Patent Description:
Guidewires and optical fibers are used in a wide variety of medical procedures, including urology, neurology, otorhinolaryngology, ophthalmology, gastroenterology, cardiology, and gynecology. Generally, a user may control and deliver a guidewire or an optical fiber from packaged spiral loops, but the guidewires and optical fibers may be difficult to handle or easy to damage. For example, a hydrophilic guidewire may be hydrated and made of polyethylene such that the guidewire may be released from a packaged loop, but, as a result, the guidewire may be slippery and difficult to control. Optical fibers are usually packaged such that the entire optical fiber must be removed from the packaging before use, increasing the risk of contamination and breaking between the removal from packaging and the use with a patient. Guidewires and optical fibers also often snag during dispensing or retracting. Moreover, dispensing the guidewire, optical fiber, or other medical device may be cumbersome and difficult to control, especially in the midst of a medical procedure, increasing the chances of user error, further complicating and prolonging the procedure, and exposing the patient to greater risk.

The systems, devices, and non-claimed methods of the current disclosure may rectify some of the deficiencies described above, and/or address other aspects of the prior art.

Document <CIT> describes an endoscope system which includes an endoscope and a treatment tool which is inserted into and removed out of a treatment tool receiving channel of the endoscope, and an insertion and removal wire which is fixed to a pointed head of a flexible sheath of the treatment tool. The insertion and removal wire extends along the whole length of the sheath and an outer diameter of the same is smaller than the sheath. A driving roller for insertion and removal of the insertion and removal wire is disposed in the endoscope.

Examples of the present disclosure relate to, among other things, medical systems, devices, and non-claimed methods. Each of the examples disclosed herein may include one or more of the features described in connection with any of the other disclosed examples.

In accordance with the invention, a medical system includes an insertion device and an insertion device handle. The insertion device handle has a proximal portion and a distal portion, with a delivery shaft extending from the distal portion. The medical system also includes a medical device, including a spool and a medical device handle radially interior to the spool. The medical device handle has a central opening, and the spool and the medical device handle are rotatably movable to one another and form a channel. The medical system also includes an adapter couplable to a portion of the insertion device handle, and the adaptor includes a post element to be received within the central opening of the medical device handle. The post element extends away from the insertion device when the adaptor is coupled to the insertion device. The adaptor is configured to rotatably lock the medical device handle when the medical device is coupled to the insertion device via the adaptor.

The medical system may further include one or more of the following features. The medical device may include a coiled element at least partially positioned in the channel between the spool and the medical device handle, and relative rotation of the spool and the medical device handle may extend or retract the coiled element. The coiled element may include an end effector. The coiled element may be at least partially surrounded by a tube or sheath. The spool may include a lock element to secure a proximal end of the coiled element, and the medical device handle may include a guide element to guide the coiled element and the tube or sheath from exterior to within the channel.

The coiled element may be surrounded by a tube, and the tube may include a stop element at a distal end of the tube. The central opening and the post element may be octagonal. The insertion device may include at least one port, and the at least one port may include a seal. A proximal end of the coiled element may extend proximal to the medical device to be coupled to an additional medical device. The insertion device may include a deflection lever positioned on the proximal portion of the insertion device handle on an opposite side of the insertion device handle from the adaptor. The system may be configured for one handed use. The deflection lever may be configured to be operated by a user's thumb, and the medical device may be configured to be operated by a user's forefinger.

The post may include a plurality of projections separated by slots. The spool may include a crank with a throughhole, and the crank may further include a locking slot configured to lock the position of a proximal end of the coiled element. The medical device may further include a control knob movable relative to the spool and including at least one slot. The medical device may further include a plurality of spool teeth positioned on the spool facing the medical device handle, and the medical device handle may include a plurality of handle teeth positioned on the medical device handle facing the spool. The medical system may further include a wave spring between the spool teeth and the handle teeth. The medical system may also further include a second medical device stacked on the adaptor.

In another example, a medical device may include a rotatable spool element including a plurality of spool teeth, a handle element including a plurality of handle teeth, and a biasing member between the spool teeth and the handle teeth. The medical device may also include a rotatable control knob movable relative to the spool element and positioned on the opposite side of the spool element from the biasing member, and a coiled element including a sheath surrounding at least a portion of a drive wire. A distal end of the drive wire may be coupled to an end effector, and the spool element or the handle element may form a channel to house at least a portion of the coiled element.

The medical device may further include one or more of the following features. Rotation of the spool element relative to the handle element may extend or retract the coiled element from the channel. Compression of the medical device in a direction perpendicular to a plane of rotation of the spool member may cause at least a portion of the spool teeth to engage with at least a portion of the handle teeth. When the medical device is compressed, rotation of the control knob relative to the spool element may extend or retract the end effector from within the sheath. The biasing member may be a cantilevered spring.

In a further example not forming part of the claimed invention, a method of operating a medical system may include inserting an insertion device into a patient, where the insertion device includes a delivery shaft, a deflection mechanism, and at least one port. The method may also include coupling a medical device to the insertion device via an adaptor, and the medical device may include at least a spool, a handle, and a coiled element at least partially stored between or within the spool and the handle. Coupling the medical device via the adaptor may rotatably lock the handle in place. The method may also include delivering the coiled element through the at least one port by rotating the spool.

The non-claimed method may further include one or more of the following features. The method may further include contemporaneously deflecting a distal end of the delivery shaft by acting on the deflection mechanism and further delivering the coiled element by rotating the spool. The coiled element may include an end effector coupled to a drive wire and a sheath at least partially surrounding the drive. The method may further include extending the end effector distally beyond the sheath by pressing the medical device toward the insertion device and rotating a control knob relative to the spool.

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. Additionally, the term "exemplary" is used herein in the sense of "example," rather than "ideal. " As used herein, the terms "about," "substantially," and "approximately," indicate a range of values within +/- <NUM>% of a stated value.

The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate various exemplary embodiments and together with the description, serve to explain the principles of the disclosure.

Examples of the present disclosure include systems, devices, and non-claimed methods to facilitate and improve the efficacy, efficiency, and safety of dispensing medical devices during medical procedures. For example, aspects of the present disclosure may provide a user (e.g., a physician, medical technician, or other medical service provider) with the ability to more easily dispense and retract a guidewire, an optical fiber, a retrieval basket, or other shaft-like medical element to be delivered within a patient and/or through an insertion device. Some aspects of the present disclosure may be used in performing an endoscopic, hysteroscopic, or ureteroscopic procedure.

Reference will now be made in detail to examples of the present disclosure described above and illustrated in the accompanying drawings.

The terms "proximal" and "distal" are used herein to refer to the relative positions of the components of an exemplary medical device or an insertion device. When used herein, "proximal" refers to a position relatively closer to the exterior of the body or closer to an operator using the medical device or insertion device. In contrast, "distal" refers to a position relatively farther away from the operator using the medical device or insertion device, or closer to the interior of the body.

<FIG> illustrates an exemplary embodiment of a medical system <NUM> in accordance with the invention that includes an insertion device <NUM>, a medical device <NUM>, and an adaptor <NUM>. Insertion device <NUM> includes a port <NUM> that connects through an internal lumen (not shown) to a delivery shaft <NUM>. Medical device includes a spool <NUM> and a handle <NUM>, and relative rotation of spool <NUM> and handle <NUM> may dispense or retract a coiled element <NUM> that is at least partially housed within medical device <NUM>. Adaptor <NUM> may couple medical device <NUM> to a portion of insertion device <NUM> such that a user may introduce coiled element <NUM> through port <NUM> by action on medical device <NUM> while also holding insertion device <NUM>. A distal end <NUM> of coiled element <NUM> may include an end effector, and a proximal end <NUM> of coiled element <NUM> may either be fixedly coupled within medical device <NUM> or may be extendable proximally to connect to another medical element via proximal connector <NUM>. While much of the below description includes medical device <NUM> and coiled element <NUM> being coupled and/or inserted into insertion device <NUM>, the disclosure is not so limited. In alternative embodiments, medical device <NUM> and coiled element <NUM> may be detached from insertion device <NUM>, and coiled element <NUM> may even be detached from medical device <NUM>.

Insertion device <NUM> may be an ureteroscope (e.g., LithoVue™ Single-Use Digital Flexible Ureteroscope by Boston Scientific Corp. ), a hysteroscope, a bronchoscope, a cystoscope, or any similar endoscope device. Insertion device <NUM> may include a body <NUM> with a distal portion <NUM>, an intermediate portion <NUM>, and a proximal portion <NUM>. Delivery shaft <NUM> may extend from distal portion <NUM> of body <NUM>. Body <NUM> of insertion device <NUM> has a longitudinal axis A aligned with a central long axis of a proximal end of the delivery shaft <NUM>. Body <NUM> may include a deflection lever <NUM> positioned on a rounded corner of the proximal portion <NUM>. Deflection lever <NUM> may be manipulated to deflect a distal end (not shown) of delivery shaft <NUM>. Although not shown, insertion device <NUM> may include a communication and power conduit connected to a display and power unit. The intermediate portion <NUM> may have a generally constant diameter, and may form a portion of insertion device <NUM> that a user may grip such that the user's thumb is proximate deflection lever <NUM>. Proximal portion <NUM> may be wider than intermediate portion <NUM>.

As mentioned, insertion device <NUM> includes at least one port <NUM>. The at least one port <NUM> may include a T-connector as shown in <FIG>, a Y-connector, or another appropriate connector. Port <NUM> may include threading <NUM>, may be a female luer, or may include a seal (e.g., a UroLok™ Adaptor seal by Boston Scientific Corp. The at least one port <NUM> connects to a proximal end of the delivery shaft <NUM> through at least one internal lumen (not shown) in the body <NUM> of insertion device <NUM>. In one aspect, port <NUM> may include a fitting <NUM>. Fitting <NUM> may include a seal such that coiled element <NUM> may be dispensed or retracted through the internal lumen in body <NUM> and delivery shaft <NUM> with a reduced likelihood of contamination or backflow of fluids.

As noted above, medical device <NUM> includes spool <NUM> and handle <NUM>. Spool <NUM> and handle <NUM> may be snap-coupled, and at least one of spool <NUM> or handle <NUM> may form an internal channel to house at least a portion of coiled element <NUM>. Coiled element <NUM> may be a guidewire, optical fiber, cautery element, or other medical element. In an aspect where coiled element <NUM> is a guidewire, the guidewire may be releasably coupled to spool <NUM>. For example, the guidewire may be uncoiled from spool <NUM> and delivered within a patient. The guidewire may then be uncoupled from spool <NUM>, and a medical device, for example, insertion device <NUM>, may be positioned on the proximal portion of the uncoupled guidewire in order for the medical device to be delivered within the patient.

Spool <NUM> and handle <NUM> are rotatably coupled such that relative rotation of spool <NUM> and handle <NUM> either dispenses or retracts coiled element <NUM> from the internal channel. Spool <NUM> may include a plurality of radially extending grip portions or knurls <NUM> on at least a portion of an outer circumferential surface of spool <NUM>. Spool <NUM> and handle <NUM> can be mounted on adaptor <NUM>, and adaptor <NUM> ensures that handle <NUM> remains stationary as spool <NUM> is rotated. Spool <NUM> and handle <NUM> may be employed without adaptor <NUM>, and the user's hand or fingers may ensure that handle <NUM> remains stationary as spool <NUM> is rotated. In one aspect, spool <NUM> and handle <NUM> may be formed of a transparent polymer, which may allow a user to see coiled element <NUM> within the internal channel to determine a length of the portion of coiled element <NUM> housed within the channel.

Adaptor <NUM> can be coupled to body <NUM> of insertion device <NUM> in order to couple medical device <NUM> to insertion device <NUM>. Adaptor <NUM> may be coupled to intermediate portion <NUM> or proximal portion <NUM> of body <NUM>. As shown in <FIG>, adaptor <NUM> may be coupled to insertion device <NUM> on an opposite side of proximal portion <NUM> relative to longitudinal axis A from deflection lever <NUM>. For example, adaptor <NUM> may be shaped to fit on insertion device <NUM> and match the contour of a portion of intermediate portion <NUM> and the wider proximal portion <NUM>.

Adaptor <NUM> also includes a post <NUM> extending away from insertion device <NUM> when adaptor <NUM> is coupled to insertion device <NUM>. Post <NUM> is sized to fit through a central hole in medical device <NUM>, through handle <NUM>, in order to securely attach medical device <NUM> to insertion device <NUM>. It is noted that post <NUM> may include a rectangular, pentagonal, hexagonal, octagonal, or otherwise shaped post extension <NUM> that matches a central hole in handle <NUM> such that handle <NUM> may be secured relative to insertion device <NUM> while still allowing spool <NUM> to rotate in response to user action. As such, the shape of post <NUM> prevents handle <NUM> from rotating while a user rotates spool <NUM>.

In another aspect, post <NUM> may be tapered as it extends away from adaptor <NUM>. A seat <NUM> may extend radially outward from post <NUM> in order to stop the vertical movement of medical device <NUM> on post <NUM>. As such, a user may hold medical system <NUM> in one hand and both deflect a distal end of delivery shaft <NUM> through action on deflection lever <NUM> and also dispense or retract coiled element <NUM> through action on spool <NUM>.

<FIG> illustrates a partially exploded view of medical system <NUM> of <FIG>. It is noted that <FIG> depicts medical device <NUM>' with knurls <NUM>', which may be larger or extend radially further than knurls <NUM> in <FIG> to aid a user in manipulating medical device <NUM>'. As shown, insertion device <NUM> may include at least one indentation or hole <NUM>, and adaptor <NUM> may include at least one adaptor pin <NUM>. In one example, adaptor pins <NUM> may be positioned at distal and proximal positions to fit, snap, or otherwise secure into corresponding indentations or holes <NUM> in intermediate portion <NUM> or proximal portion <NUM> of insertion device <NUM>. It is noted that holes <NUM> and adaptor pins <NUM> are shown on differing sides of insertion device <NUM> and adaptor <NUM> in <FIG>, but holes <NUM> and adaptor pins <NUM> may be respectively positioned on both sides of insertion device <NUM> and adaptor <NUM>. Adaptor <NUM> may also include biased or flexible extensions <NUM> that connect to at least one adaptor pin <NUM> such that extensions <NUM> may bend or flex as adaptor pins are positioned in holes <NUM> to couple adaptor <NUM> to insertion device <NUM>.

Adaptor <NUM> may also include post extension <NUM> as part of post <NUM>, and post extension <NUM> may be sized to fit within a central opening <NUM> within handle <NUM>. For example, post extension <NUM> may be rectangular, pentagonal, hexagonal, octagonal, etc., and central opening <NUM> may include a corresponding shape. Alternatively, post extension <NUM> may include ridges to be received within grooves of central opening <NUM>. Therefore, when mounted on adaptor <NUM>, action on medical device <NUM> may rotate spool <NUM>, while handle <NUM> remains stationary relative to insertion device <NUM>. Moreover, post extension <NUM> may be sized to fit snugly within central opening <NUM>, which may help to ensure that medical device <NUM>' remains coupled to insertion device <NUM> via seat <NUM> of adaptor <NUM>.

Seat <NUM> extends radially outward from post <NUM>. Seat <NUM> is wider than central opening <NUM> in order to ensure that medical device <NUM>' is positioned an appropriate distance from insertion device <NUM>.

In use, a user may insert insertion device <NUM> into a patient through any known method. With adaptor <NUM> coupled to insertion device <NUM>, a user may couple medical device <NUM> to insertion device <NUM>. While holding insertion device <NUM> in one hand, a user may dispense coiled element <NUM> of medical device <NUM> in direction A through port <NUM> by rotating spool <NUM> in direction C with a finger of the one hand or with the user's other hand. A user may also retract coiled element <NUM> in direction B by rotating spool <NUM> in direction D. Knurls <NUM> may aid in the manipulation of spool <NUM>. Coiled element <NUM> may be dispensed to the distal end of delivery shaft <NUM> such that distal end <NUM> of coiled element <NUM> may deliver therapy. Proximal end <NUM> of coiled element <NUM> may be coupled to another medical element. For example, coiled element <NUM> may be a laser fiber, and proximal end <NUM> may be coupled to a laser source (not shown). The user may quickly and easily maneuver the distal end of delivery shaft <NUM>, for example, with action on deflection lever <NUM> with the user's thumb. The user may also maneuver coiled element <NUM>, either extending distally or retracting proximally, by, for example, rotating spool <NUM> with the user's forefinger.

In another example, coiled element <NUM> may be a guidewire. Coiled element <NUM> may be dispensed from medical device <NUM> by rotating spool <NUM> relative to handle <NUM> such that coiled element <NUM> may be delivered and positioned within a patient. In this aspect, medical device <NUM> may be handheld, and separate from adaptor <NUM>. Insertion device <NUM> may be inserted into a patient over coiled element <NUM>. Once coiled element <NUM> emerges proximally from port <NUM>, coiled element <NUM> may be inserted into medical device <NUM> by the user. The physical properties (e.g., elasticity) of coiled element <NUM> and/or internal slots or protrusions within medical device <NUM> may help to secure a proximal end of coiled element <NUM> within medical device <NUM>. Then, rotation of spool <NUM> relative to handle <NUM> may help the user more quickly retract coiled element <NUM>. Additionally, coiled element <NUM> may be stored within medical device <NUM> for later use in the procedure with the same patient. Alternatively, coiled element <NUM> may be pre-inserted through port <NUM> and extend out of the distal end of delivery shaft <NUM>. Coiled element <NUM> may be delivered to the location within the patient. Insertion device <NUM> may then be inserted into patient and tracked over coiled element <NUM>. As insertion device <NUM> is inserted, coiled element <NUM> may be retracted by rotating spool <NUM>. Once insertion device <NUM> is positioned within the patient, coiled element <NUM> may be fully retracted by continuing to rotate spool <NUM>.

In an additional example, medical device <NUM> can mounted on insertion device <NUM> via adaptor <NUM>. Medical device <NUM> includes coiled element <NUM> stored between spool <NUM> and handle <NUM>. Insertion device <NUM> may be inserted into a patient, for example, into a patient urethra. Coiled element <NUM> may be delivered through port <NUM> and through a lumen in delivery shaft <NUM> by rotating spool <NUM>. Coiled element <NUM> may be extended beyond a distal tip of delivery shaft <NUM>. Using visualization and deflection capabilities of insertion device <NUM>, a user may further extend and position coiled element <NUM>. For example, a user may insert coiled element <NUM> into the ureteral orifice to access the patient's ureter. The user may further extend coiled element <NUM> through the patient's ureter, for example, into the patient's kidney. Fluoroscopy may be used to aid in the manipulation and positioning of coiled element <NUM>. The user may then manipulate insertion device <NUM> to slide distally over coiled element <NUM> to access the ureter and the kidney. Once insertion device <NUM> is positioned, the user may retract coiled element <NUM> by rotating spool <NUM>. Alternatively, the user may leave coiled element <NUM> inserted, and coiled element <NUM> may be dispensed and/or retracted as necessary during the procedure. Medical treatment may then be delivered to the patient's kidney through insertion device <NUM>, or other medical devices may be introduced through insertion device <NUM> to deliver medical treatment. It is noted that a proximal portion of coiled element <NUM>, for example, a portion of coiled element <NUM> extending from medical device <NUM> to port <NUM>, may be held by a user's forefinger and thumb to maintain a position of coiled element <NUM> as insertion device <NUM> is inserted over the coiled element <NUM>. Moreover, the user may rotate and/or torque coiled element <NUM> by manipulating the same proximal portion of coiled element <NUM>. It is further noted that in the above description, coiled element <NUM> remains coupled to spool <NUM>.

<FIG> illustrate an alternative adaptor <NUM> according to another aspect of this disclosure. <FIG> is a side view of adaptor <NUM>. <FIG> is a perspective view of adaptor <NUM>, and <FIG> is an end view of adaptor <NUM>. Similar to adaptor <NUM>, adaptor <NUM> may include at least one flexible extension <NUM> and at least one adaptor pin <NUM> to couple adaptor <NUM> to an insertion device via indentations or holes as discussed above. As shown in <FIG>, adaptor <NUM> may include an adaptor pin <NUM> on only one side of adaptor <NUM>. In this instance, a user may rotate adaptor <NUM> toward the one adaptor pin <NUM> in order to remove adaptor <NUM> from the insertion device. Alternatively, adaptor <NUM> may include adaptor pins <NUM> on both sides of adaptor <NUM>, which may affect the ease with which a user may couple and/or uncouple adaptor <NUM> to and from an insertion device. In another aspect, adaptor <NUM> may include straps, Velcro™, cables, twist ties, adhesive, or additional features to secure adaptor <NUM> to the insertion device. In the example shown in <FIG>, a post <NUM> may be positioned on a proximal portion of adaptor <NUM>. As such, when coupled to an insertion device similar to insertion device <NUM>, post <NUM> may extend from wider proximal portion <NUM>.

Post <NUM> may also include seat <NUM> and a plurality of projections <NUM> with slots <NUM> positioned between projections <NUM>. In one aspect, projections <NUM> may form the portion of adaptor <NUM> that is received within a central opening of a medical device <NUM>. Each projection <NUM> may include a corner, with the corners of the projections <NUM> forming the shape to be received within the central opening. As shown in <FIG>, post <NUM> may include eight projections <NUM> to form an octagonal shape to be received within a central opening. Projections <NUM> may also be flexible such that projections <NUM> may bend radially inward as projections <NUM> are received within a central opening. Projections <NUM> may include chamfered portions <NUM> at a top portion of projections <NUM>. Chamfered portions <NUM> may increase the ease with which a medical device may be inserted on adaptor <NUM>.

Post <NUM> may be rigid, or may be flexible. In one aspect, post <NUM> may be angled to position a mounted medical device in a different position relative to the handle of an insertion device than that shown in <FIG>. In another aspect, post <NUM> may include a flexible arm (not shown), which may bend and retain its shape for a user-customizable positioning.

Moreover, projections <NUM> on adaptor <NUM> may help allow a user to couple one or more medical devices to an insertion device as discussed above. For example, post <NUM> may extend a longer distance than that shown in <FIG>. Post <NUM> may extend a distance approximately equal to the thickness of two medical devices, three medical devices, etc. Moreover, a user may interchangeably mount different medical devices to an insertion device and selectively dispense or retract one or more coiled elements through the insertion device. Although not shown, post <NUM> may include one or more locking protrusions that may correspond to locking indentations (<FIG>) in the handle of the medical device. Although not shown, projections <NUM> may include ramps extending radially outward from the radially outermost surface. In this aspect, central portion <NUM> of medical device <NUM> may engage the ramps of projections <NUM> as medical device <NUM> is coupled to adaptor <NUM>, and the ramps may snap medical device <NUM> into place on adaptor <NUM>. Ramps on projections <NUM> may help secure medical device <NUM> on adaptor <NUM>. Medical device <NUM> may be uncoupled from adaptor <NUM>, but additional force would be necessary to remove medical device <NUM> mounted on adaptor <NUM> without ramps because projections <NUM> would be squeezed together radially inward in order for central portion <NUM> to be disconnected from adaptor <NUM>.

<FIG> illustrate additional aspects of a medical device <NUM> that may be mounted on an insertion device via an adaptor <NUM>, <NUM> as discussed above. Moreover, <FIG> depict medical device <NUM> with a spool <NUM> and a handle <NUM> radially interior to spool <NUM>. Spool <NUM> includes a plurality of knurls <NUM> on an outer circumferential surface. As discussed above, knurls <NUM> may allow a user to grip and rotate spool <NUM> to dispense or retract a coiled element. Spool <NUM> also includes a crank <NUM> positioned on a top, a bottom, or a lateral side of spool <NUM>. <FIG> illustrate a portion of crank <NUM>. Crank <NUM> may allow a user to more quickly or efficiently rotate spool <NUM> relative to handle <NUM>. Crank <NUM> may include a through-hole <NUM> extending through crank <NUM> and connecting to a channel within spool <NUM>.

In one aspect, the coiled element (not shown) may pass proximally through through-hole <NUM>. For example, a proximal portion of the coiled element may be positioned within an outer channel <NUM> of medical device <NUM>. Outer channel <NUM> may be an indention or groove formed in an outer surface of either spool <NUM> or handle <NUM>. Alternatively, outer channel <NUM> may be formed between spool <NUM> and handle <NUM> when spool <NUM> and handle <NUM> are coupled together. The user may unwind a portion of the proximal portion of the coiled element, e.g., a laser fiber, from outer channel <NUM> to a preferred length and then position the coiled element in through-hole <NUM>. The coiled element may be proximally connected to another medical device (e.g., a laser source). Moreover, the coiled element may extend through through-hole <NUM> such that a portion of the coiled element that extends proximally to through-hole <NUM> does not get tangled or interfere with the user's rotation of spool <NUM>.

Crank <NUM> may also include a slit <NUM> and/or a locking slot <NUM>. Slit <NUM> may extend through a height of crank <NUM> such that a user may selectively position the coiled element within through-hole <NUM> or exterior to crank <NUM> altogether through a side slot <NUM> in spool <NUM>. Side slot <NUM> may open into outer channel <NUM>. Alternatively or additionally, a user may position the coiled element in locking slot <NUM>. Locking slot <NUM> may extend through a portion of crank <NUM> parallel to slot <NUM>, and may connect to slot <NUM> through side slot <NUM>. Locking slot <NUM> includes a narrowing taper, which allows a user to lock a proximal portion of the coiled element in crank <NUM>. The position of locking slot <NUM> and the stiffness or rigidity of the coiled element may help prevent the coiled element from rotating and/or becoming dislodged from its position in crank <NUM>.

On an opposite side from crank <NUM>, medical device <NUM> may include guide ramp <NUM> on a portion of handle <NUM>. Guide ramp <NUM> may include a central lumen that connects to an internal channel within medical device <NUM> between spool <NUM> and handle <NUM>. Medical device <NUM> may also include a tube support <NUM>. Tube support <NUM> may also include a central lumen. As discussed in greater detail below, coiled element may be at least partially surrounded by a tube or sheath. Guide ramp <NUM> and tube support <NUM> may help guide coiled element, with or without an outer tube or sheath, as it is dispensed from or retracted into medical device <NUM>.

<FIG> illustrates an additional aspect of this disclosure in a medical device <NUM>. Medical device <NUM> includes a hub <NUM>. Hub <NUM> may be positioned on a spool <NUM> similar to crank <NUM> in <FIG>, and may also function similarly to crank <NUM> to more quickly or efficiently rotate spool <NUM> relative to handle <NUM>. Hub <NUM> may support a medical element, such as, for example, a drainage catheter <NUM>. Drainage catheter <NUM> may include a coiled element, such as, for example, a catheter shaft <NUM> that is coiled within a channel <NUM> between spool <NUM> and handle <NUM>. Drainage catheter <NUM> may also include a drainage catheter hub <NUM>. A user may couple medical device <NUM> to an insertion device via an adaptor as discussed above.

It is noted that <FIG> illustrates a plurality of locking indentations <NUM> in a central opening <NUM> in handle <NUM>, which may correspond to locking protrusions on an adaptor to lockably couple handle <NUM> to the adaptor and ensure that handle <NUM> does not rotate when a user rotates spool <NUM>. The user may rapidly dispense catheter shaft <NUM> by rotating spool <NUM>. Once positioned within the patient, the user may activate drainage catheter <NUM>. The user may reposition the distal end of catheter shaft <NUM> by deflecting the delivery shaft, or may retract catheter shaft <NUM> by rotating spool <NUM> relative to handle <NUM> to remove drainage catheter <NUM> from the patient. The user may repeat the above steps in order to introduce a different medical device, such as, for example, an additional drainage catheter, by coupling the other medical device to the insertion device via an adaptor.

In one aspect, a user may connect an extension tube to drainage catheter hub <NUM> to connect drainage catheter <NUM> to a drainage bag. In another aspect, a proximal portion of catheter shaft <NUM> may be coiled around a radially external portion of spool <NUM>, for example, within an outer channel <NUM>, as discussed above with respect to <FIG>. In this instance, drainage catheter <NUM> may be disengaged from hub <NUM>, and the user may extend drainage catheter <NUM> proximally to connect drainage catheter hub <NUM> directly to a drainage bag. The proximal portion of catheter shaft <NUM> coiled around spool <NUM> may unwind as drainage catheter <NUM> is extended proximally, which may provide a slack or surplus amount of catheter shaft <NUM> necessary for drainage catheter <NUM> to extend to couple drainage catheter hub <NUM> to the drainage bag.

<FIG> illustrates a medical system <NUM> according to additional aspect of this disclosure where two medical devices <NUM> and <NUM>' are both coupled to an insertion device <NUM> via an adaptor <NUM>. Adaptor <NUM> includes a post extension <NUM> that extends through the central openings of the handles of medical devices <NUM> and <NUM>'. In one aspect, post extension <NUM> may include a particular shape or locking protrusions to correspond to the central openings of the handles of medical devices <NUM> and <NUM>'. In another aspect, post extension <NUM> may include a taper or differently sized portions to correspond to different sized central openings of the handles of medical devices <NUM> and <NUM>'. In one example, a medical device <NUM> with a wider central opening may be positioned on a bottom portion of post extension <NUM>, and a medical device <NUM>' with a narrower central opening may be positioned on a top portion of post extension <NUM>.

Coiled elements <NUM> and <NUM>' may extend from medical devices <NUM> and <NUM>', and may be individually or both introduced through port <NUM> of insertion device <NUM>, for example, through different portions of port <NUM>. A user may then hold insertion device <NUM> such that his or her thumb may activate deflection lever <NUM>. The user's forefinger or other hand may rotate one or both of medical devices <NUM> and <NUM>' to extend or retract coiled elements <NUM> and <NUM>'. In one example, medical device <NUM>' may include a crank <NUM>, which may aid in a user more rapidly extending or retracting coiled element <NUM>'. Therefore, a user may selectively extend and retract a guidewire and a retrieval device. In an alternative example, a user may selectively extend and retract an optical fiber and a retrieval device. The user may also extend and retract the elements while also deflecting the distal end of delivery shaft <NUM> through deflection lever <NUM>.

<FIG> illustrate an additional aspect of this disclosure with a universal adaptor <NUM> and a medical device <NUM>. <FIG> is a perspective view of universal adaptor <NUM> and medical device <NUM>. <FIG> is a side view of universal adaptor <NUM> coupled to medical device <NUM>, and <FIG> is an end view. Universal adaptor <NUM> can couple medical device <NUM> to a handle of a different insertion device or to a separate medical element, such as, for example, a surgical table or a curtain. Universal adaptor <NUM> includes holes or eyelets <NUM>, which may receive one or more straps or other connection elements in order to couple universal adaptor <NUM> and medical device <NUM> to any handle or medical element. As seen in <FIG>, a post support <NUM> may extend from universal adaptor <NUM> to couple medical device <NUM> to universal adaptor <NUM> and orient medical device <NUM> parallel to the vertical plane of universal adaptor <NUM>. Post support <NUM> includes a post <NUM> which passes through a central opening <NUM> of a handle <NUM> of medical device <NUM> as discussed above. The user may rotate spool <NUM> to extend or retract a coiled element (not shown), with medical device <NUM> secured to an insertion device handle or other medical element. Additionally, spool <NUM> may also include a crank <NUM>, which may increase the rate at which the user may extend or retract the coiled element.

Although not shown, universal adaptor <NUM> may be coupled to an endoscope or another insertion device (e.g., Spyglass° Direct Visualization System by Boston Scientific Corp. ) to couple medical devices to the insertion device. In another aspect, multiple universal adaptors <NUM> may be coupled to an insertion device or other medical element used in a procedure to allow a user to dispense and retract multiple medical devices during the procedure.

Turning now to <FIG>, the figures illustrate an additional aspect of this disclosure. The figures disclose a medical device <NUM> that can be coupled to an insertion device via an adaptor as discussed in any of the embodiments disclosed above. Medical device <NUM> may allow a user to dispense or retract a coiled element. Medical device <NUM> may also allow a user to control an extension of an end effector from a sheath and/or to control the opening and closing of an end effector, such as, for example, a self-expandable retrieval basket.

<FIG> is a perspective view of a top portion of medical device <NUM>. As shown in <FIG>, medical device <NUM> includes a control knob <NUM>, a spool <NUM>, and a handle <NUM>. It is noted that medical device <NUM> may be coupled to an insertion device via an adaptor in a configuration such that control knob <NUM> is accessible to the user, such as, for example, on the top of medical device <NUM> as medical device <NUM> is shown in <FIG>. <FIG> also shows crank <NUM> extending away from spool <NUM>. Control knob <NUM> may include grips <NUM> on a top surface of control knob <NUM>. Control knob <NUM> may include snap locks <NUM> to allow control knob <NUM> to be rotatably coupled to spool <NUM> via a corresponding ledge <NUM> on spool <NUM>. Control knob <NUM> also includes a plurality of relief slots <NUM>, which allow snap locks <NUM> to flex for control knob <NUM> to be coupled to spool <NUM>.

Medical device <NUM> can be coupled to an adaptor on an insertion device as discussed in the embodiments above. A user may rotate spool <NUM> to dispense a coiled element (not shown), either by action on knurls <NUM> or crank <NUM>. Handle <NUM> may include one or more indications <NUM> to provide the user with visual indications as to the relative rotation directions to extend or retract the coiled element. Handle <NUM> may also include hemostat holes <NUM>. Hemostat holes <NUM> may be at least partially oval shaped and may allow for handle <NUM> to be coupled to a hemostat to secure medical device <NUM> during a procedure. For example, hemostat holes <NUM> may allow medical device <NUM> to be securely coupled to a drape, an IV pole, or another surface or structure in the procedure. The finger rings of the hemostat may help retain medical device <NUM>, and the partially oval shape may help prevent handle <NUM> from rotating when spool <NUM> is rotated.

A drive wire and a sheath may be coupled to control knob <NUM>, and movement of control knob <NUM> relative to spool <NUM> extends or retracts the drive wire or the sheath. For example, although not shown in <FIG>, control knob <NUM> may include a block that is rotatably movable within a groove within spool <NUM>, and the drive wire and the sheath may be coupled to control knob <NUM> or within the groove to selectively extend or retract the drive wire. As shown in <FIG>, control knob <NUM> may include a hole <NUM> within the block and through control knob <NUM> to allow a proximal portion of the drive wire to extend proximally of control knob <NUM>. Control knob <NUM> may also include one or more biased projections or clips <NUM> to secure the proximal portion of the drive wire that extends proximally of control knob <NUM>. Multiple blocks, holes <NUM>, and clips <NUM> may be positioned on control knob <NUM> to allow a user to selectively lock a proximal portion of the drive wire in different positions on control knob <NUM>. Alternatively, the drive wire and/or the sheath may be coupled to control knob <NUM> or spool <NUM> via glue or other adhesives.

In one aspect, the coiled element may include an end effector and a drive wire surrounded by a sheath, with both the drive wire and the sheath coupled to portions of medical device <NUM>. For example, the drive wire may be coupled to control knob <NUM>, and the sheath may be coupled to spool <NUM>. The user may then rotate control knob <NUM> relative to spool <NUM> and handle <NUM> to extend or retract the end effector relative to a distal end of the sheath. The end effector may be a retrieval device (e.g., expandable basket), a cautery instrument, or another sheathed device. Therefore, because the sheath is fixed relative to spool <NUM>, rotation of control knob <NUM> relative to spool <NUM> extends the drive wire of the coiled element distally beyond the sheath, for example, to expand an expandable retrieval basket. Alternatively, the sheath may be attached to control knob <NUM>, and the drive wire of the coiled element may be fixed relative to spool <NUM>. In this aspect, relative rotation of control knob <NUM> relative to spool <NUM> may retract the sheath, which in turn may cause the expandable retrieval basket to expand. In any of the above examples, indications <NUM> may indicate to a user the direction of rotation necessary to expand the retrieval basket.

<FIG> is a perspective view of medical device <NUM> with control knob <NUM> removed. Spool <NUM> may include a groove <NUM> in the surface of spool <NUM> facing control knob <NUM>. Groove <NUM> connects to the channel between or within one of spool <NUM> and handle <NUM> such that the coiled element may extend through both groove <NUM> and the channel.

Groove <NUM> may be a generally rectangular cutout in the surface of spool <NUM>, and may extend circularly around spool <NUM>. Groove <NUM> may include a plurality of U-ribs or stop surfaces 626A that decrease the width or cross-sectional area of groove <NUM>. The U-ribs or stop surfaces 626A may be U-shaped or another appropriate shape indentation toward the center of groove <NUM> forming a narrower portion. In another aspect, stop surfaces 626A may be enclosed or blocked portions of groove <NUM> with a through-hole extending through the enclosed or blocked portion to allow the drive wire to extend through the stop surface 26A. Stop surfaces 626A may aid in coupling and/or limiting the movement of one of the elements within groove <NUM>. In another aspect, groove <NUM> may include a plurality of grooves distributed around the top surface of spool <NUM> and connecting to the channel between spool <NUM> and handle <NUM>. The plurality of grooves may be different lengths and configurations, which may provide for different coiled elements, e.g., different types of expandable baskets, to be coupled and actuated with medical device <NUM>. As mentioned, one of a drive wire or a sheath may be coupled to spool <NUM>, for example, within groove <NUM>, with the other of the drive wire or sheath coupled to control knob <NUM>. Portions of control knob <NUM> may extend into and slide within groove <NUM>, with stop surfaces 626A limiting the movement of control knob <NUM>.

As shown in <FIG>, spool <NUM> and handle <NUM> are coupled as discussed above with the addition of spool teeth <NUM> and handle teeth <NUM> at the circumferential junction of spool <NUM> and handle <NUM>. Spool teeth <NUM> and handle teeth <NUM> may be distributed over <NUM> degrees of the respective components, or only over a portion of the circumferential junction. Spool teeth <NUM> and handle teeth <NUM> may be offset, for example, by approximately <NUM> degrees. Spool teeth <NUM> and handle teeth <NUM> may be triangular, square, or another shape. Although not shown, one or more wave springs, cantilevered springs, or other biasing members may be positioned between spool teeth <NUM> and handle teeth <NUM> to bias the mating of spool teeth <NUM> and handle teeth <NUM>.

In one aspect, one or both of spool teeth <NUM> and handle teeth <NUM> may include cantilevered tabs that bias the compression of spool <NUM> toward handle <NUM> rather than a separate spring element. Because the mating of spool teeth <NUM> and handle teeth <NUM> is biased by the biasing member, spool <NUM> may rotate freely relative to handle <NUM> when spool <NUM> is not compressed toward handle <NUM> such that spool teeth <NUM> do not mate with handle teeth <NUM>. If spool <NUM> is compressed toward handle <NUM> in direction E, then spool teeth <NUM> engage with handle teeth <NUM>. Therefore, if a user compresses medical device <NUM> by depressing control knob <NUM> in direction E, the user may compress spool teeth <NUM> and handle teeth <NUM>, locking the elements together, and then rotate control knob <NUM> relative to locked spool <NUM> and handle <NUM>. The compression and rotation of control knob <NUM> may allow the user to extend or retract the drive wire coupled to control knob <NUM> relative to the sheath coupled to spool <NUM>.

<FIG> is an exploded view of medical device <NUM>. Control knob <NUM> includes snap lock <NUM> with relief slots <NUM> to rotatably couple control knob <NUM> to spool <NUM>. Control knob <NUM> may include grips <NUM>. Control knob <NUM> also includes block <NUM> with passage or hole <NUM> extending through block <NUM> and control knob <NUM>. Control knob <NUM> may include clip <NUM> to selectively lock a proximal portion of the drive wire relative to control knob <NUM>.

Spool <NUM> includes ledge <NUM> and spool teeth <NUM>. Spool <NUM> may include one or more knurls <NUM>. As discussed above and shown in <FIG>, spool <NUM> includes groove <NUM>, and block <NUM> may be positioned and slide within groove <NUM> as control knob <NUM> rotates relative to spool <NUM>. Although not shown, a wave spring, cantilevered spring, or other biasing element is positioned between spool teeth <NUM> and handle teeth <NUM>. Additionally, spool <NUM> may include an inner cylindrical wall <NUM> and an outer cylindrical wall <NUM>, with a channel <NUM> between the two cylindrical walls forming an inner channel to house the coiled element (<FIG>).

Handle <NUM> includes a handle body <NUM> and one or more channel extensions <NUM>. Handle <NUM> may be rotatably snap-coupled to spool <NUM>, and channel extensions <NUM> may cap off, extend into, or otherwise cover channel <NUM> formed by inner cylindrical wall <NUM> and outer cylindrical wall <NUM> of spool <NUM>. Channel extensions <NUM> may help to prevent the coiled element from escaping from channel <NUM>. For example, channel extensions <NUM> may reduce or prevent a gap from forming between spool <NUM> and handle <NUM> and into channel <NUM> in the event that spool <NUM> and handle <NUM> were to partially separate. Circular extensions <NUM> are shown as a plurality of extensions, but may also be one single extension that spans the circumference of spool <NUM>. Handle <NUM> may also include a central opening <NUM> to couple medical device <NUM> to an adaptor.

Handle <NUM> may include a guide ramp <NUM> and a tube support <NUM>. Guide ramp <NUM> may help direct the coiled element into and out of the channel between spool <NUM> and handle <NUM>. Tube support <NUM> may help direct the coiled element toward guide ramp <NUM> or away from guide ramp <NUM>.

<FIG> illustrate additional details of control knob <NUM> and spool <NUM>. As mentioned, spool <NUM> includes grooves <NUM> with stop surfaces 626A. Control knob <NUM> includes a block <NUM> with passage or hole <NUM>. Block <NUM> may be sized to fit and move within one of grooves <NUM> between stop surfaces 626A. Control knob <NUM> may also include clip <NUM> such that a drive wire may pass through hole <NUM> and be securely coupled to control knob <NUM>. A sheath may be attached to spool <NUM> via one of stop surfaces 626A. Alternatively, the drive wire may be coupled to spool <NUM>, and the sheath may be coupled to control knob <NUM>. Therefore, movement of control knob <NUM> relative to spool <NUM> extends or retracts the drive wire or the sheath, with the other element fixed.

It is noted that the drive wire and sheath of the coiled element may loop or form a helix within channel <NUM> formed spool <NUM> several times in a fully retracted position. Moreover, as the coiled element is dispensed, the drive wire and sheath of the coiled element are dispensed at the same rate.

Once the coiled element is dispensed to a desired position within the patient, the user may compress the medical device via control knob <NUM> such that spool teeth <NUM> engage with handle teeth <NUM>. The user may then rotate control knob <NUM> relative to spool <NUM>, with spool <NUM> locked with handle <NUM> in order to extend or retract the drive wire relative to the sheath, or vice versa.

In one aspect, a sheath may be secured to a portion of groove <NUM>. For example, a sheath may be glued to a portion of groove <NUM>, or the sheath may have an enlarged portion that is secured on one of stop surfaces 626A or between two stop surfaces 626A, fixing the sheath relative to spool <NUM>. The drive wire may extend proximally of the proximal end of the sheath. The drive wire may extend through block <NUM>, through hole <NUM>, and be secured via clip <NUM>, fixing the drive wire relative to control knob <NUM>. Rotation of control knob <NUM> relative to spool <NUM> advances the drive wire distally or retracts the drive wire proximally relative to the fixed sheath.

In another aspect, the drive wire may be fixed to spool <NUM> within groove <NUM>, for example, at a position proximal of block <NUM>, fixing the drive wire relative to spool <NUM>. The sheath may be coupled to block <NUM>, fixing the sheath relative to control knob <NUM>. Rotation of control knob <NUM> relative to spool <NUM> retracts the sheath distally or extends the sheath proximally relative to the fixed drive wire. Similar to as above, if the drive wire includes an expandable retrieval basket, the basket may expand and contract as the sheath retracts proximally and extends distally.

Moreover, with control knob <NUM> rotated relative to spool <NUM>, a user may release the compression to uncouple spool teeth <NUM> from handle teeth <NUM>. The user may then further dispense or retract the coiled element with the end effector extended. It is noted that control knob <NUM>, spool <NUM>, and handle <NUM> may be varied or include various features such that the medical device <NUM> may include different end effectors disposed within a sheath.

Grooves <NUM> and stop surfaces 626A of spool <NUM> may also serve as one or more stroke limiters. The stroke limiters may limit the rotation of control knob <NUM> relative to spool <NUM>. Block <NUM> on control knob <NUM> extends into groove <NUM>, and stop surfaces 626A may restrict the movement of block <NUM>, and thus restrict the rotation of control knob <NUM> relative to spool <NUM>. As such, groove <NUM> and block <NUM> limit the distal movement of the drive wire relative to the sheath. Alternatively, groove <NUM> and block <NUM> may limit the proximal movement of the sheath relative to the drive wire. Furthermore, a biasing member or a spring may be positioned within a portion of groove <NUM>, for example, distal to block <NUM> and proximal to a stop surface 626A, to bias the movement of control knob <NUM> relative to spool <NUM>, and thus bias the relative movement of the drive wire and the sheath.

<FIG> illustrate additional aspects that may be incorporated in medical device <NUM>. Specifically, <FIG> are linear representations of the proximal end of various end effectors that may be incorporated in medical device <NUM>. The various end effectors are generally referred to as end effectors 700A-700F, with the variations discussed below. For example, if viewed from a top view, the figures would illustrate a curved configuration that matches the curved configuration of the channel formed between spool <NUM> and handle <NUM>. <FIG> illustrate end effectors 700A-700F in closed configurations, and with drive wires 731A-731F lockably coupled to control knob <NUM> through one of block <NUM>, hole <NUM>, and clip <NUM>. Drive wires 731A-731F are at least partially surrounded by respective sheaths 733A-733F. It is noted that different block <NUM> and clip <NUM> arrangements may be used for different end effectors, for example, to lockably position the drive wires 731A-731F of the end effectors 700A-700F varying distances from the proximal end of sheaths 733A-733F. Moreover, the connections to block <NUM> for the below discussion are illustrated in the figures as rectangular blocks 735A-735F. However, the movement of the respective rectangular blocks 735A-735F in the figures is understood to represent the movement of block <NUM> within groove <NUM>, and thus the rotation of control knob <NUM> relative to spool <NUM>.

<FIG> illustrates a proximal portion of an end effector assembly 700A that includes drive wire 731A and sheath 733A. Drive wire 731A is proximally secured to a control knob <NUM> and passes through block 735A. Sheath 733A is coupled to spool <NUM>. For example, sheath 733A may include a sheath extension 737A that is glued within a portion of groove 626A. End effector assembly 700A may also include a U-rib or stop surface 738A and a proximal stroke limiter 739A proximal of block 735A. Proximal stroke limiter 739A may decrease a distance block 735A may move proximally, and thus limit a distance block <NUM> may move within groove <NUM>. The distance between proximal stroke limiter 739A and sheath extension 737A may define a stroke length 741A, or a distance which control knob <NUM> may move relative to spool <NUM>, and thus a distance drive wire 731A may move relative to sheath 733A. Therefore, once the coiled element is dispensed to the desired location, the user may compress medical device <NUM> and rotate control knob <NUM> to extend a distal end of drive wire 731A of end effector assembly 700A from sheath 733A. The user may then manually rotate control knob <NUM> in the opposite direction to retract the distal end of drive wire 731A of end effector assembly 700A into sheath 733A.

<FIG> illustrates a proximal portion of an end effector assembly 700B that includes drive wire 731B and sheath 733B. Drive wire 731B is proximally connected to control knob <NUM> as discussed above, through block 735B. Sheath 733B is positioned within groove <NUM>. Sheath 733B includes a sheath extension 737B that may be slidable between two U-ribs or stop surfaces 738B. End effector assembly 700B may also include a proximal stroke limiter 739B. The distance between proximal stroke limiter 739A and one stop surface 738B may define a stroke length 741B, or a distance which control knob <NUM> may move relative to spool <NUM>, and thus a distance drive wire 731B may move relative to sheath 733B. End effector assembly 700B may also include a spring 743B positioned between sheath extension 737B and one of stop surfaces 738B. Therefore, once the coiled element is dispensed to the desired location, the user may compress medical device <NUM> and rotate control knob <NUM> to move drive wire 731B in direction N to extend a distal end of drive wire 731B of end effector assembly 700B from sheath 733B. The user may rotate control knob <NUM> in the opposite direction to retract drive wire 731B within sheath 733B. However, sheath 733B may also retract proximally with sheath extension 737A compressing spring 743B. For example, sheath 733B may retract proximally if a stone or other material retrieved with an expandable basket is too large to fit within sheath 733B. As such, end effector assembly 700B may reduce the stress on sheath 733B when retracting a large stone or piece of material, which may decrease the likelihood of sheath 733B damage or malfunction.

<FIG> illustrates a proximal portion of an end effector assembly 700C. In this aspect, a spring 743C may be coupled between block 735C and an stop surface 738C proximal of sheath 733C and sheath extension 737C. Therefore, spring 743C may bias the rotation of control knob <NUM> and thus provide a force in direction F against the movement of drive wire 731C. The distance between block 735C and the stop surface 738C that supports spring 743C defines a biased stroke length 741C. In this aspect, sheath extension 737C may be glued within groove <NUM> at one of the stop surfaces 738C, or sheath extension 737C may be movable between two stop surfaces 738C as discussed above. Spring 743C may help retract drive wire 731C proximally, and thus rotate control knob <NUM> relative to spool <NUM>, without user activation.

<FIG> illustrates a proximal portion of an end effector assembly 700D. In this aspect, spring 743D may be positioned between block 735D and sheath extension 737D. As discussed above, spring 743D biases the distal movement of block 735D, and thus the distal extension of drive wire 731A between a stroke length 741A between proximal stroke limiter 739A and sheath extension 737D. Sheath extension 737D may be stopped distally by a distal stop surface 738D, but may be free to move proximally. Proximal movement of sheath 733D and sheath extension 737D is also biased by spring 743D, which may help to prevent damage or malfunctioning of sheath 733D as discussed above. In an alternative aspect, end effector assembly 700D may be implemented without spring 743D, such that sheath 733D and sheath extension 737D may move proximally without spring bias in the case where the stone or material captured by the expandable basket coupled to drive wire 731A is too large.

<FIG> is similar to <FIG>. In this aspect, end effector assembly 700E may include a spring 743E positioned between block 735E and an intermediate stop surface 738E positioned proximal to sheath extension 737E. Spring 743E may bias the movement of drive wire 731E between proximal stroke limiter 739E and intermediate stop surface 738E. End effector assembly 700E may also include a spring 743E' positioned between sheath extension 737E and intermediate stop surface 738E. Spring 743E' may bias any movement of sheath 733E and sheath extension 737E if, for example, drive wire 731E captures a large stone, as discussed above.

<FIG> illustrates an end effector assembly 700F with drive wire 731F passing proximally of block 735F and coupled via a proximal stop surface 738F to spool <NUM>. Sheath 733F and sheath extension 737F are coupled to block 735F, and thus movable with control knob <NUM>. A distal stop surface 738F may serve as a distal limiter for sheath extension 737F, and a spring 743F may bias the proximal movement of block 735F and sheath 733F. As such, a user may rotate control knob <NUM> proximally in order to retract sheath 733F, which unsheathes the distal end of drive wire 731F, for example, to expand a retrieval basket. Spring 743F may serve to bias sheath 733F distally. As such, a user may enclose the distal end of drive wire 731F with minimal effort by allowing spring 743F to rotate control knob <NUM> distally and enclose the distal end of drive wire 731F, for example, to contract the retrieval basket.

It is understood that any of the aforementioned stroke lengths may be divided into two or more segments. For example, the end effector may be a Dakota basket. A first segment of the stroke length may open the end effector to a nominal size, and a second segment of the stroke length may open the end effector to a larger size for large stone release. Moreover, while the above discusses a proximal stroke limiter <NUM> abutting the neutral position of the drive wire <NUM> coupled to control knob <NUM>, the disclosure is not so limited. In fact, a neutral position for drive wire <NUM> coupled to control knob <NUM> may be distal to a proximal stroke limiter <NUM>. In this aspect, proximal stroke limiter <NUM> may ensure that drive wire <NUM> is retracted proximally away from a distal end of sheath <NUM>. Moreover, one or springs may bias the distal movement, proximal movement, or both of drive wire <NUM> relative to sheath <NUM> by the one or more springs being positioned between block <NUM> and proximal stroke limiter <NUM>, between block <NUM> and sheath extension <NUM>, or between block <NUM> and a stop surface <NUM>.

<FIG> illustrates another aspect of this disclosure with a partially see-through depiction of a medical device <NUM> which may allow a user to visually observe the extent to which a coiled element <NUM> is extended or retracted. Medical device <NUM> includes a handle <NUM> and a spool <NUM> that form a channel <NUM> that at least partially houses coiled element <NUM>. Similar to <FIG>, handle <NUM> may include a guide ramp <NUM> and a tube support <NUM>. Coiled element <NUM> may be partially surrounded by a tube <NUM>. Spool <NUM> may include a tapered inner portion <NUM> into which a proximal end of coiled element <NUM> may be secured. Distal to tapered inner portion, spool <NUM> may also include an abutment surface <NUM> with a hole <NUM>. Coiled element <NUM> may pass through hole <NUM>. However, tube <NUM> may be sized to not fit through hole <NUM>. Tube <NUM> may also include a radially thicker portion or a stop element <NUM> in a distal portion of tube <NUM>.

It is noted that <FIG> illustrates medical device <NUM> with coiled element <NUM> fully dispensed. Tube <NUM> may have an inner diameter larger than coiled element <NUM>, such that movement of coiled element <NUM> does not move tube <NUM> unless the proximal end of tube <NUM> is acted on by abutment surface <NUM> as spool <NUM> is rotated in direction G. The proximal portion of coiled element <NUM> may guide or direct the proximal portion of tube <NUM> toward abutment surface <NUM>. Rotation of spool <NUM> in direction G may cause abutment surface <NUM> to abut and act on the proximal end of tube <NUM> to push tube <NUM> distally out of guide ramp <NUM>. As such, the extension of tube <NUM> distally from guide ramp <NUM> may help to indicate to the user that coiled element <NUM> is almost fully dispensed. Such indication may help prevent the user from over-dispensing coiled element <NUM>, disconnecting coiled element <NUM> from the internal connections within spool <NUM>, and/or breaking coiled element <NUM>.

Tube <NUM> may also help prevent the overwinding of coiled element <NUM> and/or help prevent coiled element <NUM> from becoming dislodged from guide <NUM>, for example, to ensure that coiled element <NUM> may be dispensed again from medical device <NUM>. Moreover, tube <NUM> may be clear or at least partially transparent such that a user may view the movement of coiled element <NUM> within tube <NUM>. In one aspect, as the user winds spool <NUM> in direction H, coiled element <NUM> is retracted proximally because coiled element <NUM> is coupled to tapered portion <NUM>. As coiled element <NUM> continues proximally, the user may visually observe the distal end of coiled element <NUM> enter tube <NUM>, indicating to the user to stop winding spool <NUM> in order to prevent coiled element <NUM> from being further retracted and ensure that coiled element <NUM> remains within tube <NUM>. With coiled element <NUM> within tube <NUM>, the inner lumen of tube <NUM> may help to guide or direct coiled element <NUM> back through guide <NUM> when dispensing coiled element <NUM> again. Therefore, tube <NUM> may help to protect and dispense coiled element <NUM> again. Tube <NUM> may also include indications to provide information to the user regarding the extent to which coiled element <NUM> is retracted relative to a fully wound position. Additionally, stop element <NUM> may abut tube support <NUM> and prevent overwinding of coiled element regardless of whether the user is monitoring the winding position of coiled element <NUM>.

It is noted that the spring configurations discussed above with respect to <FIG> may also be incorporated in medical device <NUM>. For instance, medical device <NUM> may also include an end effector assembly having a drive wire and a sheath positioned radially within tube <NUM>. As such, a user may compress medical device <NUM> and rotate a control knob to extend, retract, or otherwise position an end effector coupled to the drive wire relative to the sheath. Alternatively or additionally, medical device <NUM> may include springs between tube <NUM> and abutment surface <NUM>. Moreover abutment surface <NUM> may be slideably coupled to spool <NUM>, such that the user may adjust the position of abutment surface <NUM>, thus adjusting the relative positions of tube <NUM> and a proximal end of coiled element <NUM> in tapered portion <NUM>.

It is further noted that any of the aforementioned medical device can be used in conjunction with the insertion devices and adaptors discussed above. As such, a user may fixedly couple a medical device to an insertion device. Then, using one hand, the user may position or deflect the distal end of the delivery shaft by maneuvering the deflection lever, as well as extend or retract the coiled element by rotating the medical device coupled to the adaptor. The user may couple and control more than one medical device coupled to the insertion device, and thus may carry out different aspects of the medical procedure without repositioning the insertion device. The user may also use his or her other hand to perform other aspects of the procedure.

The systems, devices, and non-claimed methods discussed herein may help to allow a user to dispense and/or retract a coiled element, such as a guidewire, optical fiber, catheter, filament, cable, or another shaft-like medical element while also controlling the position of a delivery shaft of an insertion device. The user may dispense only a length of the coiled element necessary for the procedure. The user may also retract the coiled element for use again during the medical procedure. Therefore, the length of the coiled element is adjustable throughout the procedure. Furthermore, the user may use one hand to extend and retract an end effector relative to a sheath, while also deflecting the distal end of the delivery shaft. Lastly, the devices and non-claimed methods disclosed herein may help to reduce the number of medical professionals and the duration of the medical procedure.

Claim 1:
A medical system (<NUM>) comprising:
an insertion device (<NUM>) including an insertion device handle having a proximal portion and a distal portion and a delivery shaft (<NUM>) extending from the distal portion;
a medical device (<NUM>) including a spool (<NUM>) and a medical device handle (<NUM>) radially interior to the spool (<NUM>) with a central opening (<NUM>), wherein the spool (<NUM>) and the medical device handle (<NUM>) are rotatably movable to one another and form a channel; and
an adaptor (<NUM>) coupleable to a portion of the insertion device handle, wherein the adaptor (<NUM>) includes a post element (<NUM>) to be received within the central opening (<NUM>) of the medical device handle (<NUM>),
wherein the post element (<NUM>) extends away from the insertion device (<NUM>) when the adaptor (<NUM>) is coupled to the insertion device (<NUM>), and wherein the adaptor (<NUM>) is configured to rotatably lock the medical device handle (<NUM>) when the medical device (<NUM>) is coupled to the insertion device (<NUM>) via the adaptor (<NUM>).