Patent Description:
During noninvasive procedures, a physician may use a scope and a retrieval device to engage objects in a body. For example, in ureteroscopic procedures, the physician may use a ureteroscope and a retrieval device to engage stones, stone fragments, and/or other objects in a kidney, ureter, and/or bladder. One advantage of noninvasive procedures is that the body's normal openings and passages may be utilized. In ureteroscopic procedures, for example, the physician may move the scope through the ureter toward a stone, advance an end effector (e.g., a basket) of the retrieval device toward the stone, and engage the stone with the end effector to capture the object for removal from the body.

Many noninvasive procedures require at least two operators. For example, in ureteroscopic procedures, a first user (e.g., a physician) may control the scope while a second user (e.g., a physician's assistant) controls the retrieval device. A third operator may be required to manipulate the end effector. Requiring multiple operators increases the cost and complexity of these procedures and may lead to communication gaps between operators, movement inefficiencies during the procedure, and delayed response times. Aspects of this disclosure address these difficulties, and/or other aspects of the known treatment methods. For example, one aspect of the disclosure is to consolidate the ergonomic and operational control of the retrieval device and scope to a single hand. Another aspect is to allow a single one piece assembly of the medical device to the scope.

Document <CIT> describes an apparatus including a first end configured to connect to a control of an endoscope object removal tool; a second end having a connector configured to removably connect to a handle of an endoscope; and a spine connecting the first end to the second end. The spine comprises a plurality of serially interconnected members which are rotatable relative to each other. Connections of the members to one another comprise friction locks. The friction locks are configured to be temporarily unlocked by overcoming friction forces at the friction locks such that the spine is semi-flexible.

Document <CIT> describes an insertion device which includes a body and a delivery shaft. The body includes a longitudinal axis aligned with a central long axis of a proximal end of the delivery shaft. A holder may be coupled to the body of the insertion device, and the holder includes a medical device receiving chamber having a longitudinal axis that is non-parallel to the longitudinal axis of the body.

<CIT> is prior art pursuant to Article <NUM>(<NUM>) EPC and teaches an actuator device comprising a housing having a first portion engageable with a scope and a second portion engageable with a handle of a retrieval device.

Aspects, embodiments and examples of the present disclosure which do not fall under the scope of the appended claims are provided for illustrative purposes. The present embodiments are directed to a retrieval device configured to be attached to a scope device, the retrieval device system comprising a handle including an attachment portion configured to couple the handle to the scope device, a shaft including a drive wire and a sheath, the shaft being coupled to the handle, the sheath being movable over the drive wire between a distal position and a proximal position via an actuator assembly of the handle, the actuator actuating a slider assembly of the handle, the slider assembly coupled to the sheath and movable relative to the attachment portion of the handle to move the sheath, and an expandable end effector coupled to the distal end of the drive wire, the end effector movable between a collapsed configuration when the sheath is moved distally to the distal position to cover the end effector and an expanded configuration when the sheath is moved proximally to the proximal position, uncovering the end effector.

In an embodiment, the handle includes the actuator assembly, the actuator assembly comprising a lever and an arm configured to move the slider between a first position and a second position, the lever configured to rotate the arm about a pin such that a pin portion of the arm housed within a slot of the slider moves the slider along a longitudinal slider axis.

In an embodiment, the attachment portion is removably engageable with the scope device.

In an embodiment, the shaft extends from a proximal end coupled to the handle to a distal end configured to be positioned within a working channel of the scope device.

In accordance with the invention, the handle attachment portion is coupled to the scope device via a guide member, the handle movable relative to the guide member.

The handle attachment portion includes a rod sized and shaped to be slidably received within a channel of the guide member such that the handle is movable relative to the guide member and the scope device along a longitudinal axis of the channel via the rod.

In an embodiment, the guide member includes one or more indents on an exterior surface thereof configured to receive a wedge portion of the handle to lock the handle in position relative to the guide member.

In an embodiment, the one or more indents is ramped to allow for proximal movement of the handle while preventing distal movement.

In an embodiment, the handle is rotatable about the guide member to allow for displacement of a longer length of the shaft within the working channel of the scope device.

The present embodiments are also directed to a retrieval device configured to be attached to a scope device, the retrieval handle device comprising an attachment portion configured to couple the handle to the scope device, a slider movable relative to the attachment portion of the handle to move a retrieval shaft coupled to the handle, and an actuator assembly comprising a lever and an arm configured to move the slider between a first position and a second position, the lever movable from a first position to a second position to rotate the arm about a pin such that a pin portion of the arm housed within a slot of the slider moves the slider along a longitudinal slider axis.

In an embodiment, the attachment portion is coupled to the scope device via a guide member, the handle movable relative to the guide member.

In an embodiment, the attachment portion includes a rod sized and shaped to be slidably received within a channel of the guide member such that the handle is movable relative to the guide member and the scope device along a longitudinal axis of the channel via the rod.

In an embodiment, the handle is rotatable about the guide to allow for displacement of a longer length of the shaft through the working channel of the scope device.

In an embodiment, the handle includes a spring member, the spring member biasing the lever to the first position and having a restoring force necessary to move the lever from the second position to the first position, and a second spring member, the second spring member biasing the sheath via a plunger to the first distal position and having a restoring force necessary to move the sheath from the second position to the first position.

The present embodiments are also directed to a method of retrieving tissue, not forming part of the claimed invention, comprising inserting a distal portion of a retrieval device coupled to a scope device to a target area of a living body, the distal portion of the retrieval device sized and shaped to be inserted through the working channel of the scope device, the distal portion including: a shaft including a drive wire and a sheath, the shaft being coupled to a handle, the sheath being movable over the drive wire between a distal position and a proximal position via an actuator assembly of the handle, and an expandable end effector coupled to the distal end of the drive wire, the end effector movable between a collapsed configuration when the sheath is moved distally to the distal position to cover the end effector and an expanded configuration when the sheath is moved proximally to the proximal position, uncovering the end effector, actuating the actuator assembly of the handle to move the sheath proximally to uncover the end effector allowing the end effector to move from the collapsed configuration to the expanded configuration, capturing tissue, via the end effector, and retracting the end effector by releasing the actuator assembly such that the sheath moves distally to cover the end effector, wherein the retrieval device and the scope device are operated by a single user.

In an embodiment, the actuator assembly actuates a slider of the handle, the slider coupled to the shaft and movable relative to the handle to move the sheath.

In an embodiment, the actuator assembly comprises a lever and an arm configured to move the slider between a first position and a second position, the lever movable from a first position to a second position to rotate the arm about a pin such that a pin portion of the arm housed within a slot of the slider moves the slider along a longitudinal slider axis.

In an embodiment, the handle includes a spring member, the spring member biasing the lever to the first position and having a restoring force necessary to move the lever from the second position to the first position.

In an embodiment, the actuator assembly of the handle is operated with the index finger of one hand such that the scope device is held and a scope actuator is operated with a thumb of the same hand, simultaneously or independently.

The present disclosure may be further understood with reference to the appended drawings and the following description, wherein like elements are referred to with the same reference numerals. The present disclosure relates to retrieval devices and methods for retrieving material (e.g., tissue within a living body). Specifically, the present disclosure relates to a retrieval device that may be easily coupled with a ureteroscope device such as the LithoVue™. In an exemplary embodiment, the retrieval device includes a handle and an end effector. The end effector is utilized to engage stones, stone fragments, and/or other objects to be removed from kidneys, ureters, and/or bladder. It should be noted that the terms "proximal" and "distal", as used herein, are intended to refer to a direction toward (proximal) and away from (distal) a user of the device (e.g. physician).

Referring to <FIG>, a retrieval system <NUM> includes a scope <NUM> and a retrieval device <NUM>. The retrieval device <NUM> includes a handle assembly <NUM> and an end effector assembly <NUM>. The handle assembly <NUM> is configured to be attached to the scope <NUM>, as depicted in the figures. The scope <NUM> may comprise any scope configured for use in minimally invasive procedures, a ureteroscope, for example, under the brand name LithoVue™. As shown in <FIG>, a scope <NUM> includes a scope body <NUM> extending a long a scope axis between a proximal end that remains outside the body during use and a distal end inserted into the body (e.g., through a natural body lumen accessed via a natural body opening). A scope sheath <NUM> extends distally from the distal end of this exemplary scope body <NUM>. A working channel <NUM> extends through the scope body <NUM> and the scope sheath <NUM>, allowing a drive wire <NUM> of the end effector assembly <NUM> (e.g., a wire, thread, rod or similar elongated element) to be advanced through the scope <NUM> to a treatment site in a body, such as the interior of a kidney. In some aspects, the scope <NUM> comprises an actuator configured to manipulate the scope sheath <NUM>.

The end effector assembly <NUM> includes a shaft <NUM>, composed of the drive wire <NUM> and a sheath <NUM>, and an end effector <NUM> attached to a distal end of the drive wire <NUM>. The sheath <NUM> is sized and shaped to cover and slide over a portion of the drive wire <NUM> and the end effector <NUM>. The sheath <NUM> is substantially the same length as the drive wire <NUM> plus enough extra length to cover the end effector <NUM>. In an exemplary embodiment, the length of the shaft <NUM>, including the drive wire <NUM> and sheath <NUM>, does not extend significantly past the distal end of the scope working channel <NUM>. This allows the shaft <NUM> to become substantially a straight line between the handle assembly <NUM> and working channel <NUM> of the scope <NUM>, creating a true non-retracting end effector. However, in other embodiments, the shaft <NUM> may be substantially longer than the scope working channel <NUM>. In this embodiment, the shaft <NUM> may be coiled in a loop, as shown in <FIG>. In another example, the shaft <NUM> may be only slightly longer than the working channel <NUM> of the scope. In this embodiment, the slack of the shaft <NUM> may be displaced as a bump, as shown in <FIG>. If there is extra length, the length of the shaft <NUM> extending from a distal end of the working channel <NUM> can be adjusted at the proximal end of the handle assembly <NUM> by the user's hand that is not gripping the handle assembly <NUM>. The end effector <NUM>, in this embodiment, is a self-expandable basket made of a shape memory material, similar to those sold by Boston Scientific® under the brand name Zero tip®. In another embodiment, the end effector <NUM> may be formed of wires forced or constrained to form a basket shape, similar to the Boston Scientific Dakota®.

The handle assembly <NUM>, as best seen in <FIG>, includes a handle body <NUM> comprising two covers <NUM>. The handle body <NUM> is coupled to the shaft <NUM> via the drive wire <NUM> and includes an actuator assembly <NUM> comprising a lever <NUM> and an arm <NUM>. The actuator assembly <NUM> is configured to move the sheath <NUM>, via a plunger, a first spring, and a sliding assembly, relative to the end effector <NUM> to cover and collapse the end effector <NUM> or to expose and expand the end effector <NUM>. Specifically, to retract the sheath <NUM>, the lever <NUM> is depressed in the direction of arrow M, clockwise about a first pin <NUM>, causing a second pin <NUM> to rotate counter-clockwise in a slot <NUM> of the arm <NUM>. This movement of the second pin <NUM> within the slot <NUM> causes the arm <NUM> to rotate clockwise about a third pin <NUM> which in turn rotates a pin portion <NUM> of the arm <NUM> proximally.

As can be seen in <FIG>, the pin portion <NUM> of arm <NUM> is positioned within a slot <NUM> of a slider <NUM> which is movable proximally and distally relative to the handle body <NUM>. Thus, rotational movement of the pin portion <NUM> of the arm <NUM> causes the slider <NUM> to move proximally and distally, which in turn retracts the sheath <NUM> that is coupled to a spring biased plunger <NUM>, moving the sheath <NUM> proximally to expand the end effector <NUM> or distally to collapse the end effector <NUM>. Specifically, proximal movement of the pin portion <NUM> moves the slider <NUM> proximally, pulling the plunger <NUM>, via wall <NUM> extending from the slider <NUM>, and the attached sheath <NUM> to uncover the end effector <NUM>, allowing it to expand. As depicted in <FIG>, the plunger <NUM> may be substantially cylindrical with two flat sides <NUM> and is sized and shaped to slide in a channel <NUM> having a matching profile and extending through the wall <NUM>. The plunger <NUM> also includes a trigger <NUM> sized and shaped to be moved through an upper opening <NUM> in the handle body <NUM> via a thumb or finger of the user. A support tube <NUM> extends proximally from a proximal end of the plunger <NUM> and is sized and shaped to be slid through a block <NUM>. A first compression spring <NUM> is positioned about the outer diameter of the support tube <NUM> in a compressed state between the proximal end of the plunger <NUM> and the distal end of the block <NUM>. The first spring <NUM> is at its initial height and exerts an initial restoring force to bias the sheath <NUM> to a normally distal position, such that the distal side of the trigger <NUM> abuts the wall <NUM>.

The first spring <NUM> is most often used to prevent damage to the fragile end effector <NUM> and sheaths <NUM> such as the Zero Tip™ and the Dakota™, which are both less than <NUM> French in shaft diameter. In use, the compressed first spring <NUM> biases the plunger and sheath <NUM> distally. The trigger <NUM> can be used to manually pull the sheath <NUM> more proximally than the slider can to further withdraw the sheath <NUM> and uncover the end effector <NUM> to a larger open state. This action allows stuck or oversized burdens to be released quickly from the end effector <NUM>. The first spring <NUM> also returns the plunger <NUM> and the sheath <NUM> distally when the hand force is removed from the trigger <NUM>. In this case, the first spring <NUM> will further compress to a second load height as the slider <NUM> and sheath <NUM> are moved distally to firmly close and capture the burden within the end effector <NUM>. More specifically, the sheath <NUM> and plunger <NUM> are moved distally in conjunction with the slider <NUM> until the sheath <NUM> and plunger <NUM> advancement is stopped by the abutment of the end effector <NUM> with the captured burden. With the sheath <NUM> and plunger <NUM> stopped, further advancement of the slider <NUM> distally will create a force greater than the initial force of the first spring <NUM> to compress the first spring <NUM> a distance x to a second load height. In turn, the distally extending length of the sheath <NUM> is shortened as the first spring <NUM> is compressed to its second load height. The second load is greater in magnitude than the initial load of the first spring <NUM>. The first spring <NUM> is calculated to a preferred second load (F) relative to the maximum capturable size, (converted to a linear displacement x) (where K in Hooke's Law F=-Kx is known) such that the second spring load is insufficient to cause damage to the end effector or the sheath. Fi is also known as the grip force of the end effector <NUM>. In other embodiments, the second load is calculated to provide sufficient force to strangulate or to provide cutting.

Full depression of the lever <NUM> simultaneously causes a proximal end of a stroke limiter <NUM> coupled to a proximal end of the slider <NUM> to reach a proximal wall <NUM> of the handle assembly <NUM>. When the stroke limiter <NUM> abuts the proximal wall <NUM>, the sheath <NUM> is incapable of being retracted any further via the lever <NUM> and the end effector <NUM> is, at this point, functionally opened. Thus, the handle <NUM> has an end effector stroke length SL determined by the distance between the proximal end of the stroke limiter <NUM> and the distal face of the proximal wall <NUM>. However, in some embodiments, the end effector <NUM>, such as the Dakota™ or the Escape™ end effectors, can be opened further via the trigger <NUM>. The trigger <NUM> is pulled proximally through the handle body <NUM> (composed of covers <NUM>) to further retract the sheath <NUM> and further expand the end effector <NUM>. The further retraction or expansion of the end effector <NUM> is used to release trapped or stuck stones within the end effector or to quickly reposition stones, respectively. When the trigger <NUM> is released, the first spring <NUM> returns the plunger <NUM> to its initial position. The specific distance that the trigger <NUM>, and thus the sheath <NUM>, may be moved proximally is controlled by the support tube <NUM>, which may be cut to a predetermined length to control the stroke length of the plunger <NUM>.

The lever <NUM>, sheath <NUM>, plunger <NUM>, slider <NUM>, and arm <NUM> are returned back to their initial positions (i.e., where the end effector <NUM> is covered by the sheath <NUM>) when the hand force on lever <NUM> is removed and no burden (i.e., kidney stone, tissue, foreign object, etc.) is captured. A second spring <NUM> positioned around the stroke limiter <NUM> between the proximal wall <NUM> and the proximal end of the slider <NUM> provides the restoring force necessary to return each element to its starting position when the hand force is removed from the lever <NUM>. The second spring <NUM> is selected to be stiffer than the first spring <NUM>. Therefore, the second spring <NUM> is configured to provide a force more than sufficient to close the end effector <NUM> while the first spring <NUM> controls the specific magnitude of force (i.e., to close the end effector, capture debris, or to cut a burden). When the hand force is removed from the lever <NUM>, the restoring force of the second spring <NUM>, which is compressed from its initial length by the slider <NUM>, forces the slider <NUM> back to its initial distal position, thereby forcing the spring <NUM>, biased plunger <NUM>, sheath <NUM>, and arm <NUM> to their initial positions (i.e., positions without a burden). That is, the restoring force of the second spring <NUM> provides the force exerted on the end effector <NUM> via the proximal end of the plunger <NUM> and/or the sheath <NUM> via the first spring <NUM> for closure, capture or strangulation of a burden (i.e., a second, burdened position). The stiffness of the first spring <NUM> is be pre-selected to, for example, increase the durability of the end effector <NUM>, control the specific magnitude of the end effector grip to a stone burden, or to control the strangulation force during tissue cuts. As will be understood by those skilled in the art, a spring will exert a known force at a given spring deformation (Hook's Law). In contrast, hand force applied to the end effector <NUM> relies, for example, on tactile feel of the user to gauge the magnitude of force applied and may vary from person to person. If further closure/covering of the end effector <NUM> is desired, the trigger <NUM> of the plunger <NUM> may be moved distally, moving the sheath <NUM> further distally over the end effector <NUM> to, for example, capture a small stone or debris in a tortuous pathway.

In an exemplary embodiment, the handle assembly <NUM> is configured without a first spring <NUM>. In this embodiment, the second spring <NUM> applies its restoring force directly to the end effector <NUM>, simplifying the mechanics of the handle assembly <NUM>. In one example of this embodiment, the plunger <NUM> and the support tube <NUM> are glued or otherwise coupled to the slider <NUM>. In another example, the slider <NUM> is molded with the plunger <NUM> and the support tube <NUM> to create a single part. In this example, both the first spring <NUM> and the trigger <NUM> are removed. It will be understood that these embodiments allow for a simpler handle assembly <NUM> with less component parts involved in the extension and retraction of the sheath <NUM> and will not have the benefits of the first spring <NUM>.

The handle assembly <NUM> may be removably attached to the scope <NUM> at an attachment portion <NUM> by positioning a first pin <NUM> of the covers <NUM> into a screw hole <NUM> of the scope body <NUM> and snapping a second pin <NUM> of the covers <NUM> into a center hole <NUM> of a deflection knob <NUM> of the scope body <NUM>. To release the handle assembly <NUM> from the scope body <NUM>, the second cover pin <NUM> is first removed from the center hole <NUM> and the first cover pin <NUM> is subsequently removed from the screw hole <NUM>.

The drive wire <NUM> extends through the plunger <NUM> from a distal end of the handle assembly <NUM>, through a handle lumen <NUM>, to a knob <NUM> located at a proximal end of the handle <NUM>. The drive wire <NUM> is attached to the knob <NUM> in this embodiment by a set screw <NUM>. A handle cannula <NUM>, such as a stainless steel hypotube, is used to sleeve the proximal end of the drive wire <NUM> inside the handle assembly <NUM> to increase stiffness of the drive wire <NUM>, preventing kinking as components of the handle assembly <NUM> are manipulated over the drive wire <NUM>. The knob <NUM> can be rotated about a hole <NUM> formed by mating handle covers <NUM> together. Rotation of the knob <NUM> within the hole <NUM> rotates the drive wire <NUM> and thus, the end effector <NUM> attached to the distal end thereof.

In an exemplary embodiment, the handle assembly <NUM> may include an electrosurgical feature. For example, an active plug may be connected to the proximal end of the drive wire <NUM> proximally of the knob <NUM>. In another example, the active plug may be positioned at the proximal end of the handle assembly <NUM> in lieu of the knob <NUM> if rotation of the end effector <NUM> is not required.

A retrieval system <NUM>, in accordance with the present invention is depicted in <FIG>. The retrieval system <NUM> is substantially similar to retrieval system <NUM>, including a scope <NUM> and a retrieval device <NUM> comprising a handle assembly <NUM> and an end effector assembly <NUM>, except as described herein. Specifically, the handle assembly <NUM> is movable relative to the scope <NUM> via a guide <NUM>, as will be described in further detail below.

The handle assembly <NUM>, in this embodiment, includes a <NUM>-degree closed lever ring <NUM> in lieu of a lever <NUM> as found in the handle assembly <NUM>. <FIG> depicts the lever ring <NUM> in a non-depressed state such that the slider <NUM>, plunger <NUM>, arm <NUM> and shaft <NUM> are in their distal position with the end effector <NUM> in the closed or collapsed position. The handle assembly <NUM> has an end effector stroke length SL determined by the distance between the proximal end of the stroke limiter <NUM> and the distal face of the proximal wall <NUM>. The plunger <NUM>, similarly to the plunger <NUM>, has a stroke length SLP determined by the distance between the proximal end of the support tube <NUM> and the distal end of the anchor block <NUM>. Thus, stroke lengths SL and SLP can be custom sized by cutting the stroke limiter <NUM> and the support tube <NUM>, respectively, to a predetermined length.

In this embodiment, a slide mechanism allows the handle assembly <NUM> to slide proximally and distally relative to the scope <NUM>. Specifically, the handle assembly <NUM> of this embodiment includes a guide <NUM> mounted onto the scope <NUM> using cover pins <NUM> and <NUM> as described above with respect to cover pins <NUM>, <NUM>. The guide <NUM> includes a channel <NUM> positioned at a preferred angle relative to the scope <NUM>. The channel <NUM> is open to a slot <NUM> that extends along its length. In a preferred embodiment, the channel <NUM> has a circular profile configured, for example, to match the outer profile of a circular rod <NUM> positioned on the handle body <NUM>. Thus, the handle <NUM> is movable relative to the guide <NUM> and the scope <NUM> along a longitudinal axis of the channel <NUM> via the circular rod <NUM>, which is slidable within the channel <NUM>. The rod <NUM>, in an embodiment, includes a cantilever latch <NUM> configured to lock to a proximal wall <NUM> of the guide <NUM>. The cantilever latch <NUM> prevents the rod <NUM> from sliding proximally out of the channel <NUM> once the rod <NUM> and latch <NUM> have been inserted therein distally past the wall <NUM>. In an exemplary embodiment, the rod <NUM> has a diameter slightly smaller than an inner diameter of the channel <NUM> such that there is a smooth interface between the two components. However, in another embodiment, the channel <NUM> may have a diameter slightly smaller than an outer diameter of the rod <NUM>, creating an interference fit between the rod <NUM> and the channel <NUM>. One skilled in the art will understand that while the rod <NUM> and the channel <NUM> of the present embodiment have circular profiles, any shape profile may be used such as, for example, square, oval, polygonal, etc. Furthermore, the interface between the rod <NUM> and the channel <NUM> may include a locking mechanism, as described in further detail below.

Still looking at <FIG>, the rod <NUM> of this embodiment is made with a relatively smaller diameter than the channel <NUM> of the guide <NUM>, allowing the handle assembly <NUM> to cock or tilt relative to the guide <NUM> in the direction of arrow M. Specifically, the handle assembly <NUM> includes a wedge portion <NUM> that interacts with the guide <NUM> so that, due to the angle of the channel <NUM> and the center of mass of the handle assembly <NUM>, a user may tilt the handle assembly <NUM> using the lever ring <NUM>. The guide <NUM> includes three indents <NUM> on an exterior surface thereof that are configured to receive the wedge portion <NUM> of the handle <NUM>, locking the handle assembly <NUM> in position relative to the guide <NUM> and the scope <NUM>. The lever ring <NUM>, with its <NUM>-degree closed ring, allows the user to lift the ring <NUM> with, for example, the nail side of the index finger, to lift the handle assembly <NUM> in the direction of arrow W, as shown in <FIG>. This lifting of the lever ring <NUM> and thus, the handle assembly <NUM>, moves the wedge portion <NUM> out of the indents <NUM>, allowing the handle assembly <NUM> to slide proximally or distally relative to the guide <NUM>. As can be seen in <FIG>, the indents <NUM> of this embodiment may be ramp-shaped with a depth of each indent <NUM> increasing the distal direction. Thus, the handle assembly <NUM> is able to be moved proximally without being lifted away from the indents <NUM>. However, in other embodiments, the indents <NUM> may be substantially U-shaped such that the handle assembly <NUM> must be lifted to free the wedge portion <NUM> from the indents <NUM> and move the handle assembly <NUM>. As can be seen in <FIG>, the rod <NUM> may include a proximal stop <NUM> with a larger diameter than the rod <NUM> and the channel <NUM>. The stop <NUM> prevents the rod <NUM> from sliding proximally out of the channel <NUM> by abutting against a proximal surface of the channel <NUM>.

Movement of the handle assembly <NUM> relative to the guide <NUM> (i.e., via sliding) moves the sheath <NUM>, drive wire <NUM> and end effector <NUM> a corresponding and equal distance and direction. For example, at a proximal-most position, a stroke length of the rod, SLR, is defined with the distal tip of the sheath <NUM> and end effector <NUM> positioned flush with the distal end of the scope working channel <NUM>. When the handle assembly <NUM> is moved distally such that SLR is equal to zero, the tips of the sheath <NUM> and end effector <NUM> are extended a distance of SLR from the end of the insertion device working channel <NUM>.

Referring to <FIG>, it can be seen that the handle assembly <NUM> is angled toward a T-connector <NUM> of the scope <NUM>. In a preferred embodiment, this angulation allows for there to be no slack in the shaft between the plunger <NUM> and the T-connector <NUM>. Thus, retraction of the sheath <NUM> to open the end effector <NUM> or extension of the sheath <NUM> to close/collapse the end effector <NUM> will result in a truly non-retracting end effector <NUM> because the entire reciprocal movement between the drive wire <NUM> and the sheath <NUM> is transmitted only by the sheath <NUM> while the end effector <NUM> remains stationary.

In an exemplary embodiment, the handle assembly <NUM> of the retrieval device <NUM> does not include an end effector rotation feature (i.e., knob). Rather, in this embodiment, the proximal end of the drive wire <NUM> is secured to the block <NUM> as the drive wire <NUM> is bent from the handle lumen <NUM> and into second lumen <NUM> to secure the drive wire <NUM> in place. During assembly, the drive wire <NUM> can be trimmed to a predetermined length to allow a tab <NUM> of the handle body <NUM> to push and bend the proximal end of the drive wire <NUM>, securing it in place.

A retrieval assembly <NUM>', according to another exemplary embodiment of the current disclosure, is depicted in <FIG>. The retrieval assembly <NUM>' is substantially similar to retrieval assembly <NUM>, except as described herein. Specifically, the shaft <NUM>' of the retrieval device <NUM>' of the retrieval assembly <NUM>' is separable from the handle assembly <NUM>' and the handle body <NUM>' and includes a shaft handle <NUM>' extending proximally therefrom. That is, the shaft handle <NUM>' is configured so that it maybe clipped into a shaft handle attachment portion <NUM>' of the handle assembly <NUM>'. As can be seen in <FIG>, the handle assembly <NUM>' includes two clips <NUM>' forming the shaft handle attachment portion <NUM>' of the handle assembly <NUM>'. The shaft handle <NUM>', which may, for example, be a Segura® handle or similar device, may be snapped into the clips <NUM>' to couple the slider <NUM>' to the handle assembly <NUM>'. Once the shaft handle <NUM>' has been positioned within the attachment portion, the user is able to position (i.e., extend/retract) the shaft <NUM>' within the working channel <NUM>' of the scope <NUM>' by gripping the shaft handle <NUM>' and sliding it proximally or distally within the attachment portion. The end effector <NUM>' may be expanded and/or retracted as described above with respect to retrieval assembly <NUM>'.

A retrieval assembly <NUM>, according to another exemplary embodiment of the current disclosure, is depicted in <FIG>. The retrieval assembly <NUM> is substantially similar to retrieval assembly <NUM>, except as described herein. Specifically, the handle assembly <NUM> of this embodiment is configured to rotate about the guide <NUM> allowing for displacement of a longer length of the shaft <NUM> within the working channel <NUM> of the scope <NUM> and out the distal end of the scope <NUM>. <FIG> illustrates the handle assembly <NUM> coupled to the scope <NUM> via the guide <NUM>. The shaft <NUM> of this embodiment comprises the outer sheath <NUM> and drive wire <NUM> stiffened with a hypotube <NUM> at the proximal end. The hypotube <NUM> extends from inside the handle assembly <NUM> to an inside of the T-connector <NUM>. This increase in stiffness in the proximal shaft <NUM> aids in advancing the shaft <NUM> into the T-connector <NUM> so that the shaft <NUM> straightens or becomes linear as the handle assembly <NUM> is rotated toward the T-connector <NUM>. <FIG> depicts the handle assembly <NUM> in the retracted shaft position with the distal tip of the shaft <NUM> situated just proximal to the distal deflection zone of the scope working channel <NUM>. However, in this embodiment, moving the lever ring <NUM> in the direction of arrow M, as depicted in <FIG>, rotates the handle assembly <NUM> and the attached shaft <NUM> towards the T-connector <NUM> such that the distal tip of the shaft <NUM> is advanced in the working channel <NUM> of the scope <NUM> and eventually out of the distal end of the working channel <NUM>.

Specifically, the guide <NUM> of this embodiment includes a circular surface <NUM> with a pin <NUM> that interfaces with an arced slot <NUM> of the handle assembly <NUM> and a pin <NUM> which provides an axis of rotation. When the handle assembly <NUM> is coupled to the guide <NUM>, the pin <NUM> is positioned within the slot <NUM> so as to be slidable along a length thereof to rotate the handle assembly <NUM> such that an angle between the handle assembly <NUM> and the scope <NUM> is increased or decreased. The degree to which the angle between the handle assembly <NUM> and the scope <NUM> can be increased or decreased is limited by the length of the slot <NUM>. When the pin <NUM> abuts a proximal end of the slot <NUM>, in this embodiment, the handle assembly <NUM> is angled so that a straight line is formed between the plunger <NUM> and the T-connector <NUM>. Thus, the shaft <NUM> is straightened (i.e., without any slack) and the retrieval device <NUM> includes a true non-retracting end effector/basket. Angulation of the handle assembly <NUM> relative to the guide <NUM> is controlled by the ring lever <NUM>. The ring lever <NUM> of this embodiment includes a pin <NUM> with a surface <NUM> just proximal thereof configured to abut a stop or ledge <NUM>. <FIG> depicts the pin <NUM> abutting the stop <NUM>. At this point, the angle between the handle assembly <NUM> and the scope <NUM> is at its smallest with the pin <NUM> abutting the proximal end of the slot <NUM>. Further movement of the lever <NUM> about pin <NUM>, in the direction of arrow M, when the pin <NUM> and the stop <NUM> are abutting, moves the slider <NUM> and the attached sheath <NUM> in the proximal direction to open the end effector <NUM>. When the hand force is removed, the lever ring <NUM> and the second spring <NUM> return the end effector <NUM> to the closed position to capture the burden. The shaft <NUM> is retracted from the distal end of the scope <NUM> by moving the lever ring <NUM> in a opposite direction of arrow M. Maximum retraction of the device shaft <NUM> and the handle assembly <NUM> occurs when the pin <NUM> abuts a distal end of the slot <NUM>.

A retrieval assembly <NUM>, according to another exemplary embodiment of the current disclosure, is depicted in <FIG>. The retrieval device <NUM> is substantially similar to retrieval assembly <NUM>, except as described herein. In this embodiment, the shaft <NUM> is both rotatably and linearly movable via the handle assembly <NUM>. Specifically, the two movements are used in sequence with the first rotational movement being for gross/large unrefined extension of the shaft <NUM> and the second linear movement being for fine adjustment of the shaft <NUM>. The fine adjustment can be used to position the end effector <NUM> closer to, for example, a kidney stone without moving the scope sheath <NUM>.

Similar to the embodiment of retrieval device <NUM>, the proximal end of the drive wire <NUM> is supported with a hypotube <NUM>, as described above. The distal tip of the shaft <NUM> can be advanced through the working channel <NUM> of the scope <NUM> and eventually out the distal end of the scope sheath <NUM> by moving the lever ring <NUM> in the direction of arrow M to rotate the handle assembly <NUM> and the attached shaft <NUM> toward and into the T-connector <NUM>. However, in this embodiment, the handle body <NUM> is positioned over the guide <NUM> and coupled to the guide <NUM> via a pin <NUM> that is passed through an elongated slot <NUM> in the guide <NUM>. As can be seen in <FIG>, the elongated slot <NUM> is angled such that when the guide <NUM> is coupled to the scope <NUM>, the slot <NUM> extends toward the T-connector <NUM> of the scope <NUM>. This mating of the pin <NUM> with slot <NUM> allows a user to move the lever ring <NUM> in the direction of arrow N (or in the direction opposite of arrow N) to a maximum limit at which the pin <NUM> abuts a distal (or proximal) end of the elongated slot <NUM> to make fine adjustments to the position of the shaft <NUM> in the scope working channel <NUM>. Specifically, in this embodiment, teeth on the ledge <NUM> and teeth on the surface <NUM> below pin <NUM> may engage to maintain the N direction of the shaft advance or withdrawal. The lever ring <NUM> is depressed in the direction of arrow M to open the end effector <NUM> during or after the movement of the sheath <NUM> in the N direction. When the hand force is removed from the lever ring <NUM>, the second spring <NUM> will return the end effector <NUM> to a closed position or to capture a burden. The pin <NUM> is then returned to a center position within the slot <NUM> before the handle assembly <NUM> can be rotated back to the retracted device shaft <NUM> position of <FIG>.

Although the present disclosure describes the use of retrieval devices utilized to engage stones, stone fragments, and/or other foreign objects in the kidney, ureter and/or bladder, references to a particular type of procedure, such as a ureteroscopy; device, such as a retrieval device; end effector, such as a basket; organ, such as a kidney; and/or object, such as a stone or stone fragment, are provided for convenience and not intended to limit this disclosure. Furthermore, the handle assemblies discussed herein can be configured to advance or retract a laser fiber as well as to operate two or more medical devices simultaneously or independently. The handle assemblies can also be configured to advance or retract and injection needle having a medical luer hub connector at its proximal end. Accordingly, the concepts described herein may be utilized for any analogous device or system.

Claim 1:
A retrieval device (<NUM>) configured to be attached to a scope device (<NUM>), comprising:
a handle (<NUM>) including an attachment portion configured to couple the handle (<NUM>) to the scope device (<NUM>);
a shaft (<NUM>) coupled to the handle (<NUM>) including a wire (<NUM>) immovably coupled to the handle (<NUM>) and a sheath (<NUM>), the sheath (<NUM>) being movable relative to the handle (<NUM>) over the wire (<NUM>) between a distal position and a proximal position via an actuator assembly of the handle (<NUM>), the actuator assembly actuating a slider assembly of the handle (<NUM>), the slider assembly coupled to the sheath (<NUM>) and movable relative to the attachment portion of the handle (<NUM>) to move the sheath (<NUM>);
an expandable end effector (<NUM>) coupled to the distal end of the wire (<NUM>), the end effector (<NUM>) movable between a collapsed configuration when the sheath (<NUM>) is moved distally to the distal position to cover the end effector (<NUM>) and an expanded configuration when the sheath (<NUM>) is moved proximally to the proximal position, uncovering the end effector (<NUM>); and
the handle (<NUM>) further comprising a guide member (<NUM>) comprising a channel (<NUM>),
wherein the handle attachment portion is configured to be coupled to the scope device (<NUM>) via the guide member (<NUM>), wherein the handle attachment portion includes a rod (<NUM>) sized and shaped to be slidably received within the channel (<NUM>) of the guide member (<NUM>) such that the handle (<NUM>) is movable relative to the guide member (<NUM>) and the scope device (<NUM>) along a longitudinal axis of the channel (<NUM>) via the rod (<NUM>).