FR3073384A1 - ENDOSCOPY DEVICE AND ACCESSORY FOR ENDOSCOPE - Google Patents

Abstract

The accessory (60) for endoscope (20) comprises: - a tip (67) configured to surround the distal end of the endoscope, said tip comprising a liquid distribution means on an optical window (23) at the distal end endoscope and a channel (62) for supplying the liquid to the dispensing means. In embodiments, the accessory (60) includes a sleeve (61) carrying a liquid entraining fluid inlet (65) from the sleeve to the dispensing means.

Description

TECHNICAL FIELD OF THE INVENTION

The present invention relates to an endoscopy device and an accessory for an endoscope.

It applies in particular to the field of minimally invasive surgery performed under endoscopy, for example laparoscopy, thoracoscopy, arthroscopy and otolaryngology.

STATE OF THE ART

Laparoscopy, also called laparoscopy, is a medical endoscopy technique used for diagnosis (laparoscopy proper) or surgical intervention (laparoscopy) on the abdominal cavity. The instrument used, called an endoscope, is made up of an optical tube fitted with a lighting system and a video camera transmitting the image on a screen.

Comparable techniques have been developed in thoracic surgery (thoracoscopy), orthopedics (arthroscopy), visceral surgery, gynecology and urology.

The notion of endoscope also covers fibroscopes, endoscopes in which the image is formed by a bundle of optical fibers.

Laparoscopy involves accessing the abdominal cavity without opening the abdominal wall. It is possible thanks to several devices:

- an endoscope is introduced into the abdominal cavity through a trocar crossing a scar that the surgeon practices in the umbilicus. The endoscope is connected to a screen that the surgeon looks at while operating,

- carbon dioxide (CO2) is then introduced into the abdominal cavity. The positive pressure exerted by this gas lifts the abdominal wall, thus creating a space between the wall and the viscera where the surgeon can look and where he can introduce his instruments to operate and

- finally, trocars are introduced through the wall thus raised, through which the surgeon will pass instruments 5 to 12 mm in diameter to operate (forceps, scissors, coagulation and suturing instruments, etc.).

The choice of carbon dioxide is justified by its presence in the human body, by the fact that the tissues are capable of absorbing it and that the respiratory system can evacuate it. It is also not flammable, which is important because electrosurgical instruments are used frequently.

Thus, during a laparoscopic operation, carbon dioxide is pressurized inside the patient's abdomen. The end of the endoscope's optical tube is inserted into an incision formed in the patient's skin and observes the operating field. Surgical instruments are inserted through other incisions and are manipulated in the optical field of the endoscope, allowing the surgeon to view the operating field on a video screen.

However, the atmosphere being around 37 ° C and lasting for humidity while the endoscope forms a thermal bridge with the outside atmosphere, at around 20 ° C, fogging forms on the front lens of the endoscope. In addition, liquids or pieces of fat or organ may be splashed onto this front lens during the operation. In both cases, the quality of the visualization is reduced and the surgical team is forced to take out the endoscope to clean the front lens in physiological saline.

In addition to the waste of time, and the need to prolong the patient's anesthesia, each additional insertion of the endoscope head into the abdomen increases the patient's risk of contamination.

OBJECT OF THE INVENTION

The present invention aims to remedy all or part of these drawbacks.

To this end, according to a first aspect, the present invention relates to an accessory for an endoscope, which comprises:

a tip configured to surround the distal end of the endoscope, said tip comprising a means for distributing liquid on an optical window at the distal end of the endoscope,

- a channel for supplying the liquid to the distribution means and

- a sleeve carrying a liquid entrainment gas inlet from the sleeve to the distribution means.

Thanks to these arrangements, the optical window, for example the front lens of the endoscope, can be cleaned by covering it with liquid, for example physiological saline. It therefore becomes unnecessary, or rarely necessary, to remove the head of the endoscope from the patient's body when dirt has settled on the optical window. The duration of a surgical intervention and the risk of contamination are therefore reduced. The liquid is sprayed onto the front lens of the endoscope by the transport gas.

In embodiments, the accessory comprises a liquid reservoir, the circulation of gas in the sleeve causing, by Venturi effect, the suction of liquid from the reservoir.

Thanks to these arrangements, the liquid is regularly drawn towards the front lens of the endoscope.

In embodiments, the accessory includes a non-return valve between the liquid reservoir and a removable liquid source.

In embodiments, the check valve takes the form of a sphere and a spring holding the sphere in position and preventing the passage of fluid from the reservoir to the source of liquid.

The removable liquid source can be a bottle, a volume integrated into the device, a vial or a syringe, for example. The non-return valve prevents pollution of the source by pressurized gas or air.

In embodiments, the sleeve has a locking clip on the endoscope.

Thanks to these provisions, the holding in position of the accessory is more stable.

In embodiments, the dispensing means comprises a discharge of the liquid present on the optical window.

Thanks to these provisions, excess liquid, which could affect the quality of the image captured by the endoscope, is evacuated.

In embodiments, the liquid discharge comprises a lateral slot on the front face of the endpiece.

In embodiments, the dispensing means comprises at least one radial and lateral irrigation channel inside the distal end of the nozzle.

Thanks to these arrangements, the liquid is directly applied to the edges of the optical window, itself in contact with the interior of the distal end of the tip.

In embodiments, the dispensing means includes a circular manifold at the distal end of the tip.

Thanks to these arrangements, the liquid is directly applied to all of the edges of the optical window, itself in contact with the interior of the distal end of the tip.

In embodiments, the tip has a liquid delivery channel from the liquid delivery channel to the interior of the distal end of the tip.

In embodiments, the accessory object of the invention comprises a sleeve mechanically linked to the nozzle and carrying the liquid supply channel.

Thanks to these arrangements, the tip and the channel are held in position on the endoscope optical tube.

In embodiments, the sleeve is braided.

Thanks to these arrangements, the sleeve can be deformed, for example in the case of a moving head endoscope. In addition, the braiding ensures self-locking of the sleeve on the endoscope's optical tube.

In embodiments, the accessory has a sleeve configured to attach to the optical tube of the endoscope.

In embodiments, the sleeve includes a bottle holder containing the liquid to be dispensed over the optical window.

Thanks to these arrangements, the bottle is supported on the optical tube of the endoscope and maintains an orientation towards this tube.

In embodiments, the sleeve includes a support for a rear end of the channel.

Thanks to these arrangements, the user can use a syringe to inject liquid into the canal.

According to a second aspect, the present invention relates to an endoscope which comprises:

- an optical tube comprising optical components for conveying an image from an optical window positioned at the distal end of the tube, the optical tube being provided with a light inlet for a lighting system, with an optical system for conveying light from the lighting system to the distal end of the optical tube and a connector for a video camera receiving the image conveyed by the optical components,

- a nozzle surrounding the distal end of the optical tube and comprising a liquid distribution means on the optical window, a liquid supply channel to the distribution means and a support for a bottle containing the liquid to be distributed on the optical window.

The advantages, aims and characteristics of this endoscope being similar to those of the accessory object of the invention, they are not repeated here.

BRIEF DESCRIPTION OF THE FIGURES

Other advantages, aims and characteristics of the present invention will emerge from the description which follows, given for explanatory purposes and in no way limiting with regard to the appended drawing, in which:

- Figure 1 shows a side view of an endoscope of known type,

FIG. 2 represents a side view of the endoscope illustrated in FIG. 1 and a first particular embodiment of an accessory object of the invention,

FIG. 3 represents, in perspective, the endoscope illustrated in FIGS. 1 and 2 and the accessory object of the invention illustrated in FIG. 2,

FIG. 4 represents, in side view, the endoscope illustrated in FIGS. 1 to 3 provided with the accessory illustrated in FIGS. 2 and 3,

FIG. 5 represents an enlargement of a tip of the accessory illustrated in FIG. 4,

FIG. 6 represents an enlargement of a sleeve of the accessory illustrated in FIG. 4,

FIGS. 7 and 8 represent, in perspective, the endpiece illustrated in FIG. 5,

FIGS. 9 and 10 represent, according to two orthogonal sections, the endpiece illustrated in FIGS. 5, 7 and 8,

FIGS. 11 and 12 represent, according to two orthogonal sections, the sleeve illustrated in FIGS. 9 and 10,

FIG. 13 represents, in the form of a flow diagram, steps for setting up and using the first embodiment of the accessory object of the invention and the endoscope supporting it,

FIG. 14 represents, in side view, the endoscope illustrated in FIG. 1 and a second particular embodiment of the accessory object of the invention,

FIG. 15 represents, in perspective, the endoscope and the accessory illustrated in FIG. 14,

FIG. 16 represents a section of the accessory illustrated in FIGS. 14 and 15 mounted on the endoscope,

FIG. 17 represents, in perspective, the accessory illustrated in FIGS. 14 to 16, provided with a syringe,

FIGS. 18 and 19 represent, in perspective, a clip for holding the accessory illustrated in FIGS. 14 to 17, in the closed configuration,

FIGS. 20 and 21 represent, in perspective, the clip illustrated in FIGS. 18 and 19, in the open configuration,

FIG. 22 represents a section and two elevation views of the clip illustrated in FIGS. 18 to 21 provided with a syringe,

FIGS. 23 to 25 represent, in two side views and a longitudinal section, a tip of the accessory illustrated in FIGS. 14 to 17,

FIG. 26 represents, in perspective, the endpiece illustrated in FIGS. 23 to 25,

FIGS. 27 and 28 represent, in radial and longitudinal section, respectively, a junction sleeve between the clip illustrated in FIGS. 18 to 22 and the end piece illustrated in FIGS. 23 to 26 and

- Figure 29 shows, in the form of a flowchart, steps for setting up and using the second embodiment of the accessory object of the invention and the endoscope supporting it.

DESCRIPTION OF EXAMPLES OF EMBODIMENT OF THE INVENTION

This description is given without limitation, each characteristic of an embodiment can be combined with any other characteristic of any other embodiment in an advantageous manner. We note, as of now, that the figures are not to scale.

The first embodiment, described with reference to FIGS. 1 to 13, uses only the injection of liquid onto the optical window of the endoscope. However, the second embodiment, described with reference to FIGS. 14 to 29, uses a suction gas by the Venturi effect and propels the liquid towards the optical window of the endoscope.

In FIG. 1, an endoscope 20 is observed, which comprises an optical tube 22 comprising optical components (not shown) for conveying an image from an optical window 23 positioned at the distal end of the tube 22, on the left in FIG. 1, up to a connector 21 for a video camera (not shown). The optical components integrated into the optical tube are generally either only optical lenses, or optical fibers following at least one optical imaging lens. The optical window 23 located at the distal end of the optical tube 22 is either the front lens of the optical system integrated into the optical tube 22, or a transparent window positioned upstream of this front lens and protecting it from scratches.

The optical tube 22 is provided with a light inlet 24 for a lighting system (not shown) and an optical system, for example optical fibers, for conveying light coming from the lighting system to the distal end of the optical tube 22 and illuminate the scene observed by the video camera.

The endoscope 20 can be articulated (flexoscope), that is to say that it can accept a variable or rigid curvature (boroscope).

The optical tube 22 generally measures from 40 to 160 cm in length and from 5 to 12 mm in diameter. The light source (cold) connected to the light input 24 is constituted by a high intensity lamp located outside the device. The elbow 31 allows the transmission of light from the light inlet 24 to the optical tube 22.

The endoscope is introduced inside the cavity to be explored through a trocar. A trocar is a surgical instrument in the form of a hollow cylindrical rod surmounted by a handle. One of the trocars is, in laparoscopic surgery, associated with an endoscope to perform a visual exploration of the operating field. Other trocars allow the insertion of surgical tools into the considered cavity.

As can be seen in FIGS. 2 to 4, the accessory 25 which is the subject of the invention comprises:

a tip 30 configured to surround the distal end of the endoscope and therefore the optical window 23, said tip 30 comprising a liquid distribution means illustrated in FIGS. 7 to 10, on the optical window 23, and

- A channel 27 for supplying the liquid to the distribution means.

In preferred embodiments, such as that illustrated in FIGS. 2 to 4, the accessory 25 also includes:

a sleeve 29 configured to grip the optical tube 22 between its ends (generally closer to the proximal end, to the right of FIGS. 1 and 2, than to the distal end) and

- a sleeve 26 mechanically connected to the end piece 30 and to the sleeve 29 and configured to thread onto the optical tube 22, the sleeve 26 supporting the channel 27.

The sleeve 29 here takes the form of a clip, as illustrated in FIGS. 11 and 12.

Preferably, the sleeve 26 is braided. It can then take the form of a braided sheath similar to a sheath for electric cable. This braiding has several advantages. On the one hand, it has a flexibility allowing its deformation which follows that of the flexoscopes. On the other hand, the sleeve 26 provides thermal insulation which reduces the thermal bridge between the ambient air around the part of the optical tube 22 which is located outside the abdomen and the distal end of the endoscope. . The formation of fogging is thus reduced since the optical window 23 is hotter than in the absence of the sleeve 26. Finally, the braided sleeve is self-locking since, when a pull is made on one of its ends, its diameter decreases and encloses the optical tube 22. The exit from the endoscope of a trocar provided with valves therefore does not risk causing a significant displacement of the nozzle 30.

Remember that there are three commonly used endoscope diameters: 10mm, 8mm and 5mm. The different versions of the accessory object of the invention have internal diameters corresponding to the diameters of the endoscopes, that is to say leaving a small clearance with the optical tube of the endoscope.

In the embodiment illustrated in FIGS. 2 to 4, the sleeve 29 includes a support for a flask or a flexible vial of liquid, for example physiological saline. A simple pressure on the body of such a vial or such a vial is sufficient to inject liquid into the channel 27.

In other embodiments not shown, the sleeve includes a support for a rear end of the channel 27 in which an operator can insert a syringe needle to inject liquid into the channel 27. Alternatively, a flexible transparent tube connected to the channel 27 receives the needle of the syringe, which allows easier handling.

As can be seen in FIGS. 5 and 7 to 10, in particular embodiments of the accessory, the end piece 30 comprises two parts, an external part 30 and an internal part 34, the cylindrical part of which fits into the cylindrical part of the external part 30.

The external part 30 comprises:

a distribution channel 40, in the extension of channel 27,

an internal collector 33, connected to the distribution channel 40 and traversing the internal periphery of the external part 30,

- radial channels 32 distributing the liquid coming from the internal collector 33 on the optical window 23 of the endoscope 20 and

- an outlet 35 for the liquid having flowed over the optical window 23.

The internal part 34 comprises:

a stop 37 which bears on the proximal end of the external part 30 and which prevents the internal part 34 from entering the collector 33,

- a corresponding channel 36, that is to say overlapping, with channel 40,

- a light 38, which passes through the stop 37 for the passage of the channel 27 to the distribution channel 36 and 40, and

- an evacuation 39 corresponding, that is to say superimposed, to the evacuation 35.

The sleeve 26 is secured to the end piece 30 by gluing, or overmolding, for example.

As is easily understood, when an operator injects liquid into the channel 27, by means of a soup bottle or a syringe, this liquid travels through the channel 27 then the lumen 38 and the distribution channel 36 and 40 , follows the collector 33, is shared on the radial channels 32, spreads over the optical window 23, which the liquid cleans, and is evacuated by the evacuation 35 and 39.

Of course, in other embodiments, the end piece 30 comprises a single piece or more than two pieces. These parts can be assembled with bonding, welding or any other form of joining, possibly temporary.

Note that the front (distal) face of the tip is inclined parallel to the optical window of the endoscope for which the accessory is intended. For example, for optical windows tilted at 30 ° or 45 °, the front end of the tip is tilted at the same angle.

In embodiments, the liquid inlet of the first particular embodiment is replaced by an inlet of pressurized transport gas and liquid.

As can be seen in FIGS. 11 and 12, in embodiments, the sleeve 29 consists of a single piece, which comprises:

- a clip 41 provided with a lower opening 45,

a nozzle 43 for receiving and supporting a flexible bottle of liquid, comprising a central pipe 42 and

- a light 44 for receiving the channel 27, which opens onto the central pipe 42.

The sleeve 26 is secured to the sleeve 29 by gluing or overmolding, for example.

As illustrated in FIG. 13, in order to implement the endoscope accessory illustrated in FIGS. 1 to 12, during a step 50, the distal end of the endoscope is inserted into the sleeve 29. During a step 51, the accessory is positioned on the endoscope by pulling on the sleeve 29 and pushing on the sleeve 26 until the end piece 30 abuts on the optical window 23.

In a step 52, the endoscope is inserted into a prepositioned trocar on a patient.

In the event of soiling or fogging on the front face of the optical window 23, during a step 53, is injected, by means of a flexible bottle whose walls are pressed or by means of a syringe, liquid in channel 27.

During a step 54, the liquid cleans the optical window, as explained above.

Steps 53 and 54 are repeated as often as necessary during the surgical procedure, possibly by changing the flexible vial and syringe.

At the end of the surgical intervention, during a step 55, the accessory 25 is removed from the endoscope 20.

In a step 56, the accessory 25 is cleaned or discarded and the endoscope 20 is cleaned.

With regard to the second embodiment, there are, in Figures 14 and 15, the endoscope 20 illustrated in Figure 1 and an accessory 60 object of the invention. Accessory 60 includes:

a tip 67 configured to surround the distal end of the endoscope 20 and therefore the optical window 23, said tip 67 comprising a liquid distribution means illustrated in FIGS. 23 to 26, on the optical window 23, and

- A channel 62 for supplying the liquid to the distribution means.

In preferred embodiments, such as that illustrated in FIGS. 14 to 28, the accessory 60 also includes:

a sleeve 61 configured to enclose the optical tube 22 between its ends (generally closer to the proximal end, to the right of FIGS. 14 and 15, than to the distal end) and

- a tube 63 mechanically connected to the end piece 67 and to the sleeve 61 and configured to thread onto the optical tube 22, the tube 63 comprising the channel 62.

The sleeve 61 here takes the form of a clip, as illustrated in FIGS. 16 to 22.

In the embodiment illustrated in FIGS. 14 to 28, the sleeve 61 includes a support 75 for a flask or a flexible vial of liquid, for example physiological saline. A simple pressure on the body of such a vial or such a vial is sufficient to inject liquid into the channel 62.

The sleeve 61 also includes a support 75 in which an operator can insert a removable source of liquid, for example a syringe 76 without needle, a vial or a bottle, for injecting liquid into the channel 62.

As can be seen in FIGS. 16 to 22, in embodiments, the sleeve 61 comprises:

- a clip 66 allowing tightening around the optical tube 22 of the endoscope 20

- an inlet 65 for carbon dioxide and

a non-return valve 64 so that the passage of carbon dioxide under pressure sucks up part of the liquid present in a liquid reservoir 72 and coming from the syringe 76 or in the vial (not shown) mounted on the support 75.

In variants, a push button (not shown) is positioned below the non-return valve 64, on the same side as the inlet 65 for carbon dioxide. This push button allows the aspiration of the physiological saline by venturi effect from the storage volume or liquid reservoir 72 for an aspiration command of the physiological saline.

The tube 63 is secured to the sleeve 61 by gluing or overmolding, for example.

FIGS. 18 to 21 also show an outlet for gas and liquid 77 to the tube 63.

The non-return valve 64 makes it possible to close the storage volume of physiological saline and prevent the infiltration of ambient air. Below this valve 64, the shape of the pipe towards the path of carbon dioxide from the inlet 65 towards the outlet 77 allows a suction by Venturi effect.

As illustrated in Figures 18 and 19, when the clip 66 is closed, it locks the sleeve 61 on the optical tube 22. On the contrary, as illustrated in Figures 20 and 21, when the clip 66 is open, the sleeve can slide on the optical tube 22 for positioning or removing the accessory 60.

As can be seen in FIGS. 23 to 26, in particular embodiments of the accessory, the end piece 67 consists of a single piece 69, the internal cylindrical recess of which has a corresponding diameter, that is that is, it is very slightly greater, than the diameter of the endoscope 20.

Exhibit 69 includes:

a distribution channel 71, in the extension of the channel 62 (see FIGS. 27 and 28),

an internal collector 78, connected to the distribution channel 71 and traversing the periphery of the position of the optical window 23, once the accessory has been positioned on the endoscope,

- radial channels 70 distributing the liquid coming from the internal collector 78 on the optical window 23 of the endoscope 20.

FIG. 25 represents the front face of the nozzle showing the difference in material around the optics which allows the passage of fluids in the upper part.

The tube 63 is secured to the end piece 67 by gluing or overmolding, for example.

Note that the front (distal) face of the tip is inclined parallel to the optical window of the endoscope for which the accessory is intended. For example, for optical windows tilted at 30 ° or 45 °, the front end of the tip is tilted at the same angle.

As illustrated in FIGS. 27 and 28, the tube 63 has an internal channel 73 for conveying carbon dioxide and the liquid towards the nozzle 67 and a cylindrical channel 74 whose diameter corresponds to the diameter of the optical tube 22 of the endoscope 20. The manufacture of the tube 63 can be made by extrusion. The tube 63 forms a multi-lumen tube. Tube 63 may be flexible to accommodate flexible endoscopes.

The injection of carbon dioxide through the gas inlet 65 is permanent. It keeps the patient's abdominal wall inflated and keeps the desired pressure (for example 12 to 15 mm of mercury).

As is easily understood, when an operator injects physiological liquid from the syringe 76 or the vial (not shown) mounted on the support 75 in the volume surrounding the non-return valve 64, the carbon dioxide under displacement sucks up this liquid . This gas charged with liquid traverses the channel 62 and 73 then the lumen 71, follows the collector 78, is shared on the radial channels 70 and spreads on the optical window 23, which the liquid cleans.

Of course, in other embodiments, the end piece 67 comprises more than one piece. These parts can be assembled by gluing, welding or any other form of joining, possibly temporary.

As illustrated in FIG. 29, to implement the endoscope accessory illustrated in FIGS. 14 to 28, during a step 80, the distal end of the endoscope is inserted into the sleeve 61. During a step 81, the accessory is positioned, by pulling on the sleeve 61 and pushing on the tube 63 until the end piece 60 is in abutment on the optical window 23.

During a step 82, gas is injected under pressure into the abdominal wall and the endoscope is inserted into a prepositioned trocar on a patient and a vial or syringe without a needle into the support 75. The gas inlet 65 sleeve 61 then permanently receives carbon dioxide under pressure

In the event of soiling or fogging on the front face of the optical window 23, during a step 83, physiological liquid is injected with the vial or syringe 76.

During a step 84, the liquid cleans the optical window, as explained above.

Steps 83 and 84 are repeated as often as necessary during the surgical procedure, possibly by changing the vial or syringe.

At the end of the surgical intervention, during a step 85, the accessory 60 is removed from the endoscope 20.

In a step 86, the accessory 60 is cleaned or discarded and the endoscope 20 is cleaned.

In the second embodiment, the accessory object of the invention makes it possible to aspirate, by venturi effect, with the CO2, the physiological saline present in a stored volume to clean the front lens and keep it clean. However for thoracoscopy, arthroscopy, and Otolaryngology, we do not use CO2 but the accessory makes it possible to clean the lens by closing the CO2 circuit and using only the access for physiological saline or the first mode of creation of the accessory.

Although the above description more specifically sets out the accessory object of the invention, the invention also relates to an endoscope comprising a tip configured to surround a distal optical window of the optical tube of the endoscope, said tip comprising means liquid distribution on this optical window and a liquid supply channel to the distribution means. Preferably, the channel is integrated into the wall of the endoscope optical tube, like the lighting fibers of the observed scene.

Claims (11)

1. Accessory (60) for endoscope (20), characterized in that it comprises: a tip (67) configured to surround the distal end of the endoscope, said tip comprising means (70, 78) for distributing liquid on an optical window (23) at the distal end of the endoscope, - a channel (62) for supplying the liquid to the distribution means and - a sleeve (61) carrying an inlet (65) of liquid entrainment gas from the sleeve to the distribution means (70, 78). 2. Accessory (60) according to claim 1, which comprises a reservoir (72) of liquid, the circulation of gas in the sleeve (61) causing, by Venturi effect, the suction of liquid from the reservoir. 3. Accessory (60) according to claim 2, which comprises a non-return valve (64) between the reservoir (72) of liquid and a source (76) of removable liquid. 4. Accessory (60) according to claim 3, wherein the non-return valve (64) takes the form of a sphere and a spring holding the sphere in position and preventing the passage of fluid from the reservoir to the source. (76) of liquid. 5. Accessory (60) according to one of claims 1 to 4, wherein the sleeve (61) has a clip (66) for locking on the endoscope (20). 6. Accessory (60) according to one of claims 1 to 5, wherein the means (70, 78) of distribution comprises at least one irrigation channel (78) radial and lateral inside the distal end the end piece (67). 7. Accessory (60) according to one of claims 1 to 6, wherein the means (70, 78) of distribution comprises a manifold (70) circular to the distal end of the nozzle (67). 8. Accessory (60) according to one of claims 1 to 7, which further comprises a tube (63) mechanically linked to the end piece (67) and carrying the channel (62) for supplying the liquid. 5 9. Accessory (60) for endoscope according to claim 8, wherein the tube (63) is braided. 10. Endoscope which includes: an optical tube comprising optical components for conveying a 10 image from an optical window positioned at the distal end of the tube, the optical tube being provided with a light inlet for a lighting system, an optical system for conveying light coming from the lighting system up to '' at the distal end of the optical tube and of a connector for a video camera receiving the image conveyed by the optical components and 15 - an accessory according to one of claims 1 to 9.