DE10003668A1 - Flexible endoscope - Google Patents

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

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

Such endoscopes with a flexible endoscope shaft usually have flexible cables located inside the endoscope shaft for the endo optical head and a flexible, hermetic to the inside of the Endoscope sealed working channel for inserting tools such as for example, pliers. The channels for light and optics are at the distal End connected with lenses, cameras or the like that have no opening against over the environment. These channels or lines are therefore light sealed hermetically from the environment.

In contrast, at the distal end of a working channel, an opening for the Stepping out of a tool can be provided so that through this opening the Working channel during an operation or examination by blood or the like ches is dirty. Even when using seals, for example in the form of O-rings, there is a risk of contamination entering at the distal end, so that an external cleaning is not sufficient for one next examination or surgery to ensure the necessary sterility.

The cleaning solutions existing in the prior art, in particular by flushing such channels as, for example, working channel, water and air channel, Bowden cable u. However, are cumbersome and time-consuming for the operator,  not technical but usually medical personnel, such as a doctor or medical assistant.

DE 196 27 016 C1 therefore dispenses with any seals and for a Bowden cable, a separate Bow sealed against the endoscope denzugkanal provided, for cleaning after each examination by loosening the Bowden cable at the proximal end and loosening a lock gelung on the head a carrier device from the endoscope head and the bow the cable can be pulled out of the Bowden cable duct. After that you can the Bowden cable duct easily through due to its larger inner diameter Flushing and the Bowden cable itself as well as the carrier device on simple Way to be cleaned outside the endoscope.

Despite this improvement, which has proven itself in practice, the Desire for further simplification and time saving at the Every operation or examination requires cleaning of the endoscope at least the endoscope shaft and removal of the into the channels on the distal End contaminants.

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

This is partly due to intensive manual pre-cleaning by the Bedi endoscopy staff, as well as subsequent cleaning in manu or semi-automatic endoscope washing machines with chemical disinfectants  or with fully automatic endoscopes, the chemical-thermal one Enable disinfection, achieved.

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

This hygiene standard can only be achieved with new, expensive fully automatic machines higher flow pressures and aggressive disinfectants enough, which in turn means the service intensity and thus the maintenance endoscope costs increased.

Furthermore, channels such as work, air and water channels can be used in endoscopy nal, damaged by constipation or even perforation. At acquaintances Endoscopes must disadvantageously because of such damage Endoscope can be dismantled in a costly and time-consuming general repair, to remove these channels from the air-water suction cylinders and from the di stalen head to be able to solve.

So far, for example, the violation of the working channel, e.g. B. one Perforation to be expected to cause great damage to the endoscope. As a result of the damage, it is no longer possible to use the endoscope, in particular of the inner wall of the canal, to be cleaned adequately, as with the Rei rinse liquid through the perforation into the endoscope can. In such a case, the endoscope must be damaged (perforation or liquid that has already penetrated inside the endoscope) in cost and time-consuming work from service in a special service company or at Manufacturer to be repaired.  

The cause of such perforations has been found to be that the channels, in particular in particular the working channel, through the ongoing investigation process, e.g. B. that Pushing in and pulling out the pliers in connection with tissue samples with additional angling of the distal tip from, for example, 180 ° to 210 °, are exposed to very heavy wear. Trial examinations with the Microscope showed that scratches and striations were caused in the working channels through the instruments. These surface injuries mean however always a risk to hygiene. In the worst case, it can even a perforation in the working channel, as a result of which there is a risk of an on of dirt and moisture (blood, secretions, disinfectant tel) in the distal area, in the control area and in the shaft area of the endoscope, consists.

The invention is therefore based on the object, an endoscope and little least to create a channel of such an endoscope, which is an easier one and time-saving cleaning by a non-technical operator, so a doctor or an assistant, guarantee and costly and time consuming Reduce repairs.

A cleaning that can only be carried out by technical personnel (maintenance technicians) in practice is often more in one day due to hygiene reasons times necessary cleaning processes and the resulting from Ko most time and effort inconceivable. As an operator in the sense of the invention Therefore, only medical personnel come, not technical, that cleans the endoscope after an examination or surgery (assistant) and possibly also served (doctor) in question.  

This object is achieved with an endoscope and at least a channel for this solved according to claims 1 and 10.

As a result, a simple and time-saving channel exchange is also different Channel diameter with the highest hygiene standard through a non-techni personnel, i.e. a doctor or an assistant, or through endoscopy staff guaranteed.

Through the detachable and attachable external attachment of a channel, esp special working channel, on the endoscope shaft it is also a non-technical one Personnel can easily find those parts that are at least in their distal area are also contaminated inside by the parts of the endo to separate skops or the shaft, where there is contamination inside due to the lack of necessary openings. In this way the parts that are also contaminated on the inside can easily be removed separated from the endoscope, for example by rinsing, steam, autoclave etc. cleaned and after a new attachment on the endoscope shaft like be used. In this way, in everyday medical Ge need an endoscope (operating room or examination) to make the necessary changes subsequent cleaning without special knowledge and skills on simple and carried out quickly and cost-effectively by an operator become.

Of course, after using an endoscope instead of one after subsequent cleaning of the external channels, even cleaned channels be put on again, so that the dirty channels be cleaned later, for example with other dirty channels.  

It is also conceivable to dispose of the outer channel or channels as a disposable part manufacture so that after one use the canal or canals can be removed and can be replaced by new attachable parts. It is also thought bar, for example by attaching a channel, especially Arbeitska nals on an endoscope, which is only used for examination and the half only the lines or channels for light and optics inside the shaft has, to an endoscope with at least one working channel and possibly to upgrade additional channels for air and water.

An endoscope can also be used for attaching external channels is provided by removing these channels as a pure Untersu endoscope, which only has light and optics, can be used. On in this way, it is not only possible to upgrade existing tests endoscopes, but also the dual usability of the fiction endoscope, namely with or without external channels, and carries here by advantageously at cost savings.

Furthermore, due to the external arrangement of such channels, an on penetrate contaminants into the endoscope, for example worn or broken channels and thus the destruction of the whole Endoscopes can be prevented.

Similar to the one described above for an external working channel, can additionally or instead a flexible water and / or air duct au be detachable and attachable to the outside of the endoscope shaft, in order to be flat if simple cleaning by an operator, i.e. not technical To enable staff such as a doctor or medical assistant. This will increase  the areas of application of such an endoscope advantageously because this enables further operations such as flushing, inflation, etc.

To ensure the stability of the attachment of these channels, especially the air and Water channels, can increase the channels in the proximal area at the endo scope housing advantageously via rigid tubes or Lines are connected to a valve module. This is about solubility and attachability to ensure either a connection point at for example between flexible channel and rigid tube and / or between tube and valve module, detachable, or the valve module itself together with the channel or the channel and the tube designed to be removable and insertable.

For stability and cohesion as well as the assignment between Kanä len and shaft can improve, at least for lateral fixation in one Plane perpendicular to the longitudinal axis of the shaft, along the holding bracket elements, for example in the form of rings made of elastic material his. However, these holding elements can have a relative movement between the Channels and the shaft in the longitudinal direction allow to compensate to ensure in length due to different bends.

Such holding elements can be by hand or advantageously by one Setting device, for example a sleeve, over the shaft and the channels is put on, applied or applied. While this sleeve again from the shaft and the channels can then be removed on or on the sleeve arranged rings are stripped at predetermined locations. That kind of Bracket also enables slipping in the longitudinal direction of the Endo skopschaftes a length compensation between external channels and Endoscope shaft.  

It is also conceivable, both at the distal end in a head piece and at proximal end of the channels in a connection point to a valve module and / or length compensation in a connection point to rigid pipes possibility to provide between external tubes and shaft. At for example, a lancing connection can be performed in the longitudinal direction allow the right path without breaking the connection.

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

The invention is illustrated below with the aid of one in the drawing Embodiment explained in more detail. The drawing shows:

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

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

Fig. 3 is a sectional view taken along line CC 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;

Fig. 6 is a proximal housing of an endoscope with an external working channel and

Fig. 7 is an adapter for connecting the terminals of a proximal OF INVENTION to the invention endoscope to conventional connectors.

The endoscope head shown in FIG. 1 at the distal end of an endoscope is, according to the invention, completed 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 15 a with hermetically sealed lines or lenses for optics 5 and light 4 ( FIG. 4) as well as recesses 6 , 7 and 8 or bores To take on the outer channels 16 , 17 and 18 , such as a working channel 17 , an air channel 18 and a water channel 16 , on.

As seen in Fig. 1, the sleeve 1 of a bayonet closure to the tip of the endoscope 2 can by means of a locking 3 at play, in the form to be attached, so that the sleeve 1 on this tip 2 both laterally and in the longitudinal direction of the endoscope shaft is fixable.

The other channels 16 , 17 and 18 lying outside the endoscope shaft 15 a, on the other hand, are only inserted or inserted with their tips into the sleeve 1 , it being possible for a certain play in the longitudinal direction (maximum half a sleeve length in both directions). This game can allow for a variety of bends in the flexible endoscope length compensation in the sleeve on the endoscope head between the outer channels and the endoscope shaft and the channels with each other.

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, 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 surface is not shown 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 front 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 and the endoscope tip 1 is arbitrary, and the shape may also differ from the oval or circular shape shown.

Along the shaft 15 a, the outer channels 16, 17 and 18 zueinan of and at the endoscope shaft 15 a at predetermined intervals by Halteele 19, for example, 3 mm width and 2 to 3 tenths of a mm thickness elements in the form of thin silicone rings supported, so that for example in Fig. 5 Darge presented arrangement with centrally below the shaft 15 a lying working channel 17 and each thereof laterally lying water passage 16 and air passage 18 is formed, the channels 16, 17 and 18 and the outer casing 15 are of the stem into contact.

In the interior of the shaft there are, for example, a video cable 9 for a CCD chip seated in the endoscope head and cables 10 for light and cable guides 11 for control cables 12 . Here, the shaft 15 a is hermetically encapsulated over its entire length and also at the tip 2 with respect to the environment, as shown by the shaft spring 13 , the shaft net 14 and the surrounding outer jacket 15 in FIG. 5.

In the proximal area of the endoscope there is an endoscope housing 20 with a valve module 21 which is detachable and usable therein, for example by means of a dovetail guide, 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 . for example, a coax cable 26 is connected. In contrast, the multiple line 27 for air, water and suction is connected directly via the connection 28 to the valve module 21 . Here, 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 42 lead out of the valve module 21 in the distal direction, the lines 40 , 41 and 42 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 connection or a Leurlock 43 with the external channels 16 , 17 and 18 communicates. 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 connection point 43 and separately from the endoscope shaft externally and internally, for example, cleaned by means of an autoclave, steam or rinsing. In addition, these parts can be designed to be disposable, as described above, so that the necessary sterility for a new examination is possible even 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 easy for a non-technical operator possible to completely clean all paths outside and inside from the endoscope 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 .

In order to ensure easy 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 using an adapter element shown in FIG. 7, the lines 25 and 26 (here as a multiple - or two-fold or double line shown) and 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 must be open at the distal end due to their design and consequently can be contaminated up to the proximal area.

In addition to simplified cleaning, the endoscope according to the invention offers through the external channels and parts as well as the simply trained Ver the possibility of simple repairs or maintenance as well as interchangeability with new parts or parts of other types for different purposes.

In addition, due to the fact that the additional channels, such as one or more working channels, and one or more air and / or water channels 18 and 16 can be fitted and removed completely, such an endoscope can be used in many ways, for example after an examination or operation with tools through the working channel 17 , as well as on blowing, rinsing and suctioning, a follow-up examination, for which only light 4 and optics 5 are required, in which the patient is protected by the reduced cross-sectional area due to the omission of these channels, without a special endoscope must be purchased for this.

It is also conceivable microscopes by such external channels such Spezialendo having only light and optics to upgrade to an endoscope having a working channel, for example, 17th

The invention is of course not on the Darge in the embodiment placed arrangement of individual channels limited. Likewise, multiple channels to an external multi-channel with a common shell or jacket summarized or endoscopes with several working channels and / or what 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 the 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 disposable product or sterilizable material, such as standard material for disinfectant solutions.

Apart from the exchangeability of the channels 16, 17, 18 and 27 and the lines 40, 41, 41 and 45 and cylinder block or valve module 21 as well as derivative may also be formed 27 detachably as mutually connectable and as an operation in the Endoskopeabteilung from the hermetically sealed main endoscope part be cleaned and autoclaved separately.

In addition, it is possible through the interchangeability of the valve module 21 , special modules such. B. 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 which Possibility of variants of endoscopes, in lower repair costs own interchangeability in the endoscopy departments, as well as maximum hygiene nestandard through disposable channels or through autoclavable channels, in particular their working channels.

Claims (12)

1. Endoscope with a flexible endoscope shaft ( 15 a) 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 ( 15 a) in a detachable and attachable manner 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 ) with a removable and insertable valve module ( 21 ) are connected. 3. Endoscope according to claim 2, characterized in that the rigid tube re ( 40 , 41 , 42 ) on the outside of the endoscope housing ( 20 ) are arranged detachably and attachable bar. 4. Endoscope according to claim 2 or 3, characterized in that the Ver 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 in the longitudinal direction of the endoscope shaft ( 15 a) in predetermined from arranged holding elements ( 19 ). 7. Endoscope according to claim 6, characterized in that the holding elements ( 19 ) are ausgebil det 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 placed over the endoscope shaft ( 15 a) 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 ( 15 a) on the endoscope head a head piece ( 1 ) is detachably and attachable to the channel or 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 ( 15 a). 10. At least one flexible channel ( 16 , 17 , 18 ), in particular working channel ( 17 ), of an endoscope, which on the outside of a flexible endoscope shaft ( 15 a) is detachable and attachable. 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 detachable with an in or on the endoscope housing ( 20 ) and a settable valve module ( 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.