U.S. patent application number 17/319550 was filed with the patent office on 2021-08-26 for endoscope head, endoscope and albarran lever holding member.
This patent application is currently assigned to DIGITAL ENDOSCOPY GMBH. The applicant listed for this patent is DIGITAL ENDOSCOPY GMBH. Invention is credited to Stefan KOLBERG.
Application Number | 20210259524 17/319550 |
Document ID | / |
Family ID | 1000005582944 |
Filed Date | 2021-08-26 |
United States Patent
Application |
20210259524 |
Kind Code |
A1 |
KOLBERG; Stefan |
August 26, 2021 |
ENDOSCOPE HEAD, ENDOSCOPE AND ALBARRAN LEVER HOLDING MEMBER
Abstract
The invention refers to an attachment for an endoscope
attachable to and detachable from an endoscope head body, which is
provided on a distal side of an insertion portion of an endoscope.
The attachment for the endoscope comprises a plate-shaped portion;
an Albarran lever pivotally supported by the plate-shaped portion;
and an attachment unit detachably attached to the endoscope head
body, wherein the plate-shaped portion extends from the attachment
unit.
Inventors: |
KOLBERG; Stefan; (Friedberg,
DE) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
DIGITAL ENDOSCOPY GMBH |
Friedberg |
|
DE |
|
|
Assignee: |
DIGITAL ENDOSCOPY GMBH
Friedberg
DE
|
Family ID: |
1000005582944 |
Appl. No.: |
17/319550 |
Filed: |
May 13, 2021 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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16087903 |
Sep 24, 2018 |
11058284 |
|
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PCT/EP2017/069800 |
Aug 4, 2017 |
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17319550 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 1/2736 20130101;
A61B 1/00098 20130101; A61B 1/018 20130101; A61B 1/00135 20130101;
A61B 8/12 20130101; A61B 1/00181 20130101; A61B 1/00101 20130101;
A61B 1/00137 20130101 |
International
Class: |
A61B 1/00 20060101
A61B001/00; A61B 1/018 20060101 A61B001/018 |
Foreign Application Data
Date |
Code |
Application Number |
Aug 11, 2016 |
DE |
10 2016 114 881.4 |
Claims
1. An attachment for an endoscope attachable to and detachable from
an endoscope head body, which is provided on a distal side of an
insertion portion of an endoscope, the attachment for the endoscope
comprising: a plate-shaped portion; an Albarran lever pivotally
supported by the plate-shaped portion; and an attachment unit
detachably attached to the endoscope head body, wherein the
plate-shaped portion extends from the attachment unit.
2. The attachment for the endoscope according to claim 1, wherein
the plate-shaped portion has a through-hole penetrating in a
thickness direction, and the Albarran lever has an Albarran lever
shaft inserted into the through-hole.
3. The attachment for the endoscope according to claim 1, wherein
the attachment unit is provided with a tool opening cut out in a
U-shape, and the Albarran lever is disposed to face the tool
opening.
4. The attachment for the endoscope according to claim 3, wherein
the attachment unit is a hollow cylinder that is open at an
attachment opening provided along a longitudinal direction of the
hollow cylinder, and the tool opening is disposed at a location
facing the attachment opening.
5. The attachment for the endoscope according to claim 4, wherein
the plate-shaped portion protrudes toward the attachment opening
from one side of an edge of the tool opening, wherein the
plate-shaped portion extends along the longitudinal direction of
the attachment unit.
6. The attachment for the endoscope according to claim 4, further
comprising a fixing means that detachably engages with the
endoscope head body at an edge of the attachment opening.
7. The attachment for the endoscope according to claim 6, wherein
the fixing means is a rib that engages with a groove provided in
the endoscope head body.
8. The attachment for the endoscope according to claim 6, wherein
the fixing means includes a hinge member connected to one edge of
the attachment opening, and an engagement member which is provided
on another edge of the attachment opening and engages with an end
portion of the hinge member.
9. The attachment for the endoscope according to claim 6, wherein
the fixing means includes two hinge members that are connected to
both edges of the attachment opening and include engagement members
engaging with each other.
10. The attachment for the endoscope according to claim 4, wherein
the attachment unit is an elastic attachment unit and is capable of
expanding a space of the attachment opening by spreading apart
parts of the attachment unit.
11. The attachment for the endoscope according to claim 1, wherein
the endoscope is an ultrasonic endoscope in which an ultrasonic
head transmitting and receiving an ultrasonic signal is disposed at
an end portion of the endoscope head body.
12. An ultrasonic endoscope comprising: an endoscope head body that
is disposed on a distal side of an insertion portion of the
ultrasonic endoscope and is provided with an Albarran lever chamber
which is open continuously at an end portion and a side surface of
the endoscope head body; and a convex-shaped ultrasonic head that
is disposed at the end portion of the endoscope head body and
capable of transmitting and receiving ultrasonic signals in a
lateral viewing direction corresponding to the side surface of the
endoscope head body, wherein an attachment for the ultrasonic
endoscope, which includes a plate-shaped portion, an Albarran lever
pivotally supported by the plate-shaped portion, and an attachment
unit detachably attached to the endoscope head body wherein the
plate-shaped portion extends from the attachment unit, is
attachable to and detachable from the endoscope head body, and the
Albarran lever chamber accommodates the Albarran lever when the
attachment for the ultrasonic endoscope is attached.
13. An attachment for an endoscope comprising an endoscope head in
which at least one working channel is formed, wherein an Albarran
lever capable of being pivoted is provided at the distal working
channel end portion of the endoscope; the attachment including: a
sheath element, a plate-shaped portion extending from the sheath
element, and an Albarran lever pivotally supported at the
plate-shaped portion, said attachment being attachable to the
endoscope head and being detachable from the endoscope head.
14. The attachment according to claim 13, wherein the sheath
element forms a common assembly with the Albarran lever, wherein
the common assembly of the sheath element and the Albarran lever
can be attached at and removed from the endoscope head as one
single unit.
15. The attachment according to claim 13, wherein the sheath
element is formed as a laterally open cylinder whose open side can
be attached to the endoscope head, the Albarran lever pivotally
supported in the sheath element has an opening adapted to be able
to engage in an operating element supported on the endoscope head.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] The present application is a divisional of U.S. patent
application Ser. No. 16/087,903 filed Sep. 24, 2018, which is a
U.S. National Stage Application of International Patent Application
No. PCT/EP2017/069800 filed Aug. 4, 2017, which claims the benefit
of German Patent Application No. 10 2016 114 881.4 filed Aug. 11,
2016. The disclosure of each of the above-noted applications is
expressly incorporated herein by reference in its entirety.
[0002] The present invention relates to an endoscope head
comprising an endoscope head body, in which at least one working
channel is formed and in which an Albarran lever capable of being
pivoted is provided at the distal working channel end portion, and
to an endoscope comprising such an endoscope head. Further, the
present invention relates to an Albarran lever holding member for
an endoscope.
[0003] Such an endoscope head body can, for example, be applied to
a duodenoscope, i.e. an endoscope for examining e.g. the esophagus
or the duodenum, the bile duct, the gall bladder, the pancreatic
duct, the pancreas, etc.
[0004] By means of the duodenoscope it is possible to reach the
duodenum through the esophagus, the stomach and the pylorus.
[0005] The duodenoscope comprises optics (illumination means and
camera) directed to the side (lateral). This may complicate
inserting and advancing the duodenoscope through the esophagus
since a "forward-facing" observation is not easily possible. Only
the stomach or the duodenum provides enough room to bend the distal
end of the duodenoscope by about 90.degree. so as to enable forward
viewing.
[0006] Further, at the working channel outlet, the duodenoscope
comprises an Albarran lever which, by means of pivoting, enables a
precise deflection of the tools advanced through the working
channel.
[0007] After the duodenoscope has been used, it is subjected to
reprocessing. The reprocessing must reliably prevent microorganisms
such as bacteria, viruses, fungi, worms and spores from being
transmitted. In the course of reprocessing, the duodenoscope is
initially cleaned manually in order to remove all traces of organic
material or chemical residues. After cleaning, a mechanical
disinfection or sterilization is carried out.
[0008] It is the object of the present invention to provide an
endoscope head comprising an endoscope head body, which is easy to
clean but also versatile. Moreover, an endoscope and an Albarran
lever holding member for an endoscope shall be provided.
[0009] This object is achieved by an endoscope head comprising an
endoscope head body including the features of claim 1. Advantageous
further developments are described in the dependent claims.
[0010] Thus, an endoscope head has been provided which comprises an
endoscope head body, in which at least one working channel is
formed, wherein an Albarran lever capable of being pivoted is
provided at the distal working channel end portion. The Albarran
lever can be inserted at the endoscope head body laterally to the
axis of the endoscope head body and removed from the endoscope head
body laterally to the axis of the endoscope head body. Thus, the
Albarran lever can be removed from the endoscope head body
laterally to the axis of the endoscope head body and is easily
detachable from the endoscope head body.
[0011] The endoscope head may comprise a housing sheath part at
which the Albarran lever is pivotally disposed, wherein the housing
sheath part can be applied at and removed from an outer
circumferential portion of the endoscope head body laterally to the
axis of the endoscope head body. The housing sheath part and the
Albarran lever may form a common assembly which is separate from
the endoscope head and can be treated as an individual unit. Hence,
the Albarran lever provided on the housing sheath part is provided
separately and detachably from the endoscope head body. The
Albarran lever can be separated from the endoscope head body by the
housing sheath part being removed from the endoscope head body.
[0012] In the endoscope head, the housing sheath part may be formed
as an elastic housing sheath part which can be spread apart and can
be completely separated from the endoscope head body, and which can
include fastening means which fasten the housing sheath part to the
outer circumferential portion of the endoscope head body. Thus, the
assembly consisting of the housing sheath part and the Albarran
lever can be easily attached to the endoscope head. The fastening
means can be formed as engagement means. Protrusions capable of
engaging in recesses formed on the outer circumferential portion of
the endoscope head body may be formed as engagement means on the
housing sheath part.
[0013] The housing sheath part may be formed as a hollow cylinder
whose sheath includes an attachment opening extending along the
cylinder extension direction and along the entire hollow cylinder.
The hollow cylinder may be elastically spread apart at the
attachment opening thereof and placed on the outer circumferential
portion of the endoscope head body. Thus, the housing sheath part
can be easily and quickly detached from the endoscope head
body.
[0014] On the hollow cylinder, on the side opposite to the
attachment opening, a tool opening may be formed, through which a
tool can project laterally from the endoscope head body when the
housing sheath part is placed on the endoscope head body. When the
housing sheath part is attached to the endoscope head body, the
endoscope is ready for operation. Tools can be advanced through the
working channel to the Albarran lever which appropriately changes
the lateral alignment of the tools. In the course of this, the
tools project laterally from the endoscope head body through the
tool opening of the housing sheath part.
[0015] The fastening means may be formed as a hinge member. The
housing sheath part may comprise a hinge member which is hinged on
the housing sheath part and is able to close the attachment
opening. When the hinge member is closed, the housing sheath part
can abut against the endoscope head body along the entire outer
circumferential portion of the endoscope head body. In such a
design, the housing sheath part is mounted to the endoscope head
body in a fixed and stable manner. One side of the hinge member may
be supported on the housing sheath part in a hinged manner and the
opposite side of the hinge member may include a closing means, e.g.
a nose, capable of engaging at the housing sheath part. Due to the
elasticity of the housing sheath part, the housing sheath part can
thus tightly abut against the endoscope head body in a correct
position and with a predefined tension.
[0016] The housing sheath part may comprise a protrusion extending
radially inward, on which the pivot axis of the Albarran lever is
rotatably supported. Therefore, the housing sheath part is provided
with the elements pivotally supporting the Albarran lever. The
element (operating element) effecting the pivoting process of the
Albarran lever may be provided in the endoscope head body.
[0017] The housing sheath part and the Albarran lever may be formed
as a unit designed as a single-use product. For example, the
housing sheath part and the Albarran lever can form a common
assembly which is manufactured at low cost from plastic or any
other suitable material. Thus, the common assembly consisting of
the housing sheath part and the Albarran lever can be disposed of
after a single use. When the endoscope is used again, a new
assembly consisting of the housing sheath part and the Albarran
lever is placed on the endoscope head body.
[0018] The endoscope head body may comprise a pivotable operating
element which can be operated from the proximal side and with which
the Albarran lever releasably engages when the housing sheath part
is attached to the endoscope head body.
[0019] The endoscope head may comprise an ultrasonic head on the
distal end of the endoscope head body and the portion of the
endoscope head body where the Albarran lever can be applied at and
removed from, may be situated proximally from the ultrasonic head.
In this way, an endoscope can be provided which comprises an
ultrasonic head on the distal end and includes, proximally from the
ultrasonic head, an Albarran lever which is easily separable from
the endoscope head.
[0020] In an alternative, an endoscope head according to the
invention has been provided, the endoscope head comprising an
ultrasonic head at the distal end and an Albarran lever arranged
proximally from the ultrasonic head.
[0021] In a further alternative, an endoscope head according to the
invention has been provided, the endoscope head comprising an
ultrasonic head therein and an Albarran lever arranged distally
from the ultrasonic head. In this further alternative, a working
channel and a movement transmission channel are guided past the
ultrasonic head.
[0022] In the endoscope head, the Albarran lever may be operated by
means of a movement transmission mechanism, wherein the movement
transmission mechanism in the endoscope head acts via a movement
transmission channel and the movement transmission channel is
sealed against the environment.
[0023] The movement transmission mechanism may be, for example, a
pulling wire mechanism, a wire mechanism (pushing wire or pulling
wire), a hydraulic mechanism or a pneumatic mechanism, transmitting
a movement generated at a proximal control element (e.g. a
joystick) via the movement transmission channel so as to actuate
(pivot) the Albarran lever. In the case of the solution by means of
the hydraulic mechanism or the pneumatic mechanism, the movement
transmission channel is a simple channel which is sealed and filled
with a movement transmission medium (hydraulic mechanism: e.g.
water or another hydraulic medium; pneumatic mechanism: e.g.
air).
[0024] Since the movement transmission channel and thus, the medium
contained therein (hydraulic medium, air, pulling wire or wire,
etc.) is sealed against the environment, it is avoided that germs
and contaminations enter the movement transmission channel.
Incidentally, the movement transmission channel and the Albarran
lever are completely separated from each other.
[0025] Moreover, an Albarran lever holding member has been provided
for an endoscope comprising an endoscope head in which at least one
working channel is formed, wherein an Albarran lever capable of
being pivoted is provided at the distal working channel end portion
of the endoscope; the Albarran lever holding member including: a
sheath element which can be placed on the endoscope head and in
which the Albarran lever is pivotally supported.
[0026] The sheath element may be formed as a laterally open
cylinder whose open side can be placed on the endoscope head, and
the Albarran lever pivotally supported in the sheath element may
include an opening adapted to be able to engage such that an
operating element supported on the endoscope head can engage in the
opening of the Albarran lever.
[0027] The Albarran lever holding member may be formed of plastic,
for example, or any other suitable material. The Albarran lever
holding member may be manufactured, for example, by means of a
3D-printer or an injection molding method. The sheath element and
the Albarran lever can be manufactured separately and the Albarran
lever can be installed in the sheath element in an assembly
step.
[0028] The previously explained aspects of the present invention
may be appropriately combined.
BRIEF DESCRIPTION OF THE DRAWINGS
[0029] FIG. 1 shows a perspective view of an inventive endoscope
head of a first embodiment in a disassembled state.
[0030] FIG. 2 shows a perspective view of the inventive endoscope
head of the first embodiment in the assembled state.
[0031] FIG. 3 shows a perspective view of a housing sheath part of
the inventive endoscope head of the first embodiment.
[0032] FIG. 4 shows a further perspective view of a housing sheath
part of the inventive endoscope head of the first embodiment.
[0033] FIG. 5 shows a further perspective view of a housing sheath
part of the inventive endoscope head of the first embodiment.
[0034] FIG. 6 shows a perspective view of an endoscope head body of
the endoscope head of the first embodiment with an Albarran lever
being in a non-pivoted state.
[0035] FIG. 7 shows a perspective view of the endoscope head body
of the endoscope head of the first embodiment with the Albarran
lever being in a pivoted state.
[0036] FIG. 8 shows a perspective view of the endoscope head of the
first embodiment obliquely from above, without the housing sheath
part.
[0037] FIG. 9 shows a perspective view of an inventive endoscope
head of a second embodiment in a disassembled state.
[0038] FIG. 10 shows a perspective view of the inventive endoscope
head of the second embodiment, with a housing sheath part being
placed on the endoscope head.
[0039] FIG. 11 shows a perspective view of the inventive endoscope
head of the second embodiment, with a hinge member of the housing
sheath part being closed.
[0040] FIG. 12 shows a perspective view of the inventive endoscope
head of the second embodiment with the hinge member of the housing
sheath part on the endoscope head being closed.
[0041] FIG. 13 shows a perspective view of the inventive endoscope
head of the second embodiment, with a hinge member of the housing
sheath part being closed.
[0042] FIG. 14 shows a perspective view of an inventive housing
sheath part of a third embodiment.
[0043] Below, the present invention is described in detail with
reference to the drawings and based on the embodiments.
[0044] The endoscope head of the present invention can be used in
the field of endoscopic ultrasound.
[0045] Endoscopic ultrasound (EUS) is a medical procedure in which
endoscopy is combined with ultrasound to obtain images of the
internal organs e.g. in the chest, abdomen and colon. EUS can be
used to visualize the walls of these organs, or to look at adjacent
structures. Combined with Doppler imaging, nearby blood vessels can
also be evaluated.
[0046] Endoscopic ultrasonography is most commonly used in the
upper digestive tract and in the respiratory system. For the
patient, the procedure feels almost identical to the endoscopic
procedure without the ultrasound part, unless ultrasound-guided
biopsy of deeper structures is performed.
[0047] Ultrasound endoscopes are commonly used for diagnostic and
therapeutic purposes in the upper gastroenterology area. The tools
in use are penetrating the human tissue and are out of optical
visibility, in that moment. In that case the ultrasound sensor
still shows the way and location of the tools tip. Necessary tools
can be controlled by the albarranlever of the respective endoscope.
The physician observes e.g. either the stomach or the duodenum with
the optical camera as well as taking pancreatic biopsy with support
from the EUS sensors view.
[0048] In particular, for endoscopic ultrasound of the upper
digestive tract, a probe is inserted into the esophagus, stomach,
and duodenum during a esophagogastroduodenoscopy. Among other uses,
it allows for screening for pancreatic cancer, esophageal cancer,
and gastric cancer, as well as benign tumors of the upper
gastrointestinal tract. It also allows for characterization and
biopsy of any focal lesions found in the upper gastrointestinal
tract, such as esophageal tuberculosis. Further, this procedure can
also be used to identify malformations and masses in the bile ducts
and pancreatic ducts.
[0049] Endoscopic ultrasound is performed with the patient sedated.
The ultrasound endoscope is passed through the mouth and advanced
through the esophagus to the suspicious area. From various
positions between the esophagus and duodenum, organs within and
outside the gastrointestinal tract can be imaged to see if they are
abnormal, and they can be biopsied by a process called fine needle
aspiration. Organs such as the liver, pancreas, and adrenal glands
are easily biopsied, as are any abnormal lymph nodes. In addition,
the gastrointestinal wall itself can be imaged to see if it is
abnormally thick, suggesting inflammation or malignancy.
[0050] The technique is highly sensitive for detection of
pancreatic cancer. With respect to pancreatic cancer, by endoscopic
ultrasound local metastases can be detected. However, in
combination with a CT scan which provides information on regional
metastases, endoscopic ultrasound provides an excellent imaging
modality for diagnosis and staging of pancreatic carcinoma.
[0051] Endoscopic ultrasound can also be used in conjunction with
endoscopic retrograde cholangio pancreatography. The ultrasound
probe is used to locate gall stones which may have migrated into
the common bile duct.
[0052] Endoscopic ultrasound can also be used for imaging of the
rectum and colon, although these applications are lesser known.
Endoscopic ultrasound can be used primarily to stage newly
diagnosed rectal or anal cancer. EUS-guided fine needle aspiration
may be used to sample lymph nodes during this procedure. Evaluation
of the integrity of the anal sphincters may also be done during
lower EUS procedures.
[0053] An endoscopic ultrasound probe placed in the esophagus can
also be used to visualize lymph nodes in the chest surrounding the
airways (bronchi), which is important for the staging of lung
cancer. Ultrasound can also be performed with an endoscopic probe
inside the bronchi themselves, a technique known as endobronchial
ultrasound.
Embodiment 1
[0054] First of all, a first embodiment of the present invention is
described with reference to FIGS. 1 to 8.
[0055] FIGS. 1 and 2 both show a perspective view of a first
embodiment of an endoscope head 1 according to the invention. More
precisely, FIG. 1 shows a disassembled state of the endoscope head
1 and FIG. 2 shows the assembled state.
[0056] The endoscope head 1 shown in the Figures forms part of an
endoscope according to the invention. This endoscope may be formed
as a flexible endoscope for the gastro-intestinal tract. The
endoscope comprises an operation unit and an insertion portion. The
operation unit is positioned on the proximal side and the insertion
portion is positioned on the distal side of the endoscope. The
operation unit (not shown in the drawings) comprises an actuating
lever (such as a joystick or a simple lever arm, for example) for
actuating an Albarran lever, a working channel inlet and an
adjusting knob for bending a bending portion of the endoscope. The
operation unit is connected to a video processor, a light source
device, a display device and the like.
[0057] The insertion portion is a long tube-like element. The
proximal end of the insertion portion is connected with the
operation unit. The insertion portion comprises, in this order seen
from the operation unit, a flexible portion, the bending portion
and a cap. The flexible portion is elastic. The bending portion is
bent as a reaction to an actuation of the adjusting knob. A rigid
end piece portion is formed on the distal end of the bending
portion. The rigid end piece portion forms the so-called endoscope
head.
[0058] The inventive endoscope head 1 of FIGS. 1 and 2 comprises a
longitudinal endoscope head body 11 and a subsequently further
described housing sheath part 3 including a subsequently further
described Albarran lever 20.
[0059] The endoscope head body 11 is constructed in a cylinder-like
manner and, on the distal side thereof, provided with an ultrasonic
head chamber 4 in which an ultrasonic head 40 is installed. On its
proximal side, the endoscope head body 11 is connected to an
operation unit (not shown) via a cable (not shown) or without a
cable. The operation unit is used to control the endoscope head
1.
[0060] The endoscope head body 11 comprises a working channel 13
and a pulling wire channel 14 (see FIG. 7), both extending along
the longitudinal direction of the endoscope head body 11 and
parallel to each other. The pulling wire channel 14 contains a
subsequently described pulling wire for actuating the subsequently
described Albarran lever 20. The working channel 13 guides micro
tools for examining e.g. the esophagus or the duodenum, the bile
duct, the gall bladder, the pancreatic duct, the pancreas, etc. The
Albarran lever 20 which is described below and able to change the
lateral alignment of the micro tools in the known manner is
arranged at the outlet of the working channel 13. In other words,
the Albarran lever 20 changes the alignment angle of the micro
tools advanced through the working channel 13 in parallel to the
axis of the endoscope head 1. The alignment of the micro tools is
then changed to a lateral direction by means of the Albarran lever
20, the micro tools then project laterally from the endoscope head
so as to be advanced in a bile duct, for example.
[0061] The shape and the deflection angle of the Albarran lever are
not restricted in the present invention.
[0062] As shown in FIGS. 1, 2 and 5, the endoscope head body 11
comprises an Albarran lever chamber 12 extending in the embodiment
from a region near the longitudinal axis of the endoscope head body
11 in the radial direction. In other words, the Albarran lever
chamber 12 is open in the radial direction. Moreover, the Albarran
lever chamber 12 extends in the axial direction of the endoscope
head body 11. On the proximal side of the Albarran lever chamber
12, the working channel 13 enters into the Albarran lever chamber
12. On the distal side of the Albarran lever chamber 12, the
ultrasonic head chamber 4 is provided.
[0063] The endoscope head body 11 comprises two lateral extension
portions 11A and 11B which are formed as side walls or side
portions and are adjacent to the Albarran lever chamber 12. More
precisely, as is shown in FIGS. 1, 2 and 6 to 8, the endoscope head
body 11 includes a first side portion 11A for a camera and an
illumination means, and a second side portion 11B for a pulling
wire.
[0064] A camera 17 and an illumination means 18, aligned laterally
upwards in FIGS. 1, 2 and 6 to 8, are installed in the first side
portion 11A. The direction in which the camera 17 and the
illumination means 18 are aligned is defined as the viewing
direction. In the embodiment, the illumination means 18 is
positioned on the distal end of the first side portion 11A and the
camera 17 is provided proximally to the illumination means 18.
Thus, the supply lines and signal lines for the camera 17 and the
illumination means 18 can be arranged inside the first side portion
11A. These supply lines and signal lines extend toward the
operation unit.
[0065] As is described below in further detail, a pulling wire
channel 14 as a movement transmission channel, a pulling wire end
and a pivot lever 6 are accommodated in the second side portion
11B.
[0066] On the side directed to the viewing direction, the first
side portion 11A and the second side portion 11B are formed in a
flat manner such that a flattening 19 of the endoscope head body 11
is provided. The flattening 19 of the endoscope head body 11 is a
plane surface facing toward the viewing direction. In the
embodiment, the camera 17 and the illumination means 18 are
arranged distally to the flattening 19.
[0067] Thus, the Albarran lever chamber 12 is sandwiched between
and laterally delimited by the first side portion 11A and the
second side portion 11B. The limitation walls of the first side
portion 11A and the second side portion 11B extend in an
approximately radial direction in parallel to each other. Thus, the
Albarran lever chamber 12 in the embodiment has a cuboid shape. The
limitation walls of the first side portion 11A and the second side
portion 11B are perpendicular to the flattening 19.
[0068] An accommodation chamber 11B1 is formed in the second side
portion 11B. On the distal side, on the proximal side, on the side
facing towards the Albarran lever chamber 12, on the side facing
towards the viewing direction and on the side opposed to the
viewing direction, the accommodation chamber 11B1 is surrounded by
the second side portion 11B and is open only on the side opposed to
the Albarran lever chamber 12. The pulling wire channel 14, in
which a pulling wire (control wire, not shown) is guided, opens out
on the proximal side of the accommodation chamber 11B1. The pulling
wire (control wire) extends up to the operation unit and is
actuated by the actuating lever for actuating an Albarran
lever.
[0069] A pivot lever 6 is rotatably supported in the accommodation
chamber 11B1. More precisely, a bearing bore (passage bore) 1162
extends through the wall of the accommodation chamber 11B1, which
is provided on the side facing towards the Albarran lever chamber
12. This bearing bore 1162 connects the accommodation chamber 11B1
with the Albarran lever chamber 12. The pivot lever rotating shaft
62 of the pivot lever 6 is rotatably supported in the bearing bore
1162. The pivot lever rotating shaft 62 protrudes on both sides of
the bearing bore 1162, i.e. on the side of the accommodation
chamber 11B1 and on the side of the Albarran lever chamber 12. The
pivot lever rotating shaft 62 is installed in a sealed manner in
the bearing bore 1162. Thus, the accommodation chamber is
(watertightly) sealed against the Albarran lever chamber 12. The
pivot lever rotating shaft 62 is formed perpendicularly to the
pivot lever 6 and integrally with the pivot lever 6 on an end
portion of the pivot lever 6. The pivot lever rotating shaft 62 and
the pivot lever 6 may be formed as one body or may be separate
components which are connected with each other in a form-fitting or
force-fitting manner. The pivot lever 6 has a pulling wire nipple
accommodation 63 on the end portion opposed to the pivot lever
rotating shaft 62. The pulling wire nipple accommodation 63 may be
molded to the pivot lever 6 or fixed to the pivot lever 6 as a
separate body. The distal pulling wire end of the pulling wire is
hooked in or fitted in the pulling wire nipple accommodation 63 or
otherwise fixed thereto.
[0070] The open side of the accommodation chamber 11B1, i.e. the
side of the accommodation chamber 11B1 opposed to the Albarran
lever chamber 12, is closed by a cover member 5. The cover member 5
is a flat plate member adapted to the outer contour of the
endoscope head body 11 and has a suitable size completely covering
the open side of the accommodation chamber 11B1. The cover member 5
covers the open side of the accommodation chamber 11B1 in such a
manner that the open side of the accommodation chamber 11B1 is
(watertightly) sealed. For example, the cover member 5 is screwed
to the outer circumference of the endoscope head body 11 by means
of two screws so as to cover the accommodation chamber 11B1, as it
is shown in FIG. 1. Thus, the accommodation chamber 11B1, except
for the pulling wire channel, is completely sealed. In other words,
the pulling wire channel is completely sealed against the
environment (in a watertight manner).
[0071] On the end of the pivot lever rotating shaft 62, arranged in
the Albarran lever chamber 12, the pin 16 formed as a round rod
body is arranged as an operating element. The pin 16 extends from
the pivot lever rotating shaft 62 approximately in parallel to the
pivot lever 6. However, the pin 16 may also extend from the pivot
lever rotating shaft 62 at a predetermined angle offset with
respect to the pivot lever 6 in the proximal or the distal
direction. The relative extension direction of the pin 16 and the
pivot lever 6 is not restricted in the invention and can be
appropriately selected.
[0072] Thus, the pin 16 can be actuated by means of the actuating
lever of the operation unit by pulling the pulling wire via the
actuating lever; this causes the pulling wire nipple accommodation
63 to be pivoted about the pivot lever rotating shaft 62 as
rotation point and the pin 16 to be rotated about the same angular
extent.
[0073] An Albarran lever described in the following can be placed
on the pin 16.
[0074] An ultrasonic head chamber 4 is arranged on the distal side
of the endoscope head body 11. The ultrasonic head chamber 4 may be
constructed in any suitable manner and holds the ultrasonic head 40
therein such that the ultrasonic head 40 is at least aligned to the
viewing direction. The ultrasonic head 40 is capable of
transmitting and receiving ultrasonic signals in the viewing
direction. Ideally, the ultrasonic head 40 is configured such that
it is capable of transmitting and receiving ultrasonic signals in
and from directions which are not limited to the viewing direction
alone.
[0075] The ultrasonic head chamber 4 may be mounted on the distal
side of the endoscope head body 11 or form an integral unit with
the endoscope head body 11. Alternatively, the ultrasonic head
chamber 4 may be dismounted on the distal side of the endoscope
head body 11.
[0076] As it is shown in FIG. 1, grooves 15 extending in the axial
direction of the endoscope head body 11 are provided on the
endoscope head body 11. More precisely, a first groove 15 is formed
on the first side portion 11A below the accommodation chamber 11B1
(i.e. on the side opposed to the flattening 19) on the outer
circumferential surface of the endoscope head body 11.
[0077] A second groove 15 is provided on the second side portion
11B on the same level as the first groove 15 and parallel to the
first groove 15. The second groove 15 is not visible in the
drawings since it is positioned on the side of the endoscope head
body 11, which faces away from the viewer.
[0078] The first groove 15 and the second groove 15 are formed as
longitudinal recesses or depressions.
[0079] The housing sheath part 3 comprises a sheath 31 having a
hollow cylinder-like shape. The inner contour of the sheath 31 of
the housing sheath part 3 is adapted to the outer contour of the
endoscope head body 11. More precisely, the hollow cylinder shape
of the sheath 31 is open on one cylinder sheath side. Thus, the
sheath 31 includes two lateral extensions which are elastic. The
cylinder sheath side of the sheath 31 is open between the ends of
the lateral extensions. The sheath 31 is elastic and can be bent
open on the lateral extensions thereof. Thus, an attachment opening
32 is provided between the ends of the lateral extensions. Since
the housing sheath part 3 is elastic, the attachment opening 32 can
be expanded by bending open the sheath ends adjacent to the
attachment opening 32. When the lateral extensions of the sheath 31
are bent open, the housing sheath part 3 can be placed on the
endoscope head body 11 by inserting the endoscope head body 11
quasi through the attachment opening 32 into the sheath 31, see
FIGS. 1 and 2.
[0080] On the circumferential side opposed to the attachment
opening 32, the housing sheath part 3 has a tool opening 33
extending in the axial direction of the housing sheath part 3. When
the housing sheath part 3 is placed on the endoscope head body 11,
the tool opening 33 is arranged exactly above the Albarran lever
chamber 12. The size (in particular the width) of the tool opening
33 is adapted to the Albarran lever chamber 12.
[0081] On the lateral extensions of the sheath 31, on the end
portion opposed to the tool opening 33, ribs 35 are formed adjacent
to the attachment opening 32, as this is shown in FIGS. 3 to 5.
Each rib 35 extends in the axial direction of the housing sheath
part 3. When the housing sheath part 3 is placed on the endoscope
head body 11, the ribs 35 engage in the grooves 15. The shape and
size of the ribs 35 is suitably adapted to the shape and size of
the grooves 15.
[0082] On the inner circumferential side, adjacent to the tool
opening 33, the housing sheath part 3 has a housing sheath
flattening adapted to the flattening 19. In this region adjacent to
the tool opening 33, the housing sheath flattening is provided with
a thicker wall thickness than the rest of the sheath 31. When the
housing sheath part 3 is placed on the endoscope head body 11, the
housing sheath flattening abuts against the flattening 19. On an
axial side of the tool opening 33, a protrusion 34 is formed on the
housing sheath flattening. The protrusion 34 extends radially
inwards in the housing sheath part 3, perpendicular to the housing
sheath flattening. The protrusion 34 forms an Albarran lever
holder. The protrusion 34 is formed to be flat and projects into
the Albarran lever chamber 12 when the housing sheath part 3 is
arranged on the endoscope head body 11.
[0083] On the end portion opposed to the housing sheath flattening,
the protrusion 34 has a passage bore 341 formed perpendicular to
the extension direction of the protrusion 34 and perpendicular to
the axis of the housing sheath part 3. An Albarran lever shaft 21
is rotatably supported in the passage bore 341. The Albarran lever
shaft 21 protrudes laterally from the Albarran lever 20, as it is
shown in FIG. 3. Thus, the Albarran lever 20 is rotatably supported
on the radially inner end portion of the protrusion 34.
[0084] The Albarran lever 20 has an insertion bore which is not
shown in the drawings and in which the previously described pin 16
is inserted. The inner diameter of the insertion bore of the
Albarran lever 20 is adapted to the outer diameter of the pin 16,
such that a smooth relative displacement between the pin 16 and the
insertion bore of the Albarran lever 20 is realized.
[0085] When the housing sheath part 3 is placed on the endoscope
head body 11, the Albarran lever 20 is slid on the pin 16. In other
words, in this position the pin 16 engages in the Albarran lever 20
and can pivot the Albarran lever. Thus, the Albarran lever 20 can
be applied (inserted) on the endoscope head body 11 laterally to
the axis of the endoscope head body 11 and, in turn, removed from
the endoscope head body 11 laterally to the axis of the endoscope
head body 11.
[0086] When the housing sheath part 3 is placed on the endoscope
head body 11, the Albarran lever shaft 21 is arranged at a position
which forms an imagined extension to the pivot lever rotating shaft
62.
[0087] The Albarran lever 20 may have any suitable shape and
includes a tool pushing surface 22. By means of the tool pushing
surface 22, tools guided through the working channel 13 can be
pushed to the lateral side of the endoscope head body 11 in the
known manner. In the installed state of the Albarran lever 20, the
tool pushing surface 22 is positioned opposite to the orifice of
the working channel 13 into the Albarran lever chamber 12.
[0088] The Albarran lever 20 can be slid on the pin 16 such that it
extends approximately parallel to the pivot lever 6, as it is shown
in FIGS. 6 and 7. Thus, in a state when the housing sheath part 3
is placed on the endoscope head body 11, there are two end
positions for the position of the Albarran lever 20. FIG. 6 shows
the Albarran lever 20 in a non-pivoted state with the pulling wire
being released. FIG. 7 shows the Albarran lever 20 in a pivoted
state with the pulling wire being pulled.
[0089] The housing sheath part 3 and the Albarran lever 20 form a
common assembly. The housing sheath part 3 and the Albarran lever
20 are each made of plastic or any other cost-efficient material.
They can be cost-efficiently manufactured by means of injection
molding or a 3D-printer. Thus, the assembly consisting of the
housing sheath part 3 and the Albarran lever 20 is suitable for
single use. After the use, the assembly consisting of the housing
sheath part 3 and the Albarran lever 20 can be disposed of. The
endoscope itself comprising the endoscope head body 11 according to
the invention includes hardly any undercuts and is therefore easy
to clean. The Albarran lever 20, on the other hand, includes
undercuts and is more difficult to clean. Germs and contaminations
might remain stuck to locations of the Albarran lever that are
difficult to access. In the present invention, this problem is
solved by designing the assembly consisting of the housing sheath
part 3 and the Albarran lever 20 such that it is replaceable. For
the next application, the cleaned and sterilized endoscope is
provided with a new assembly of housing sheath part 3 and Albarran
lever 20. In this way, the endoscope can be cost-effectively used
again after an application, namely free of germs and
contaminations.
[0090] The Albarran lever is completely separated from the pulling
wire. Due to this construction, the pulling wire channel is sealed,
with the pulling wire being completely sealed against the
environment. The sealing of the pulling wire channel and the
pulling wire is watertight.
[0091] Preferably, the housing sheath part as an Albarran lever
holding member and the Albarran lever are made of plastic by means
of a 3D-printer or injection molding, for example. By the
manufacturing by means of a 3D-printer or injection molding, the
housing sheath part and the Albarran lever can be manufactured
accurately, but still at low cost. Other appropriate manufacturing
methods may be applied as long as they allow for an accurate and
cost-efficient production. Preferably, the housing sheath part and
the Albarran lever are manufactured separately and then put
together as an assembly for the purpose of a single use.
[0092] In a molding step, the housing sheath part as sheath element
and the Albarran lever are separately manufactured and in an
assembly step, the Albarran lever is installed in the housing
sheath part.
Embodiment 2
[0093] In the following, a second embodiment of the present
invention is described with reference to FIGS. 9 to 13.
[0094] In the first embodiment, the housing sheath part 3 is
engaged at the endoscope head body 11 by the ribs 35 engaging in
the grooves 15. Thus, in the first embodiment, the ribs 35 and the
grooves 15 represent the fastening means by which the housing
sheath part 3 is attached to the endoscope head body 11.
[0095] In the second embodiment, the endoscope head 1 of the first
embodiment and a housing sheath part 3 modified compared to the
housing sheath part 3 of the first embodiment, are applied.
Therefore, only those aspects in which the second embodiment
differs from the first embodiment are described in the
following.
[0096] In the second embodiment, another (additional) fastening
means in the shape of a hinge member 310 is provided on the housing
sheath part 3. The hinge member 310 bridges over the attachment
opening 32. One side of the hinge member 310 is supported in a
hinged manner on the housing sheath part 3 in an edge region of the
attachment opening 32. The opposite side of the hinge member 310
includes a closing means, such as a nose 311, capable of engaging
in an engagement groove 315 on the opposite edge region of the
attachment opening 32 at the housing sheath part 3.
[0097] The hinge mechanism of the hinge member 310 on the housing
sheath part 3 may be formed as a film hinge. More precisely, the
hinge member 310 is integrally provided on the housing sheath part
3 as a thin-walled connection (e.g. in the shape of a fold). Due to
its flexibility, the thin-walled connection enables a rotational
movement of the hinge member 310 on the housing sheath part 3.
Manufacturing the film hinge is extremely cost-effective.
[0098] Apart from that, the housing sheath part 3 corresponds to
the housing sheath part 3 of the first embodiment.
Embodiment 3
[0099] FIG. 14 shows a perspective view of an inventive housing
sheath part of a third embodiment.
[0100] In the third embodiment, the endoscope head 1 of the first
embodiment and a housing sheath part 3 modified compared to the
housing sheath part 3 of the first embodiment are applied. In the
first embodiment, the housing sheath part 3, in the region of the
housing sheath flattening adjacent to the tool opening 33, has a
thicker wall thickness than the rest of the sheath 31.
[0101] In the third embodiment, a housing sheath part 3 also
includes the region of the housing sheath flattening, which is
adjacent to the tool opening 33, as it is shown in FIG. 14.
However, the housing sheath part 3 does not include the two lateral
extensions of the first embodiment which comprise the ribs 35 and
the ends of which define the attachment opening 32. As opposed to
the first embodiment, the housing sheath part 3 in the third
embodiment includes only that portion of the housing sheath
flattening which is adjacent to the tool opening 33. On each of the
lateral sides of the portion of the housing sheath flattening, the
housing sheath part 3 is provided with a fastening means in the
shape of a hinge member 320. One side of the hinge member 320 is,
on an edge region of the portion of the housing sheath flattening,
supported on the housing sheath part 3 via a hinge mechanism 322.
The opposite side of the hinge member 320 includes a closing means
such as a nose 321 which can engage at the endoscope head body in
an engagement groove provided for this purpose.
[0102] The hinge mechanism of the two hinge members 320 on the
housing sheath part 3 may be designed as a film hinge 322. More
precisely, each of the hinge members 320 is integrally provided on
the housing sheath part 3 in the shape of a thin-walled connection
as a film hinge 322 (e.g. as a fold). Due to its flexibility, the
thin-walled connection of the film hinge 322 enables a rotational
movement of the hinge member 320 on the housing sheath part 3. The
manufacture of the film hinge 322 is extremely cost-effective.
[0103] Alternatives
[0104] In embodiment 1, the rib 35 is provided as a fastening means
which is formed at the housing sheath part 3 and engages with the
groove 15 of the endoscope head body 11. Adjacent to the attachment
opening 32, a right and a left rib 35 is provided, each being
parallel to the extension direction of the endoscope head body 11.
The invention is not restricted thereto. Instead of the rib 35, one
or more pin-like protrusions may be formed on the housing sheath
part 3, which respectively engage in one or more hole-like recesses
on the endoscope head body 11 instead of the groove 15. Any type of
fastening means is possible, as long as the same ensures that the
housing sheath part 3 is securely held in place at the endoscope
head body 11. Thus, as a matter of fact, the rib 35 may also be
formed on the endoscope head body 11 and the groove 15 acting
together with the rib 35 may be formed on the housing sheath part
3. Further, screws by which the housing sheath part is screwed to
the endoscope head body may be used as fastening means. "Fastening
means" thus refers to any releasable fastening means.
[0105] In embodiment 1, the region of the housing sheath flattening
on the housing sheath part 3 is formed such that the wall thickness
of the housing sheath part 3 is reinforced (see the drawings).
Thereby, the housing sheath part 3 becomes more rigid and more
stable. The invention is not restricted thereto. The wall thickness
of the housing sheath part 3 may also be uniform.
[0106] In embodiment 1, a protrusion 34 is shown as Albarran lever
holder. The protrusion 34 extends approximately radially inward in
the housing sheath part 3, in a manner perpendicular to the housing
sheath flattening. In other words, the protrusion 34 projects
downward from the housing sheath part 3. In the drawings, the
protrusion 34 projects from the housing sheath part 3 downward into
the Albarran lever chamber 12 on the right-hand side of the
Albarran lever chamber 12, seen from the distal side. In an
alternative, two flat protrusions 34 may protrude downward from the
housing sheath part 3 into the Albarran lever chamber 12 on the
right-hand and left-hand side of the Albarran lever chamber 12,
seen from the distal side. On the end portion opposite to the
housing sheath flattening, each of these two protrusions 34 has a
passage bore 341 in each of which a shaft end of the Albarran lever
shaft 21 is rotatably supported. Then, the Albarran lever is
supported in the housing sheath part 3 in a more stable manner.
[0107] In embodiment 1, the cover member 5 is screwed to the outer
circumference of the endoscope head body 11 by means of two screws,
so as to cover the accommodation chamber 11B1. Here, it is also
possible to use one screw or more than two screws. Moreover, the
cover member 5 may be glued to the outer circumference of the
endoscope head body 11, so as to cover the accommodation chamber
11B1. As a further alternative, the cover member 5 may be
releasably attached to the outer circumference of the endoscope
head body 11 by locking-engagement, so as to cover the
accommodation chamber 11B1.
[0108] In the second embodiment, the ribs 35 and the grooves 15 may
be omitted. The housing sheath part 3 can then be kept closed by
the hinge member 310 only and tightly abuts against the endoscope
head body 11. The housing sheath part 3 is aligned towards the
endoscope head body 11 via the connection between the Albarran
lever 20 and the pin 16. In this way, the relative position between
the housing sheath part 3 and the endoscope head body 11 is
sufficiently specified.
[0109] In the first embodiment, the ends of the sheath 31 which are
opposed to the flattening 19 and form the edge regions of the
attachment opening 32 are formed to be thin on the housing sheath
part 3, as it is shown in FIG. 4, for example. In an alternative
not shown in the drawings, the ends of the sheath 31 which are
opposed to the flattening 19 have a thicker wall thickness and are
provided with round U-depressions extending in parallel to the
axial direction of the housing sheath part 3. The U-depressions are
open towards the attachment opening 32. Round rod elements of an
appropriate size can be inserted into the
[0110] U-depressions. The round rod elements constitute the
respective side edges of a plate member (not shown) inserted into
the above-mentioned U-depressions from the distal or the proximal
side. The round rod elements are formed in one piece with the plate
member. The U-depressions have a smaller opening dimension on the
open side so as to safely hold the round rods. Thus, the round rod
elements can be snap-fitted into the U-depressions and are
rotatably supported in the U-depressions. The plate member bridges
over and closes the attachment opening 32.
[0111] In a similar alternative, one of the two round rod elements
of the plate member is fixedly seated in its U-depression of the
housing sheath part, is rotatably supported thereon and cannot be
pulled out. The other one of the two round rod elements is
snap-fitted in its U-depression. Then, the plate member functions
in much the same way as the hinge member 310 of the second
embodiment. This means, one of the two round rod elements of the
plate member is used as pivot bearing of the plate member on the
housing sheath part 3 and the other one of the two round rod
elements of the plate member is used as a closing member of the
plate member on the housing sheath part 3.
[0112] Fastening means fastening the housing sheath part 3 to the
endoscope head body 11 are described in the embodiments. The rib
35, the groove 15 and the hinge member 310, 320 are specifically
mentioned as examples. The invention is not restricted thereto. The
term "fastening means" shall include any fastening means suitable
to fasten the housing sheath part 3 to the endoscope head body 11.
The fastening means may be attached to the housing sheath part 3 or
to the endoscope head body 11 or to both of them. It is also
possible to use one (or more) external fastening means attached
neither to the housing sheath part 3 nor to the endoscope head body
11, such as, for example, an external annular member which is slid
on or clamped on the outer circumference of the housing sheath part
3 and the endoscope head body 11 in FIG. 2 of embodiment 1. In case
an external fastening means is applied, fastening means attached to
the housing sheath part 3 or the endoscope head body 11 (the rib
35, the groove 15 and the hinge member 310, 320) may be
omitted.
[0113] In the embodiments, the ultrasonic head is arranged on the
distal end of the endoscope head, and the endoscope head includes
an Albarran lever arranged proximally from the ultrasonic head. The
invention may also be applied to an endoscope head including an
Albarran lever arranged distally from the ultrasonic head. In this
alternative, a working channel and a movement transmission channel
are guided past the ultrasonic head. This can be easily
accomplished by arranging, with reference to FIG. 1, an ultrasonic
head chamber similar to the ultrasonic head chamber 4 between the
proximal portion of the endoscope 1 and the endoscope head body 11.
The endoscope head body 11 is then arranged on the distal end of
the endoscope. The ultrasonic head chamber 4 is arranged proximally
of the endoscope head body 11, the bottom region of the ultrasonic
head chamber 4 including a working channel portion and a movement
transmission channel portion, extending below the ultrasonic head
40 in the bottom region of the ultrasonic head chamber 4 towards
the endoscope head body 11.
[0114] The described alternatives may be combined and may be
applied to all embodiments.
[0115] The present invention may preferably be applied to a
duodenoscope, a gastroscope, a colonoscope or a similar endoscope.
However, the principle of the invention may as well be applied to
any other type of endoscope.
LIST OF REFERENCE SIGNS
[0116] 1 endoscope head [0117] 2 housing sheath part [0118] 3
ultrasonic head chamber [0119] 4 cover member [0120] 5 pivot lever
[0121] 6 endoscope head body [0122] 11A side portion for camera and
illumination means [0123] 11B side portion for pulling wire [0124]
11B1 accommodation chamber [0125] 11B2 bearing bore [0126] 12
Albarran lever chamber [0127] 13 working channel [0128] 14 pulling
wire channel [0129] 15 groove (fastening means) [0130] 16 pin
(operating element) [0131] 17 camera [0132] 18 illumination means
[0133] 19 flattening [0134] 20 Albarran lever [0135] 21 Albarran
lever shaft [0136] 22 Albarran lever tool pushing surface [0137] 31
sheath [0138] 32 attachment opening [0139] 33 tool opening [0140]
34 Albarran lever holder (protrusion) [0141] 35 rib (fastening
means) [0142] 40 ultrasonic head [0143] 62 pivot lever rotating
shaft [0144] 63 pulling wire nipple accommodation [0145] 310 hinge
member (fastening means) [0146] 311 nose [0147] 315 engagement
groove [0148] 320 hinge member (fastening means) [0149] 321 nose
[0150] 322 film hinge [0151] 341 bore for Albarran lever shaft
* * * * *