WO2003082394A1 - Biopsy instrument - Google Patents

Biopsy instrument Download PDF

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Publication number
WO2003082394A1
WO2003082394A1 PCT/EP2003/003390 EP0303390W WO03082394A1 WO 2003082394 A1 WO2003082394 A1 WO 2003082394A1 EP 0303390 W EP0303390 W EP 0303390W WO 03082394 A1 WO03082394 A1 WO 03082394A1
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WO
WIPO (PCT)
Prior art keywords
catheter
channel
distal end
guided
working
Prior art date
Application number
PCT/EP2003/003390
Other languages
German (de)
French (fr)
Inventor
Hansgeorg Schaaf
Original Assignee
Polydiagnost Gmbh
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Polydiagnost Gmbh filed Critical Polydiagnost Gmbh
Priority to AU2003236833A priority Critical patent/AU2003236833A1/en
Priority to DE10391070T priority patent/DE10391070D2/en
Publication of WO2003082394A1 publication Critical patent/WO2003082394A1/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
    • A61B10/02—Instruments for taking cell samples or for biopsy
    • A61B10/04—Endoscopic instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
    • A61B10/02—Instruments for taking cell samples or for biopsy
    • A61B10/06—Biopsy forceps, e.g. with cup-shaped jaws
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
    • A61M25/0133—Tip steering devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/003—Steerable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421—Cannulas
    • A61B2017/3445—Cannulas used as instrument channel for multiple instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/361—Image-producing devices, e.g. surgical cameras
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
    • A61M25/0133—Tip steering devices
    • A61M2025/0163—Looped catheters

Definitions

  • a biopsy instrument A biopsy instrument
  • the invention relates to a biopsy instrument with which tissue samples are taken from a living organism for examination purposes.
  • biopsy forceps are known, in which movements of a handle are transmitted to the forceps parts of the forceps provided at the distal end of the shaft via tension and pressure elements which are guided through a shaft.
  • the object of the invention is to create a biopsy instrument with which the biopsy forceps can be moved and rotated in a controlled manner while continuously observing the working space in which tissue samples are taken with the biopsy forceps.
  • This biopsy instrument has a multi-channel catheter, in particular made of bendable material, at the proximal end of which a working socket with different inputs for the channels of the catheter is provided.
  • One of these channels is designed as a working channel, at the distal end of which a biopsy forceps, which has a larger dimension than the diameter of the working channel, can be arranged.
  • the jaw parts of the biopsy forceps are transmission transmission device, which in particular can transmit tensile and compressive forces.
  • the elongated, in particular rod-shaped and preferably bendable, motion transmission device can be inserted into the working channel from the distal end of the working channel and extends up to the assigned input of the working channel on the working nozzle, which is provided at the proximal end of the catheter.
  • a preferably manually operable actuating device is provided, which is connected to the proximal end of the motion transmission device which is guided through the working channel.
  • the actuating device generates the tensile and compressive forces acting on the jaw parts. These forces are transmitted from the motion transmission device to the forceps parts of the biopsy forceps.
  • the actuating device is preferably detachably connected to the proximal end of the movement transmission device. In this way, the biopsy forceps can be exchanged for the respective tissue sample withdrawals.
  • observation optical system is guided in another channel (optical channel) of the catheter.
  • the observation optics can contain an illumination device for illuminating the work space, in which the tissue samples are removed with the biopsy forceps.
  • the observation optics can be connected to an eyepiece or to a reproduction device with a camera and monitor.
  • a control mechanism is guided in a separate control channel of the catheter, which is connected at the proximal end to a hand-operated control device and which is connected at its distal end to the distal end of the catheter.
  • Rotational movements and pulling and pushing movements, which are generated by the proximal control device, are controlled by the control Mechanism transferred to the distal end of the catheter so that it is bendable transversely to the catheter axis and rotatable about the catheter axis.
  • An irrigation channel open at the distal end also extends through the catheter.
  • the flushing channel is connected to a flushing system at its inlet provided on the working nozzle.
  • the biopsy instrument according to the invention can be used as a papillotome (three-lumen papilloto).
  • Biopsy instrument which is an embodiment of the invention; 2 shows a section along a section line II
  • FIG. 4 shows the distal end of the catheter to explain the mode of operation of the control device.
  • the biopsy instrument shown as an exemplary embodiment in the figures contains a catheter 1, which preferably consists of a bendable material.
  • Four channels extend in the longitudinal direction in the catheter. This is a working channel 3, an optics channel 4, a rinsing channel 5 and a control channel 6.
  • a biopsy forceps 8 is located at the distal end of the working channel 3.
  • the biopsy forceps 8 has jaw parts whose dimensions transversely to the longitudinal direction of the working channel 3 are larger than the diameter of the working channel 3.
  • the jaw parts of the forceps can be designed like spoons with large spoon bulbs.
  • the jaw parts of the biopsy forceps 8 are connected to the distal end of a movement transmission device 7. This movement transmission device 7 extends through the working channel 3.
  • the movement transmission device 7 can be designed in a known manner as a pull / push rod or as a Bowden cable and movements which are generated by an actuating device 13 for the biopsy forceps on the jaw parts of the biopsy forceps 8 transferred.
  • the movement transmission device 7 extends through the working channel 3.
  • the actuating device 13 is connected to the proximal end of the movement transmission device 7.
  • a working socket 2 which has four different entrances for the channels running longitudinally in the catheter 1. It is an input 9 for the working channel, an input 10 for the optics channel, an input 11 for the rinsing channel and an input 12 for the control channel.
  • the actuating device 13 is preferably detachably connected to the proximal end of the movement transmission device 7. This makes it possible to insert the movement transmission device 7 into the catheter 1 from the distal end through the working channel 3. This allows the use of a biopsy forceps with dimensions larger than the diameter of the working channel 3.
  • an observation optical unit 14 which is connected to an observation device 15 via corresponding optical fibers that extend through the optical channel 4.
  • the observation device 15 preferably has an illumination system for illuminating the work space in which the biopsy forceps 8 is used.
  • the observation device 15 can have an eyepiece.
  • the observation device 15 preferably has a reproduction system which is equipped with a camera and monitor in a known manner. At the input 10, the observation device 15 is connected to the observation optics 14 guided through the optics channel 4.
  • a flushing device 19 is connected to the inlet 11 for the flushing channel 5.
  • the rinsing channel 5 is open at the distal end of the catheter 1 and is used to rinse the work space in which the tissue samples are removed with the biopsy forceps.
  • the illustrated embodiment of the biopsy instrument also includes a control device 16 which can be operated by hand. With the control device 16, tensile forces can be transmitted to the distal end of the catheter 1 via a wire-shaped adjusting element 17.
  • the wire-shaped adjusting element 17 is firmly connected to the distal end of the catheter 1 in a connection point 18.
  • the wire-shaped adjusting element 17 extends up to an opening 20 through the control channel 6. At the opening 20, the control channel 6 opens onto the outside of the catheter 1.
  • the wire-shaped adjusting element 17 extends from the opening 20 to the connection point 18 on the outside of the catheter 1, as shown in Figure 1.
  • the catheter 1 with the distal, axial region in which the adjusting element 17 is guided on the outside of the catheter 1 can be bent transversely to the longitudinal axis of the catheter 1.
  • a rotation about the axis of the catheter 1 is also possible. Both the bending of the axial, distal end piece of the catheter 1 and the rotation are effected by the control device 16.
  • the movement is transmitted from the control device 16 to the distal end of the catheter 1 with the aid of the wire-shaped actuating element 17.
  • the biopsy forceps 8 and the observation optics 14 likewise perform these controlled movements of the distal end of the catheter. This results in a controllable and rotatable biopsy forceps with simultaneous observation of the work space in which the biopsy forceps 8 is operated.
  • the control element 17 is preferably designed to be torsionally rigid in its longitudinal extent and guided in the control channel 6 so that it can rotate.
  • the control mechanism and the control device are preferably designed as described in DE 100 45 036 AI.
  • the control element 17 is guided in the longitudinal direction in the control channel 6.
  • the control channel 6 has an outer diameter of, for example, 0.6 mm and an inner diameter of 0.4 mm.
  • the adjusting element 17 is largely designed as a tube 21 with a wall thickness of approximately 0.16 mm.
  • the inner diameter can be, for example, 0.2 mm and the outer diameter 0.36 mm.
  • the actuator is preferably made of metal. This configuration of the actuating element 17 achieves a torsionally rigid design about its longitudinal axis 23 over its entire length.
  • the torque applied is transmitted exactly to the distal end 22, since the actuating element 5 is designed to be torsionally rigid about its longitudinal axis 23 over its entire length.
  • the tube 21 extends the substantial part of the length of the catheter and can have a length of about 1.70 m or more.
  • the proximal end 24 of the actuating element 17 is connected via a connecting piece 25 to the control device 16 for an axial displacement (double arrow 26 in FIG. 4) and rotation (double arrow 27 in FIG. 4).
  • the distal end 22 of the tubular part 21 of the actuating element 17 is connected to a flexible shaft 29 via a connecting sleeve 28.
  • the flexible shaft 29 thus forms an extension of tubular part 21 of the actuating element 17.
  • the flexible shaft 29 is guided outwards through the opening 20 in the catheter 1 and extends on the outside of the catheter in the longitudinal direction of the catheter. In the area of the distal end of the catheter, the flexible shaft 29 is firmly connected to the catheter in the connection point 18.
  • the length of the flexible shaft 29 corresponds to slightly more than the length of the catheter part to be bent according to FIG. 4 and can be approximately 6 cm, with a length of 3.0 cm to 3.5 cm, in particular 3.2 cm, being guided outside the probe 2 are.
  • the tube 21 and the associated flexible shaft 29 are mounted on the catheter 1 so as to be displaceable in the longitudinal direction.
  • the connecting sleeve 28 from the end of the control channel 6 a corresponding distance of z. B. have about 4 cm. If a pull is exerted on the control element 17 and the flexible shaft 29 by means of the control device 16, the distal end of the catheter is bent, as shown in FIG. 4.
  • the adjusting element 17 and the associated flexible shaft 29 are in the longitudinal direction of the catheter 1 is slidably mounted, as is illustrated by the double arrow 26 in FIG. 4.
  • tubular part 21 of the actuating element 17 and the flexible shaft 29 are rotatably mounted about the axis 23.
  • the axis 23 is angled in the region of the flexible shaft 29. If a torque is transmitted to the tubular part 21 of the actuating element 17 via the connecting piece 25 by means of the control device 16, this torque is transmitted to the flexible shaft 29 by the axially torsionally rigid design of the tubular part 21, so that the flexible shaft 29 also is rotated about the axis 23.
  • These rotary movements are illustrated in FIG. 4 by the double arrows 27, 29.
  • control of the movement of the distal end of the catheter transversely to the axis of the catheter and a rotation of the end of the catheter are controlled with the aid of the control device 16, which is manually operated at the proximal end hen of the catheter, especially in the region of its distal end.
  • the observation optics 14 and the biopsy forceps 8 are carried along.
  • the actuating element 17 is designed at least partially, but over the largest part of its longitudinal extent as a thin tube 21. A torque applied at the proximal end of the adjusting element 17 is transmitted exactly to the distal end. Due to the tubular shape, the control element 17 is designed to be torsionally rigid over its entire length.

Abstract

A biopsy instrument comprising a multichannelled catheter (1), a work support (2) which is arranged on the proximal end of the catheter (1); biopsy forceps (8) arranged on the distal end of a work channel (3) of the catheter (1), an elongate movement transfer device (7) which is joined to the bits of the forceps (8) on the distal end of said movement transfer device, an actuator device (13) which is joined to the proximal end of the movement transfer device (7), an observation lens (14) guided through an lens channel (4) of the catheter (1), a rinsing channel (5) extending longitudinally in the catheter (1), and a control device (16,17) which is guided through a control channel (6) of the catheter (1) and which enables the distal end of the catheter (1) to be bent across the axis of the catheter (30) and to be rotated about the axis of the catheter (30).

Description

Biopsieinstrument A biopsy instrument
[Beschreibung][Description]
Die Erfindung betrifft ein Biopsieinstrument , mit welchem zu Untersuchungszwecken an einem lebenden Organismus Gewebsproben entnommen werden.The invention relates to a biopsy instrument with which tissue samples are taken from a living organism for examination purposes.
[Stand der Technik][State of the art]
Für die Gewebsentnahme sind beispielsweise Biopsiezangen bekannt, bei denen Bewegungen eines Handgriffs über Zug- und Druckelemente, welche durch einen Schaft geführt sind, auf die Zangenteile der am distalen Ende des Schaftes vorgesehe- nen Zange übertragen werden.For tissue extraction, for example, biopsy forceps are known, in which movements of a handle are transmitted to the forceps parts of the forceps provided at the distal end of the shaft via tension and pressure elements which are guided through a shaft.
[Aufgabe der Erfindung]OBJECT OF THE INVENTION
Aufgabe der Erfindung ist es ein Biopsieinstrument zu schaffen, mit welchem bei ständiger Beobachtung des Arbeitsrau- mes, in welchem mit der Biopsiezange Gewebsproben entnommen werden, die Biopsiezange gesteuert bewegt und gedreht werden kann.The object of the invention is to create a biopsy instrument with which the biopsy forceps can be moved and rotated in a controlled manner while continuously observing the working space in which tissue samples are taken with the biopsy forceps.
Diese Aufgabe wird durch ein Biopsieinstrument gemäß dem Schutzanspruch 1 gelöst.This object is achieved by a biopsy instrument according to protection claim 1.
Dieses Biopsieinstrument besitzt einen mehrkanaligen Katheter, insbesondere aus biegbarem Material, an dessen proximalen Ende ein Arbeitsstutzen mit verschiedenen Eingängen für die Kanäle des Katheters vorgesehen ist. Einer dieser Kanäle ist als Arbeitskanal ausgebildet, an dessen distalem Ende eine Biopsiezange, welche eine größere Abmessung als der Durchmesser des Arbeitskanals aufweist, angeordnet werden kann. Die Maulteile der Biopsiezange sind mit einer Bewe- gungsübertragungseinrichtung, welche insbesondere Zug- und Druckkräfte übertragen kann, verbunden. Die längliche, insbesondere stangenförmig ausgebildete und vorzugsweise biegbare Bewegungsübertragungseinrichtung ist vom distalen Ende des Arbeitskanals her in den Arbeitskanal einsteckbar und ragt bis zum zugeordneten Eingang des Arbeitskanals am Arbeitsstutzen, der am proximalen Ende des Katheter vorgesehen ist. Am Eingang des Arbeitskanals oder in der Nähe des Eingangs des Arbeitskanals ist eine vorzugsweise von Hand be- dienbare Betätigungseinrichtung vorgesehen, welche mit dem proximalen Ende der Bewegungsübertragungseinrichtung, die durch den Arbeitskanal geführt ist, verbunden ist. Die Betätigungseinrichtung erzeugt die auf die Maulteile wirkenden Zug- und Druckkräfte. Diese Kräfte werden von der Bewegungs- Übertragungseinrichtung auf die Zangenteile der Biopsiezange übertragen. Vorzugsweise ist die Betätigungseinrichtung lösbar mit dem proximalen Ende der Bewegungsübertragungsein- richtung verbunden. Auf diese Weise kann für -die jeweiligen Gewebsprobenentnahmen die Biopsiezange ausgewechselt werden.This biopsy instrument has a multi-channel catheter, in particular made of bendable material, at the proximal end of which a working socket with different inputs for the channels of the catheter is provided. One of these channels is designed as a working channel, at the distal end of which a biopsy forceps, which has a larger dimension than the diameter of the working channel, can be arranged. The jaw parts of the biopsy forceps are transmission transmission device, which in particular can transmit tensile and compressive forces. The elongated, in particular rod-shaped and preferably bendable, motion transmission device can be inserted into the working channel from the distal end of the working channel and extends up to the assigned input of the working channel on the working nozzle, which is provided at the proximal end of the catheter. At the entrance of the working channel or in the vicinity of the entrance of the working channel, a preferably manually operable actuating device is provided, which is connected to the proximal end of the motion transmission device which is guided through the working channel. The actuating device generates the tensile and compressive forces acting on the jaw parts. These forces are transmitted from the motion transmission device to the forceps parts of the biopsy forceps. The actuating device is preferably detachably connected to the proximal end of the movement transmission device. In this way, the biopsy forceps can be exchanged for the respective tissue sample withdrawals.
In einem weiteren Kanal (Optikkanal) des Katheters wird eine Beobachtungsoptik geführt. Die Beobachtungsoptik kann eine Beleuchtungseinrichtung zum Ausleuchten des Arbeitsraumes, in welchem die Gewebeproben mit der Biopsiezange entnommen werden, enthalten. Die Beobachtungsoptik kann an ein Okular oder an eine Widergabeeinrichtung mit Kamera und Monitor angeschlossen sein.An observation optical system is guided in another channel (optical channel) of the catheter. The observation optics can contain an illumination device for illuminating the work space, in which the tissue samples are removed with the biopsy forceps. The observation optics can be connected to an eyepiece or to a reproduction device with a camera and monitor.
In einem separaten Steuerkanal des Katheters wird ein Steu- ermechanismus geführt, welcher am proximalen Ende mit einem von Hand betätigbaren Steuergerät verbunden ist und der an seinem distalen Ende mit dem distalen Katheterende verbunden ist. Drehbewegungen und Zug und Druckbewegungen, welche vom proximalen Steuergerät erzeugt werden, werden vom Steuerme- chanismus auf das distale Katheterende übertragen, so dass dieses quer zur Katheterachse biegbar und um die Katheterachse drehbar ist.A control mechanism is guided in a separate control channel of the catheter, which is connected at the proximal end to a hand-operated control device and which is connected at its distal end to the distal end of the catheter. Rotational movements and pulling and pushing movements, which are generated by the proximal control device, are controlled by the control Mechanism transferred to the distal end of the catheter so that it is bendable transversely to the catheter axis and rotatable about the catheter axis.
Ferner erstreckt sich durch den Katheter ein am distalen Ende offener Spülkanal. Der Spülkanal ist an seinem am Arbeitsstutzen vorgesehenen Eingang mit einem Spülsystem verbunden .An irrigation channel open at the distal end also extends through the catheter. The flushing channel is connected to a flushing system at its inlet provided on the working nozzle.
Beispielsweise kann das erfindungsgemäße Biopsieinstrument als Papillotom (Dreilumenpapilloto ) zum Einsatz kommen.For example, the biopsy instrument according to the invention can be used as a papillotome (three-lumen papilloto).
[Beispiele][Examples]
Anhand der Figuren wird an einem Ausführungsbeispiel die Er- findung noch näher erläutert. Es zeigt:On the basis of the figures, the invention is explained in more detail using an exemplary embodiment. It shows:
Figur 1 den distalen und proximalen Bereich eines1 shows the distal and proximal area of a
Biopsieinstruments , welches ein Ausführungsbeispiel der Erfindung ist; Figur 2 einen Schnitt entlang einer Schnittlinie IIBiopsy instrument, which is an embodiment of the invention; 2 shows a section along a section line II
- II in der Figur 1 ; Figur 3 eine Ausführungsform der Steuereinrichtung; und Figur 4 eine Darstellung des distalen Katheterendes zur Erläuterung der Wirkungsweise der Steuereinrichtung .- II in Figure 1; Figure 3 shows an embodiment of the control device; and FIG. 4 shows the distal end of the catheter to explain the mode of operation of the control device.
Das in den Figuren als Ausführungsbeispiel dargestellte Biopsieinstrument beinhaltet einen Katheter 1, der vorzugswei- se aus einem biegbaren Material besteht. Im Katheter erstrecken sich in Längsrichtung vier Kanäle (Lumen) . Es handelt sich hier um einen Arbeitskanal 3, einen Optikkanal 4, einen Spülkanal 5 und einen Steuerkanal 6. Am distalen Ende des Arbeitskanals 3 befindet sich eine Biopsiezange 8. Die Biopsiezange 8 besitzt Maulteile, deren Abmessungen quer zur Längsrichtung des Arbeitskanals 3, größer sind als der Durchmesser des Arbeitskanals 3. Die Maul- teile der Zangen können löffelartig mit großen Löffelbauschen ausgebildet sein. Die Maulteile der Biopsiezange 8 sind mit dem distalen Ende einer Bewegungsübertragungsein- richtung 7 verbunden. Diese Bewegungsübertragungseinrichtung 7 erstreckt sich durch den Arbeitskanal 3. Die Bewegungs- Übertragungseinrichtung 7 kann in bekannter Weise als Zug-/ Druckstange oder als Bowdenzug ausgebildet sein und Bewegungen, welche von einer Betätigungseinrichtung 13 für die Biopsiezange von Hand erzeugt werden, auf die Maulteile der Biopsiezange 8 übertragen. Die Bewegungsübertragungseinrich- tung 7 erstreckt sich durch den Arbeitskanal 3. Am proximalen Ende der Bewegungsübertragungseinrichtung 7 ist im Bereich des Einganges 9 für den Arbeitskanal die Betätigungseinrichtung 13 an das proximale Ende der Bewegungsübertra- gungseinrichtung 7 angeschlossen.The biopsy instrument shown as an exemplary embodiment in the figures contains a catheter 1, which preferably consists of a bendable material. Four channels (lumens) extend in the longitudinal direction in the catheter. This is a working channel 3, an optics channel 4, a rinsing channel 5 and a control channel 6. A biopsy forceps 8 is located at the distal end of the working channel 3. The biopsy forceps 8 has jaw parts whose dimensions transversely to the longitudinal direction of the working channel 3 are larger than the diameter of the working channel 3. The jaw parts of the forceps can be designed like spoons with large spoon bulbs. The jaw parts of the biopsy forceps 8 are connected to the distal end of a movement transmission device 7. This movement transmission device 7 extends through the working channel 3. The movement transmission device 7 can be designed in a known manner as a pull / push rod or as a Bowden cable and movements which are generated by an actuating device 13 for the biopsy forceps on the jaw parts of the biopsy forceps 8 transferred. The movement transmission device 7 extends through the working channel 3. At the proximal end of the movement transmission device 7, in the area of the input 9 for the working channel, the actuating device 13 is connected to the proximal end of the movement transmission device 7.
Am proximalen Ende des Katheters 1 befindet sich ein Arbeitsstutzen 2, der vier verschiedene Eingänge für die im Katheter 1 längsverlaufen Kanäle aufweist. Es handelt sich um einen Eingang 9 für den Arbeitskanal, einen Eingang 10 für den Optikkanal, einen Eingang 11 für den Spülkanal und einen Eingang 12 für den Steuerkanal.At the proximal end of the catheter 1 there is a working socket 2 which has four different entrances for the channels running longitudinally in the catheter 1. It is an input 9 for the working channel, an input 10 for the optics channel, an input 11 for the rinsing channel and an input 12 for the control channel.
Die Betätigungseinrichtung 13 ist vorzugsweise lösbar mit dem proximalen Ende der Bewegungsübertragungseinrichtung 7 verbunden. Hierdurch ist es möglich, die Bewegungsübertra- gungseinrichtung 7 vom distalen Ende her durch den Arbeitskanal 3 in den Katheter 1 einzuführen. Dies erlaubt die Verwendung einer Biopsiezange, mit größeren Abmessungen als der Durchmesser des Arbeitskanals 3. Am distalen Ende des Katheters 1 befindet sich ferner eine Beobachtungsoptik 14, die über entsprechende Lichtleiterfasern, die sich durch den Optikkanal 4 erstrecken, mit einer Beobachtungseinrichtung 15 verbunden ist. Die Beobachtungseinrichtung 15 besitzt vorzugsweise ein Beleuchtungssystem zum Ausleuchten des Arbeitsraumes, in welchem die Biopsiezange 8 eingesetzt wird. Die Beobachtungseinrichtung 15 kann ein Okular aufweisen. Vorzugsweise besitzt die Beobachtungs- einrichtung 15 ein Wiedergabesystem, welches mit Kamera und Monitor in bekannter Weise ausgestattet ist . Am Eingang 10 ist die Beobachtungseinrichtung 15 mit der durch den Optikkanal 4 geführten Beobachtungsoptik 14 verbunden.The actuating device 13 is preferably detachably connected to the proximal end of the movement transmission device 7. This makes it possible to insert the movement transmission device 7 into the catheter 1 from the distal end through the working channel 3. This allows the use of a biopsy forceps with dimensions larger than the diameter of the working channel 3. At the distal end of the catheter 1 there is also an observation optical unit 14, which is connected to an observation device 15 via corresponding optical fibers that extend through the optical channel 4. The observation device 15 preferably has an illumination system for illuminating the work space in which the biopsy forceps 8 is used. The observation device 15 can have an eyepiece. The observation device 15 preferably has a reproduction system which is equipped with a camera and monitor in a known manner. At the input 10, the observation device 15 is connected to the observation optics 14 guided through the optics channel 4.
Am Eingang 11 für den Spülkanal 5 ist eine Spüleinrichtung 19 angeschlossen. Der Spülkanal 5 ist am distalen Ende des Katheters 1 geöffnet und dient zur Spülung des Arbeitsraumes, in welchem die Gewebsproben mit der Biopsiezange entnommen werden.A flushing device 19 is connected to the inlet 11 for the flushing channel 5. The rinsing channel 5 is open at the distal end of the catheter 1 and is used to rinse the work space in which the tissue samples are removed with the biopsy forceps.
Das dargestellte Ausführungsbeispiel des Biopsieinstruments beinhaltet ferner ein Steuergerät 16, welches von Hand betätigbar ist. Mit dem Steuergerät 16 können über ein drahtför- miges Stellelement 17 Zugkräfte auf das distale Ende des Ka- theters 1 übertragen werden. Das drahtförmige Stellelement 17 ist hierzu in einer Verbindungsstelle 18 mit dem distalen Ende des Katheters 1 fest verbunden.The illustrated embodiment of the biopsy instrument also includes a control device 16 which can be operated by hand. With the control device 16, tensile forces can be transmitted to the distal end of the catheter 1 via a wire-shaped adjusting element 17. For this purpose, the wire-shaped adjusting element 17 is firmly connected to the distal end of the catheter 1 in a connection point 18.
Das drahtförmige Stellelement 17 erstreckt sich bis zu einer Öffnung 20 durch den Steuerkanal 6. An der Öffnung 20 mündet der Steuerkanal 6 an die Außenseite des Katheters 1. Von der Öffnung 20 bis zur Verbindungsstelle 18 erstreckt sich das drahtförmige Stellelement 17 an der Außenseite des Katheters 1, wie es in der Figur 1 dargestellt ist. Mit dem Steuerge- rät 16 und dem Stellelement 17, kann der Katheter 1 mit dem distalen, axialen Bereich, in welchem das Stellelement 17 an der Außenseite des Katheters 1 geführt wird, quer zur Längsachse des Katheters 1 gebogen werden. Ferner ist eine Dre- hung um die Achse des Katheters 1 möglich. Sowohl das Biegen des axialen, distalen Endstückes des Katheters 1 als auch die Drehung, werden von dem Steuergerät 16 bewirkt. Die Bewegungsübertragung erfolgt mit Hilfe des drahtförmigen Stellelementes 17 vom der Steuergerät 16 zum distalen Ende des Katheters 1. Die Biopsiezange 8 sowie die Beobachtungsoptik 14 führen diese gesteuerten Bewegungen des distalen Katheterendes ebenfalls aus. Hierdurch erreicht man eine steuerbare und rotierbare Biopsiezange mit gleichzeitiger Beobachtung des Arbeitsraumes, in welchem die Biopsiezange 8 betätigt wird.The wire-shaped adjusting element 17 extends up to an opening 20 through the control channel 6. At the opening 20, the control channel 6 opens onto the outside of the catheter 1. The wire-shaped adjusting element 17 extends from the opening 20 to the connection point 18 on the outside of the catheter 1, as shown in Figure 1. With the tax advises 16 and the adjusting element 17, the catheter 1 with the distal, axial region in which the adjusting element 17 is guided on the outside of the catheter 1 can be bent transversely to the longitudinal axis of the catheter 1. A rotation about the axis of the catheter 1 is also possible. Both the bending of the axial, distal end piece of the catheter 1 and the rotation are effected by the control device 16. The movement is transmitted from the control device 16 to the distal end of the catheter 1 with the aid of the wire-shaped actuating element 17. The biopsy forceps 8 and the observation optics 14 likewise perform these controlled movements of the distal end of the catheter. This results in a controllable and rotatable biopsy forceps with simultaneous observation of the work space in which the biopsy forceps 8 is operated.
Vorzugsweise ist das Stellelement 17 in seiner Längsausdeh- nung drehsteif ausgebildet und verdrehbar im Steuerkanal 6 geführt. Der Steuermechanismus und die Steuereinrichtung sind vorzugsweise so ausgebildet, wie es in der DE 100 45 036 AI beschrieben ist.The control element 17 is preferably designed to be torsionally rigid in its longitudinal extent and guided in the control channel 6 so that it can rotate. The control mechanism and the control device are preferably designed as described in DE 100 45 036 AI.
Eine bevorzugte Ausführungsform der Steuereinrichtung wird anhand der Figuren 3 und 4 erläutert. Im Steuerkanal 6 wird das Stellelement 17 in Längsrichtung geführt. Der Steuerkanal 6 besitzt einen Außendurchmesser von beispielsweise 0,6 mm und einen Innendurchmesser von 0,4 mm. Das Stellelement 17 ist größtenteils als Röhrchen 21 ausgebildet mit einer Wandstärke von ca. 0,16 mm.. Der Innendurchmesser kann bei- spielsweise 0,2 mm und der Außendurchmesser 0,36 mm betragen. Das Stellelement besteht vorzugsweise aus Metall. Durch diese Ausgestaltung des Stellelements 17 erreicht man über seine gesamte Länge hin eine drehsteife Ausbildung um seine Längsachse 23. Ein am proximalen Ende 24 des Röhrchens 21 aufgebrachtes Drehmoment wird exakt zum distalen Ende 22 ü- bertragen, da das Stellelement 5 um seine Längsachse 23 über seine gesamte Länge hin drehsteif ausgebildet ist. Das Röhrchen 21 erstreckt sich über den wesentlichen Teil der Länge des Katheters und kann eine Länge von etwa 1,70 m oder mehr habe .A preferred embodiment of the control device is explained with reference to FIGS. 3 and 4. The control element 17 is guided in the longitudinal direction in the control channel 6. The control channel 6 has an outer diameter of, for example, 0.6 mm and an inner diameter of 0.4 mm. The adjusting element 17 is largely designed as a tube 21 with a wall thickness of approximately 0.16 mm. The inner diameter can be, for example, 0.2 mm and the outer diameter 0.36 mm. The actuator is preferably made of metal. This configuration of the actuating element 17 achieves a torsionally rigid design about its longitudinal axis 23 over its entire length. One at the proximal end 24 of the tube 21 The torque applied is transmitted exactly to the distal end 22, since the actuating element 5 is designed to be torsionally rigid about its longitudinal axis 23 over its entire length. The tube 21 extends the substantial part of the length of the catheter and can have a length of about 1.70 m or more.
Das proximale Ende 24 des Stellelementes 17 ist über ein Verbindungsstück 25 mit dem Steuergerät 16 für eine axiale Verschiebung (Doppelpfeil 26 in Figur 4) und Drehung (Doppelpfeil 27 in Figur 4) verbunden. Das distale Ende 22 des röhrchenförmigen Teiles 21 des Stellelementes 17 ist über eine Verbindungshülse 28 mit einer flexiblen Welle 29 verbunden. Die flexible Welle 29 bildet somit eine Verlängerung röhrchenförmigen Teils 21 des Stellelementes 17. Die flexible Welle 29 ist durch die Öffnung 20 im Katheter 1 nach außen geführt und erstreckt sich an der Katheteraußenseite in Längsrichtung des Katheters. Im Bereich des distalen Katheterendes ist die flexible Welle 29 in der Verbindungsstelle 18 fest mit dem Katheter verbunden. Die Länge der flexiblen Welle 29 entspricht etwas mehr als der Länge des gemäß Figur 4 abzubiegenden Katheterteils und kann etwa 6 cm betragen, wobei etwa eine Länge von 3,0 cm bis 3,5 cm, insbesondere 3,2 cm außerhalb der Sonde 2 geführt sind.The proximal end 24 of the actuating element 17 is connected via a connecting piece 25 to the control device 16 for an axial displacement (double arrow 26 in FIG. 4) and rotation (double arrow 27 in FIG. 4). The distal end 22 of the tubular part 21 of the actuating element 17 is connected to a flexible shaft 29 via a connecting sleeve 28. The flexible shaft 29 thus forms an extension of tubular part 21 of the actuating element 17. The flexible shaft 29 is guided outwards through the opening 20 in the catheter 1 and extends on the outside of the catheter in the longitudinal direction of the catheter. In the area of the distal end of the catheter, the flexible shaft 29 is firmly connected to the catheter in the connection point 18. The length of the flexible shaft 29 corresponds to slightly more than the length of the catheter part to be bent according to FIG. 4 and can be approximately 6 cm, with a length of 3.0 cm to 3.5 cm, in particular 3.2 cm, being guided outside the probe 2 are.
Das Röhrchen 21 und die damit verbundene flexible Welle 29 sind in Längsrichtung verschiebbar am Katheter 1 gelagert. Hierzu kann die Verbindungshülse 28 vom Ende des Steuerkanals 6 einen entsprechenden Abstand von z. B. etwa 4 cm auf- weisen. Wenn auf das Stellelement 17 und die flexible Welle 29 mittels des Steuergerätes 16 ein Zug ausgeübt wird, erreicht man eine Abwinkelung des distalen Katheterendes, wie es in Fig. 4 dargestellt ist. Das Stellelement 17 und die dazugehörige flexible Welle 29 sind hierzu in Längsrichtung des Katheters 1 verschiebbar gelagert, wie es durch den Doppelpfeil 26 in Fig. 4 verdeutlicht ist.The tube 21 and the associated flexible shaft 29 are mounted on the catheter 1 so as to be displaceable in the longitudinal direction. For this purpose, the connecting sleeve 28 from the end of the control channel 6 a corresponding distance of z. B. have about 4 cm. If a pull is exerted on the control element 17 and the flexible shaft 29 by means of the control device 16, the distal end of the catheter is bent, as shown in FIG. 4. For this purpose, the adjusting element 17 and the associated flexible shaft 29 are in the longitudinal direction of the catheter 1 is slidably mounted, as is illustrated by the double arrow 26 in FIG. 4.
Ferner sind der röhrchenförmige Teil 21 des Stellelements 17 und die flexible Welle 29 drehbar um die Achse 23 gelagert. Bei abgewinkeltem Katheterende (Fig. 4) verläuft die Achse 23 im Bereich der flexiblen Welle 29 abgewinkelt. Wenn mittels des Steuergerätes 16 ein Drehmoment über das Verbindungsstück 25 auf das röhrchenförmige Teil 21 des Stellele- mentes 17 übertragen wird, wird dieses Drehmoment durch die axiale drehsteife Ausbildung des röhrchenförmigen Teils 21 auf die flexible Welle 29 übertragen, so dass auch die flexible Welle 29 um die Achse 23 gedreht wird. Diese Drehbewegungen sind in der Fig. 4 durch die Doppelpfeile 27, 29 ver- deutlicht. Bei der Drehung der flexiblen Welle 29 wird auf das abgewinkelte distale Katheterende ein Drehmoment übertragen, so dass dieses sich um eine Längsachse 30 des Katheters 1 verschwenkt. Diese Schwenkbewegung ist durch einen Doppelpfeil 31 in der Fig. 4 verdeutlicht. Je nachdem, in welche Richtung das distale Katheterende geführt werden uss, kann über das Stellelement 17 eine Zugwirkung zur entsprechenden Abwinkelung des Katheterendes ausgeübt werden und anschließend das distale Katheterende in die erforderliche Richtung im Sinne des Doppelpfeiles 31 um die Längsachse 30 des Katheters 1 geschwenkt werden. Mit Hilfe der am distalen Katheterende vorgesehenen Beobachtungsoptik 14, welche an ein Okular oder ein anderes Beobachtungsgerät wie Bildschirm oder Monitor angeschlossen sein kann, lässt sich eine exakte Führung des distalen Katheterendes im Arbeits- räum (Körperlumen) erreichen.Furthermore, the tubular part 21 of the actuating element 17 and the flexible shaft 29 are rotatably mounted about the axis 23. When the catheter end is angled (FIG. 4), the axis 23 is angled in the region of the flexible shaft 29. If a torque is transmitted to the tubular part 21 of the actuating element 17 via the connecting piece 25 by means of the control device 16, this torque is transmitted to the flexible shaft 29 by the axially torsionally rigid design of the tubular part 21, so that the flexible shaft 29 also is rotated about the axis 23. These rotary movements are illustrated in FIG. 4 by the double arrows 27, 29. When the flexible shaft 29 rotates, a torque is transmitted to the angled distal end of the catheter, so that it pivots about a longitudinal axis 30 of the catheter 1. This pivoting movement is illustrated by a double arrow 31 in FIG. 4. Depending on the direction in which the distal end of the catheter has to be guided, a pulling action can be exerted via the adjusting element 17 to correspondingly bend the end of the catheter and then the distal end of the catheter can be pivoted in the required direction in the direction of the double arrow 31 about the longitudinal axis 30 of the catheter 1 , With the aid of the observation optics 14 provided at the distal end of the catheter, which can be connected to an eyepiece or another observation device such as a screen or monitor, an exact guidance of the distal end of the catheter in the working space (body lumen) can be achieved.
Hierdurch wird mit Hilfe des am proximalen Ende von Hand zu betätigenden Steuergerätes 16 die Steuerung der Bewegung des distalen Katheterendes quer zur Katheterachse sowie ein Dre- hen des Katheters, insbesondere im Bereich seines distalen Ende erreicht. Die Beobachtungsoptik 14 und die Biopsiezange 8 werden dabei mitgeführt.In this way, the control of the movement of the distal end of the catheter transversely to the axis of the catheter and a rotation of the end of the catheter are controlled with the aid of the control device 16, which is manually operated at the proximal end hen of the catheter, especially in the region of its distal end. The observation optics 14 and the biopsy forceps 8 are carried along.
Das Stellelement 17 ist hierzu zumindest teilweise, jedoch über den größten Teil seiner Längsausdehnung als dünnes Rόhrchen 21 ausgeführt. Ein am proximalen Ende des Stellelements 17 aufgebrachtes Drehmoment wird exakt bis zum distalen Ende übertragen. Durch die Röhrchenform ist das Stell- element 17 über seine gesamte Länge hin drehsteif ausgebildet . For this purpose, the actuating element 17 is designed at least partially, but over the largest part of its longitudinal extent as a thin tube 21. A torque applied at the proximal end of the adjusting element 17 is transmitted exactly to the distal end. Due to the tubular shape, the control element 17 is designed to be torsionally rigid over its entire length.
[Bezugszeichenliste][REFERENCE LIST]
Katheter Arbeitsstutzen Arbeitskanal Optikkanal SpülkanalCatheter working socket working channel optical channel rinsing channel
6 Steuerkanal Bewegungsübertragungseinriehtung 8 Biopsiezange6 control channel motion transmission device 8 biopsy forceps
9 Eingang für Arbeitskanal9 Input for working channel
10 Eingang für Optikkanal10 input for optical channel
11 Eingang für Spülkanal11 Entrance for flushing channel
12 Eingang für Steuerkanal 13 Betätigungseinrichtung für Biopsiezange12 Input for control channel 13 Actuator for biopsy forceps
14 Beobachtungsoptik14 observation optics
15 Beobachtungseinrichtung15 observation device
16 Steuereinrichtung16 control device
17 draht örmiges Stellelement 18 Verbindungsstelle17 wire-shaped control element 18 connection point
19 Spüleinrichtung19 rinsing device
20 Öffnung20 opening
21 Röhrchen21 tubes
22 distales Ende des Röhrchens 23 Längsachse des Stellelements22 distal end of the tube 23 longitudinal axis of the adjusting element
24 proximales Ende des Röhrchens24 proximal end of the tube
25 Verbindungsstück25 connector
26 Axialverschiebung26 axial displacement
27 Drehrichtungen 28 Verbindungshülse27 directions of rotation 28 connecting sleeve
29 Drehrichtungen29 directions of rotation
30 Katheterlängsachse30 longitudinal catheter axis
31 Drehrichtungen 31 directions of rotation

Claims

[Patentansprüche] [Claims]
1. Biopsieinstrument gekennzeichnet durch einen mehrkanaligen Katheter (1); - einen am proximalen Ende des Katheters (1) angeordneten Arbeitsstutzen (2) mit mehreren, insbesondere vier Eingängen (9 - 12) für die Kanäle (3 - 6) des Katheters (1) ; eine am distalen Ende eines Arbeitskanals (3) des Ka- theters (1) angeordnete Biopsiezange (8) , welche quer zur Katheterachse (30) eine größere Abmessung aufweist, als der Durchmesser des Arbeitskanals (3) ; eine länglich ausgebildete Bewegungsübertragungsein- richtung (7), die an ihrem distalen Ende mit den Maulteilen der Biopsiezange (8) verbunden ist und vom distalen Ende des Arbeitskanals (3) her durch den Arbeitskanal (3) bis mindestens zum zugeordneten Eingang (9) am Arbeitsstutzen (2) geführt ist; eine am Eingang (9) des Arbeitskanals (3) vorgesehene Betätigungseinrichtung (13), welche mit dem proximalen Ende der durch den Arbeitskanal (3) geführten Be- wegungsübertragungseinrichtung (7) verbunden ist; eine durch einen Optikanal (4) des Katheters (1) geführte Beobachtungsoptik (14); - einen in Katheter (1) längs verlaufenden Spülkanal1. Biopsy instrument characterized by a multi-channel catheter (1); - A working nozzle (2) arranged at the proximal end of the catheter (1) with several, in particular four, entrances (9-12) for the channels (3-6) of the catheter (1); a biopsy forceps (8) which is arranged at the distal end of a working channel (3) of the catheter (1) and which has a larger dimension transverse to the catheter axis (30) than the diameter of the working channel (3); an elongated movement transmission device (7) which is connected at its distal end to the jaw parts of the biopsy forceps (8) and from the distal end of the working channel (3) through the working channel (3) to at least the assigned entrance (9) on Working nozzle (2) is guided; an actuating device (13) provided at the entrance (9) of the working channel (3), which is connected to the proximal end of the movement transmission device (7) guided through the working channel (3); observation optics (14) guided through an optic channel (4) of the catheter (1); - A flushing channel running lengthwise in catheter (1)
(5), welcher am Spüleingang (10) des Arbeitsstutzens (2) mit einer Spüleinrichtung (19) verbunden ist; eine durch einen Steuerkanal (6) des Katheters (1) geführte Steuereinrichtung (16, 17), mit welcher das distale Ende des Katheters (1) quer zur Katheterachse (30) biegbar und um die Katheterachse (30) drehbar is .(5), which is connected to a flushing device (19) at the flushing inlet (10) of the work nozzle (2); a control device (16, 17) which is guided through a control channel (6) of the catheter (1) and by means of which the distal end of the catheter (1) is transverse to the catheter axis (30) bendable and rotatable about the catheter axis (30).
2. Biopsieinstrument nach Anspruch 1, dadurch gekennzeichnet, dass die Betätigungseinrichtung (13) mit dem proximalen Ende der Bewegungsübertragungs- einrichtung (7) lösbar verbunden ist.2. Biopsy instrument according to claim 1, characterized in that the actuating device (13) with the proximal end of the movement transmission device (7) is detachably connected.
3. Biopsieinstrument nach Anspruch 1, dadurch gekennzeichnet, dass die Beobachtungsoptik (14) in den Optikkanal (4) modular einsetzbar ist.3. Biopsy instrument according to claim 1, characterized in that the observation optics (14) in the optics channel (4) can be used modularly.
4. Biopsieinstrument nach Anspruch 1, dadurch gekennzeichnet, dass die Steuereinrichtung (16, 17) ein Stellelement (17) aufweist, welches an seinem distalen Ende mit dem distalen Ende des Katheters (1) in einer Verbindungsstelle (18) verbunden ist und dass das Stellelement (17) sich durch den Steuerkanal (6) im Katheter (1) erstreckt und in der Nähe des distalen Ende durch eine Öffnung (20) an die Katheteraußenseite geführt ist und von der Öffnung (20) bis zur Verbindungsstelle (18) an der Außenseite des Katheters (1) ver- läuft.4. Biopsy instrument according to claim 1, characterized in that the control device (16, 17) has an actuating element (17) which is connected at its distal end to the distal end of the catheter (1) in a connection point (18) and that Control element (17) extends through the control channel (6) in the catheter (1) and is guided in the vicinity of the distal end through an opening (20) to the outside of the catheter and from the opening (20) to the connection point (18) at the The outside of the catheter (1) runs.
5. Biopsieinstrument nach einem der Ansprüche 1 bis 4, dadurch gekennzeichnet, dass das Stellelement (17) in seiner Längsrichtung drehsteif ausgebildet ist.5. Biopsy instrument according to one of claims 1 to 4, characterized in that the adjusting element (17) is torsionally rigid in its longitudinal direction.
6. Biopsieinstrument nach einem der Ansprüche 1 bis 5, dadurch gekennzeichnet, dass das Stellelement (17) zumindest teilweise röhrchenförmig ausgebildet ist. 6. Biopsy instrument according to one of claims 1 to 5, characterized in that the adjusting element (17) is at least partially tubular.
PCT/EP2003/003390 2002-04-03 2003-04-01 Biopsy instrument WO2003082394A1 (en)

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AU2003236833A AU2003236833A1 (en) 2002-04-03 2003-04-01 Biopsy instrument
DE10391070T DE10391070D2 (en) 2002-04-03 2003-04-01 A biopsy instrument

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DE20205190U DE20205190U1 (en) 2002-04-03 2002-04-03 A biopsy instrument

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GB2598710A (en) * 2020-08-05 2022-03-16 Creo Medical Ltd Catheter and catheter kit including such catheter

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US9339173B2 (en) 2004-03-23 2016-05-17 Boston Scientific Scimed, Inc. In-vivo visualization system
US11064869B2 (en) 2004-03-23 2021-07-20 Boston Scientific Scimed, Inc. In-vivo visualization system
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US10058236B2 (en) 2004-08-09 2018-08-28 Boston Scientific Scimed, Inc. Fiber optic imaging catheter
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US10863889B2 (en) 2007-08-23 2020-12-15 Polydiagnost Entwicklungs—, Produktions—, Vertriebs—, Und Service GmbH Modular endoscope

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