EP1250080A1

EP1250080A1 - Flexible endoscope

Info

Publication number: EP1250080A1
Application number: EP01914998A
Authority: EP
Inventors: Viktor Josef Wimmer
Original assignee: Xion GmbH
Current assignee: Xion GmbH
Priority date: 2000-01-28
Filing date: 2001-01-25
Publication date: 2002-10-23
Also published as: WO2001054564A1; DE10003668A1; DE10003668B4

Abstract

The invention relates to an endoscope comprising a flexible endoscope shaft (15a) and at least one flexible channel (16, 17, 18), open at the distal end, in particular, a working channel (17), which is arranged externally on the endoscope shaft (15a), such that it may be attached and removed and to permit a simple cleaning by an operator. The invention further relates to a flexible channel (16, 17, 18) for the above.

Description

Flexible endoscope

The invention relates to a flexible endoscope with the features of the preamble of claim 1 and a flexible channel for such an endoscope.

Endoscopes of this type with a flexible endoscope shaft usually have flexible lines lying inside the endoscope shaft for the optics located on the endoscope head as well as a flexible, hermetic to the inside of the

Endoscope sealed working channel for inserting tools such as pliers. The channels for light and optics are connected at the distal end to lenses, cameras or the like which have no opening to the surroundings. These channels or lines are therefore easily hermetically sealed from the environment.

In contrast, an opening for the emergence of a tool must be provided at the distal end of a working channel, so that through this opening the working channel becomes contaminated with blood or the like during an operation or examination. Even when using seals, for example in the form of O-rings, there is a risk of dirt penetrating at the distal end, so that external cleaning is not sufficient to ensure the necessary sterility for a next examination or operation.

However, the cleaning solutions existing in the prior art, in particular by flushing such channels, such as, for example, working channel, water and air channel, Bowden cable, etc., are cumbersome and time-consuming for the operator. medical personnel, such as doctors or medical assistants.

DE 196 27 016 C1 therefore dispensed with any seals and provided a dedicated Bowden cable channel for a Bowden cable that was sealed with respect to the endoscope, with cleaning after each examination by loosening the Bowden cable cable at the proximal end and releasing a lock on the head Carrier device from the endoscope head and the Bowden cable can be pulled out of the Bowden cable channel. After that, the Bowden cable duct can easily pass through due to its larger inner diameter

Flushing and the Bowden cable itself and the carrier device can be easily cleaned outside the endoscope.

Despite this improvement, which has proven itself in practice, there is a desire for further simplification and time saving in the cleaning of the endoscope or at least the endoscope shaft necessary after each operation or examination and removal of the contaminants which have penetrated into the channels at the distal end.

In general, flexible endoscopes with ducts must be cleaned and then placed in a disinfectant solution, whereby a flushing flow of the ducts should be ensured so that hygiene is guaranteed in these critical zones.

This is partly due to intensive manual pre-cleaning by the operating staff, i.e. the endoscopy staff, and subsequent cleaning in manual or semi-automatic endoscope washing machines with chemical disinfectants. fection agents or with fully automatic endoscopes that enable chemical-thermal disinfection.

In addition, according to new future EU regulations, the flow rate through all channels, some with a cross-section less than one millimeter, must be verifiably shown over a length of one to two meters (validation).

However, this hygiene standard can only be achieved with new, expensive, fully automatic machines that work with higher flow pressures and aggressive disinfectants, which in turn increases the service intensity and thus the maintenance costs of the endoscopes.

Furthermore, canals in the endoscopy, such as working, air and water canals, can be damaged by constipation or even perforation. In known endoscopes, this must disadvantageously due to such damage

Endoscope can be disassembled in a costly and time-consuming general repair in order to be able to remove these channels from the air-water suction cylinders and to detach them from the distal head.

So far, for example, the violation of the working channel, e.g. one

Perforation to be expected to cause great damage to the endoscope. As a result of the damage, it is no longer possible to adequately clean the endoscope, in particular the inner wall of the canal, since rinsing liquid can get through the perforation into the inside of the endoscope during cleaning. In such a case of damage (perforation or even liquid that has already penetrated into the endoscope), the endoscope has to be repaired in a costly and time-consuming work by the service in a special service company or at the manufacturer. The cause of such perforations has been found to be that the channels, in particular the working channel, are exposed to very high levels of wear due to the ongoing examination process, for example pushing the forceps in and pulling out the forceps in the case of tissue samples in conjunction with additional bending in the distal tip of, for example, 180 ° to 210 ° are. Trial examinations with the

Microscopes showed that scratches and scratches appear in the working channels caused by the instruments. However, these surface injuries always pose a threat to hygiene. In the worst case, perforation can even occur in the working channel, as a result of which there is a risk of dirt and moisture (blood, secretions, disinfectants) penetrating into the distal area, in the control area and in the shaft area of the endoscope.

The invention is therefore based on the object of creating an endoscope and at least one channel of such an endoscope, which ensure simple and time-saving cleaning by non-technical operating personnel, that is to say a doctor or an assistant, and reduce costly and time-consuming repairs ,

Cleaning, which can only be carried out by technical personnel (maintenance technicians), is inconceivable in practice due to the hygiene reasons, cleaning operations that are often necessary several times a day and the resulting cost and time expenditure. For the purposes of the invention, therefore, only an operator, not medical personnel, is considered as the operator, who cleans the endoscope after an examination or operation (assistant) and possibly also operates it (doctor). This object is achieved according to the invention with an endoscope and at least one channel therefor according to claims 1 and 10.

As a result, a simple and time-saving channel exchange, even of different channel diameters with the highest hygiene standard, is guaranteed by a non-technical staff, ie a doctor or an assistant, or by the endoscopy staff.

Due to the detachable and attachable external attachment of a channel, in particular a working channel, to the endoscope shaft, it is also non-technical

Personnel can easily separate those parts that are also contaminated at least in their distal area from the parts of the endoscope or the shaft where there is no contamination on the inside due to the lack of necessary openings. In this way, the parts which are also contaminated on the inside can be separated from the endoscope in a simple manner, for example by rinsing, steam, autoclave, etc., and can be reused on the endoscope shaft after being replaced. In this way, in everyday medical use of an endoscope (operating room or examination), the subsequent cleaning required in each case can be carried out quickly and easily by an operator without special knowledge and skills, in a cost-effective and time-saving manner.

Of course, after using an endoscope, instead of subsequent cleaning of the external channels, already cleaned channels can be put on for a new use, so that the dirty channels are cleaned later, for example with other dirty channels. In addition, it is conceivable to manufacture the external channel or channels as a disposable part, so that after a single use, the channel or channels can be removed and replaced by new attachable parts. Furthermore, it is conceivable, for example by attaching a channel, in particular a working channel, to an endoscope, which is only used for examination and therefore only has the lines or channels for light and optics in the interior of the shaft, to an endoscope with at least one Upgrade working channel and possibly additional channels for air and water.

In addition, an endoscope, which is provided for attaching external channels, can be used as a pure examination endoscope, which only has light and optics, by removing these channels. In this way, not only is it possible to upgrade existing examination endoscopes, but also the dual usability of the endoscope according to the invention, namely with or without external channels, and thereby advantageously contributes to cost savings.

Furthermore, the external arrangement of such channels allows contaminants to penetrate into the interior of the endoscope, for example, through worn or broken channels and thus destroy the entire system

Endoscopes can be prevented.

In a similar way to that described above for an external working channel, a flexible water and / or air channel can additionally or instead be arranged on the outside of the endoscope shaft in a detachable and attachable manner, in order also for simple cleaning by an operator, that is to say non-technical staff such as a doctor or medical assistant to enable. Hereby the areas of application of such an endoscope are advantageously increased, since this enables further work processes such as rinsing, inflation, etc.

In order to increase the stability of the attachment of these channels, in particular the air and water channel, the channels in the proximal area on the endoscope housing can advantageously be connected to a valve module via rigid tubes or lines that are also located on the outside. In order to ensure the releasability and attachability, either a connection point, for example between a flexible duct and rigid tube and / or between a tube and valve module, is designed to be detachable, or the valve module itself is designed to be removable and insertable together with the duct or the duct and the tube ,

In order to improve the stability and the cohesion as well as the assignment between channels and shaft, holding elements, for example in the form of rings made of elastic material, can be provided along the shaft, at least for lateral fixation in a plane perpendicular to the longitudinal axis of the shaft. However, these holding elements can allow a relative movement between the channels and the shaft in the longitudinal direction in order to ensure compensating processes in the length due to different bends.

Such holding elements can be applied or applied by hand or advantageously by a setting device, for example a sleeve which is put over the shaft and the channels. While this sleeve is withdrawn again from the shaft and the channels, rings arranged on or on the sleeve can then be stripped off at predetermined locations. That kind of

The holder also enables a length compensation between the external channels and the endoscope shaft by sliding in the longitudinal direction of the endoscope shaft. In addition, it is conceivable to provide a length compensation option between the outer tubes and the shaft both at the distal end in a head piece and at the proximal end of the channels in a connection point to a valve module and / or in a connection point to rigid tubes. For example, a lug connection in the longitudinal direction can allow a predetermined path without loosening the connection.

Further advantageous configurations according to the invention result from the dependent claims.

The invention is explained in more detail below with reference to an embodiment shown in the drawing. The drawing shows:

1 shows an endoscope head at the distal end of a shaft of an endoscope with a cap for external channels and endoscope tip;

2 shows an endoscope head according to FIG. 1 with the endoscope tip pulled out;

Fig. 3 is a sectional view taken along the line C-C of Fig. 4;

FIG. 4 shows a front view of an endoscope head according to FIG. 1 from direction A according to FIG. 3;

Fig. 5 is a sectional view taken along line BB of Fig. 3; 6 shows a housing of an endoscope with an external working channel located in the proximal area

7 shows an adapter for connecting the proximal connections of an endoscope according to the invention to conventional connections.

According to the invention, the endoscope head shown in FIG. 1 at the distal end of an endoscope is closed off with a head piece, for example in the form of a plastic sleeve 1. Here, the plastic sleeve 1 has a recess or bore for the distal endoscope tip 2 of an endoscope shaft 15a with hermetically sealed lines or lenses for optics 5 and light 4 (FIG. 4) as well as recesses 6, 7 and 8 or bores Recording the external channels 16, 17 and 18, such as a working channel 17, an air channel 18 and a water channel 16.

As can be seen in FIG. 1, the sleeve 1 can be fastened to the endoscope tip 2 by means of a lock 3, for example in the form of a bayonet lock, so that the sleeve 1 can be fixed on the tip 2 both laterally and in the longitudinal direction of the endoscope shaft.

The other channels 16, 17 and 18 lying outside the endoscope shaft 15a, on the other hand, are only inserted or inserted with their tips into the sleeve 1, it being possible for some play in the longitudinal direction (maximum half a sleeve length in both directions). With various bends of the flexible endoscope, this play can enable a length compensation in the sleeve on the endoscope head between the outer channels and the endoscope shaft and the channels among one another. As shown in Fig. 2, the endoscope tip 2 is inserted or inserted into the sleeve 1, wherein a lock can be provided in the fully inserted state. Such a lock can be formed, for example in the form of a latch or bayonet lock 3, in which a nose or projection arranged in this area on the outer circumference of the endoscope tip 2, which is not shown in detail in FIG. 2, engages.

When all the channels 16, 17 and 18 and the endoscope tip 2 are inserted into the sleeve 1, the state shown in longitudinal section in FIG. 3 is produced, it being clearly visible that the endoscope tip 2 is completely accommodated in the sleeve 1, so that the ends of which are aligned, whereas the end of the working channel 17 is more than half the length of the sleeve 1 from the end of the sleeve 1, in order to enable length compensation.

The end view of an endoscope head according to FIG. 1 shown in FIG. 4 from direction A according to FIG. 3 shows how the endoscope tip 2 with its large lens for the optics 5 or image and the two small lenses 4 is received in the sleeve 1 , Centrally below the, for example, oval or circular receptacle for this endoscope tip 2 is the, for example, likewise oval receptacle 8 for the working channel 17 and of these, for example, laterally receptacles 6 and 7 for the air channel 18 and the water channel 16. Of course, the arrangement of the channels 16 17 and 18 as well as the endoscope tip 1, whereby the shape can also differ from the oval or circular shape shown.

Along the shaft 15a are the outer channels 16, 17 and 18 to each other and on the endoscope shaft 15a at predetermined intervals by holding elements in the form of thin silicone rings 19 of, for example, 3 mm wide and 5 to 3 tenths of a millimeter in thickness, so that, for example, the arrangement shown in FIG. 5 with the working channel 17 lying centrally below the shaft 15a and water channel 16 and air channel 18 lying laterally therefrom is created, the channels 16, 17 and 18 and the outer jacket 15 of the shaft are in contact.

Inside the shaft there are, for example, a video cable 9 for a CCD chip seated in the endoscope head and cable 10 for light and cable guides 11 for control cables 12. Here, the shaft 15a is hermetically encapsulated over its entire length and also at the tip 2 with respect to the environment, such as it through the

Shaft spring 13, the shaft net 14 and the surrounding outer jacket 15 is shown in FIG. 5.

In the proximal area of the endoscope there is an endoscope housing 20 with a valve module 21 which can be detachably and inserted therein, for example by means of a dovetail guide, and which has connections 23 and 24 for light conduction, for example optical fiber 25 and image conduction, which are brought up via the endoscope housing 20 Coax cable 26 is connected. In contrast, the multiple line 27 for air, water and suction is connected directly to the valve module 21 via the connection 28. In this case, the connections 23 and 24 can be designed such that they extend through openings in the endoscope housing 20 into openings in the valve module 21 and contact them directly.

Rigid lines 40, 41 and lead from the valve module 21 in the distal direction

42, which at the end of the endoscope housing 20 seen in the distal direction via a connection point 43, for example in the form of a plug-in connection or a Leurlock 43 with the external channels 16, 17 and 18 in connection bond stands. In the area between the connection point 43 and the module 21 there is a branch 45 on the rigid pipe 40 for continuing the working channel for the insertion of a tool, for example pliers.

In this case, an outwardly open U-shaped receptacle can be arranged or formed on the housing 20 in the region of the connection point 43, which can be locked, for example, with a lock. In this way, both the flexible working channels 16 to 18 and the rigid tubes 40 to 42 can be arranged detachably on the endoscope or the endoscope housing 20 and can be removed therefrom after the lock has been released. In addition, as shown in FIG. 6, the valve module 21 can be removed from the housing 20 and arranged thereon, for example by means of a dovetail guide (perpendicular to the housing with possible additional locking).

In the case of a cleaning process which is necessary for hygiene reasons after each operation or examination, the flexible channels 16 to 18 can be removed in a simple manner by loosening or cutting open the silicone bands 19 and loosening the connecting point 43 and separately from the endoscope shaft both externally and internally , for example using an autoclave, steam or

Rinsing can be cleaned. In addition, these parts can be designed to be disposable, as described above, so that the necessary sterility for a new examination is possible without cleaning the previously contaminated channels.

If contaminants, for example granules, have also penetrated into the proximal area of the endoscope into the valve module 21 or beyond, for example during a suction process through the working channel 17 or its continuation 40, it is also possible for a non-technical operator without great effort, by opening the connection point 43 or the U-shaped receptacle and possibly removing the valve module 21 and loosening the connections 23, 24 and 28 all ways Can be completely cleaned outside and inside from the endoscope.

In order to ensure simple cleaning of the lines 25, 26 and 27 leading from the valve module 21 to the light source and processor units, these connections can be made via an adapter element shown in FIG. 7, the lines 25 and 26 (here as Multiple or double or double line shown) as well as the multiple or double line 27 via their connections 30, 31 can be easily solved by this adapter element, for example by means of a twist or bayonet lock.

As a result, total cleaning of the inner paths of the channels is one

Endoscopes possible, which have to be open at the distal end due to their design and can therefore be contaminated up to the proximal area.

In addition to the simplified cleaning, the endoscope according to the invention offers the possibility of simple repair or maintenance as well as the interchangeability with new parts or parts of other types for different purposes due to the external channels and parts as well as the simply designed connection points.

In addition, due to the complete attachability and detachability, the additional

Channels, such as one or more working channels, as well as one or more air and / or water channels 18 and 16, give such an endoscope a wide range of uses since, for example, after an examination chung or operation with tools through the working channel 17, as well as inflation, rinsing and suction, a follow-up examination, for which only light 4 and optics 5 are required, in which the patient is spared due to the reduced cross-sectional area by omitting these channels, without having to purchase a special endoscope.

It is also conceivable to use such external channels to upgrade such special endoscopes, which only have light and optics, to an endoscope with, for example, a working channel 17.

The invention is of course not limited to the arrangement of individual channels shown in the exemplary embodiment. Likewise, several channels can be combined to form an external multiple channel with a common sheath or jacket, or endoscopes with multiple working channels and / or water channels and / or air channels.

In summary, it follows that the external routing of the channels, in particular working channels, avoids the disadvantages of the prior art because they are not hermetically connected to the shaft system. The operator or endoscopy personnel normally change the channels for the next use after use, so that a repair of damaged channels is advantageously eliminated. The exchangeable channels 16, 17, 18 and 27 can either be designed as a single-use product or sterilizable material, such as standard material for disinfectant solutions.

In addition to the interchangeability of the channels 16, 17, 18 and 27, the lines 40, 41, 41 and 45 and the cylinder block or valve module 21 and the line 27 can also be designed to be detachable and also connectable to one another and as one The workflow in the endoscope department must be cleaned and autoclaved separately from the hermetically sealed main endoscope part.

In addition, the interchangeability of the valve module 21 makes it possible to use special modules e.g. to be designed with a small working channel for children's gastroscopes or a large channel or with two channels (multichannel) and two inputs 45. If, on the other hand, only a thin endoscope is desired for the diagnosis, the endoscope according to the invention can be used for this purpose without external channels, for example without connecting a working channel.

The present invention thus offers advantages in terms of economy, in the possibility of variants of endoscopes, in lower repair costs due to interchangeability in the endoscopy departments, as well as the highest hygiene standard through disposable channels or through autoclavable channels, in particular working channels.

Claims

claims

1. endoscope with a flexible endoscope shaft (15a) with at least one flexible channel (16, 17, 18) open at the distal end, in particular working channel (17),

characterized in that

the at least one channel (16, 17, 18), in particular the working channel (17), is arranged on the outside of the endoscope shaft (15a) so as to be detachable and attachable in order to allow easy cleaning by an operator.

2. Endoscope according to claim 1, characterized in that the one or more external channels (16, 17, 18) in the region of the endoscope housing (20) by means of a connection point (43) with rigid tubes (40, 41, 42), and via this Pipes (40, 41, 42) are connected to a removable and insertable valve module (21).

3. Endoscope according to claim 2, characterized in that the rigid tubes (40, 41, 42) on the outside of the endoscope housing (20) are arranged detachably and attachable.

4. Endoscope according to claim 2 or 3, characterized in that the connection point (43) is designed as a quickly releasable and connectable connector or Leurlock.

5. Endoscope according to one of claims 2 to 4, characterized in that the rigid tubes (40, 41, 42) are releasably held in a receptacle on the endoscope housing (20).

6. Endoscope according to one of the preceding claims, characterized in that the or the outer flexible channels (16, 17, 18) are held by means of holding elements (19) arranged at predetermined intervals in the longitudinal direction of the endoscope shaft (15a).

7. Endoscope according to claim 6, characterized in that the holding elements (19) are designed as rings made of an elastic material.

8. Endoscope according to claim 7, characterized in that the rings can be applied by an operator by means of a setting device which can be put over the endoscope shaft (15a) and the one or more external channels (16, 17, 18).

9. Endoscope according to one of the preceding claims, characterized in that at the distal end of the endoscope shaft (15a) on the endoscope head a head piece (1) is detachably and attachable to the or the channels (16, 17, 18) and to fix the endoscope tip (2) located at the shaft end to one another at least in one plane perpendicular to the longitudinal axis of the shaft (15a).

10. At least one flexible channel (16, 17, 18), in particular working channel (17), of an endoscope, which is detachable and attachable on the outside on a flexible endoscope shaft (15a).

11. At least one channel according to claim 10, characterized in that the channel or channels are designed as an air and / or water channel (16, 18) which is arranged in or on the endoscope housing (20) so as to be detachable and insertable (21) is connected.

12. At least one channel according to claim 10, characterized in that the channel or channels are designed as an air and / or water channel (16, 18) which by means of a releasable and connectable connection point (43) with an in or on the endoscope housing (20 ) arranged valve module

(21) is connected.