Adapter for Attaching Devices to Endoscopes

Abstract

An improved system for attaching devices to the distal end of endoscopic instruments is described. An attachment adapter comprises a distal stop, such as a complete or partial loop or cylinder, which limits the penetration of an endoscope into the adapter. The adapter has at least one flange protruding proximally along the endoscope. The adapter is secured on the endoscope by a securing means, which compresses the flange or flanges sufficiently to provide a friction fit. The flexibility of the inventive adapter system allows the adapter to work reliably with endoscopes that are used, damaged or repaired. The adapter may further provide a slit or window allowing viewing of the vessel wall by a lens on an endoscope, thereby improving the operator's ability to understand the location of the endoscope during operation. The adapter may carry any of a variety of devices, including devices for closing a surgical incision, or treating or manipulating tissue. Improvements are described in a number of areas to allow more flexible pairing of particular endoscopes or endoscopic instruments with devices to be carried on their exteriors, while maintaining a tightly locked position of the external device on the carrier.

What is claimed is: 
     
         1 . An adapter for attaching devices to the distal end of an endoscopic instrument, the adapter comprising distal stop means to limit the penetration of said endoscopic instrument into said adapter; wherein the adapter is constructed so that the central axis of said adapter and the center axis of said endoscopic instrument are not concentric when said adapter is mounted on said instrument. 
     
     
         2 . The adapter of  claim 1 , wherein the distal stop means has a closed perimeter. 
     
     
         3 . The adapter of  claim 1  having at least one flange projecting from said distal stop means, wherein said flange comprises a securing means to secure said flange to said endoscopic instrument to prevent motion of said flange with respect to said instrument. 
     
     
         4 . The adapter of  claim 3  wherein the flange is comprised of a material flexible enough to at least partially encircle an endoscopic instrument circumference, said encirclement being sufficient to allow the securing of the adapter to the distal end of endoscopic instruments having a range of diameters and shapes at their distal tips. 
     
     
         5 . The adapter of  claim 3 , wherein the flange has a non-closed perimeter. 
     
     
         6 . The adapter of  claim 3 , wherein the flange has a perimeter with at least one opening, and the distal stop has a perimeter with at least one opening. 
     
     
         7 . The adapter of  claim 3 , wherein the projecting flange perimeter openings and the distal stop perimeters openings are aligned. 
     
     
         8 . The adapter of  claim 1 , wherein the adapter is constructed so that the central axis of said adapter and the center axis of said endoscopic instrument are substantially parallel when said adapter is mounted on said instrument. 
     
     
         9 . The adapter of  claim 3 , wherein said securing means is constructed and arranged to provide a force that is sufficient to impede movement of said adapter with respect to said endoscope, when said adapter is placed on said endoscope and said securing means is engaged with said adapter. 
     
     
         10 . The adapter of  claim 3 , wherein said securing means may be one or more of an o-ring, a wrap around, an overlapping wrap around, a hook-loop closure, at least one hook or snap closure, an elastomeric material, a thermoplastic material, a thermoset material, a spring material, a super-elastic material, a metallic material, an adhesive material, an inflatable element, a collapsible shrink wrap, a welded in place securing means, a cut or sever to remove securing means, or any combination thereof. 
     
     
         11 . The adapter of  claim 3 , wherein said at least one flange, after it is secured to the endoscopic instrument, defines at least one region which is open or sufficiently transparent to allow visualization of tissues surrounding said endoscopic instrument by visualization means mounted on said endoscopic instrument. 
     
     
         12 . The adapter of  claim 1 , further comprising a sheath covering said adapter. 
     
     
         13 . The adapter of  claim 12  further comprising a sheath or membrane covering the adapter proximally of the distal end of the adapter, which may be deployed before or during a medical procedure. 
     
     
         14 . The adapter of  claim 13  wherein the sheath is optically clear at least in part. 
     
     
         15 . The adapter of  claim 14  wherein the sheath is extendable to enclose the full length of the endoscopic instrument. 
     
     
         16 . The adapter of  claim 1 , wherein said adapter is used to attach one or more devices to an endoscopic instrument to allow specific functions to be performed at a tissue site located remotely in the body. 
     
     
         17 . The adapter of  claim 16  wherein the attached device comprises one or more of
 a tissue fastener, or a dispenser therefor; additional lumens for access to the operative site; functional means to dynamically resize or reconfigure the attached device portion; drug delivery or medicament dispensing means; energy delivery means; sensor or measurement devices; visualization means; and markers to assist in determination of the location of the endoscope tip. 
 
     
     
         18 . The adapter of  claim 16  wherein said at least one device is connected to said adapter by connecting means, wherein said connecting means include without limitation one or more of co-fabrication, mechanical assembly of discrete function components and sub assemblies, bonded assembly of discrete function components and sub assemblies, fused assembly of discrete function components and sub assemblies. 
     
     
         19 . The adapter of  claim 3 , wherein the adapter can accommodate endoscopes varying in diameter over a range wherein the largest diameter of endoscope that can be accommodated by the adapter is at least 150% of the smallest diameter of endoscope onto which the adapter can reliably stabilized. 
     
     
         20 . The adapter of  claim 3 , wherein said flange is arranged to have a highly expandable portion to accommodate the insertion of an endoscopic device having a diameter greater than that of said distal stop. 
     
     
         21 . The adapter of  claim 20 , wherein after the binding of said flange to said endoscope, a sealing property is created between said adapter and said endoscope sufficient to allow suction to occur at the distal end of said endoscope upon provision of a vacuum to said endoscope at its proximal end. 
     
     
         22 . The adapter of  claim 20 , wherein said flange is arranged to have a highly expandable portion which is visually clear. 
     
     
         23 . The adapter of  claim 20 , wherein said flange is arranged to have a highly expandable portion which overlaps an expandable flange portion. 
     
     
         24 . The adapter of  claim 20 , wherein said flange has at least one slit. 
     
     
         25 . The adapter of  claim 1  further comprising at least one delivery channel attached to said adaptor, said channel suitable for the conveyance of at least one of a fluid or an instrument from outside of the body to an interior site. 
     
     
         26 . The adapter of  claim 25  in which said channel can be changed in functional cross section by one or more of mechanical manipulation and inflation by gas or liquid. 
     
     
         27 . The adapter of  claim 1 , wherein said adapter is used to attach one or more devices to an endoscopic instrument to allow specific functions to be performed at a tissue site located remotely in the body said adaptor comprising:
 at least one flange projecting from said distal stop means,   a securing means to secure said flange to said endoscopic instrument,   a means for attaching a device to said adapter,   and a means for discharging said device from said adapter.   
     
     
         28 . An adapter for attaching devices to the distal end of an endoscopic instrument, the adapter comprising:
 a distal stop means to limit the penetration of said endoscopic instrument into said adapter;   at least one flange projecting axially from said distal stop means; and   a securing means for locking said adapter on to said endoscope; wherein   said flange comprises a non closed cross-section portion of a generally hollow cylinder.   
     
     
         29 . An adapter for attaching devices to the distal end of an endoscopic instrument, the adapter comprising:
 a distal stop means to limit the penetration of said endoscopic instrument into said adapter;   at least one flange projecting axially from said distal stop means;   a securing means for locking said adapter on to said endoscope; and   an attachment means for engaging the securing means, said attachment means located proximal from said distal stop means.   
     
     
         30 . A method of conveying a device to a remote location in the body using an endoscopic device, the method comprising:
 providing an adapter for attaching a device to be transported to an endoscope, said adapter consisting essentially of a terminal stop, a flange, means for attaching a device to said adapter, a means for discharging said device from said adapter and means for attaching said adapter to an endoscope;   attaching a device to be transported to said adapter;   attaching said adapter to said endoscopic instrument; and delivering said device to said remote location using said endoscope.   
     
     
         31 . The method of  claim 30  wherein the means for attaching said flange to said endoscope are selected from mechanical assembly of discrete function components and sub assemblies, bonded assembly of discrete function components and sub assemblies, fused assembly of discrete function components and sub assemblies or any combinations thereof. 
     
     
         32 . The method of  claim 30  wherein the adapter provides means for lateral visualization of tissue through the side of said flange, through one or more of an opening or window, and an optically transparent material. 
     
     
         33 . The method of  claim 30  wherein the adapter is constructed so that the central axis of said adapter and the center axis of said endoscopic instrument are not aligned when said adapter is mounted on said instrument. 
     
     
         34 . A method of manufacturing an adapter, said adapter consisting essentially of a terminal stop, a flange, means for attaching a device to said adapter, and means for attaching said adapter to an endoscopic instrument;
 the method of manufacturing selected from one or more of injection molding, insert molding, multi-material molding, casting, mechanical assembly of discrete function components and sub assemblies, bonded assembly of discrete function components and sub assemblies, fused assembly of discrete function components and sub assemblies or any combinations thereof.   
     
     
         35 . The method of manufacturing of  claim 34 , wherein the adapter is constructed so that the central axis of said adapter will be essentially parallel to the center axis of said endoscopic instrument when said adapter is mounted on said instrument. 
     
     
         36 . The method of  claim 35  wherein the manufacturing method ensures that the parallel axes of said adapter and said instrument will not be concentric. 
     
     
         37 . The adapter of  claim 3  wherein the endoscope is selected to be larger in diameter than the distal stop effective diameter and wherein said flange, when in contact with said endoscopic instrument prevents movement of the endoscope with respect to the flange. 
     
     
         38 . The adapter of  claim 3  wherein the endoscope is selected to be larger in diameter than the distal stop effective diameter and wherein said flange, once in contact with said endoscopic instrument along at least a portion of its length and secured on said instrument by said securing means, prevents proximal movement of the endoscope with respect to the flange. 
     
     
         39 . The adapter of  claim 3  wherein the endoscope is selected to be no larger in diameter than the distal stop, and wherein the flange, once in contact with said endoscopic instrument and secured on said instrument by the securing means, prevents both proximal and distal movement of the endoscope with respect to the flange. 
     
     
         40 . The adapter of  claim 3  wherein said flange covers more than  180  degrees of the circumference of said endoscopic instrument. 
     
     
         41 . The adapter of  claim 3 , wherein at least a portion of the flange is optically transparent. 
     
     
         42 . The adapter of  claim 1  wherein said adapter consists essentially of a single device having at least a distal stop and attaching means for attaching said device to an endoscopic instrument. 
     
     
         43 . An adapter for attaching devices for dispensing tissue fasteners to the distal end of an endoscopic instrument, the adapter comprising:
 a distal stop means to limit the penetration of said endoscopic instrument into said adapter;   at least one flange projecting axially from said distal stop means;   a securing means for locking said adapter on to said endoscope; and   wherein said adapter carries a deployment assembly activated by actuating means operated from outside the patient by a wire sheath connected to a pusher, wherein said pushing said pusher into said deployment assembly pushes a tissue-affixing clip out of said assembly.