numbers will be used through the drawings to refer to the same or like parts. The term "distal" refers to a portion farthest away from a user when introducing a device into a subject (e.g., a patient). By contrast, the term "proximal" refers to a portion closest to the user when placing the device into the subject.

Both the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of the features, as claimed. As used herein, the terms "comprises," "comprising," "having," "including," or other variations thereof, are intended to cover a non-exclusive inclusion such that a process, method, article, or apparatus that comprises a list of elements does not include only those elements, but may include other elements not expressly listed or inherent to such a process, method, article, or apparatus. In this disclosure, relative terms, such as, for example, "about," "substantially," "generally," and "approximately," are used to indicate a possible variation of ±<NUM>% in a stated value or characteristic.

Embodiments of the disclosure may solve one or more of the limitations in the art. The scope of the disclosure, however, is defined by the attached claims and not the ability to solve a specific problem. The disclosure is drawn to medical devices including a shaft, which may be rotatable relative to a handle of the medical device. The medical devices can be, as examples, any scope (e.g., bronchoscope, duodenoscope, endoscope, colonoscope, ureteroscope, etc.), catheter, tool, instrument, or the like, having a shaft that extends distally from a handle. In embodiments, medical devices include a handle having a distal portion rotatable clockwise or counter-clockwise relative to a proximal portion of the handle. The medical devices further include a shaft fixedly coupled to and housed within the distal portion of the handle. Thus, as the distal portion of the handle is rotated relative to the proximal portion of the handle, the shaft simultaneously rotates likewise. The distal portion of a handle may be in one of two states or configurations. In a first state, the distal portion may remain stationary, relative to the proximal portion of the handle. In a second state, the distal portion of the handle may be rotating or capable of rotating, relative to the proximal portion of the handle. Alternatively, the proximal portion of the handle may be rotating or capable of rotating, relative to said distal portion. The shaft of the medical device rotates or remains stationary, in accordance with the distal portion of the handle.

Embodiments of medical devices of the disclosure may employ any suitable means, e.g., friction, a locking/unlocking mechanism, etc., to place or maintain the distal portion of a handle in one of the two states described above. Moreover, such medical devices may provide a user the option of rotating the distal portion of the handle (and thus, the shaft) in-procedure, via any suitable manner, e.g., by hand, mechanically, electrically, etc., and an option of maintaining the distal portion of the handle stationary in its current rotational position relative to a remainder of the device. Thus, a user of the device may comfortably access, view, and/or perform a therapeutic/diagnostic procedure at intended target sites, via rotation of the distal portion of the handle and the shaft, without having to twist and contort his/her wrists or other parts of the body, regardless of a patient's position relative to the user.

Referring to <FIG>, a medical device <NUM>, e.g., a bronchoscope, according to an embodiment is shown. Medical device <NUM> includes a flexible shaft <NUM> (e.g., a catheter) and a handle <NUM> connected to a proximal end of flexible shaft <NUM>. Handle <NUM>, or some other device for actuating or controlling medical device <NUM> and any tools or devices associated with medical device <NUM>, includes an actuating device <NUM>. Actuating device <NUM> controls articulation of flexible shaft <NUM>, and/or an articulation joint at a distal end of flexible shaft <NUM>, in multiple directions. Device <NUM> may be, for example, a rotatable knob that rotates about its axis to push/pull actuating elements, e.g., steering wires (not shown). The actuating elements, such as cables or wires suitable for medical procedures (e.g., medical grade plastic or metal), extend distally from a proximal end of medical device <NUM> and connect to a distal portion of flexible shaft <NUM> to control movement thereof. Alternatively, or additionally, a user may operate actuating elements independently of handle <NUM>. Distal ends of actuating elements may extend through flexible shaft <NUM> and terminate at an articulation joint and/or a distal tip of flexible shaft <NUM>. For example, one or more actuating elements may be connected to an articulation joint, and actuation of actuating elements may control the articulation joint or the distal end of flexible shaft <NUM> to move in multiple directions (e.g. up/down and or left/right).

In addition, one or more electrical cables (not shown) may extend from the proximal end of medical device <NUM> to the distal end of flexible shaft <NUM> and may provide electrical controls to imaging, lighting, and/or other electrical devices at the distal end of flexible shaft <NUM>, and may transmit imaging signals from the distal end of flexible shaft <NUM> proximally to be processed and/or displayed on a display. Handle <NUM> may also include ports <NUM>, <NUM> for introducing and/or removing tools, fluids, or other materials from the patient. Port <NUM> may be used to introduce tools, via a working channel <NUM>. Port <NUM> may be connected to an umbilicus for introducing fluid, suction, and/or wiring for electronic components. Furthermore, medical device <NUM> may further include a strain relief <NUM> that is attached to a distal end of handle <NUM>. Strain relief <NUM> may be a cover of any suitable soft material that tapers distally and has an opening for shaft <NUM> at its distal end. Strain relief <NUM> is not particularly limited, and may assist in preventing shaft <NUM> from kinking.

Referring to <FIG> and <FIG>, handle <NUM> is discussed in further detail below. Handle <NUM> includes a proximal portion <NUM> and a rotatable distal portion <NUM>. Distal portion <NUM> is a discrete, separate component from proximal portion <NUM>. Thus, in some embodiments, handle <NUM> is not a single piece, and is instead two distinct pieces, proximal portion <NUM> and distal portion <NUM>. Distal portion <NUM> is rotatably attached to proximal portion <NUM>, so that portions <NUM> and <NUM> are adjacent to one another.

Proximal portion <NUM> may be of any suitable shape configured for handling or gripping by a user, and may also be any suitable material, e.g., plastic, steel, etc. Proximal portion <NUM> includes actuating device <NUM> and ports <NUM>, <NUM>, which are discussed above. As indicated above, proximal portion <NUM> may be the portion of handle <NUM> that is configured to be connected to additional wirings and tools, via ports <NUM> and <NUM>. Port <NUM> may lead to proximal working channel <NUM>, through which various tools may be introduced.

Proximal working channel <NUM> may be of any suitable form, and is not particularly limited. For example, in some embodiments, proximal working channel <NUM> may be a tube, coupled to port <NUM> and flexible and/or shaped to accommodate the shape of proximal portion <NUM>. In other embodiments, a hollow, tubular channel may be molded within proximal portion <NUM> to form proximal working channel <NUM>, which may be of any suitable material, e.g., plastic, steel, etc. Channel <NUM> may be of any suitable diameter or length. A distal portion of channel <NUM> transitions into a lumen <NUM>' of a guide <NUM>. Guide <NUM> may be molded with channel <NUM>, as an integral unit. Guide <NUM> is tubular/cylindrical in shape, and includes lumen <NUM>'. Lumen <NUM>' extends along the central axis of guide <NUM>. Lumen <NUM>' has a diameter that is equal or about equal the diameter of channel <NUM>. Guide <NUM> may be a molded feature that is anchored within proximal portion <NUM>, via supports <NUM> extending from the inner surfaces of proximal portion <NUM> to guide <NUM>. Supports <NUM> may also be molded features or supports inserted within proximal portion <NUM>. Supports <NUM> may also include suitable openings or channels to allow any wires and/or suction or irrigation tubing to pass through supports <NUM>, and toward the distal end of shaft <NUM>. Furthermore, device <NUM> may also define spaces within portions <NUM> and <NUM> to allow the same.

Guide <NUM> and lumen <NUM>' serve as a transition between the distal end of channel <NUM> of proximal portion <NUM> and the proximal end of a distal working channel <NUM> of distal portion <NUM>. A distal end of guide <NUM> includes a circular void or recess <NUM> to accommodate a sealing ring <NUM>. Ring <NUM> (e.g. an O-ring) fits around distal working channel <NUM>. Thus, the diameter of the space within ring <NUM> may be of the same or about the same diameter as an outer diameter of working channel <NUM>. However, ring <NUM> fits around channel <NUM> so that channel <NUM> may still rotate within ring <NUM>. Alternatively, ring <NUM> and channel <NUM> may rotate together within recess <NUM>. Ring <NUM> may be of any suitable material that allows for it to seal around distal channel 22and provide for a centering of a proximal end of channel <NUM> within recess <NUM> of guide <NUM>. Thus, in view of the above, proximal channel <NUM>, lumen <NUM>', and distal channel <NUM> remain in direct alignment, without any offset.

Distal portion <NUM> includes a proximal portion of distal working channel <NUM>. Distal working channel <NUM>, like proximal channel <NUM>, may be of any suitable form. For example, channel <NUM> may be a tube extending from the end of lumen <NUM>' of guide <NUM>, as described above, to the distal end of shaft <NUM>. Regardless of form, the diameter of channel <NUM> is the same or about the same as channel <NUM>. In other embodiments, the diameter of channel <NUM> may be less than or greater than the diameter of channel <NUM>. Furthermore, as discussed above, proximal channel <NUM> leads to and is in fluid communication with lumen <NUM>', which leads to and is in fluid communication with distal channel <NUM>.

Distal portion <NUM> further includes a proximal portion of shaft <NUM>, and a clamp <NUM>. Shaft <NUM> may be a tubing of any suitable length that encompasses at least a portion of, or all of, distal working channel <NUM>, and extends from distal portion <NUM> to the distal end of medical device <NUM>. Shaft <NUM> may be a tubing of any suitable material that is flexible. The diameter of shaft <NUM> is not particularly limited, so long as said diameter may accommodate distal working channel <NUM> and any desired wires, suction/irrigation tubing, etc. Clamp <NUM> is a circular clamp/opening that is molded as part of distal portion <NUM>. Clamp <NUM> is configured to hold/clamp a proximal portion of shaft <NUM>, so that shaft <NUM> is fixed to distal portion <NUM>. In view of such configuration, the opening of clamp <NUM> has a diameter that is the same or about the same as the outer diameter of shaft <NUM>. Additional means for securing clamp <NUM> to shaft <NUM> may be used, including adhesives, welding, etc. Thus, the proximal portion of shaft <NUM> is fixedly clamped to distal portion <NUM>, so that shaft <NUM> (and working channel <NUM>) rotates, as distal handle portion <NUM> rotates clockwise or counter-clockwise, relative to proximal handle portion <NUM>. At least a portion of distal working channel <NUM> may be fixed to shaft <NUM> (via adhesives, welding, etc.), so they may rotate simultaneously.

As noted above, distal portion <NUM> is rotatably attached to proximal portion <NUM>. Portions <NUM>, <NUM> abut one another and are flush against one another. The abutting ends of portions <NUM>, <NUM> are circular and have a same diameter. The means by which distal portion <NUM> is rotatably attached to proximal portion <NUM> is not particularly limited, and both portions <NUM>, <NUM> may include any suitable coupling components/elements (not shown). For example, a proximal surface of distal portion <NUM> may engage with a distal surface of proximal portion <NUM> via an anchor/slot coupling mechanism that prevents detachment of portions <NUM> and <NUM>. In such an example, a distal surface of proximal portion <NUM> may have a recess extending circumferentially throughout said distal surface, and a proximal surface of distal portion <NUM> may have a proximally-protruding component/feature, configured to be securely slotted within said recess. In an alternative example, the distal surface of proximal portion <NUM> may have a distally-protruding feature, while the proximal surface of distal portion <NUM> includes a recess. However, the attachment between distal portion <NUM> and proximal portion <NUM> is not limited as described, and may employ other suitable means.

Distal portion <NUM> may also be attached to proximal portion <NUM>, so that distal portion <NUM> is limited in its degree of rotation, e.g., approximately <NUM>°, <NUM>°, <NUM>°, etc., relative to proximal portion <NUM>. Thus, in such examples, coupling components of distal portion <NUM> and proximal portion <NUM> may include additional means to limit the rotation of distal portion <NUM>. For example, stops may be positioned at predetermined or selected positions within the previously discussed recesses, thereby inhibiting rotation of distal portion <NUM> past said stops, due to contact between the protruding features and the stops. However, again, the coupling means is not limited as described, and may employ other suitable components/features to limit distal a degree of rotation of portion <NUM>.

Distal portion <NUM> and working channel <NUM> rotate about central axis A of distal working channel <NUM>. Channel <NUM> therefore maintains direct alignment with lumen <NUM> and proximal channel <NUM>, throughout the rotation of distal portion <NUM>. Thus, accessory devices or tools extending through both channels <NUM> and <NUM> are protected from any damage, e.g., pinching, as distal channel <NUM> rotates (by rotation of distal portion <NUM>), relative to proximal channel <NUM>.

As discussed above, distal portion <NUM> may remain in a stationary state or configuration, relative to proximal portion <NUM>. To remain stationary, distal portion <NUM> or at least the surface of distal portion <NUM> abutting proximal portion <NUM> may be of any suitable frictious material, thereby inhibiting undesired movement of distal portion <NUM> while abutting proximal portion <NUM>. To enhance friction between both portions <NUM> and <NUM>, proximal portion <NUM>, or at least the surface of proximal portion <NUM> abutting distal portion <NUM>, may also be of any suitable frictions material. Frictional forces generated between distal portion <NUM> and proximal portion <NUM> may be of a sufficient degree to inhibit undesired rotation of distal portion <NUM>, relative to proximal portion <NUM>. However, said frictional forces may not be greater than the ordinary torsional forces applied by a user of medical device <NUM>, so that distal portion <NUM> may be rotated as desired by said user.

Referring to <FIG>, an example of how medical device <NUM> may be used is further discussed below. The distal end of shaft <NUM> of medical device <NUM> may be delivered into the body of a subject, adjacent to an intended target site. The delivery may be via a natural body orifice, such as the mouth, nose, anus, etc. Imaging associated with medical device <NUM>, via any suitable image processing device, may assist in positioning of the distal end of shaft <NUM>. Depending on the position of the subject and/or the intended target site relative to medical device <NUM> and/or a user of medical device <NUM>, the user may choose to rotate shaft <NUM> relative to handle <NUM>. To rotate shaft <NUM>, the user may rotate distal portion <NUM> of handle <NUM> relative to proximal portion <NUM> by applying a torsional force greater than the frictional force between portions <NUM> and <NUM>. The user may rotate distal portion <NUM> (and shaft <NUM>) to allow the user's handling of handle <NUM> in a more ergonomic position, or for various other reasons. Thus, a user may rotate shaft <NUM> (via rotation of distal portion <NUM>) or proximal portion <NUM> of handle <NUM>, relative to the other, to any desired degree.

Medical device <NUM>', as shown in FIG. <NUM>, is similar to device <NUM> in many respects. Like reference numerals refer to like parts. Differences between device <NUM> and device <NUM>' will be described below. Device <NUM>' further includes a lock <NUM>. Lock <NUM> may include a configuration (e.g. a locked configuration) in which distal portion <NUM> and shaft <NUM> may be freely rotatable in any direction (clockwise or counterclockwise), relative to proximal portion <NUM>, and another configuration (e.g. an unlocked configuration) in which distal portion <NUM> and shaft <NUM> remain stationary and are not rotatable relative to proximal portion <NUM>. Referring to <FIG>, lock <NUM> includes a slideable locking washer <NUM> having a locking pin <NUM>, a receiving washer <NUM> configured to engage with locking washer <NUM> and pin <NUM>, a base washer <NUM>, and a spring <NUM> coupling locking washer <NUM> to base washer <NUM>. Lock <NUM> is positioned so that it is distal to guide <NUM>, and channel <NUM> extends through the central openings along the axes of washers <NUM>, <NUM>, and <NUM>. Lock <NUM> further includes a center tube <NUM>, also extending through the central openings along the axes of washers <NUM> and <NUM>. Tube <NUM> is hollow and sheaths over the portion of channel <NUM> extending from guide <NUM> to washer <NUM>. Thus, a portion of tube <NUM> is sheathed within recess <NUM> of guide <NUM>. Tube <NUM> may be fixed to washer <NUM> so that tube <NUM> may rotate or slide linearly along with washer <NUM>, as further described below. However, tube <NUM> may not be fixed to washer <NUM> so that tube <NUM> may rotate and slide linearly relative to washer <NUM>. The distal end of tube <NUM> is fixed to washer <NUM>.

Locking washer <NUM> is circular/disk-like in shape, but is not limited thereto. The dimensions of washer <NUM> are not particularly limited, so long as it may be fixed within distal portion <NUM>. Locking washer <NUM> may be fitted around tube <NUM> via a central opening, so that washer <NUM> may be able to slide linearly over tube <NUM>. Locking washer <NUM> includes locking pin <NUM>, which may be a pin protruding proximally. Pin <NUM> is located on the proximal surface of washer <NUM>, at a location from which pin <NUM> may engage one of the receiving holes <NUM> of receiving washer <NUM> (described in further detail below). The length and diameter of pin <NUM> are not particularly limited so long as pin <NUM> may engage with said receiving holes <NUM>. Similarly, washer <NUM> is also circular/disk-like in shape, but not limited thereto. In device <NUM>', washer <NUM> is of a smaller diameter than washer <NUM>. However, the dimensions, e.g., diameter, of washer <NUM> are not particularly limited. Washer <NUM> may be fitted around tube <NUM> via a central opening of washer <NUM>, so that tube <NUM> may slide and/or rotate about its central axis, relative to washer <NUM> and proximal portion <NUM>. Washer <NUM>, which is proximal and adjacent to washer <NUM>, includes a plurality of receiving holes <NUM> on its distal surface. Holes <NUM> may extend completely through a thickness of washer <NUM> or partially through washer <NUM> (e.g. as a recess). Holes <NUM> may have shapes and widths/diameters that accommodate pin <NUM> of washer <NUM>. Receiving holes <NUM> may be distributed circumferentially and evenly about the center point of washer <NUM>. The number of receiving holes <NUM> is not particularly limited. Base washer <NUM> is also circular/disk-like in shape, but not limited thereto. The dimensions of washer <NUM> are also not particularly limited, so long as it may be fixed within distal portion <NUM>. In device <NUM>°, a portion of the proximal surface of washer <NUM> is fixed to the distal end of guide <NUM> which is within distal portion <NUM>. Washer <NUM> therefore does not rotate with distal handle portion <NUM>. However, washer <NUM> is not limited to being fixed to the distal end of guide <NUM>. Washer <NUM> may also be fixed to other portions or cornponents within proximal portion <NUM>, so that washer <NUM> does not rotate with distal portion <NUM>. Washer <NUM> is distal to locking washer <NUM>, and thus, is the distalmost end of lock <NUM>. Spring <NUM> is positioned between washer <NUM> and locking washer <NUM>, as it couples the proximal surface of washer <NUM> to the distal surface of locking washer <NUM>. The distal surface of washer <NUM> is fixed to the proximal surface of clamp <NUM>. Thus, washer <NUM> may serve as a fixed base from which locking washer <NUM> may slide linearly over tube <NUM>, via compression or extension of spring <NUM>. Washers <NUM> and <NUM>, and spring <NUM> will rotate with distal handle portion <NUM>.

As discussed above, the distal surface of washer <NUM> is coupled to base washer <NUM> via spring <NUM>. As a result, washer <NUM>, of distal portion <NUM>, may be spring-biased to engage with washer <NUM>, via pin <NUM> and one of holes <NUM>. As previously noted, washer <NUM> is fixed to guide <NUM>, which is anchored to proximal portion <NUM> via supports <NUM>. Thus, lock <NUM> may be defaulted into a locked configuration, thereby inhibiting any rotation of distal portion <NUM> (and shaft <NUM>) or proximal portion <NUM>, relative to the other.

To transition lock <NUM> from its default, locked configuration to an unlocked configuration (shown in <FIG>), a force pulling distal portion <NUM> distally may be applied (as indicated by the directional arrows). The connection between distal portion <NUM> and proximal portion <NUM> permits some relative translation between them along axis A. This is illustrated by the gaps between distal portion <NUM> and proximal portion <NUM>, while lock <NUM> is in the unlocked configuration. For example, the protruding portion(s) and recess(es) or facing surfaces of proximal portion <NUM> and distal portion <NUM> mentioned above (not shown) may be configured to permit relative translation. The pulling force disengages locking washer <NUM> from receiving washer <NUM> of proximal portion <NUM>. Pin <NUM> of washer <NUM> retracts outside of one of openings <NUM> of washer <NUM>. The pulling force may be applied via any suitable manner, e.g., by hand, mechanically, electrically, etc. While disengaged, distal portion <NUM> (and shaft <NUM> which is fixed to portion <NUM>) or proximal portion <NUM> may freely rotate clockwise or counter-clockwise, relative to the other. Release of the applied force may revert locking washer <NUM> to its original position, in which it abuts and is engaged with washer <NUM>. If washer <NUM> fails to engage with washer <NUM> due to misalignment between pin <NUM> and one of holes <NUM> of washer <NUM>, further rotation may occur until alignment and engagement is established.

Medical device l' may be used in a similar manner as medical device <NUM>, except a user may pull on distal portion <NUM> distally to unlock lock <NUM>, rotate distal portion <NUM> (and shaft <NUM>) or proximal portion <NUM>, relative to the other, to a desired degree, and release distal portion <NUM> to revert lock <NUM> into a locked configuration.

<FIG> illustrates a rotatable gyro <NUM> that may be included in medical device embodiments, including devices <NUM>, <NUM>' described above. As shown, rotatable gyro <NUM> surrounds a portion of guide <NUM> and working channel <NUM>, and also holds a steering wire <NUM>. Gyro <NUM> may be fitted around the area in which lumen <NUM>' and working channel <NUM> meet. However, gyro <NUM> is not limited to such a position, and may also be fitted around, for example, portions of guide <NUM> within proximal portion <NUM>. Furthermore, it is noted that the presence of gyro <NUM> and lock <NUM> in a medical device handle is not mutually exclusive. In some examples, a handle may include gyro <NUM> fitted around guide <NUM> and channel <NUM>, and lock <NUM> also fitted around channel <NUM>.

Each steering wire of a conventional medical device (e.g. a scope) is a single piece routed from the handle to the distal end of a shaft. However, rotation of such steering wires, while rotating the shaft, may result in damage to the steering wires due to the twisting from rotation. To address such a concern, steering wire <NUM> is of two separate, decoupled wires, proximal wire <NUM> and distal wire <NUM>, to help enable rotation of distal portion <NUM> (and shaft <NUM>) without damaging steering wire <NUM>, as described above. The proximal end of proximal wire <NUM> may be connected to any suitable controller, e.g., device <NUM> shown in <FIG>. The distal end of proximal wire <NUM> is connected to, or integral with, a first termination/ferrule ball <NUM>. The distal end of distal wire <NUM> connects to the distal end of shaft <NUM> to control articulation thereof. The proximal end of distal wire <NUM> is connected to, or integral with, a second termination/ferrule ball <NUM>. Balls <NUM> and <NUM> may be of any suitable material, e.g., lead, and is not particularly limited. Alternatively, each ball <NUM>, <NUM> may be a machined or heat treated end of corresponding wire <NUM>, <NUM>. Furthermore, ball <NUM>, <NUM> are not particularly limited to being balls, and may be any suitable enlargement. Similarly, wires <NUM> and <NUM> are not particularly limited, and may be any suitable cables or wires used for medical procedures (e.g., medical grade plastic or metal).

Gyro <NUM> includes a proximal gyro <NUM> and a distal gyro <NUM>, which are rotatably interlinked with one another. Proximal gyro <NUM> is a structure surrounding guide <NUM> and holding proximal wire <NUM>. Distal gyro <NUM> is a structure surrounding distal working channel <NUM> and holding distal wire <NUM>. Distal gyro <NUM> may be fixed around channel <NUM> so that it may be rotatable with channel <NUM>, relative to proximal gyro <NUM>. Proximal gyro <NUM> may be fixed to guide <NUM>. Proximal gyro <NUM> includes a recess <NUM>, and a flange <NUM> that protrudes proximally, thereby partially covering recess <NUM>. Proximal gyro <NUM> further includes a flange <NUM> that is proximal to recess <NUM>, and protrudes radially outward, relative to the remainder of proximal gyro <NUM>. The distance by which flange <NUM> protrudes is not particularly limited, so long as it may be accommodated within device <NUM>". Flange <NUM> includes a channel <NUM> at about the midpoint of its radial protrusion. Channel <NUM> runs parallel or about parallel to a longitudinal axis of guide <NUM>. The width of channel <NUM> may be such that it accommodates for proximal wire <NUM>, but is narrower than the diameter of first ball <NUM>, which is distal to channel <NUM>. Thus, channel <NUM> holds proximal wire <NUM> while also anchoring first ball <NUM>, so that proximal wire <NUM> is inhibited from slipping out of channel <NUM> when pulled proximally. Distal gyro <NUM> includes a void <NUM> and a flange <NUM> that protrudes distally, thereby partially covering void <NUM>. Distal gyro <NUM> also includes a flange <NUM> that is similar in many respects to flange <NUM>. Flange <NUM> includes a channel <NUM> at about the midpoint of its radial protrusion. Flange <NUM>, similar to flange <NUM>, holds distal wire <NUM> while also anchoring second ball <NUM>, so that distal wire <NUM> is inhibited from slipping out of channel <NUM> when distal gyro <NUM> is pulled proximally. It is noted that void <NUM>, flange <NUM>, recess <NUM>, and flange <NUM> are annular, so they are in engagement around the circumferences of proximal gyro <NUM> and distal gyro <NUM>.

Proximal gyro <NUM> and distal gyro <NUM> may be in constant engagement with one another due to their interlocking. Distal gyro <NUM> is interlocked around flange <NUM> of proximal gyro <NUM>, such that portions of distal gyro <NUM> and proximal gyro <NUM> tightly abut one another, while also allowing rotation of distal gyro <NUM> or proximal gyro <NUM>, relative to the other. Flange <NUM> of distal gyro <NUM> and flange <NUM> of proximal gyro <NUM> hook against one another, as flange <NUM> remains within recess <NUM> of proximal flange <NUM>, and flange <NUM> remains within void <NUM> of distal gyro <NUM>. Thus, the hook-like features of flanges <NUM> and <NUM> inhibit proximal gyro <NUM> and distal gyro <NUM> from disengaging from one another. It is noted that the dimensions of flanges <NUM>, <NUM>, recess <NUM>, and void <NUM> are not particularly limited, and may be any suitable dimensions that allow for the above described rotatable, interlocked engagement between proximal gyro <NUM> and distal gyro <NUM>.

In view of the above, rotatable gyro <NUM> enables the rotation of proximal steering wire <NUM> or distal steering wire <NUM>, as distal portion <NUM> or proximal portion <NUM> is rotated, relative to the other. Furthermore, the above configuration of gyro <NUM> enables the articulation of flexible shaft <NUM>, via steering wire <NUM>. Proximal wire <NUM>, including first ball <NUM>, may be pulled via actuation of any suitable controller, e.g., device <NUM> (not shown), which in turn pulls on proximal gyro <NUM> due to first ball <NUM> pulling against flange <NUM>. Pulling on proximal gyro <NUM> results in distal gyro <NUM> being pulled, due to their interlocked engagement. This, in turn, pulls on distal steering wire <NUM>, due to flange <NUM> pushing against second ball <NUM>, and results in steering wire <NUM> pulling on the distal end of shaft <NUM>, thereby enabling articulation thereof.

<FIG> illustrates a medical device <NUM>" including two rotatable gyros 50a and 50b, both of which are identical to rotatable gyro <NUM> of <FIG>. Gyros 50a and 50b respectively hold the two steering wires, 60a and 60b. It is noted that the number of gyros included in medical devices is not particularly limited, and may be any suitable number that corresponds with the number of steering wires (e.g. one, two or four) within a medical device embodiment. As shown in <FIG>, one gyro, rotatable gyro 50a, may be positioned around the area in which the lumen (not shown) of guide <NUM> and working channel <NUM> meet, as described above for <FIG>. Meanwhile, the second gyro, rotatable gyro 50b, may be positioned proximal to gyro 50a, so that it may also be within proximal portion <NUM>. Steering wires 60a and 60b are coupled to the distal end of shaft <NUM>. Thus, as shaft <NUM> rotates, distal gyros 55a and 55b, which hold distal wires 63a and 63b, also may rotate.

Suctioning may also be enabled in medical devices that include a rotatable working channel. Medical device <NUM>‴, as shown in <FIG>, is similar to device <NUM> in some respects. Like reference numerals refer to like parts. Differences between device <NUM> and device <NUM>‴ will be described below. In device <NUM>"', working channel <NUM>' is a rotatable tube that extends from proximal portion <NUM>, through rotatable distal portion <NUM>", to the distal end of a shaft (not shown). At least a portion of channel <NUM>' may be fixed to the shaft. Thus, channel <NUM>', as a whole, may rotate as distal portion <NUM>" and the shaft also rotate. Working channel <NUM>' includes a plurality of circular/oval-shaped openings <NUM> distributed about its circumference. The number of openings <NUM> and the shape of openings <NUM> is not particularly limited. Furthermore, openings <NUM> are sealed from the remaining, unopened portions of working channel <NUM>', via sealing rings 13a and 13b. Rings 13a and 13b are fitted around the portions of working channel <NUM>' that are adjacent to openings <NUM>, with one ring 13a distal to openings <NUM> and the other ring 13b proximal to openings <NUM>. Rings 13a and 13b may be fitted around working channel <NUM>' so that they serve as a seal, while also enabling rotation of channel <NUM>' within rings 13a and 13b. Rings 13a and 13b may be of any suitable material used for sealing purposes, e.g., rubber.

Device <NUM>‴ further includes a tubular suction body <NUM>, one end of which is fitted around a portion of working channel <NUM>'. Suction body <NUM> includes a tube wall <NUM>, a lumen <NUM>, and a cavity <NUM>. One end of lumen <NUM> may be connected to a suctioning source (not shown) and/or a disposal collecting suctioned materials (not shown). The other end of lumen <NUM> leads to cavity <NUM> of tubular suction body <NUM>, surrounding the portion of working channel <NUM>' including openings <NUM>. The portion of suction body <NUM> including cavity <NUM> includes proximal and distal openings <NUM>, <NUM>. Openings <NUM>, 205sheath over channel <NUM>' and include rings 13a, 13b. In <FIG>, the portion of suction body <NUM> including cavity <NUM> is fitted around the aforementioned portion of working channel <NUM>', so that cavity <NUM> and openings <NUM> are sealed from the remainder of device <NUM>‴. Thus, such a configuration enables suction body <NUM> to suction and remove materials, e.g., fluids, that have been captured within a portion of working channel <NUM>' that is distal to openings <NUM>. Said materials may exit from channel <NUM>' through openings <NUM> and fall into lumen <NUM>, via suction. The above-described configuration enables suctioning while still introducing accessory devices, e.g., accessory <NUM>, through port <NUM> and working channel <NUM>'.

Claim 1:
A medical device (<NUM>, <NUM>', <NUM>"), comprising:
a shaft (<NUM>);
a handle (<NUM>) including a proximal portion (<NUM>) and a distal portion (<NUM>), wherein the distal portion (<NUM>) is fixed to a proximal portion of the shaft (<NUM>); and
a working channel for receiving a tool, the working channel extending from the handle (<NUM>) into the shaft (<NUM>), wherein the working channel includes a proximal working channel (<NUM>) and a distal working channel (<NUM>), the proximal working channel (<NUM>) being rotatable relative to the distal working channel (<NUM>) and aligned with the distal working channel (<NUM>) throughout rotation of the proximal working channel (<NUM>),
wherein the proximal working portion (<NUM>) includes the proximal working channel (<NUM>) and the distal portion (<NUM>) includes the distal working channel (<NUM>), wherein the distal portion (<NUM>) is rotatable relative to the proximal portion (<NUM>) of the handle (<NUM>), and the shaft (<NUM>) is configured to rotate with the distal portion (<NUM>) of the handle (<NUM>).