Patent Description:
Endoscopic and surgical procedures of the gastrointestinal (GI) tract include, for example, submucosal dissection, colonic resection, bariatric surgery, esophagectomy, gastric bypass, and sleeve gastrectomy, among others. These procedures may involve lifting and/or removing tissue from the body of a patient. Accessory devices for performing such procedures may include complex interfaces for operating said device. Further, the interfaces may provide limited articulating capabilities for maneuvering the device within the patient, thereby requiring use of additional devices or multiple hands to manipulate said device.

<CIT> discloses a surgical tool and method of operation. The surgical tool includes an end effector, such as a surgical scissor. The end effector is coupled to an actuating mechanism having a clevis and a pulley. A cable engages the pulley and is attached to one side of the clevis. When one portion of the cable is pulled, the clevis is moved in a first direction causing the end effector to open. When a second portion of the cable is pulled, the clevis moves in the opposite direction and the end effector is closed. The system also includes a mechanism for changing the orientation of the end effector. Another embodiment includes a mechanism for actuating the cable and the end effector.

<CIT> discloses a fine surgical instrument capable of performing a joint movement and a rotational movement. The fine surgical instrument includes a rod portion") which is formed in a longitudinal direction to enter a surgery site located in a narrow space, a joint portion") which is formed on one side of the rod portion") and rotates in one direction from the one side of the rod portion"), a shaft which is inserted into the rod portion"), a handle portion which is coupled with the other side of the rod portion"), and a distal end portion which is coupled with one end of the shaft and is connected to the handle portion, in which the distal end portion is operated along a manipulation of the handle portion.

<CIT> discloses an endoscopically inserting surgical tool. The tool is composed of an elongated flexible cord to be passed through a tool guide channel on an endoscope, and a tool action mechanism mounted on a fore distal end of the flexible cord to be projected out of the tool guide channel. The flexible cord has such a length that, when the tool action mechanism is projected out of a tool exit opening at the end of the tool guide channel, a proximal end portion of the flexible cord still remains outside and rearward of a tool entrance way which is provided on a manipulating head grip of the endoscope as an approach to the tool guide channel. A proximal end portion of the flexible cord is gripped in a rotary tool adjustor which is manipulable to turn the tool action mechanism clockwise or counterclockwise together with the flexible cord in the tool guide channel of the endoscope.

<CIT> discloses a guide sheath that includes: an elongated member extending along a longitudinal axis; a manipulation wire extending along the longitudinal axis of the elongated member so as to be capable of advancing and retracting; a bent section formed of a thermoplastic resin in a tubular shape and configured to be bent in accordance with advance or retraction of the manipulation wire; and a first hard section provided at a distal end surface of the bent section and formed by cross-linking the thermoplastic resin to which a distal end section of the manipulation wire is fixed.

Aspects of the disclosure relate to, among other things, systems, devices, and methods for treating a target treatment site using an articulating device providing enhanced degree of maneuverability, among other aspects. Each of the aspects disclosed herein may include one or more of the features described in connection with any of the other disclosed aspects.

The invention is defined by a medical device according to the independent claim. No methods are claimed.

Any of the medical devices described herein may include any of the following features. The handle includes a first track extending along a body of the handle. The first actuator is received within the first track and configured to translate along the first track. The first track has a longitudinal length that corresponds to (<NUM>) a first degree of articulation of the shaft; and (<NUM>) a first extent of actuation of the end effector. The handle includes a second track extending along the body of the handle. The second actuator is received within the second track and configured to translate along the second track. The second track has a longitudinal length that corresponds to (<NUM>) a second degree of articulation of the shaft; and (<NUM>) a second extent of actuation of the end effector. The first actuator is configured to move the first wire in the first direction to articulate the shaft and move the first part and the second part in the first direction. The second actuator is configured to move the second wire in the second direction to move the second part relative to the first part. The second actuator is configured to move the second wire in the first direction to articulate the shaft and move the first part and the second part in the first direction. The first actuator is configured to move the first wire in the second direction to move the second part relative to the first part. The first actuator is configured to move the first part relative to the second part, and the second actuator is configured to move the second part relative to the first part. The first actuator is configured to articulate the shaft toward the first actuator and in the first direction in response to translating the first actuator in the first direction relative to the handle and the second actuator. The second actuator is configured to articulate the shaft toward the second actuator and in the first direction in response to translating the second actuator in the first direction relative to the handle and the first actuator. The first actuator and the second actuator are disposed about a circumference of the handle. The first actuator and the second actuator are at least partially disposed within the handle. The first actuator includes a first finger ring, the second actuator includes a second finger ring, and the handle includes a third finger ring. The third finger ring is fixed relative to the first and second finger rings, and the first and second finger rings are move relative to one another and the third finger ring. The first actuator has a proximalmost position corresponding to an articulated position of the shaft, a distalmost position corresponding to an actuated position of the end effector, and a neutral position between the proximalmost position and the distalmost position, and corresponding to an unarticulated position of the shaft and an unactuated position of the end effector.

According to another example, a medical device includes a handle having a first movable actuator and a second movable actuator, a shaft extending distally from the handle and having an end effector at a distal end of the shaft, a first wire disposed within the shaft and coupled to the first movable actuator and the end effector, and a second wire disposed within the shaft and coupled to the second movable actuator and the end effector. The first movable actuator is configured to (<NUM>) articulate the shaft in response to translating the first wire proximally relative to the shaft and the second movable actuator, and (<NUM>) actuate the end effector in response to translating the first wire distally relative to the shaft and the second movable actuator. The second movable actuator is configured to (<NUM>) articulate the shaft in response to translating the second wire proximally relative to the shaft and the first movable actuator, and (<NUM>) actuate the end effector in response to translating the second wire distally relative to the shaft and the first movable actuator.

Any of the medical devices described herein may include any of the following features. The handle includes a first track and a second track extending along opposing sides of the handle. The first movable actuator is received within the first track and configured to translate along the first track, and the second movable actuator is received within the second track and configured to translate along the second track. The first track has a first longitudinal length that corresponds to (<NUM>) a first degree of articulation of the shaft; and (<NUM>) a first extent of actuation of the end effector. The second track has a second longitudinal length that corresponds to (<NUM>) a second degree of articulation of the shaft; and (<NUM>) a second extent of actuation of the end effector. The first movable actuator is configured to articulate the shaft toward the first movable actuator and in the first direction in response to translating the first actuator in the first direction relative to the handle and the second actuator. The second movable actuator is configured to articulate the shaft toward the second movable actuator and in the first direction in response to translating the second actuator in the first direction relative to the handle and the first actuator.

According to a further example, a medical device includes a handle having a first longitudinal track and a second longitudinal track, a shaft extending distally from the handle, an end effector at a distal end of the shaft, and a first actuator coupled to a first wire disposed within the shaft. The first actuator translates along the first longitudinal track. The medical device includes a second actuator coupled to a second wire disposed within the shaft. The second actuator translates along the second longitudinal track. The first actuator is configured to retract the first wire proximally relative to the shaft to articulate the shaft in a first direction when the first actuator moves proximally in the first longitudinal track and the second actuator is fixed relative to the second longitudinal track. The second actuator is configured to retract the second wire proximally relative to the shaft to articulate the shaft in a second direction when the second actuator moves proximally in the second longitudinal track and the first actuator is fixed relative to the first longitudinal track. The second direction is opposite of the first direction.

In ESD, an object in the GI tract is targeted for removal, such as, for example, a tumor. A medical device capable of removing the target object is received in a medical instrument (e.g., an endoscope) that is endoscopically placed through the GI tract and at the target treatment site. An ancillary device may be placed endoscopically at the target treatment site for manipulating tissue surrounding the target object. Ancillary devices and systems suited for ESD are limited, however. The disclosure, however, is not limited to ESD procedures, and instead can be used in any suitable medical procedure.

Examples of the disclosure include systems, devices, and methods for manipulating materials and/or objects (e.g., tissue) at a target treatment site within a subject (e.g., patient) with enhanced degree of maneuverability. In examples, ESD includes endoluminal placement of an end effector, e.g., a jaw assembly or other like tool at the target treatment site. Placement of the end effector may be via a catheter, scope (endoscope, bronchoscope, colonoscope, etc.), tube, or sheath, inserted into the GI tract via a natural orifice. The orifice can be, for example, the nose, mouth, or anus, and the placement can be in any portion of the GI tract, including the esophagus, stomach, duodenum, large intestine, or small intestine. Placement also can be in other organs or other bodily spaces reachable via the GI tract, other body lumens, or openings in the body.

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 patient. By contrast, the term "proximal" refers to a portion closest to the user when placing the device into the subject. As used herein, the terms "comprises," "comprising," or any other variation 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 necessarily include only those elements, but may include other elements not expressly listed or inherent to such process, method, article, or apparatus. The term "exemplary" is used 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.

Examples of the disclosure may relate to devices and methods for performing various medical procedures and/or treating portions of the large intestine (colon), small intestine, cecum, esophagus, any other portion of the gastrointestinal tract, and/or any other suitable patient anatomy (collectively referred to herein as a "target treatment site"). As mentioned above, this disclosure is not limited to any specific medical device or method, and aspects of the disclosure may be used in connection with any suitable medical tool and/or medical method, at any suitable site within the body. Various examples described herein include single-use or disposable medical devices.

<FIG> show an exemplary medical device <NUM> in accordance with an example of this disclosure. Medical device <NUM> may include a handle <NUM> having a longitudinal length defined by a proximal end <NUM> and a distal end <NUM>. Proximal end <NUM> may include a grasping feature that is configured to facilitate manual control of handle <NUM>. For example, the grasping feature may include a ring that is sized and shaped to receive a finger of the user of medical device <NUM>. Handle <NUM> may further include a pair of tracks <NUM>, <NUM> positioned along opposing sides of handle <NUM> and extending between proximal end <NUM> and distal end <NUM>. As described further herein, tracks <NUM>, <NUM> may define a travel path of one or more actuators <NUM>, <NUM>, and a longitudinal length of tracks <NUM>, <NUM> may define an articulation and actuation extent of medical device <NUM>.

Medical device <NUM> may further include a pair of actuators <NUM>, <NUM> movably coupled to handle <NUM> at tracks <NUM>, <NUM>. For example, medical device <NUM> may include a first actuator <NUM> slidably coupled to first track <NUM>, and a second actuator <NUM> slidably coupled to second track <NUM>. First actuator <NUM> may be configured to translate along first track <NUM>, and second actuator <NUM> may be configured to translate along second track <NUM>, in one or more directions A, B. That is, each of first actuator <NUM> and second actuator <NUM> may move in either a first direction A or a second direction B. First actuator <NUM> and second actuator <NUM> may be configured to move independently of, and relative to, one another. Actuators <NUM>, <NUM> may be actuated in various suitable manners and sequences, such as simultaneously and/or separately from one another. In some embodiments, first actuator <NUM> and second actuator <NUM> may be disposed about a circumference of handle <NUM> and collectively enclose at least a portion of handle <NUM> therebetween.

Although not shown, it should be understood that first actuator <NUM> may be coupled to a first wire <NUM> received within handle <NUM>, and second actuator <NUM> may be coupled to a second wire <NUM> received within handle <NUM> (see <FIG>). Wires <NUM>, <NUM> may be coupled to actuators <NUM>, <NUM> via various suitable mechanism, including, for example, crimping, an adhesive, ultrasonic curing, etc. Accordingly, each actuator <NUM>, <NUM> may be configured to move the corresponding wire <NUM>, <NUM> relative to handle <NUM> in response to translating along the respective track <NUM>, <NUM>.

Still referring to <FIG>, first actuator <NUM> may include a body with a grasping feature <NUM> extending laterally outward from the body of first actuator <NUM>. Second actuator <NUM> may include a body with a grasping feature <NUM> extending laterally outward from the body of second actuator <NUM>. Each grasping feature <NUM>, <NUM> may be configured to facilitate movement of the respective actuator <NUM>, <NUM> relative to the corresponding track <NUM>, <NUM>. In the example, each grasping feature <NUM>, <NUM> may include a ring that is sized and shaped to receive a corresponding finger of a user of medical device <NUM>. It should be appreciated that grasping features <NUM>, <NUM> may have various other suitable sizes, shapes, and/or configurations without departing from a scope of this disclosure.

Medical device <NUM> may include a shaft <NUM> fixed to and extending distally from handle <NUM>, and particularly from distal end <NUM>. Shaft <NUM> may include a proximal shaft <NUM> and a distal articulation joint <NUM>. A proximal end of proximal shaft <NUM> may extend be coupled to distal end <NUM>, and a proximal end of distal articulation joint <NUM> may be coupled to a distal end of proximal shaft <NUM>. Medical device <NUM> may further include an end effector <NUM> coupled to a distal end of distal articulation joint <NUM>. End effector <NUM> may include one or more parts, such as a clevis <NUM>, a first jaw 148A, and a second jaw 148B. Clevis <NUM> may be secured to the distal end of distal articulation joint <NUM>, and jaws 148A, 148B may be pivotably coupled to clevis <NUM>. As described further herein, each jaw 148A, 148B may be movable in response to translation of actuators <NUM>, <NUM>. In the embodiment, end effector <NUM> may exclude one or more links coupled to the pair of jaws 148A, 148B. As described further herein, medical device <NUM> may be configured to enhance a grasping force between jaws 148A, 148B from the exclusion of links in end effector <NUM>.

Referring now to <FIG>, each jaw 148A, 148B may be coupled to at least one of the actuators <NUM>, <NUM> via the corresponding wire <NUM>, <NUM>. For example, first jaw 148A may be coupled to second actuator <NUM> via second wire <NUM>, and second jaw 148B may be coupled to first actuator <NUM> via first wire <NUM>. In the example, first jaw 148A may include a proximal arm 144A that receives second wire <NUM>, and second jaw 148B may include a proximal arm 144B that receives first wire <NUM>. Accordingly, it should be understood that end effector <NUM> excludes links (or any other structures) between jaws 148A, 148B and wires <NUM>, <NUM>, such that wires <NUM>, <NUM> are coupled directly to jaws 148A, 148B at the corresponding proximal arm 144A, 144B. Medical device <NUM> may be operable to minimize a mechanical loss of force transfer between actuators <NUM>, <NUM> and jaws 148A, 148B from the exclusion of one or more links (or any other structures) between wires <NUM>, <NUM> and jaws 148A, 148B.

It should be appreciated that end effector <NUM> is depicted in <FIG> with clevis <NUM> omitted for illustrative purposes only. End effector <NUM> may include a pin <NUM> defining a pivot point of jaws 148A, 148B, i.e., jaws 148A, 148B may be movably coupled to one another about pin <NUM>. Further, first jaw 148A and second jaw 148B may be movably coupled to clevis <NUM> at pin <NUM>. Each jaw 148A, 148B may include a plurality of teeth along an interior surface for grasping an object disposed between jaws 148A, 148B, such as, for example, tissue. It should be understood that end effector <NUM> may include various suitable configurations, including, but not limited to, one or more clamps, shears, forceps, scissors, suturing devices, lighting devices, imaging systems, grasper assemblies, and various other suitable tools and/or devices. Accordingly, end effector <NUM> shown and described herein is merely exemplary such that medical device <NUM> may include various other end effectors without departing from a scope of this disclosure.

Referring now to <FIG>, first wire <NUM> and second wire <NUM> may be disposed within shaft <NUM>, and extend distally from distal articulation joint <NUM> to couple with proximal arms 144B, 144A, respectively. In the example, shaft <NUM> may include a first lumen 128A configured to receive first wire <NUM>, and a second lumen 128B configured to receive second wire <NUM>. It should be understood that movement of first actuator <NUM> along handle <NUM> may provide movement of first wire <NUM> within first lumen 128A and a corresponding movement of second jaw 148B. Further, movement of second actuator <NUM> along handle <NUM> may provide movement of second wire <NUM> within second lumen 128B and a corresponding movement of first jaw 148A. As described in detail herein, each of first actuator <NUM> and second actuator <NUM> may be configured to actuate end effector <NUM> and articulate distal articulation joint <NUM>. Additionally, as described in further detail below, shaft <NUM> (e.g., proximal shaft <NUM>, distal articulation joint <NUM>) may include one or more inner layers, including a first inner layer <NUM> that is in a braided configuration and a second inner layer <NUM> (e.g., multi-lumen shaft) that defines first lumen 128A and second lumen 128B.

Referring now to <FIG>, proximal shaft <NUM> is depicted with a plurality of layers. In the example, proximal shaft <NUM> may include an outer layer <NUM>, a first inner layer <NUM>, a second inner layer <NUM>, and a third inner layer <NUM>. Outer layer <NUM> may be disposed about first inner layer <NUM>, and may be configured to insulate first inner layer <NUM>, such as, for example, from a tool (e.g., cautery knife) positioned adjacent to medical device <NUM>. In some examples, outer layer <NUM> may be formed of an insulating material, such as, for example, reflow including Pebax® resin. Outer layer <NUM> may be further formed of a material having a predefined hardness ranging from about <NUM> D (durometer) to about <NUM> D, and more particularly <NUM> D to <NUM> D. In other embodiments, outer layer <NUM> may be omitted entirely.

First inner layer <NUM> may be disposed about second inner layer <NUM>, and may include a braid formed of a plurality of wires (e.g., flat, round, etc.) braided to one another. In some examples, first inner layer <NUM> may include a plurality of wires ranging from about <NUM> wires to about <NUM> wires, and more particularly <NUM> to <NUM> wires. In some embodiments, a braiding of first inner layer <NUM> may be angled, such as at an angle ranging from about <NUM> degrees to about <NUM> degrees, and more particularly <NUM> to <NUM> degrees. The braiding of first inner layer <NUM> may be in various suitable patterns, including, for example, a diamond braid, a Hercules braid, and more. First inner layer <NUM> may be configured to increase a torque and/or stiffness of proximal shaft <NUM>. In other embodiments, first inner layer <NUM> may be omitted entirely.

Still referring to <FIG>, second inner layer <NUM> may be disposed about third inner layer <NUM>, and may include a coil that is wound (e.g., clockwise, counter clockwise, etc.) about third inner layer <NUM>. In some embodiments, a coil pitch of second inner layer <NUM> may be substantially similar to a wire diameter of the coil. Second inner layer <NUM> may be configured to provide a rigidity to proximal shaft <NUM>.

Third inner layer <NUM> may be formed of polytetrafluoroethylene (PTFE) and include first lumen 128A and second lumen 128B for receiving each of first wire <NUM> and second wire <NUM>, respectively. In the example, the lumens of third inner layer <NUM> may have similar and/or different diameters relative to one another. Third inner layer <NUM> may include a diameter ranging from about <NUM> millimeters to about <NUM> millimeters, and particularly <NUM> millimeters. First lumen 128A may include a diameter ranging from about <NUM> millimeters to about <NUM> millimeters, and particularly <NUM> millimeters, and second lumen 128B may include a diameter ranging from about <NUM> millimeters to about <NUM> millimeters, and particularly <NUM> millimeters. In other embodiments, third inner layer <NUM> may be omitted entirely or in lieu of a pair of sheaths each defining a lumen for receiving at least one of wires <NUM>, <NUM>.

Still referring to <FIG>, first wire <NUM> and second wire <NUM> may be formed of various materials, including, for example, stainless steel, Nitinol, plastic, aluminum, etc. In some examples, first wire <NUM> and/or second wire <NUM> may be coated with PTFE and/or other suitable materials. Additionally, first wire <NUM> and/or second wire <NUM> may each include a single wire or may be a multi-strand wire assembly. As described in further detail herein, each of first wire <NUM> and second wire <NUM> may be configured to provide articulation of shaft <NUM> and actuation of end effector <NUM>.

Referring now to <FIG>, distal articulation joint <NUM> is depicted with a plurality of layers. In the example, distal articulation joint <NUM> may include an outer layer <NUM>, a first inner layer <NUM>, and a second inner layer <NUM>. Outer layer <NUM> may be disposed about first inner layer <NUM>, and may be configured to insulate first inner layer <NUM>. For example, outer layer <NUM> may be formed of an insulating material, such as, for example, reflow including Pebax® resin. Outer layer <NUM> may be formed of a material having a predefined hardness that is relatively less than outer layer <NUM> of proximal shaft <NUM>. For example, outer layer <NUM> may have a predefined hardness ranging from about <NUM> D to about <NUM> D, and more particularly <NUM> D to about <NUM> D. As described in detail herein, distal articulation joint <NUM> may be configured to bend relative to proximal shaft <NUM> in response to an actuation of at least one of wires <NUM>, <NUM>.

First inner layer <NUM> may be disposed about second inner layer <NUM>, and may include a braid formed of a plurality of wires (e.g., flat, round, etc.) braided to one another. First inner layer <NUM> may be substantially similar to first inner layer <NUM>. For example, first inner layer <NUM> may include a plurality of wires ranging from about <NUM> wires to about <NUM> wires, and more particularly <NUM> to <NUM> wires. In other examples, first inner layer <NUM> may include fewer wires than first inner layer <NUM>. First inner layer <NUM> may be configured to increase a torque and/or stiffness of distal articulation joint <NUM>. In some embodiments, a braiding of first inner layer <NUM> may be angled, such as at an angle ranging from about <NUM> degrees to about <NUM> degrees, and more particularly <NUM> to <NUM> degrees. The braiding of first inner layer <NUM> may be in various suitable patterns, including, for example, a diamond braid, a Hercules braid, and more.

Still referring to <FIG>, second inner layer <NUM> may be formed of polytetrafluoroethylene (PTFE), and may include first lumen 128A and second lumen 128B for receiving each of first wire <NUM> and second wire <NUM>, respectively. In the example, first lumen 128A and second lumen 128B of second inner layer <NUM> may have similar and/or different diameters relative to one another. In other embodiments, second inner layer <NUM> may be omitted entirely or in lieu of a pair of sheaths each defining a lumen for receiving at least one of wires <NUM>, <NUM>. Second inner layer <NUM> may be formed of a material having a predefined hardness ranging from about <NUM> D to about <NUM> D, and more particularly <NUM> D to <NUM> D. First wire <NUM> may extend distally from second inner layer <NUM> and through clevis <NUM> for engagement with proximal arm 144B (see <FIG>). First wire <NUM> may be secured to proximal arm 144B by an adhesive, welding, crimping, ultraviolet (UV) curing, etc. Second wire <NUM> may extend distally from second inner layer <NUM> and through clevis <NUM> for engagement with proximal arm 144A (see <FIG>). Second wire <NUM> may be secured to proximal arm 144A by an adhesive, welding, crimping, ultraviolet (UV) curing, etc..

According to an exemplary method of using medical device <NUM>, a medical instrument (e.g., an endoscope) may be initially navigated through the body of a subject to position a distal end of the medical instrument at a target treatment site. Medical device <NUM> may be received within the medical instrument and end effector <NUM> may extend outwardly from the distal end of the medical instrument. In this instance, end effector <NUM> may be positioned within the subject and at the target treatment site while handle <NUM> is positioned external from the subject at a proximal end of the medical instrument. It should be appreciated that end effector <NUM> will be maintained in an actuated (closed) state during delivery through the medical instrument.

Referring now to <FIG>, first actuator <NUM> and second actuator <NUM> may each be positioned in a first position relative to handle <NUM> such that distal articulation joint <NUM> is maintained in an unarticulated state (e.g., a longitudinal axis of distal articulation joint <NUM> is aligned with a longitudinal axis of shaft <NUM>), and end effector <NUM> is maintained in an actuated state. Stated differently, actuators <NUM>, <NUM> may be positioned along an intermediate portion of tracks <NUM>, <NUM> such that wires <NUM>, <NUM> are maintained at a neutral position relative to shaft <NUM> and end effector <NUM>. In this instance, first wire <NUM> does not apply a tensile force onto second jaw 144B, and second wire <NUM> does not apply a tensile force onto first jaw 144A, thereby maintaining end effector <NUM> in the actuated state and distal articulation joint <NUM> in an unarticulated state (e.g., parallel to shaft <NUM> and/or handle <NUM>).

Referring now to <FIG>, first actuator <NUM> may be translated along first track <NUM> in the first direction A (e.g., proximally) to pull first wire <NUM> proximally relative to shaft <NUM> and handle <NUM>. In this instance, first actuator <NUM> may be moved to a proximalmost position, and configured to articulate distal articulation joint <NUM> toward a side of handle <NUM> including first actuator <NUM>, thereby moving end effector <NUM> radially outward and in the first direction A. For example, a user of medical device <NUM> may move first actuator <NUM> relative to handle <NUM> by pulling first actuator <NUM> proximally toward proximal end <NUM>. First actuator <NUM> may slide relative to handle <NUM> in response to applying a proximal force on grasping feature <NUM>. In this instance, first wire <NUM> (secured to a body of first actuator <NUM> along a portion within handle <NUM>) may move with grasping feature <NUM> in the first direction A relative to handle <NUM>. With first wire <NUM> secured to proximal arm 144B, first actuator <NUM> may be configured to move first wire <NUM> relative to handle <NUM> and shaft <NUM>.

First actuator <NUM> may pull first wire <NUM> proximally to apply a proximal (pulling) force onto proximal arm 148B, thereby causing distal articulation joint <NUM> to bend. In this instance, end effector <NUM> may be deflected in the first direction A, i.e. the same direction of movement as first actuator <NUM> relative to handle <NUM>, since a connection point between wire <NUM> and arm 148B is off-center and radially outward of a longitudinal axis of distal articulation joint <NUM>, towards a same side of medical device <NUM> as first actuator <NUM>. A user of medical device <NUM> may selectively adjust a degree of articulation of distal articulation joint <NUM>, and the corresponding extent of deflection of end effector <NUM>, in response to a degree of movement of first actuator <NUM> relative to handle <NUM>. Further, handle <NUM> may be rotated, to rotate shaft <NUM> and move end effector <NUM> relative to the target treatment site to facilitate further movement of medical device <NUM> toward a target object within the target treatment site. In some embodiments, second actuator <NUM> may remain stationary during translation of first actuator <NUM> relative to handle <NUM>.

Still referring to <FIG>, second actuator <NUM> may be translated along second track <NUM> in the second direction B, that is opposite of the first direction A, to push second wire <NUM> distally relative to shaft <NUM> and handle <NUM>. In this instance with distal articulation joint <NUM> already articulated by first actuator <NUM>, second actuator <NUM> may be moved to a distalmost position, thereby causing end effector <NUM> to transition from an actuated state (<FIG>) to an unactuated state. For example, a user of medical device <NUM> may move second actuator <NUM> relative to handle <NUM> by sliding second actuator <NUM> distally toward distal end <NUM> to the distalmost position. Second actuator <NUM> may slide relative to handle <NUM> in response to applying a distal force on grasping feature <NUM>. In this instance, second wire <NUM> (secured to a body of second actuator <NUM> along a portion within handle <NUM>) may move with grasping feature <NUM> relative to handle <NUM>. With second wire <NUM> secured to proximal arm 144A, second actuator <NUM> may be configured to move second wire <NUM> relative to handle <NUM> and shaft <NUM>.

Second actuator <NUM> may push second wire <NUM> distally to apply a distal (pushing) force onto the proximal arm 144A, thereby causing first jaw 148A to move about pin <NUM> and away from second jaw 148B. In this instance, end effector <NUM> may be transitioned to the unactuated state with jaws 148A, 148B disengaged from one another. A user of medical device <NUM> may selectively adjust a degree of disengagement between jaws 148A, 148B in response to an extent of translation of second actuator <NUM> relative to second track <NUM>. Stated differently, a gap formed between jaws 148A, 148B may correspond to a longitudinal translation of second actuator <NUM> along handle <NUM>. In some embodiments, first actuator <NUM> may remain stationary during translation of second actuator <NUM> relative to handle <NUM>.

End effector <NUM> may be maneuvered about the target treatment site by manipulating a position, orientation, and/or configuration of handle <NUM> with the grasping feature at proximal end <NUM> to position end effector <NUM> adjacent to the target object. With the target object positioned between an opening formed between jaws 148A, 148B, second actuator <NUM> may be translated proximally in the first direction A (e.g., to a neutral and/or proximalmost position) to move first jaw 148A toward second jaw 148B, and clamp the target object (e.g., tissue) therebetween.

It should be appreciated that actuators <NUM>, <NUM> may provide multifunctional capabilities depending on a sequence of actuation of each actuator <NUM>, <NUM> relative to one another. For example, in other embodiments, second actuator <NUM> may be moved in the first direction A (e.g., to the proximalmost position) in lieu of first actuator <NUM>, such that distal articulation joint <NUM> may bend toward second actuator <NUM> and in the first direction A. In this instance, subsequent actuation of first actuator <NUM> in the second direction B (e.g., to the distalmost position) may provide movement of second jaw 148B relative to first jaw 148A to transition end effector from the closed configuration to the open configuration. With both actuators <NUM>, <NUM> capable of articulating shaft <NUM> and actuating end effector <NUM>, medical device <NUM> may provide an ergonomic interface for manipulating a target object (e.g., tissue) during a procedure with a single hand of a user. Further, medical device <NUM> may provide multiple degrees of articulation and/or directions of movement via actuators <NUM>, <NUM>.

Referring now to <FIG>, another exemplary medical device <NUM> is depicted according to an example of the disclosure. Except as otherwise described herein, medical device <NUM> may be configured and operable similar to medical device <NUM>. Accordingly, like reference numerals are used to identify like components.

Medical device <NUM> may include a handle <NUM> having a longitudinal length defined between a proximal end <NUM> and a distal end <NUM>. Handle <NUM> may be sized, shaped, and configured to be graspable by a user of medical device <NUM>. That is, handle <NUM> may provide an ergonomic interface for grasping medical device <NUM> and maneuvering handle <NUM> with a single hand. Handle <NUM> may further include a pair of tracks positioned along opposing sides of handle <NUM>, and extending between proximal end <NUM> and distal end <NUM>. For example, handle <NUM> may include a first track <NUM> along a top wall of handle <NUM> and a second track (not shown) positioned along a bottom wall of handle <NUM>. Each track may define a travel path of one or more actuators <NUM>, <NUM>, and a longitudinal length of the tracks may define an articulation and actuation extent of medical device <NUM>.

Medical device <NUM> may further include a pair of actuators <NUM>, <NUM> movably coupled to handle <NUM> at the tracks. For example, medical device <NUM> may include a first actuator <NUM> slidably coupled to first track <NUM>, and a second actuator <NUM> slidably coupled to the second track. In the example, first track <NUM> and the second track may include openings formed along an exterior of handle <NUM>, such that actuators <NUM>, <NUM> may be at least partially disposed within the openings and seated inside handle <NUM>. First actuator <NUM> may be configured to translate along first track <NUM>, and second actuator <NUM> may be configured to translate along the second track in one or more directions (e.g., proximally, distally, etc.). Although not shown, it should be understood that first actuator <NUM> may be coupled to first wire <NUM> within handle <NUM>, and second actuator <NUM> may be coupled to second wire <NUM> within handle <NUM>. Accordingly, each actuator <NUM>, <NUM> may be configured to move the corresponding wire <NUM>, <NUM> relative to handle <NUM> in response to translating along the respective track.

Still referring to <FIG>, first actuator <NUM> may include a body with a grasping feature <NUM>, and second actuator <NUM> may include a body with a grasping feature <NUM>. Each grasping feature <NUM>, <NUM> may be configured to facilitate movement of the respective actuator <NUM>, <NUM> relative to the corresponding track. In the example, grasping features <NUM>, <NUM> may include a slidable button and/or knob that is sized and shaped to receive a finger of a user thereon. It should be appreciated that grasping features <NUM>, <NUM> may have various other suitable sizes, shapes, and/or configurations without departing from a scope of this disclosure.

Medical device <NUM> may further include shaft <NUM> extending distally from handle <NUM>, and particularly from distal end <NUM>. Although not shown, it should be understood that medical device <NUM> may include proximal shaft <NUM> and distal articulation joint <NUM>, with end effector <NUM> coupled to a distal end of articulation joint <NUM>. Medical device <NUM> may be configured and operable similar to medical device <NUM> described above, such that movement of actuators <NUM>, <NUM> relative to handle <NUM> may provide a similar articulation and actuation of shaft <NUM> and end effector <NUM>, respectively, as described in detail above with respect to medical device <NUM>.

Each of the aforementioned systems, devices, assemblies, and methods may be used to manipulate target tissue with enhanced degree of maneuverability. By providing a medical device with an intuitive handle capable of controlling an actuation and articulation of an end effector with a single hand, a user may utilize another hand to control other devices and/or tools during a procedure for treating the target site. In this instance, a user may reduce overall procedure time, increase efficiency of procedures, and/or avoid unnecessary harm to a subject's body caused by limited control of the other tools/devices.

Claim 1:
A medical device (<NUM>, <NUM>), comprising:
a handle (<NUM>, <NUM>);
a shaft (<NUM>) extending distally from the handle (<NUM>, <NUM>) and including a proximal shaft (<NUM>) and a distal articulation joint (<NUM>);
an end effector (<NUM>) extending distally from the shaft (<NUM>);
a first actuator (<NUM>, <NUM>) movably coupled to the handle (<NUM>, <NUM>);
a second actuator (<NUM>, <NUM>) movably coupled to the handle (<NUM>, <NUM>); and
a first wire (<NUM>) and a second wire (<NUM>) disposed within the handle (<NUM>, <NUM>) and the shaft (<NUM>),
wherein the first wire (<NUM>) is coupled to the first actuator (<NUM>, <NUM>) and a first part of the end effector (<NUM>),
wherein the second wire (<NUM>) is coupled to the second actuator (<NUM>, <NUM>) and a second part of the end effector (<NUM>), and
wherein the distal articulation joint (<NUM>) is configured to bend relative to the proximal shaft (<NUM>) in response to an actuation of at least one of the wires (<NUM>, <NUM>);
wherein the first actuator (<NUM>, <NUM>) is configured to (a) articulate the shaft (<NUM>) in response to translating the first actuator (<NUM>, <NUM>) in a first direction relative to the handle (<NUM>, <NUM>) and the second actuator (<NUM>, <NUM>) to pull the first wire (<NUM>) proximally relative to the shaft (<NUM>) and the handle (<NUM>), and (b) actuate the end effector (<NUM>) in response to translating the first actuator (<NUM>, <NUM>) in a second direction relative to the handle (<NUM>, <NUM>) and the second actuator (<NUM>, <NUM>) to push the first wire (<NUM>) distally relative to shaft (<NUM>) and handle (<NUM>); and
wherein the second actuator (<NUM>, <NUM>) is configured to (a) articulate the shaft (<NUM>) in response to translating the second actuator (<NUM>, <NUM>) in the first direction relative to the handle (<NUM>, <NUM>) and the first actuator (<NUM>, <NUM>) to pull the second wire (<NUM>) proximally relative to the shaft (<NUM>) and the handle (<NUM>), and (b) actuate the end effector (<NUM>) in response to translating the second actuator (<NUM>, <NUM>) in the second direction relative to the handle (<NUM>, <NUM>) and the first actuator (<NUM>, <NUM>) to push the second wire (<NUM>) distally relative to the shaft (<NUM>) and the handle (<NUM>).