Method of and apparatus for positioning and maintaining the position of endoscopic instruments

Abstract

The present invention provides an apparatus for, and a method of, accurate positioning of endoscopic instruments. Accurate positioning of the instruments is accomplished through the inclusion of a steering ability within the device. After the endoscopic instrument is properly positioned, the present invention may use rapid exchange technology, soft locks, and mechanical locks to maintain the position of the endoscopic instrument. Rapid exchange technology is used to minimize displacement forces present on the guidewire or catheters. Soft locks and mechanical locks resist movements caused by displacement forces.

What is claimed is: 
     
         1 . An apparatus for use with an endoscope, comprising:
 an elongate catheter shaft extending from a distal catheter shaft region to a proximal catheter shaft region;   a hub disposed near the proximal catheter shaft region;   a guidewire port disposed within the hub;   a guidewire lumen extending distally from the hub;   a cutting wire lumen extending distally from the hub; and   a cutting wire disposed within the cutting wire lumen.   
     
     
         2 . The apparatus of  claim 1 , further comprising a handle coupled to the proximal catheter shaft region of the elongate catheter shaft, proximal of the hub. 
     
     
         3 . The apparatus of  claim 2 , wherein the cutting wire extends proximally from the handle. 
     
     
         4 . The apparatus of  claim 2 , wherein the cutting wire has a first portion attached to the distal region of the elongate catheter shaft, a second portion disposed outside of the elongate catheter shaft and a third portion that is attached to the handle. 
     
     
         5 . The apparatus of  claim 4 , wherein at least part of the second portion of the cutting wire is configured to provide cauterizing energy. 
     
     
         6 . The apparatus of  claim 2 , wherein the handle is configured such that manipulating the handle causes the cutting wire to deflect the distal region of the elongate catheter shaft and thus places at least part of the second portion of the cutting wire in a position to cauterize tissue. 
     
     
         7 . The apparatus of  claim 1 , wherein the guidewire port is disposed at an acute angle relative to the elongate catheter shaft. 
     
     
         8 . The apparatus of  claim 1 , further comprising a fluid lumen extending distally through the elongate catheter shaft. 
     
     
         9 . A sphincterotome configured for use with an endoscope, the sphincterotome comprising:
 an elongate catheter shaft extending from a distal catheter shaft region to a proximal catheter shaft region;   a hub assembly disposed near the proximal catheter shaft region;   a guidewire lumen extending distally through the elongate catheter shaft, the guidewire lumen having a C-shaped cross-section including a lumen portion that is sized to accommodate a guidewire therein and a slot portion that is sized to permit the guidewire to be pulled laterally from the lumen portion if desired to do so;   a cutting wire lumen extending distally from the hub assembly; and   a cutting wire disposed within the cutting wire lumen.   
     
     
         10 . The sphincterotome of  claim 9 , wherein the guidewire lumen extends from a proximal end near the hub assembly to a distal end near the distal catheter shaft region. 
     
     
         11 . The sphincterotome of  claim 9 , wherein the guidewire lumen extends from a proximal guidewire port disposed within the elongate catheter shaft to an intermediate guidewire port disposed within the elongate catheter shaft at a position distal to the proximal guidewire port. 
     
     
         12 . The sphincterotome of  claim 9 , further comprising a handle coupled to the proximal catheter shaft region of the elongate catheter shaft, proximal of the hub assembly. 
     
     
         13 . The sphincterotome of claim  22 , wherein the cutting wire extends proximally from the handle. 
     
     
         14 . The sphincterotome of  claim 12 , wherein the cutting wire has a first portion attached to the distal region of the elongate catheter shaft, a second portion disposed outside of the elongate catheter shaft and a third portion that is attached to the handle. 
     
     
         15 . The sphincterotome of  claim 14 , wherein at least part of the second portion of the cutting wire is configured to provide cauterizing energy. 
     
     
         16 . The sphincterotome of  claim 12 , wherein the handle is configured such that manipulating the handle causes the cutting wire to deflect the distal region of the elongate catheter shaft and thus places at least part of the second portion of the cutting wire in a position to cauterize tissue. 
     
     
         17 . The sphincterotome of  claim 1 , further comprising a fluid lumen extending distally through the elongate catheter shaft. 
     
     
         18 . The sphincterotome of  claim 17 , wherein the fluid lumen has a smaller diameter than the guidewire lumen. 
     
     
         19 . A medical device, comprising:
 an elongate catheter shaft extending from a distal catheter shaft region to a proximal catheter shaft region;   a hub disposed near the proximal catheter shaft region, the hub defining a guidewire port;   a guidewire lumen extending distally from the guidewire port;   a cutting wire lumen extending distally from the hub; and   a cutting wire disposed within the cutting wire lumen.   
     
     
         20 . The medical device of  claim 19 , further comprising a guidewire disposable within the guidewire lumen.