JP2017217441A - Water-cleaning device for nose and throat soft endoscope by reverse-radial and swirl water flow - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a cleaning device for nose and throat soft endoscope water-cleaning which operates only by water flow pressure and provides a cleaning effect.SOLUTION: The present invention includes a cleaning pipe lower part with a double pipe structure of a cleaning pipe outer cylinder (4) and a cleaning pipe inner cylinder (5), in which the water filled in the cleaning pipe outer cylinder from a waterworks is pressure-ejected into the inner cylinder through a plurality of small water holes. The water ejected into the inner cylinder from three bottom-plate water holes (7) provided on an inner cylinder bottom plate is sent upward while cleaning a vicinity of a tip of an endoscope by coming into contact with a tip lens face provided at 10-20 mm above the bottom plate. Then, the water ejected from fifteen reverse-radial water holes (8) opening on the inner cylinder side face at 30 mm above the bottom plate in an inner cylinder central direction reduces uneven cleaning effect by providing an effect of moving centerward at a vicinity of the endoscope tip which is liable to be moved toward an inner wall of the inner cylinder. Further, the water ejected diagonal-upwardly inside the inner cylinder through three side diagonal water holes (9) provided at 45 mm above the bottom plate causes rotation in the water moving upward from the lower side, the water further moves upward while surrounding an upper portion above the vicinity of an insertion part of the endoscope by a swirl water flow.SELECTED DRAWING: Figure 1

Description

この発明は耳鼻咽喉科診療において多用される鼻咽喉軟性内視鏡の汚染を除去するための、上水道流水圧のみで作動する鼻咽喉軟性内視鏡流水洗浄器に関するものである。  The present invention relates to a nasopharyngeal flexible endoscope flusher that operates only with water supply water pressure to remove contamination of a nasopharyngeal flexible endoscope that is frequently used in otolaryngology practice.

従来、次のような鼻咽喉軟性内視鏡用の比較的安価な流水洗浄器が市販されている。垂直に設置した洗浄パイプ内に鼻咽喉内視鏡挿入部を入れて内視鏡操作部を固定し、パイプ上方から水道水が注入されパイプ内を満たしながら下方に流れ落ちる流水によって内視鏡挿入部を洗浄し、真下を向いている内視鏡挿入部先端のレンズ面については、その直下に流水反転板と称されるパイプ内径よりやや小さな平面の、または凹曲面を持つ円板がパイプ中央に水平に設置されていることにより流水の一部が反転され、これがレンズ面に当たって洗浄してから流水反転板周囲を通って排水される構造のものである。  Conventionally, the following relatively inexpensive flushers for nasopharyngeal flexible endoscopes are commercially available. Insert the nasopharyngeal endoscope insertion part into the vertically installed cleaning pipe, fix the endoscope operation part, tap water is injected from above the pipe, and the endoscope insertion part by flowing water flowing down while filling the pipe As for the lens surface at the tip of the endoscope insertion section facing directly below, a disk with a slightly smaller plane than the inner diameter of the pipe, called a running water reversal plate, or a concave curved surface is located in the center of the pipe. By being installed horizontally, a part of the flowing water is inverted, and after having hit the lens surface and washed, it is drained through the periphery of the flowing water reversing plate.

従来の鼻咽喉軟性内視鏡流水洗浄器には次のような欠点があった。この洗浄器で効果的な洗浄をするには内視鏡先端を流水反転板直上に位置させることにより、反転された流水が勢いよく先端レンズ面に当たることが必要であるが、実際には内視鏡先端を毎回この位置に置いたまま洗浄を完了することは難しいのが現実である。これは洗浄対象が硬い棒状の物でなく堯性の軟性内視鏡であるため、挿入部全体が洗浄管中心に位置することが少なく、その一部が内径１５ｍｍ程度の洗浄管内壁に寄って付着してしまうことが多いこと、また洗浄開始直前は理想的な位置にあった内視鏡先端が、洗浄開始と同時に反転された流水の勢いによりパイプ中央にある流水反転板上から外れて、外側に位置してしまいがちであることが主な原因である。多くの医療施設において内視鏡先端が最も適当な位置にあることの確認がされないまま洗浄が行われ、本来の洗浄効果が不十分になっていることが懸念される。  Conventional nasopharyngeal soft endoscope flushers have the following drawbacks. In order to perform effective cleaning with this washer, it is necessary to place the tip of the endoscope directly above the flowing water reversing plate so that the reversed flowing water strikes the tip lens surface vigorously. The reality is that it is difficult to complete the cleaning with the mirror tip in this position every time. This is because the object to be cleaned is a rigid flexible endoscope rather than a hard rod-like object, and therefore the entire insertion portion is rarely located at the center of the cleaning tube, and a part of the insertion portion approaches the inner wall of the cleaning tube having an inner diameter of about 15 mm. In many cases, the endoscope tip that was in an ideal position immediately before the start of cleaning comes off from the flow reversing plate at the center of the pipe due to the flow of water that was reversed simultaneously with the start of cleaning, The main reason is that it tends to be located outside. In many medical facilities, there is a concern that the cleaning is performed without confirming that the endoscope tip is at the most appropriate position, and the original cleaning effect is insufficient.

また上記の鼻咽喉軟性内視鏡洗浄器発売以前に、先駆モデルとして内視鏡先端レンズ面をパイプ下端に設けたＬ字型パイプの中に位置させ、流水が直角に流れを変えることで真下を向いている先端レンズ面を洗浄する構造の機種もあったが、やはり堯性の軟性内視鏡のレンズ面は洗浄中真下を向いていないことも多く、レンズ面への洗浄効果の安定性が疑問視された。  Prior to the release of the above nasopharyngeal soft endoscope washer, as a pioneering model, the endoscope front lens surface was positioned in an L-shaped pipe provided at the lower end of the pipe, and the flowing water changed the flow at right angles to Although there are models with a structure that cleans the tip lens surface that faces the lens, the lens surface of a flexible flexible endoscope is often not facing directly down during cleaning, so the stability of the cleaning effect on the lens surface Was questioned.

上記２つの構造の鼻咽喉軟性内視鏡に共通することであるが、内視鏡挿入部の先端部以外については、単に流水がその側面を流れることによる洗浄であるため、流水量が十分でないと内視鏡周囲に水の接触しない部分が出来ることがあり、洗浄効果に斑ができることが懸念される。また流水量を多くしすぎると水が洗浄管上部から溢れてしまうことから洗浄に最適な流水量の調節が難しいという欠点もあった。  This is common to nasopharyngeal flexible endoscopes of the two structures described above, but the flow rate is not sufficient because the flow of water other than the distal end of the endoscope insertion portion is simply washed by flowing the side of the endoscope. There may be a portion where the water does not come into contact with the endoscope, and there is a concern that the cleaning effect may be spotted. In addition, if the amount of flowing water is excessively large, water overflows from the upper part of the cleaning pipe, so that it is difficult to adjust the optimal amount of flowing water for cleaning.

実登３１８５０７７Actual climbing 3185077 特開２００８−１６８０９９JP2008-168099 特開平０７−１１６１１６JP 07-116116 A

株式会社高研“鼻咽喉ファイバースコープタイプ３”、［平成２８年６月１日検索］、インターネット＜ＵＲＬ：ｈｔｔｐ：／／ａｍｅｂｌｏ．ｊｐ／ｈｉｒｏｍｔｓｕｋａｍｏｔｏ／ｅｎｔｒｙ−１１４９０６８５４５３．ｈｔｍｌ＞Koken Co., Ltd. “Nasopharyngeal fiberscope type 3”, [searched on June 1, 2016], Internet <URL: http: // ameblo. jp / hiromtsukamoto / entry-1190685453. html> 板橋隆嗣、他６名、「流水によるファイバースコープ洗浄器の検討」耳鼻臨床８４：１１；１６１５〜１６２３，１９９１Takashi Itabashi, 6 others, "Study of fiberscope washer using running water" Otolaryngology Clinical 84:11;

発明が解決しようとする課題Problems to be solved by the invention

本発明は従来の鼻咽喉軟性内視鏡の流水洗浄器における欠点を除き、比較的安価で簡易型の流水洗浄器でありながら内視鏡挿入部及び先端レンズ面をより効果的に洗浄できるよう工夫したものである。  The present invention eliminates the disadvantages of the conventional flushing device for nasopharyngeal flexible endoscopes, so that the endoscope insertion portion and the tip lens surface can be more effectively washed while being a relatively inexpensive and simple flushing device. It is a devised one.

課題を解決するための手段Means for solving the problem

垂直に固定した透明アクリル製の洗浄管の中で鼻咽喉軟性内視鏡挿入部（１）と先端レンズ面（３）を流水洗浄するものであるところは従来の流水洗浄器と同じであるが、大きく異なる工夫として洗浄管の下部を洗浄管外筒（４）と洗浄管内筒（５）の２重のパイプ構造とし、上下を閉じた洗浄管外筒（４）に注入され満たされた水が直径１．５ｍｍの複数の注水孔から内筒の中に噴出される構造とした。また洗浄管内の水流を確認するために上水道から洗浄管外筒（４）に流水が注入される手前に市販の泡発生器（１４）を装着した。まず内筒底板（６）に開けた４個の底板注水孔（７）から勢いよく噴出された水は、内筒底板（６）の上面より１０〜２０ｍｍ上方に位置する内視鏡先端レンズ面（３）に当たりながら上昇する。次に内筒底板（６）の上面より３０ｍｍの位置に設けた洗浄管内筒側壁の１５個の逆放射状注水孔（８）から勢いよくパイプ中心方向に向かって噴出された水により、内筒内壁に寄ってしまいがちな内視鏡先端付近が中央に寄せられる効果が出る。さらに内筒底板（６）の上面より４５ｍｍ上方に開けた３個の側斜注水孔（９）から斜め上方に噴出される水が、下方から昇ってくる水に回転を与えて、内視鏡挿入部（１）の先端より上の部分を渦巻き水流で取り囲みながら上昇する構造とした。  Although the nasopharyngeal flexible endoscope insertion part (1) and the tip lens surface (3) are washed with running water in a transparent acrylic washing tube fixed vertically, it is the same as a conventional flushing machine. As a greatly different device, the lower part of the cleaning pipe has a double pipe structure of the cleaning pipe outer cylinder (4) and the cleaning pipe inner cylinder (5), and the water filled by filling the upper and lower cleaning pipe outer cylinders (4) is filled. Was ejected into the inner cylinder from a plurality of water injection holes having a diameter of 1.5 mm. Moreover, in order to confirm the water flow in a washing pipe, the commercially available foam generator (14) was mounted before flowing water was poured into the washing pipe outer cylinder (4) from a water supply. First, the water that is ejected vigorously from the four bottom plate water injection holes (7) opened in the inner cylinder bottom plate (6) is the endoscope tip lens surface located 10 to 20 mm above the upper surface of the inner cylinder bottom plate (6). It rises while hitting (3). Next, the inner cylinder inner wall is vigorously ejected from the 15 reverse radial water injection holes (8) on the inner side wall of the cleaning pipe provided at a position 30 mm from the upper surface of the inner cylinder bottom plate (6). The effect is that the vicinity of the tip of the endoscope that tends to be close to the center is brought to the center. Further, the water jetted obliquely upward from the three side oblique water injection holes (9) opened 45 mm above the upper surface of the inner cylinder bottom plate (6) gives rotation to the water rising from below, and the endoscope It was set as the structure which rises, enclosing the part above the front-end | tip of insertion part (1) with a spiral water flow.

発明の効果Effect of the invention

泡発生装置（１４）によって発生する泡の動きから次のことが明らかになった。内視鏡先端レンズ面（３）に近い挿入部下方が流水注入開始直後に逆放射状注水孔（８）から勢いよく噴出される流水により洗浄管内筒（５）の中心近くに寄せられる。これによって内視鏡先端レンズ面（３）は、内筒底部にある底板注水孔（７）から上方に勢いよく噴出される水と上方に存在する水の影響で生じる内筒中心下部の乱流の中に包まれる。すなわち先端レンズ面を含む内視鏡挿入部先端付近は十分に流水洗浄されることが期待される。先端部以外の内視鏡挿入部（１）については、３個の側斜注水孔（９）から噴出される水によって明らかな回転要素を持った流水の渦が挿入部（１）を取り囲みながら勢いよく上昇して排水部（１０）に至ることから、この部分も十分に流水洗浄される可能性が高い。加えて逆放射状注水孔（８）から洗浄管内筒（５）の中心に向かって勢いよく噴出される水は、洗浄管内筒内の水が回転することによる内視鏡挿入部先端付近の不必要な回転も抑えてくれる。この方法で洗浄することにより、従来の流水洗浄器使用で懸念されていた内視鏡先端レンズ面および内視鏡挿入部の洗浄効果が不十分になる危険性が減少し、また泡発生器（１４）による泡により流水の回転などの動きを確認できるため洗浄に適した流水量の調節が容易になる。  The following became clear from the movement of the foam generated by the foam generating device (14). The lower part of the insertion portion near the endoscope front end lens surface (3) is brought close to the center of the cleaning tube inner cylinder (5) by the flowing water that is ejected vigorously from the reverse radial water injection hole (8) immediately after the start of flowing water injection. As a result, the endoscope front lens surface (3) is turbulent in the lower part of the inner cylinder center caused by the influence of water ejected from the bottom plate water injection hole (7) at the bottom of the inner cylinder and water existing upward. Wrapped in. That is, it is expected that the vicinity of the distal end of the endoscope insertion portion including the distal lens surface is sufficiently washed with running water. With respect to the endoscope insertion portion (1) other than the distal end portion, a vortex of flowing water having a clear rotating element is surrounded by the water ejected from the three side oblique water injection holes (9) while surrounding the insertion portion (1). Since it rises vigorously and reaches the drainage part (10), there is a high possibility that this part is also sufficiently washed with running water. In addition, the water ejected vigorously from the reverse radial water injection hole (8) toward the center of the cleaning tube inner cylinder (5) is unnecessary in the vicinity of the distal end of the endoscope insertion portion due to the rotation of the water in the cleaning tube inner cylinder. He / she suppresses special rotation. By washing with this method, the risk that the cleaning effect of the endoscope front lens surface and the endoscope insertion portion, which has been a concern with the use of a conventional flushing device, will be insufficient, and the foam generator ( Since movement such as rotation of running water can be confirmed by the foam of 14), adjustment of the running water amount suitable for washing becomes easy.

本発明の斜視図である。It is a perspective view of the present invention. 本発明の水流説明図である。It is water flow explanatory drawing of this invention.

以下、本発明の実施の形態について説明する。
垂直に設置された透明アクリル製パイプの下方を洗浄管外筒（４）と洗浄管内筒（５）の２重構造とする。内視鏡挿入部（１）は洗浄管内筒の中に、内視鏡先端レンズ面（３）が内筒底板（６）上面より１０〜２０ｍｍの位置に来るよう内視鏡操作部（２）を固定することで設置される。上水道蛇口からホースにて水道水流入口（１３）に流水を導き、市販の泡発生器《家庭用マイクロバブル発生器ＢＵ‐ＢＵ》（１４）と洗浄終了後に洗浄管の水を抜くための排水コック（１５）を経由して流水注入Ｌ字管（１７）から洗浄管外筒（４）に流水を注入する。上下を閉ざした洗浄管外筒の中に満たされた水は洗浄管内筒に開けた多数の直径１．５ｍｍの注水孔から内筒内に勢いよく噴出される。まず底板注水孔（７）から噴出された水は内筒底板（６）の上面より１０〜２０ｍｍ上方に位置する内視鏡先端レンズ面（３）を洗浄しながら上昇する。内筒底板上面より３０ｍｍの位置に開けた内筒側壁の１５個の逆放射状注水孔（８）から内筒の中心方向に向かって噴出された水は、軟性内視鏡のフレキシビリティのために内筒内壁に接触してしまいがちな内視鏡先端付近を中央に寄せ、内視鏡先端付近の洗浄効果を高める。さらに内筒底板上面より４５ｍｍ上方に開けた３個の側斜注水孔（９）から斜め上方に噴出される水は下方から昇ってくる水に回転を与え、内視鏡挿入部（１）の先端付近部より上の部分を渦巻き水流で効果的に洗浄する。洗浄管内筒（５）より排水部漏斗管（１１）に上って溢れた水は排水部（１０）に溜り、排水管（１２）よりホースを通して流し台のシンクなどに排水される。排水部漏斗管（１１）は内視鏡挿入部（１）を洗浄管内筒（５）に挿入しやすくするための形態であるが、患者に使用した内視鏡挿入部が触れることによる汚染が避けられない部位であるため洗浄管内筒と同様に、上昇して来る流水で常に洗浄される構造とした。泡発生器（１４）については泡の大きさを調節できるので、マイクロバブルの洗浄効果も考慮して流水の動きを確認できる最小の泡の大きさに調節しておく。また泡の動きから判断し、効果的な水流を得られる範囲の流水量に水道栓の開閉を調節して洗浄を行う。洗浄終了後は排水コック（１５）を開けて洗浄管内残水排水口（１６）を通して洗浄管内筒（５）および洗浄管外筒（４）の水を抜く。Embodiments of the present invention will be described below.
Below the transparent acrylic pipe installed vertically, a double structure of a cleaning pipe outer cylinder (4) and a cleaning pipe inner cylinder (5) is provided. The endoscope operation section (2) is arranged so that the endoscope front lens surface (3) is positioned 10 to 20 mm from the upper surface of the inner cylinder bottom plate (6) in the inner tube of the cleaning tube. It is installed by fixing. Drain cock for leading the running water from the tap to the tap water inlet (13) with a hose, and draining the water from the commercially available foam generator << Home Micro Bubble Generator BU-BU >> (14) and washing Flowing water is injected from the flowing water injection L-shaped pipe (17) into the washing tube outer cylinder (4) via (15). The water filled in the outer tube of the cleaning tube closed at the top and bottom is ejected vigorously into the inner tube from a large number of 1.5 mm diameter water injection holes opened in the inner tube of the cleaning tube. First, the water ejected from the bottom plate water injection hole (7) rises while cleaning the endoscope front end lens surface (3) located 10 to 20 mm above the upper surface of the inner cylinder bottom plate (6). For the flexibility of the flexible endoscope, the water ejected from the 15 reverse radial water injection holes (8) on the inner cylinder side wall opened at a position 30 mm from the upper surface of the inner cylinder bottom plate toward the center of the inner cylinder. The vicinity of the distal end of the endoscope, which tends to come into contact with the inner wall of the inner cylinder, is moved to the center to enhance the cleaning effect near the distal end of the endoscope. Further, the water jetted obliquely upward from the three side oblique water injection holes (9) opened 45 mm above the upper surface of the inner cylinder bottom plate gives rotation to the water rising from below, and the endoscope insertion part (1) The part above the vicinity of the tip is effectively washed with a spiral water flow. The water overflowing from the cleaning pipe inner cylinder (5) to the drain funnel pipe (11) is accumulated in the drain section (10), and is drained from the drain pipe (12) through the hose to the sink of the sink. The drainage funnel tube (11) is a form for facilitating insertion of the endoscope insertion portion (1) into the cleaning tube inner cylinder (5), but contamination caused by touching the endoscope insertion portion used for the patient. Since it is an unavoidable part, it was constructed so that it was always washed with the rising running water like the inner tube of the washing tube. Since the foam size of the foam generator (14) can be adjusted, it is adjusted to the minimum foam size that can confirm the movement of running water in consideration of the cleaning effect of the microbubbles. Judging from the movement of bubbles, washing is performed by adjusting the opening and closing of the water tap so that an effective water flow can be obtained. After completion of the cleaning, the drain cock (15) is opened and the water in the cleaning tube inner tube (5) and the cleaning tube outer tube (4) is drained through the remaining water drain port (16) in the cleaning tube.

本発明は、患者の鼻、咽頭、喉頭を観察後に病原微生物に汚染された鼻咽喉軟性内視鏡を介する医原性感染症を避けることに役立つものである。上水道の流水圧で動作するため安価で手軽なことから、内視鏡洗浄器を製造する産業において市販されることにより耳鼻咽喉科を中心とする医療施設に広く普及する可能性がある。  The present invention helps to avoid iatrogenic infections through nasopharyngeal soft endoscopes contaminated with pathogenic microorganisms after observing the patient's nose, pharynx and larynx. Since it operates at the water pressure of the water supply, it is inexpensive and easy to use, so that it may be widely spread to medical facilities such as otolaryngology by being marketed in the industry for manufacturing endoscope cleaning devices.

１ 内視鏡挿入部 ２ 内視鏡操作部 ３ 内視鏡先端レンズ面 ４ 洗浄管外筒 ５ 洗浄管内筒 ６ 内筒底板 ７ 底板注水孔 ８ 逆放射状注水孔 ９ 側斜注水孔 １０ 排水部 １１ 排水部漏斗管 １２ 排水管 １３ 水道水流入口 １４ 泡発生器 １５ 排水コック １６ 洗浄管内残水排水口 １７水道水流入Ｌ字管DESCRIPTION OF SYMBOLS 1 Endoscope insertion part 2 Endoscope operation part 3 Endoscope lens surface 4 Washing pipe outer cylinder 5 Washing pipe inner cylinder 6 Inner cylinder bottom plate 7 Bottom plate water injection hole 8 Reverse radial water injection hole 9 Side oblique water injection hole 10 Drainage part 11 Drainage funnel pipe 12 Drain pipe 13 Tap water inlet 14 Foam generator 15 Drain cock 16 Drain outlet in cleaning pipe 17 Tap water inflow L-shaped pipe

Claims (3)

下端を閉じ垂直に設置したパイプの外壁表面から、パイプ内に向かって右上または左上方向に角度を付けた小孔を複数開け、ここより水または洗浄液を噴出させることにより、パイプ内に設置した軟性内視鏡挿入部の周りを水または洗浄液が回転しながら流れて洗浄する構造を持つ軟性内視鏡洗浄器。Softness installed in the pipe by opening a plurality of small holes with an angle in the upper right or upper left direction from the surface of the outer wall of the pipe that is installed vertically with the lower end closed and water or cleaning liquid is ejected from here. A flexible endoscope cleaner having a structure in which water or cleaning liquid flows around the endoscope insertion portion while rotating. 請求項１のパイプにおいてパイプ下端面に小孔を開け、水または洗浄液をパイプ内の上方に向けて噴出させることにより、パイプ下端の直上に設置された内視鏡先端レンズ面を洗浄する構造を持つ軟性内視鏡洗浄器。A structure for cleaning the endoscope front lens surface installed immediately above the lower end of the pipe by opening a small hole in the lower end surface of the pipe and ejecting water or a cleaning liquid upward in the pipe. A flexible endoscope washer. 請求項１および請求項２のパイプにおいて、パイプ下方の外壁表面からパイプ中心に向けて逆放射状に多数の小孔を設け、ここから水または洗浄液を噴出させて内視鏡挿入部先端部分をパイプ中心付近に水圧で固定することにより、パイプ内の流水による内視鏡挿入部先端部分の振れ回りやパイプ内での偏りを避けるという構造を持つ軟性内視鏡洗浄器。3. The pipe according to claim 1 or 2, wherein a plurality of small holes are provided in a reverse radial shape from the outer wall surface below the pipe toward the center of the pipe, and water or a cleaning liquid is ejected from the small holes to connect the distal end portion of the endoscope insertion portion to the pipe. A flexible endoscope washer that has a structure that avoids deflection of the end of the endoscope insertion part and deviation due to flowing water in the pipe by fixing it near the center with water pressure.

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