Surgery – Truss – Perineal
Patent
1988-04-21
1990-08-21
Grieb, William H.
Surgery
Truss
Perineal
A61B 100
Patent
active
049497065
DESCRIPTION:
BRIEF SUMMARY
The invention is directed to a side-viewing endoscope comprising an instrumentation channel that forms an outlet opening in the operative region (distal end), and comprising a deflection element as well as an actuation means for the latter.
Side-viewing endoscopes serve for endoscopic examination of, in particular, the duodenum of life forms, particularly for the portrayal of the papilla vateri (duct opening of the gall and pancreatic issue), with the possibility of introducing instruments (catheters, brushes, tissue forceps, slings) into the pancreatic duct as well as into the biliferous duct in order to thus be able to carry out diagnostic or, respectively, therapeutic measures for the implantation of endoprotheses as well.
In side-viewing endoscopes previously available as known, for example, from the brochure Duodenoscope DUO-X, DUO-XL 181-3-3 of Fujinon Optical Incorporated, the operative region of the endoscope is of such a nature that the instrumentation channel guided in the endoscope shaft and exits in the direction of the longitudinal axis of the endoscope in a small shaft at the distal end. The exit angle of the complement of instruments guided through the instrumentation channel can be varied by a deflecting element that is attached in this shaft, and this deflecting element is capable of being mechanically moved from the head end of the endoscope. Given a completely relaxed deflecting element, the complement of instruments (catheter, guide wire, permanent catheter) distally emerges at an angle of about 30.degree.-40.degree. relative to the longitudinal axis of the endoscope. Given complete angling of the deflecting element, an exit angle of a maximum of 90.degree. relative to the longitudinal axis of the endoscope can be achieved.
As a consequence of structurally conditioned circumstances, a guidance of the complement of instruments in the sense of an elastic line does not arise given complete angling; on the contrary, the formation of a buckling at the level of the outlet location of the instrumentation channel occurs in the operating shaft. As a result thereof, great frictional forces arise both due to the buckling at the outlet opening of the instrumentation channel as well as at the inside surface of the angling lever. Dependent on the caliber of the complement of instruments and the inherent stiffness thereof, a further advance is then made considerably more difficult or, respectively, impossible. Particularly given the employment of stiff instrumentations such as large-caliber permanent catheters, shearing forces or, respectively, tangential forces that do not allow any axially suited power transmission and, thus, that do not represent an optimal solution for the introduction of, in particular, stiff instrumentations arise upon deflection with the deflecting element, arising as a consequence of the stiffness of the material.
SUMMARY OF THE INVENTION
It is therefore the object of the invention to improve a side-viewing endoscope of the species initially cited such that an axially suited power transmission is possible and, thus, an optimum solution for the introduction of, in particular, stiff, large-caliber instrumentations is created.
This object is inventively achieved in that the instrumentation channel comprises a prescribed curvature at the outlet end and, in the operative region, is directed toward the outlet opening provided in the lateral wall of the endoscope.
The inventive solution creates a side-viewing endoscope that avoids the appearance of shearing or, respectively, tangential forces even given large-caliber and stiff complements of instruments such as, for example, large-caliber permanet catheters, so that an axially suited power transmission is possible. Since shearing forces are eliminated to the farthest-reaching degree, dislocations of the complement of instruments in a distal direction that lead to an interruption of the introduction in the known devices practically no longer occur. Given a correct position of the distal end in the middle of the descending branch of
REFERENCES:
patent: 1901731 (1933-03-01), Buerger
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