CN113520276A

CN113520276A - Portable and ergonomic endoscope with disposable cannula

Info

Publication number: CN113520276A
Application number: CN202110957621.9A
Authority: CN
Inventors: 欧阳小龙; 王士平
Original assignee: Meguiar Vision Co
Current assignee: Meguiar Vision Co
Priority date: 2021-06-29
Filing date: 2021-08-19
Publication date: 2021-10-22
Also published as: CN216602813U

Abstract

The present invention relates to an endoscope system having a disposable portion and a reusable portion. The two parts may or may not be butted. The disposable portion comprises an elongated cannula having a bendable portion near the distal end of the cannula providing a "bendable" distal tip. The distal tip includes an LED illumination and imaging module that delivers real-time video to the display screen of the reusable portion. Important parts of the ergonomically designed steering control and steering structure are located in the reusable part. The cannula is arranged to be rotatable, which when combined with bending along a single axis, further enlarges the field of view. In some embodiments, automatic distal tip bending and/or omnidirectional tip bending is also included.

Description

Portable and ergonomic endoscope with disposable cannula

RELATED APPLICATIONS

This patent application claims benefit from and is incorporated by reference into the following provisional applications:

U.S. provisional application No. 63/183,151, filed on 3/5/2021;

U.S. provisional application No. 63/153,252, filed 24/2/2021;

U.S. provisional application No. 63/149,338, filed on 14/2/2021;

U.S. provisional application No. 63/138,751, filed on 18/1/2021;

united states provisional application No. 63/129,703 filed on 23/12/2020;

united states provisional application No. 63/124,803 filed on 12/13/2020;

united states provisional application No. 63/121,924 filed on 6.12.2020;

united states provisional application No. 63/121,246 filed on day 4, 12/2020;

united states provisional application No. 63/107,344 filed on 29/10/2020;

united states provisional application No. 63/087,935 filed on 6/10/2020;

united states provisional application No. 63/083,932 filed on 27/9/2020;

united states provisional application No. 63/077,675 filed on 13/9/2020; and

united states provisional application No. 63/077,635 filed on 13/9/2020.

The present patent application is also related to the following international, non-provisional and provisional applications, and is incorporated herein by reference:

international patent application No. PCT/US17/53171, filed 2017, 9, 25;

U.S. patent No. 8,702,594 issued on 4/22 2014;

us patent No. 16/363,209 filed on 3,25, 2019;

international patent application No. PCT/US19/36060 filed on 7.6.2019;

united states patent No. 16/972,989 filed on 12/7/2020;

us provisional application No. 62/816,366 filed on 11/3/2019;

us provisional application No. 62/671,445 filed on 2018, 5, 15;

us provisional application No. 62/654,295 filed on 6.4.2018;

us provisional application No. 62/647,817 filed on 25/3/2018;

us provisional application No. 62/558,818 filed on 9, 14, 2017;

us provisional application No. 62/550,581 filed on 26.8.2017;

us provisional application No. 62/550,560 filed 2017, 8, 25;

us provisional application No. 62/550,188 filed 2017, 8, 25;

us provisional application No. 62/502,670 filed on 6.5.2017;

us provisional application No. 62/485,641 filed on 14/4/2017;

us provisional application No. 62/485,454 filed on 14/4/2017;

united states provisional application No. 62/429,368 filed on 12/2/2016;

united states provisional application No. 62/428,018 filed on 2016, 11, 30;

united states provisional application No. 62/424,381 filed on 11/18/2016;

united states provisional application No. 62/423,213 filed on 11, 17, 2016;

united states provisional application No. 62/405,915 filed on 8/10/2016;

united states provisional application No. 62/399,712 filed on 9, 26, 2016;

united states provisional application No. 62/399,436 filed on 25/9/2016;

united states provisional application No. 62/399,429 filed on 25/9/2016;

united states provisional application No. 62/287,901 filed on 28/1/2016;

united states provisional application No. 62/279,784 filed on date 17/1 in 2016;

united states provisional application No. 62/275,241 filed on 6/1/2016;

united states provisional application No. 62/275,222 filed on 5.1.2016;

U.S. provisional application No. 62/259,991 filed on 25/11/2015;

us provisional application No. 62/254,718 filed 11/13/2015;

U.S. provisional application No. 62/139,754 filed 3/29 in 2015;

us provisional application No. 62/120,316 filed 24/2/2015; and

U.S. provisional application No. 62/119,521 filed on 23/2/2015.

All of the non-provisional, provisional and international patent applications identified above are collectively referred to herein as "commonly assigned co-pending applications".

Technical Field

The present invention relates generally to endoscopes. And more particularly to a portable endoscopic device having a reusable handle portion and a disposable or single-use cannula portion.

Background

Conventional rigid and flexible endoscopes, lenses, or fiber optic systems are relatively expensive and are reused multiple times. Therefore, each time it is used, it must be rigorously sterilized and disinfected. Disposable endoscopes are an emerging class of endoscopic instruments. In some cases, the manufacturing cost of the endoscope may become inexpensive enough to be used for only a single patient. Disposable or single use endoscopes reduce the risk of cross-contamination and nosocomial diseases.

The subject matter described or claimed in this patent specification is not limited to what has been described in terms of solving any particular disadvantages or to only what has been described in particular embodiments operating in environments such as those described above. Rather, the above background is provided merely to illustrate the feasibility of some embodiments described herein in an exemplary technology area.

Endoscopes having deflectable or "steerable" distal tips are useful in many applications, including where a fixed field of view is beyond. In this case, the portion of the cannula proximal to the distal tip may be configured to be bendable and controlled by the operator. Examples of such known techniques are discussed in U.S. patent No. 10,918,268 and U.S. patent No. 11,013,396. Both of these patents are incorporated herein by reference.

Disclosure of Invention

In some embodiments, an endoscope comprises: (a) a reusable portion comprising a handle and a bend control lever extending from a proximal end and/or upwardly thereof, wherein said handle is shaped and dimensioned for a user to grasp said handle with his hand while ergonomically reaching and manually thumb-manipulating said bend control lever, said handle comprising a force-generating cable drive; (b) a disposable portion releasably attached to the reusable portion, comprising: a fluid hub extending distally from the handle and bending lever and having one or more proximal fluid ports; a cannula connected to the fluidic hub and having a distal end extending distally along a longitudinal axis, wherein the cannula has a bendable distal portion and a distal imaging module, and further has one or more distal fluid ports; one or more lumens extending from the one or more proximal fluid ports to the one or more distal fluid ports; a steering line extending from the fluidic hub to the bendable portion of the cannula and releasably connected with the force-producing cable drive of the reusable portion. The curvable portion is coupled with the bend control lever through the force generating cable driver such that manually operating the bend control lever selectively bends the curvable portion of the cannula to a selected degree in a selected angular direction; and the force generating cable drive applies the force required to cause the bend to the steering line.

In some embodiments, the endoscope further comprises one or more of the following features: (a) the force-producing cable drive includes one or more electric motors in the reusable portion that are coupleable with the thumb-operated bend control lever to impart the force required to cause the bend to the steering line; (b) the one or more electric motors comprise one or more stepper motors; (c) the force-producing cable drive includes one or more drive gears driven by the one or more motors; (d) the fluid hub includes one or more driven gears releasably engaged with the one or more drive gears and connected with the steering line to selectively bend the bendable portion of the cannula in response to rotation of the one or more driven gears; (e) the force-producing cable drive is configured to cease applying the force required to cause the bend to the steering line if the curvable portion of the insertion tube reaches a selected threshold of resistance to bending applied to the insertion tube by an external force; (f) the force-producing cable drive includes one or more gears driven by the manually-imparted motion of the thumb-operated bending lever; (g) said thumb operated bend control lever comprises a joystick; (h) the thumb-operated bending control lever comprises a touch pad; (i) said reusable portion further comprising a display screen mounted on said handle and coupled to said imaging module for displaying images provided thereby, wherein said display screen includes a touch sensitive area that is selectively displayed and acts as a touch pad and responds to touches to cause said force generating cable driver to selectively bend said bendable portion of the cannula; (j) at least one of (i) the cannula and (ii) a portion of the fluid hub including the proximal port is mounted for selective rotation relative to the handle about the longitudinal axis; (k) wherein the cannula is mounted for rotation about the longitudinal axis relative to the proximal portion of the fluidic hub; (l) The distal portion of the fluidic hub comprises a ring secured to the cannula and manually rotatable to rotate the cannula relative to the proximal portion of the fluidic hub about the longitudinal axis; (m) a proximal portion of the fluidic hub is mounted for rotation about the longitudinal axis relative to the handle; (n) the proximal portion of the fluidic hinge includes a ring secured thereto and rotatable by hand, thereby rotating the proximal portion of the fluidic hinge about the longitudinal axis relative to the handle; (o) the cannula is mounted for rotation relative to a proximal portion of the fluidic hub, the proximal portion of the fluidic hub being mounted for rotation relative to the handle; (p) the reusable portion is configured to selectively bend the bendable portion of the cannula while at least one of the cannula and the proximal portion of the fluid hub rotates relative to the handle.

In some embodiments, an endoscope comprises: a handle shaped and sized to be grasped by a hand of a user while a thumb of the hand ergonomically reaches a proximal control portion of the handle; a fluid hub and a cannula extending distally along a longitudinal axis, the cannula having a distal bendable portion and a distal imaging module; one or more drive gears in the handle and one or more driven gears in the fluid hub that mate with the one or more drive gears when the fluid hub is removably connected to the handle; said one or more driven gears being connected to said distal bendable portion of the cannula for bending said bendable distal portion of the cannula to a selected angle and in a selected angular direction upon rotation of the one or more driven gears; wherein at least one of the cannula and the fluid hub is mounted for rotation relative to the handle when the fluid hub is detachably connected to the handle; wherein the control portion of the handle includes an interface responsive to manual manipulation by a user's thumb to bend the bendable distal end portion of the cannula in a selected angular direction by transmitting to the one or more drive gears the force required to cause the bending; wherein the handle, the fluid hub and the cannula are configured to simultaneously effect bending of the distal bendable portion of the cannula and rotation of at least one of the cannula and the fluid hub relative to the handle.

In some embodiments, the endoscope described in the immediately preceding paragraph may further include one or more of the following features: (a) the handle, the fluid hub, and the cannula are configured to simultaneously effect bending of the bendable portion of the cannula and rotation of each of the cannula and the fluid hub relative to the handle, thereby providing an omnidirectional view of the imaging module; (b) the bendable portion of the cannula is arranged to bend in more than one plane.

In some embodiments, a method comprises: removably assembling (a) a reusable portion comprising a handle and a display mounted on the handle with (b) a disposable portion (i) a fluidic hub having one or more proximal fluid ports and (ii) a cannula extending distally from the fluidic hub and having a bendable distal portion, a distal imaging module and one or more distal ports, wherein the disposable portion further comprises one or more lumens connecting the one or more proximal and distal fluid ports; manually operating a bend controller mounted on a handle of said reusable portion to bend said bendable portion of the cannula at a selected angle in a selected angular direction; selectively rotating at least one of the cannula and the fluid hub relative to the handle while bending the bendable portion of the cannula to point the imaging module omnidirectionally; displaying an image from the imaging module on the display screen; the reusable portion is manually removable from the disposable portion without the need for tools and discarded after the patient's procedure, leaving the reusable portion ready for assembly with another disposable portion.

The method further includes operating the bend control device, including operating a joystick extending proximally from the handle using a thumb of a hand holding the handle.

As used herein, the grammatical conjunctions "and", "or" and/or "are intended to indicate that one or more alternatives may or may already exist for the situation, object or subject matter to which they are connected. In this manner, as used herein, the term "or" in all cases means an inclusive or rather than an exclusive or.

As used herein, the term "surgical" or "operation" refers to any physical intervention on a patient's tissue, and does not necessarily involve cutting the patient's tissue or closing a previously existing wound.

Drawings

To further clarify the above and other advantages and features of the subject matter of this patent specification, a specific embodiment is illustrated in the accompanying drawings. The drawings are to be understood as depicting exemplary embodiments only, and therefore should not be considered as limiting the scope of the patent specification or the appended claims. The subject matter of the invention will be described and explained with specificity and detail through the use of the accompanying drawings in which:

FIGS. 1A, 1B and 1C are side, top and rear views, respectively, of a portable and ergonomic endoscope with a disposable cannula in some embodiments of the present invention;

FIGS. 2A and 2B are perspective views of a portable and ergonomic endoscope with a disposable cannula in some embodiments of the invention;

FIGS. 3A-3C are side views of a portable and ergonomic endoscope with a disposable cannula, in some embodiments, provided with a thumb stick for manipulating the distal tip thereof;

FIGS. 4A-4C illustrate assembled and separated perspective views of the reusable and disposable portions of the portable and ergonomic endoscope in some embodiments;

FIG. 5 is an exploded view of a portable and ergonomic endoscope with a disposable cannula in some embodiments;

6A-6C illustrate perspective views of a steering structure and steering drive mechanism of a portable and ergonomic endoscope in some embodiments;

FIG. 7 is a cross-sectional view of a fluid hub and a rotatable cannula of a portable and ergonomic endoscope in some embodiments;

FIGS. 8A and 8B are cross-sectional and side views of a cannula of a portable and ergonomic endoscope in some embodiments;

fig. 8C is a cross-sectional view of a multi-fluid/device lumen cannula of a portable and ergonomic endoscope in some embodiments;

FIG. 9A is a partially exploded perspective view of the distal tip of a portable and ergonomic endoscope in some embodiments;

FIG. 9B is a partial cross-sectional view of the insertion tube of the portable and ergonomic endoscope in some embodiments;

FIG. 9C is a partially exploded perspective view of the distal tip of the portable and ergonomic endoscope in some embodiments;

FIGS. 10A-10B are side and perspective views of a portable and ergonomic endoscope in other embodiments;

FIG. 11 is a perspective view of a portable and ergonomic endoscope in other embodiments;

FIG. 12A is a side view of a portable and ergonomic endoscope in other embodiments;

12B-12D are a series of perspective views of further aspects of the portable and ergonomic endoscope shown in FIG. 12A in some other embodiments;

FIGS. 13A-13C are side views of a portable and ergonomic endoscope in some other embodiments; and

FIG. 14 is a perspective view of an endoscope insertion tube and control handle configured to interact with a remote image processor and display.

Detailed Description

A detailed description of the preferred embodiments is provided below. While several embodiments have been described, it should be understood that the novel subject matter described in this patent specification is not limited to any one embodiment or combination of embodiments described herein, but includes many alternatives, modifications, and equivalents. In addition, while numerous specific details are set forth in the following description in order to provide a thorough understanding, some embodiments may be practiced without some or all of these specific details. Moreover, for the purpose of clarity, certain technical material that is known in the prior art has not been described in detail in order to avoid unnecessarily obscuring the new subject matter described herein. It is to be understood that each feature of one or more specific embodiments described herein may be used in combination with other features of other described embodiments. Further, like reference numbers and designations in the various drawings indicate like elements.

Fig. 1A, 1B, and 1C are side, top, and back views of a portable and ergonomic endoscope with a disposable cannula in some embodiments. The system 100 is adapted for simple and rapid use, minimizes patient discomfort and has high placement accuracy. The system 100 is comprised of a disposable portion 102 and a reusable portion 104. The disposable portion 102 may be disposable or may be sterilized and reused on a relatively small number of occasions, such as 2, 4 or even 10 occasions. The reusable part 104 may be used more often, e.g. 100 times, 1000 times or even more. The two

portions

102 and 104 may be mated and unmated with each other by connectors, as will be described in further detail below. Distal tip 110 of cannula 120 has an imaging and illumination module. A cable (not shown) is provided within the cannula that provides control signals and power to the camera and LED illumination module on distal tip 110 and transmits video image data from the camera module to handle 140 and display 150 for viewing by the user. In the illustrated embodiment, the handle 140 includes two

control buttons

142 and 144, which may be provided as a power switch and an image capture, respectively. In some embodiments, the handle 140 is shaped as a pistol grip as shown, and includes a rechargeable battery (not shown) that may be inserted through the battery door 148. In some embodiments, electronics (not shown) within the handle 140 are provided for video capture, processing, and display on the display 150. In some embodiments, the display 150 may be tilted and rotated to provide the user with an optimal viewing angle. The rotational joint 152 is configured to rotate the display 150, as indicated by the dashed arrow in FIG. 1C, while the hinge joint 154 is configured to tilt the display 150, as indicated by the dashed arrow in FIG. 1B. In some embodiments, the hinge joint is configured to allow the display to tilt about 90 degrees, or nearly 90 degrees, in the distal direction. Such tilting is beneficial, for example, when giving the user an unobstructed or less obstructed view. The handle 140 also includes a thumb lever 146 that can be moved up or down, as indicated by the dashed arrow. Moving the thumb lever 146 upward and downward bends the distal tip 110 upward and downward, respectively, as will be described in further detail below.

Cannula 120 is connected at its proximal end to a fluid hub 172, which in this embodiment includes

fluid ports

132 and 134. At the proximal end of the fluid hub is a ring 168. In some embodiments, band 168 is configured to be rotatable so as to allow a "plug and twist-lock" type engagement of disposable portion 102 and reusable portion 104, as will be described in further detail below. In some embodiments, the distal end of fluid hub 172 is a textured collar 170 and portion 174 that is manually rotatable relative to fluid hub 172 and handle 140 along the principal longitudinal axis of cannula 120, as indicated by solid arrow 124. Collar 170 and portion 174 are in fixed rotational relationship with cannula 120 and distal tip 110. Thus, rotating collar 170 and portion 174 causes rotation of cannula 120 and distal tip 110, as indicated by solid arrow 124. In some embodiments, the combination of rotating collar 170 and moving thumb lever 146 allows the user to "steer" the direction of the distal tip as desired. In some embodiments, cannula 120 has a working length in the range of 320 mm to 400 mm and an outer diameter in the range of 1mm to 7 mm. In some embodiments, cannula 120 has a length of 380 millimeters and an outer diameter of 5.5 millimeters or less.

Fig. 2A and 2B are perspective views of a portable and ergonomic endoscope with a disposable cannula in some embodiments. Fig. 2A shows a syringe 230 for supplying a fluid, such as saline, through a fluid lumen (not shown) within the cannula 120 via a tube 232, a connector 234, and a fluid port 134. In some embodiments, cannula 120 is semi-rigid. The cannula 120 is sufficiently stiff so as not to collapse under longitudinal push-pull forces. On the other hand, cannula 120 is sufficiently flexible so that it can bend as it passes through a curved anatomy.

Fig. 3A-3C are side views of a portable and ergonomic endoscope with a disposable cannula configured with a thumb stick for manipulating the distal tip thereof in some embodiments. Fig. 3A shows the thumb lever 146 of the system 100 pushed upward, causing the distal bent portion 320 of the cannula 120 to bend upward. FIG. 3B shows the thumb lever 146 of the system 100 in a neutral "neutral position" with the distal bent portion 320 of the cannula 120 in a straight line. FIG. 3C shows the thumb lever 146 of the system 100 pushed downward, bending the distal bent portion 320 of the cannula 120 downward. In some embodiments, a portion of the steering structure is located on the reusable handle 104 to minimize disposable components and increase the ergonomics of yaw control. In some embodiments, the distal flexure 320 has a structural layer, such as stainless steel, including a plurality of transverse grooves spaced to provide suitable upward and downward flexure characteristics of the distal flexure 320. Further details of the possible shapes, arrangements and spacings of the flexures are discussed in U.S. patent No. 10,918,268, which is incorporated herein by reference. In some embodiments, other structures may be used to achieve the bending of the distal tip. For example, known techniques such as a "snake bone" arrangement may be used in place of the groove bend embodiments. In some embodiments, the upward and downward bend angles are in the range of 130 ° and 210 °. In some embodiments, the bend angles are unequal, such as 210 ° bendable upward and 130 ° bendable downward. In some embodiments, the system 100 is configured to only curve upward or only curve downward based on its intended application.

Fig. 4A-4C are perspective views of the engagement and disengagement of the reusable and disposable portions of the portable and ergonomic endoscope in some embodiments. The disposable portion 102 and the reusable portion 104 may be connected and disconnected by mechanical and electrical connectors. Electrical connections are made through a USB-C type plug 402 on the disposable portion 102 (fig. 4B and 4C) and a USB-C type receptacle 404 on the multiple use portion 104 (fig. 4A). The mechanical connection includes both a structural connection that fixedly connects the disposable portion 102 and the reusable portion 104, and a steering connection by which steering inputs from steering structures in the reusable portion 104 can be relayed to steering components in the disposable portion 102. In this embodiment, the structural connection includes a male cylindrical portion 412 on the disposable portion 102, the male cylindrical portion 412 being shaped to mate with a female socket 414 on the reusable portion 104. The structural connection also includes a twist-lock type mechanism in which the male portion 422 can be inserted through the female opening 424 and then locked by twisting the male portion 422 approximately one-quarter turn (90 degrees). The twisting action may be applied manually by means of a textured or knurled collar 168. In this way, the connection may be configured as a "plug and twist" type connection. The steering connection is provided by meshing a drive gear 434 on the reusable portion 104 with a driven gear 432 on the disposable portion 102.

Fig. 5 is an exploded view of a portable and ergonomic endoscope with a disposable cannula in some embodiments. Rotatable portion 570 is shown to contain textured loop 170. In some embodiments, the rotatable portion 570 is formed of two parts that are joined together. Loop 572 is provided to hold upper and lower covers 564 and 566 together. The non-rotating portion of the fluid hub body is formed by the upper and lower covers 564 and 566, which receive the luer prongs 530. In some embodiments, both

fluid ports

132 and 134 are connected to a single fluid channel with a fork 530. Fork 530 is attached to channel 532. The distal end of channel member 532 is inserted into the proximal end of outer sleeve 574. One or more O-rings may be used to seal the non-rotating channel 532 from the outer sleeve 574 and/or fluid chamber 576. In other embodiments,

proximal ports

132 and 134 are connected to separate fluid/device lumens within cannula 120. The driven gear 432 pivots on the shaft 518 and is held by a lower housing 562 and an upper housing 560. It is noted that proximal portions of the upper and

lower housings

560, 562 form a male cylindrical portion 412 (see fig. 4A-4C) on the disposable portion 102. Steering wire 520 is coupled to driven gear 432 at a proximal end and to curved portion 320 (fig. 3A-3C) at a distal end. Also shown is a USB-C connector 402. The cover 526, which forms part of the reusable part 104, includes a female receptacle 414. The distal portion of the cap 526 also includes a female opening 424 (FIG. 4B). Also shown is a USB-C receptacle 404. The drive gear 434 is shown engaged with the drive gear 510. The drive gear 510 has a square central opening to receive the shaft 612 (see fig. 6C). Bearing 521, outer ring 524 and bearing seal 522 are mounted as shown. For ease of installation, the thumb lever 146 is formed in two pieces, a left side 546 and a right side 548. Toggling the thumb lever 146 directly rotates the drive gear 510. Also shown is a spring 502 that is configured to bias the thumb lever 146 and drive gear 510 toward a center position that corresponds to the cannula 120 being in a straight position (i.e., neither bent up nor down). The handle portion (140 in fig. 1A-1C) is formed from a top cover 542 and a bottom cover 540. A main Printed Circuit Board (PCB)552 is mounted on the top cover 542 with screws (not shown). Rechargeable batteries 550 are mounted so that they can be inserted and replaced through the battery door 148. In some embodiments, battery 550 is a 18650 type lithium ion battery. An electronics module 554 mounted on the PCB 552 is configured to perform various processes such as video processing and capture, data transfer to external devices wi-fi, lighting control, user interface processing, and diagnostics. The electronics module 554 is also configured to include at least one non-volatile memory module for storing video and images from the camera module.

It should be noted that in the embodiment shown in fig. 5, the battery, printed circuit board, and various electronic modules are included within the housing of the handle 140, rather than the display 150, and the overall system is less "heavy" than some other designs that include more components in the display module. As shown in fig. 1A and 1B, cannula 120, collar 170, and portion 174 are configured to rotate separately from the other proximal components (including handle 140 and display 150), as indicated by

arrows

124 and 122. Such an embodiment is more ergonomically advantageous than in other embodiments where the entire handle (as with conventional endoscope systems) or the handle and integrated display module must be rotated with the cannula. The relatively close alignment of the display 150 and the cannula 120 provides a further ergonomic advantage over some other designs. As shown in FIG. 1B, the angle 190 formed with the main longitudinal axis along cannula 120 from distal tip 110 to the top of display 150 is relatively small. In some embodiments, angle 190 is preferably 7.5, and may range from 5-15. This facilitates maintaining both the display 150 (or at least the screen thereof) and the distal portion of the cannula 120 within the user's field of view while the user is focused on the center of the display 150. Alternatively, when the distal end of the cannula is within the patient, this facilitates maintaining the display 150 and thumb stick 146 within the user's field of view when the user's eyes are centered on the display 150.

Fig. 6A-6C are perspective views of a steering structure and steering drive mechanism of a portable and ergonomic endoscope in some embodiments. As shown, the thumb lever 146 is moved up and down as indicated by the dashed line arrow, causing the drive gear 510, the drive gear 434, and the driven gear 432 to rotate as indicated by the solid line arrows shown. The driven gear 432 includes a recess 600, an upper pin 602, and a lower pin 604. Upper and lower steering lines (not shown) extending along the cannula to the curved portion of the cannula are connected at their proximal ends to the upper and

lower pins

602 and 604, respectively. Rotation of the driven gear 432 causes the steering wire to be tightened and loosened, thereby causing the distal tip to bend upward and downward. In some embodiments, the thumb lever 146 is formed from a right portion 546 and a left portion 548, respectively, which are connected at the seam 622.

Fig. 7 is a cross-sectional view of various aspects of a fluid hub and a rotatable cannula of a portable and ergonomic endoscope in some embodiments. Figure 7 is a bottom sectional view along the midline or major longitudinal axis of the cannula and the fluid hub. Steering wire 520 is shown coupled proximally to driven gear 432 and distally to curved portion 320 (see fig. 3A-3C). It should be noted that there are two steering wires 520, and since the cross-section of fig. 7 is at the midline, only one wire is sometimes visible, particularly near the widely spaced gears 432. Also shown is a cable 730 extending from the distal tip and cannula (not shown in fig. 7) and through the fluid hub shown in fig. 7. The cable 730 has insulation protection and includes a plurality of electrical conductors for powering and controlling the LEDs and camera module (see fig. 9A), as well as transmitting image data from the camera module at the distal tip. As shown, the proximal end of the cable 730 is electrically connected to the USB-C plug 402. Also shown in FIG. 7 are O-

ring seals

740 and 742 which are configured to form a fluid-tight seal between non-rotating channel member 532 and outer sleeve 574 of the rotating member and fluid chamber 576. Also shown in fig. 7 is a plate 720 and a sandwich 722, the plate 720 including two holes for the steering wires 520 to pass through. Also visible in fig. 7 is a push-and-pull type of structural connection, in which the male portion 422 is inserted through the female opening 424 as shown.

Fig. 8A and 8B are cross-sectional and side views, respectively, of an insertion tube of a portable and ergonomic endoscope in some embodiments. The exterior of cannula 120 includes three layers: a metallic inner layer 820, a mesh intermediate layer 822, and a polymeric outer layer 824. In some embodiments, the inner layer 820 is made of a stainless steel material, such as "SUS 304". In some embodiments, the intermediate layer 822 is a mesh material, such as #300 gauge mesh, and is made of a stainless steel material, such as "SUS 304". In some embodiments, the outer layer 824 is a polymeric material, such as Low Density Polyethylene (LDPE). In some embodiments, inner layer 820 has a thickness of about 0.15mm, intermediate layer 822 has a thickness of about 0.1mm, and outer layer 824 has a thickness of about 0.15 mm. Within inner layer 820 of cannula 120, in some embodiments, are cable 730, steering wire 520, and fluid/device lumen wall 576, which define lumen 830. The cable 730 is insulated and includes a plurality of electrical conductors for powering and controlling the LEDs and camera module (see fig. 9A), as well as for communicating image data from the camera module. The steering line 520 is used to apply a bending force to the bent portion of the cannula. Chamber wall 576 defines fluid lumen 830. Fig. 8B shows the outer layer 824 partially cut away in side view, exposing the intermediate layer 822. In some embodiments, lumen 830 may be used for inflow (out of the device and into a body cavity or tissue), outflow (from a body cavity or tissue into the device), or both inflow and outflow. Alternatively, both

ports

132 and 134 may be connected to the same lumen. In addition, lumen 830 may serve as a device channel through which needles, shavers, scalpels, and the like may pass, depending on the application. In some embodiments, lumen 830 is configured as a device channel with an inner diameter of about 2.4 mm and a thickness of lumen wall 576 of about 0.2 mm. In other embodiments, the inner diameter of lumen 830 is less than 2.4 millimeters, and for some applications may be as small as 1.2 millimeters, or less. In some embodiments, the outer diameter of cable 730 is about 0.9 millimeters. In some embodiments, the unoccupied space within the inner layer 820 defines another "cavity" 850, which may be used, for example, to transport fluids.

Fig. 8C is a cross-sectional view of a multi-fluid lumen cannula of a portable and ergonomic endoscope in some embodiments. In some embodiments, within the inner layer 820 of the cannula 120, in addition to the cable 730, steering wire 520, and fluid/device lumen 830, there is another fluid lumen 860. In some embodiments, a fluid hub (not shown in fig. 8C) can include two proximal ports (e.g.,

ports

132 and 134 shown in fig. 1A), one of which is connected to one of the fluid/

device lumens

830 and 860 and the other of which is connected to the other of the fluid/

device lumens

830 and 860.

Fig. 9A is a partially exploded perspective view of the distal tip of a portable and ergonomic endoscope in some embodiments. Curved portion 320 of cannula 120 shows a plurality of upper slots 920 and lower slots 922. In some embodiments, a separate distal housing 910 is provided to receive the distal end of cannula 120. Housing 910 includes a circular opening 912 (shown in fig. 8A) that communicates with a fluid lumen 830 defined by a lumen wall 576. The housing 910 also includes a socket 934 for providing a camera module, and a socket 944 for providing an LED. Lumen 850 (fig. 8A) houses cable 730 (fig. 8A) and provides fluid communication to a forward fluid port 950 (fig. 9C) on distal tip 110. In this embodiment, distal tip 110 is formed from a separate housing 910.

Fig. 9B is a partial cross-sectional view of a cannula for a portable and ergonomic endoscope in some embodiments. This view shows further details of curved portion 320 of cannula 120, including the staggered arrangement of upper slots 920 and lower slots 922 formed in inner layer 820.

Fig. 9C is a partially exploded perspective view of the distal tip of a portable and ergonomic endoscope in some embodiments. Depicted is a distal tip structure compatible with the multi-fluid lumen embodiment as shown in fig. 8C. An upper fluid guide 960 is shown that is configured to be coupled at its proximal end to a fluid lumen, such as lumen 860 (see fig. 8C), and at its distal end to two distal fluid ports 950 formed in tip member 914. Also shown is the distal end of fluid lumen 830 defined by chamber wall 576, which is in fluid connection with lower forward circular opening 912. The camera module 930, including the lens 932, is a CMOS type image sensor in some embodiments.

LEDs

940 and 942 are also shown. The camera module 930 and

LEDs

940 and 942 can also be configured for a single fluid lumen embodiment as shown in fig. 9A.

Fig. 10A-10B are side and perspective views of a portable and ergonomic endoscope. The system 1000 is comprised of a disposable portion 102 and a reusable portion 1004. The two

portions

102 and 1004 may be mated and unmated with each other by a "plug and twist" connector, as described elsewhere in this specification. The system 1000 is similar or identical in all respects to the system 100 described elsewhere herein, except for steering, steering input, and a steering drive mechanism. In some embodiments, the cannula 120 is configured to be steered in more than one plane. That is, in addition to turning up and down as shown and described elsewhere herein, the curved portion 320 is configured to also provide lateral bending as shown in fig. 10A and 10B. In some embodiments, this enables the distal tip to deflect in any desired direction (i.e., be "omnidirectional"). The reusable part 1004 includes a joystick 1046, the joystick 1046 being configured to accept user input of a desired direction and magnitude (amount) of tip deflection. A motor module 1020 is provided to provide the driving force for causing the desired tip deflection, e.g., one or more stepper motors coupled to the gear module 1010, which are controlled by the user via the thumb lever 146, joystick 1046, and/or a touch screen incorporated into the display 150 or handle 140. The user input controls the direction and extent of the bend of the bent portion 320 of the cannula 120, as well as the rotation of the cannula 120 and/or the fluid hinge 172 relative to the handle member 140, as indicated by

arrows

1276 and 1274 in fig. 12A. The motor module may be configured to cease driving the bent cannula 120 and/or the rotated cannula 120 and/or the rotating fluid hub 172 if the resistance to rotation and/or bending meets or exceeds a corresponding threshold, such that further input of a bending or rotating command by the user does not cause the motor module 1020 to apply further bending or rotating force to the cannula 120 and/or the fluid hub 172. The gear module 1010 is arranged to transmit drive force from the motor module 1020 to a mechanical interface 1032 on the disposable portion 102. In some embodiments, a plurality of

gears

1012 and 1014 are used to transmit the driving force to the disposable portion 102. In the case of a yaw that can occur along two axes (e.g., up and down and left and right), two "drive gears" 1014 can be used on the reusable portion 1004 and two "driven gears" 1032 can be used on the disposable portion 102. Each driven gear 1032 is connected to two steering lines running distally to the curved portion 320 of the cannula 120. A total of four steering lines provide steering inputs to produce the desired deflection at the curved portion 320. In some embodiments, the drive gear 1014 and receptacle twist interface on the reusable part 1004 are configured to be compatibly mountable to an up/down (single axis deflection) type disposable part 102 (e.g., fig. 1A-1B, fig. 2A-2B, fig. 3A-3C, fig. 4A-4C, etc.). In this case, lateral input from the joystick 1046 will not result in any lateral offset, but the upward and downward offsets will be fully operational. The reusable part 1004 and the overall system may be made more versatile by providing the option of matching different types of disposable parts to a single type of reusable part, and the option of matching different types of reusable parts to a single type of disposable part.

FIG. 11 is a perspective view of a portable and ergonomic endoscope in other embodiments. The system 1100 is comprised of a disposable or disposable portion 102 and a reusable portion 1104. The two

portions

102 and 1104 may be mated and unmated with each other via a "plug and twist" connector, as shown and described elsewhere herein. The system 1100 is similar or identical in all respects to the system 1000 shown and described in fig. 10A-10B, except for the steering input. 10A-10B are similar or identical in all respects to the system 1000 shown and described herein. For example, although not shown, it is understood that the reusable portion 1104 is provided with a motor module 1020 and a gear module 1010, as shown in fig. 10A. In the case shown in fig. 11, a touch panel 1146 is used in place of the joystick 1046 of the system 1000 shown in fig. 10A-10B. In some embodiments, the user may "slide" the trackpad 1146 with a thumb or finger in different directions to control the angle and amount of distal deflection of the cannula 120. In other embodiments, the display 150 may be configured as a touch-sensitive display, and the user may touch and drag on the area 1148 of the display 150 with a thumb or finger to control the angle and amount of deflection. In some embodiments, other types of known multi-axis user interfaces, such as a trackball, may be applied in place of the trackpad 1146.

FIG. 12A is a side view of a portable and ergonomic endoscope in other embodiments. The system 1200 is comprised of a disposable or disposable portion 102 and a reusable portion 1204. The two

portions

102 and 1204 may be mated and unmated with each other by a "plug and twist" connector, as shown and described elsewhere herein. The system 1200 is similar or identical in all respects to the

systems

100 and 1000 described elsewhere herein, except for steering, steering input, and a steering drive mechanism. In the embodiment shown in fig. 3A-3C, the cannula 120 is configured to be angled so that it can be deflected up and down. The reusable portion 1204 includes a joystick 1046 configured to accept user input of a desired direction and magnitude (amount) of tip deflection. The motor module 1020 is configured to provide a driving force for causing a desired tip deflection. The gear module 1010 is arranged to transmit driving force from the motor module 1020 to a mechanical interface 1032 of the disposable part 102. In some embodiments, gears 1012 and 1014 are used to transmit the driving force to disposable portion 102. The driven gear 432 is connected to two steering wires that run distally to the curved portion 320 of the cannula 120. The drive gear 1014 and the plug and twist interface on the reusable part 1004 are configured to be compatibly mounted to an up/down (single axis deflection) type disposable part 102 (see fig. 1A-1B, 2A-2B, 3A-3C, 4A-4C, etc.). In some embodiments, a lateral input from the joystick 1046 is provided to rotate the connector 1212, as indicated by arrow 1272. When disposable portion 102 and reusable portion 1204 are mounted together, rotation of connector 1212 causes disposable portion 102 to rotate in the same manner, as indicated by

arrows

1274 and 1276. In some embodiments, motor module 1020 and connector 1212 are configured to detect the precise angular position of cannula 120 and distal tip 110. The image displayed to the user on display 150 is corrected to compensate for the known rotation.

Fig. 12A illustrates a portable and ergonomic endoscope, such as some of the embodiments of fig. 12B-12D. Fig. 12B shows the system 1200 in a "neutral" rotational position, in which the disposable portion 102 is not rotated in any direction. The curved portion 320 of the cannula will deflect up and down depending on the control input to the joystick 1046. Fig. 12C shows the disposable part 102 rotated counterclockwise (from the user's perspective), as indicated by arrow 1282, in response to leftward movement of the joystick 1046, as indicated by arrow 1280. Fig. 12D shows the disposable part 102 rotated clockwise (from the user's perspective), as indicated by arrow 1286, in response to the rightward movement of the joystick 1046, as indicated by arrow 1284.

In some embodiments, a motor module 1020 and a cannula rotation gear module 1212 are provided that are configured to interface with the disposable portion 102 to allow electrical rotation of the cannula 120 as indicated by arrow 1276. In some embodiments, the proximal fluid luer port does not rotate with the cannula 120 (as is the case with many of the other embodiments described herein). In other embodiments, the proximal fluid luer port does rotate with the cannula 120, as shown by arrow 1274. Such rotation will simplify some structures and reduce the cost of the disposable portion 102. In some embodiments, motorized cannula rotation allows for full range control of the distal tip while eliminating the need for more complex dual-axis cannula deflection structures, particularly in the more cost-sensitive disposable portion of the system. In some embodiments, user interface types other than joysticks may be applied, such as: a touch pad; a touch screen; a trackball, etc. In some embodiments, the user interface can include a separate input device, such as a dial 1248 for cannula rotation.

In some embodiments, the joystick 1046 in the embodiment of fig. 10A-10B may have a longer post and/or have a longer "throw" for improved ergonomics. Having a longer post (i.e., projecting a longer distance from the body of the handle 140) or having a longer throw can facilitate fine-tuning of the position of the distal tip.

In some embodiments, the joystick 1046 in the embodiments of fig. 10A-10B and 12A-12D may be provided as an "absolute" or "relative" input device. When set as an absolute input device, the position of the joystick determines the absolute position of the distal tip, while when set as a relative input device, the motion of the joystick controls the speed and acceleration of the motion of the distal tip. In many applications where fine control of the position of the distal tip is desired, it may be beneficial to position the joystick relative to the input device.

In some embodiments, in the case of motorized articulation, a warning signal may be displayed to the user when the intended motion of the distal tip is blocked (e.g., by tissue, membranes, walls, or other physical structures). In some embodiments, the motor module 1020 (in fig. 10A and 12A) is configured to sense a resistance force that exceeds a threshold for expected movement. When this occurs, a warning (such as a text message or a red box) may be displayed on the screen 150. Other examples of warnings or indications may be tactile feedback through the handle 140 or joystick 1046.

Fig. 13A-13C are side views of portable and ergonomic endoscopes of some other embodiments. As shown in fig. 13A, the system 1300 is comprised of a disposable portion 102 and a reusable portion 1304. The two

parts

102 and 1304 can be mated and unmated with each other by a "plug and twist" connector such as shown and described elsewhere herein. System 1300 is similar or identical in all respects to

systems

100 and 1000 and 1200 described elsewhere herein, except for translational movement and control, and the use of a joystick 1046 instead of a thumb stick 146. In the embodiment shown in fig. 3A-3C, the cannula 120 is configured to be angled so that it can be deflected up and down. The motor module 1020 is configured to provide the driving force for causing the desired tip deflection and translation drive. The gear and translation module 1310 is configured to transmit drive force from the motor module 1020 to the driven gear 432 on the disposable portion 102. In some embodiments, module 1310 is further configured to provide a translational force parallel to the main axis of cannula 120 (when connected), as indicated by arrow 1370. In some embodiments, the inner housing 1350 is configured to slide into the outer housing 1352 to an extent that the range of translational motion can be accommodated. The drive gear 1014 and the plug and twist interface on the reusable portion 1304 are configured to be compatibly mountable to an up/down (single axis deflection) type disposable portion 102 (e.g., fig. 1A-1B, fig. 2A-2B, fig. 3A-3C, fig. 4A-4C, etc.). In some embodiments, a lateral input from the joystick 1046 is provided to rotate the coupling 1212 as indicated by arrow 1272. When the disposable portion 102 and the reusable portion 1304 are mounted together, rotation of the coupling 1212 causes the disposable portion 102 to rotate in the same manner, as indicated by

arrows

1274 and 1276. Up and down movement or lateral movement of joystick 1046 controls deflection of the distal portion of cannula 120, as does up and down movement of the thumb lever in the embodiment of FIGS. 3A-3C. Control of the translational movement may also come from joystick 1046. For example, the joystick pushes on joystick 1046 to move cannula 120 distally, which automatically returns to its starting position at the maximum in the distal direction. Alternatively, the joystick 1046 may be configured to: pushing on the lever, which may be spring loaded, moves cannula 120 distally, so that when pressure on the lever is released, cannula 120 moves proximally. Optionally, a control input device, such as dial 1348, may be provided to control the desired translation, while joystick 1046 is used exclusively to control deflection of the distal portion of cannula 120.

Fig. 13B illustrates another control configuration for translational movement in some embodiments. In this case, a three-axis joystick 1320 is provided on the handle 140. The three-axis joystick 1320 may be tilted up and down and side to side as shown by the solid arrow and dashed line 1324. This movement is like the joystick 1046 in fig. 12A and 10A-10B and is configured to control the steering angle and cannula rotation as previously described herein. In addition, lever 3120 includes a rotatable knob 1322, as indicated by dashed arrow 1326. Knob 1322 is rotated to control the translational movement of the cannula. The user's thumb and forefinger may be used to control the tilt of the joystick and the rotation of the knob, while the user's other fingers and palm are used to firmly support and engage the handle 140.

Fig. 13C shows another control of the translational movement. In this case, a "teeter-totter" type button 1310, which includes a rocking or teeter-totter potentiometer, is mounted in a "trigger" position for ergonomic use by the operator's index finger. The button 1310 may "rock" up or down as indicated by dashed

arrows

1326 and 1324, respectively. Dashed line 1322 represents a downward rocking motion.

The reusable part 1304, when configured to provide translation, rotation, and tilt, resembles a robotic arm. In some embodiments, rotation, translation, and deflection may all be digitally controlled and parameterized and calibrated for a particular application. The camera at the distal tip can be uniquely and adequately identified by the three-dimensional coordinates of the lens center and the direction of its optical axis. These parameters can be fed back to the system for control purposes and can also be corrected for display if necessary. The precise location of the distal tip and the orientation of the camera can be accurately determined, recorded and controlled. Thus, some embodiments described herein provide a fully robotic endoscope. It should be noted that in some embodiments, most of the more complex and expensive parts of the system 1300 are contained in the reusable portion 1304, rather than in the disposable portion 102, which can greatly reduce the cost of the disposable portion, thereby facilitating widespread use of the endoscopic systems described herein.

FIG. 14 is a perspective view of an endoscope insertion tube and control handle configured to interact with a remote image processor and display. The system 1400 is comprised of a disposable portion 102, a reusable control handle 1404, and a processing and display unit 1406. The disposable portion 102 is similar or identical to the disposable portion 102 described elsewhere herein. The reusable portion 1404 is identical to the

reusable portions

104, 1004, 1204, and 1304 described elsewhere herein, except that it includes an electrical connector 1408 that is configured to connect to the processing and display unit 1406 via a cable 1402. In some embodiments, the reusable portion 1404 may not include the integrated display shown in fig. 14. In other embodiments, a display is included in the reusable portion 1404, such as the display 150 shown in other figures, e.g., fig. 1A and 1B. 102 and 1404 may be mated and unmated with each other by a "plug and twist" connector such as shown and described elsewhere herein. It should be noted that processing and display unit 1406 may be located remotely (i.e., one meter or more) from disposable portion 102 and reusable control handle 1404. One advantage of the arrangement of fig. 14 is that the processing and display unit 1406 can be conveniently viewed by several people, and it can be other standard work tables or hospital towers programmed to interact with the 102 and 1404 sections.

Although the foregoing has been described in some detail for purposes of clarity of understanding, it will be apparent that certain changes and modifications may be made without departing from the principles of the invention. It should be noted that there are many alternative ways of implementing the processes and apparatuses described herein. Accordingly, the present embodiments are to be considered as illustrative and not restrictive, and the subject matter described herein is not to be limited to the details given herein, but may be modified within the scope and equivalents of the appended claims.

Claims

1. An endoscope, comprising:

a reusable portion comprising a handle and a proximally and/or upwardly extending bending lever, wherein: the handle being shaped and dimensioned such that a user's hand can grasp the handle while ergonomically reaching and manually operating the bending lever with the thumb; and the handle includes a cable drive that generates the force; a disposable portion releasably attached to the reusable portion, the disposable portion comprising: a fluid hub extending distally from the handle and bending lever and having one or more proximal fluid ports; a cannula connected to the fluidic hub and extending distally along a longitudinal axis, wherein the cannula has a bendable distal end portion and a distal imaging module and one or more distal fluid ports; one or more lumens extending from the one or more proximal fluid ports to the one or more distal fluid ports; a steering line extending from the fluidic hub to the bendable portion of the cannula and releasably connecting with the force-generating cable drive in the reusable portion; wherein the curvable portion is coupled with the bend control lever through the force generating cable driver such that manual operation of the bend control lever selectively bends the curvable portion of the cannula to a selected degree in a selected angular direction; wherein the force generating cable drive applies the force required for bending to the steering line.

2. The endoscope of claim 1, wherein: the force-producing cable drive includes one or more electric motors in the reusable portion coupled with the thumb-operated bend lever to impart the force required to cause the bend to the steering line.

3. The endoscope of claim 2, wherein: the one or more electric motors include one or more stepper motors.

4. The endoscope of claim 2, wherein: the force-generating cable drive includes one or more drive gears driven by the one or more electric motors.

5. The endoscope of claim 4, wherein: the fluid hub includes one or more driven gears releasably engaged with the one or more drive gears and connected with the steering line to selectively bend the bendable portion of the cannula in response to rotation of the one or more driven gears.

6. The endoscope of claim 2, wherein: the force-producing cable drive is configured to cease applying the force required to cause the bend to the steering line if the bendable portion of the insertion tube reaches a threshold of resistance to bending applied to the insertion tube by an external force.

7. The endoscope of claim 1, wherein: the force generating cable drive includes one or more gears driven by manually applied movement of the thumb operated bending control lever.

8. The endoscope of claim 1, wherein: the thumb-operated bending control lever comprises a joystick.

9. The endoscope of claim 1, wherein: the thumb-operated bending control lever includes a touch pad.

10. The endoscope of claim 1, wherein: the reusable portion further includes a display screen mounted on the handle and coupled to the imaging module for displaying images provided thereby, wherein the display screen includes a touch sensitive area that is selectively displayed and acts as a touch pad and responds to touches to cause the force generating cable driver to selectively bend the bendable portion of the cannula.

11. The endoscope of claim 1, wherein: (i) at least one of the cannula and (ii) a portion of the fluid hub with the proximal port is mounted for selective rotation relative to the handle about the longitudinal axis.

12. The endoscope of claim 11, wherein: the cannula is mounted for rotation about the longitudinal axis relative to the proximal portion of the fluidic hub.

13. The endoscope of claim 12, wherein: the distal portion of the fluidic hub includes a ring secured to the cannula and manually rotatable to rotate the cannula about the longitudinal axis relative to the proximal portion of the fluidic hub.

14. The endoscope of claim 11, wherein: the proximal portion of the fluid hub is mounted for rotation relative to the handle about the longitudinal axis.

15. The endoscope of claim 14, wherein: the proximal portion of the fluidic hinge includes a collar secured thereto and manually rotatable to rotate the proximal portion of the fluidic hinge about the longitudinal axis relative to the handle.

16. The endoscope of claim 11, wherein: the cannula is mounted for rotation relative to a proximal portion of the fluidic hub, which is mounted for rotation relative to the handle.

17. The endoscope of claim 11, wherein: the reusable portion is configured to selectively cause bending of the bendable portion of the cannula while at least one of the cannula and the proximal portion of the fluidic hub is rotated relative to the handle.

18. An endoscope, comprising: a handle shaped and sized to be grasped by a user's hand while a thumb of the user's hand ergonomically reaches a proximally facing control portion of the handle; a fluid hub and a cannula extending distally along a longitudinal axis, the cannula having a distal bendable portion and a distal imaging module; one or more drive gears in the handle and one or more driven gears in the fluid hub that mate with the one or more drive gears when the fluid hub is releasably connected to the handle; the one or more driven gears being connected to the distal bendable portion of the cannula for bending the bendable distal portion of the cannula to a selected angle and a selected angular orientation upon rotation of the one or more driven gears; wherein at least one of the cannula and the fluid hub is mounted for rotation relative to the handle when the fluid hub is releasably connected to the handle; wherein the control portion of the handle includes an interface responsive to manual manipulation by a user's thumb to cause the distal curvable portion of the cannula to bend in a selected angular direction beyond a selected angle by transmitting the force required for the bending to the one or more drive gears; wherein the handle, the fluid hub and the cannula are configured to simultaneously effect bending of the distal bendable portion of the cannula and rotation of at least one of the cannula and the fluid hub relative to the handle.

19. The endoscope of claim 18, wherein: the handle, the fluid hub, and the cannula are configured to simultaneously effect bending of the bendable portion of the cannula and rotation of each of the cannula and the fluid hub relative to the handle, thereby providing an omni-directional viewing angle of the imaging module.

20. The endoscope of claim 18, wherein: the bendable portion of the cannula is arranged to bend in more than one plane.

21. A method, comprising: releasably assembling (a) a reusable portion comprising a handle and a display mounted on the handle with (b) a disposable portion comprising (i) a fluidic hub having one or more proximal fluid ports and (ii) a cannula extending distally from the fluidic hub and having a bendable distal portion, a distal imaging module, and one or more distal ports, wherein the disposable portion further comprises one or more lumens connecting the one or more proximal fluid ports with the distal fluid ports; manually operating a bend controller mounted on a handle of said reusable portion to bend said bendable portion of the cannula at a selected angle in a selected angular direction; selectively rotating at least one of the cannula and the fluid hub relative to the handle while bending the bendable portion of the cannula to point the imaging module omnidirectionally; displaying an image from the imaging module on the display screen; the reusable portion is manually detached from the disposable portion without the need for tools, the disposable portion is disposed of after the patient's surgery, and the reusable portion is retained for assembly with another disposable portion.

22. The method of claim 21, wherein: the bend control operation includes operating a joystick extending proximally from the handle using a thumb of a hand holding the handle.