WO2015045429A1 - Elastic tube, control device, and medical equipment - Google Patents

Elastic tube, control device, and medical equipment Download PDF

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Publication number
WO2015045429A1
WO2015045429A1 PCT/JP2014/051725 JP2014051725W WO2015045429A1 WO 2015045429 A1 WO2015045429 A1 WO 2015045429A1 JP 2014051725 W JP2014051725 W JP 2014051725W WO 2015045429 A1 WO2015045429 A1 WO 2015045429A1
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WO
WIPO (PCT)
Prior art keywords
elastic tube
main body
medical
control device
tube
Prior art date
Application number
PCT/JP2014/051725
Other languages
French (fr)
Japanese (ja)
Inventor
和弘 谷口
正純 岡島
岩城　敏
Original Assignee
公立大学法人広島市立大学
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from JP2013197558A external-priority patent/JP2014076348A/en
Application filed by 公立大学法人広島市立大学 filed Critical 公立大学法人広島市立大学
Publication of WO2015045429A1 publication Critical patent/WO2015045429A1/en

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/313—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes
    • A61B1/3132—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes for laparoscopy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/005—Flexible endoscopes
    • A61B1/0051—Flexible endoscopes with controlled bending of insertion part
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
    • A61B1/015—Control of fluid supply or evacuation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00199—Electrical control of surgical instruments with a console, e.g. a control panel with a display
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00203—Electrical control of surgical instruments with speech control or speech recognition
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/003—Steerable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00535—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
    • A61B2017/00539—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated hydraulically
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00535—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
    • A61B2017/00557—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated inflatable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00743—Type of operation; Specification of treatment sites
    • A61B2017/00818—Treatment of the gastro-intestinal system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06—Measuring instruments not otherwise provided for
    • A61B2090/064—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension

Definitions

  • the present invention relates to an elastic tube, a control device, and a medical device.
  • an endoscope apparatus that performs imaging of an affected area when operating a patient, for example, a medical device as an endoscope apparatus suitable for use in single-hole laparoscopic cholecystectomy About.
  • the present invention relates to a medical device including a catheter, a laser knife, or an electric knife as a medical instrument.
  • FIG. 8 is a front view showing a state of conventional surgery.
  • the surgeon (camera assistant) 104 operates the endoscope camera 103 to project the state of the patient 101 inside the camera monitor 6.
  • a surgeon (operator) 105 other than the camera assistant 104 operates the two forceps 102, one for each of the right hand and the left hand, while looking at the camera monitor 6.
  • the endoscopic camera 103 wraps around the forceps 102 and reflects the affected area of the patient 101.
  • Reference numeral 8 denotes an operating table on which a patient 101 is placed.
  • Single-hole laparoscopic cholecystectomy has the following advantages because the wound is only in the navel. (1) It is cosmetically superior because scratches are not noticeable. (2) Less pain after surgery. (3) Because recovery is fast, the patient can be discharged in a shorter hospitalization period (2 to 3 days) than the conventional surgical method. Therefore, medical expenses can be suppressed. (4) Even a patient (elderly) whose physical strength has decreased because the burden on the body is small, the operation can be safely performed.
  • the distal end portion of the endoscope apparatus needs to have a bendable structure in order to image the treatment site in the abdominal cavity.
  • This curved structure is generally composed of a plurality of joints and wires operated by pulling the joints.
  • a structure in which a fluid is supplied to the inside, the membrane is expanded by the fluid pressure, and a bending motion is caused by the tensile stress generated in the membrane Patent Document 1. More specifically, it is a balloon actuator in which two film bodies having different tensile stresses caused by elongation are combined, and by forming one film body in a concave shape, a portion between the two film bodies is partially formed. A configuration for forming a plurality of spaces is disclosed.
  • Patent Document 2 discloses a configuration in which a bending operation is performed by adjusting the pressure inside a cylindrical body that includes a cylindrical elastic body and a reinforcing member that is less elastically deformed than the cylindrical elastic body.
  • Patent Document 3 discloses a configuration including an air bag, a braid surrounding the air bag, and a back column bent in an arc shape disposed between the air bag and the braid.
  • Patent Document 1 is a complex configuration in which two film bodies are combined and one film body is formed in a concave shape, it cannot be easily manufactured.
  • Patent Document 2 since the reinforcing member has a size that completely covers the bottom surface of the cylindrical elastic body, the corners on the side surfaces of the reinforcing member cause invasion of the human body when performing a bending operation. There is a fear.
  • the structure disclosed by patent document 3 consists of a several different raw material, it cannot manufacture easily.
  • the present invention adopts a novel structure for bending operation at the distal end portion of a medical device such as an endoscope apparatus, thereby realizing a safe device with a simple structure, and the bending operation can be automatically operated by a control device.
  • a medical device such as an endoscope apparatus
  • the problems in the conventional single-hole laparoscopic cholecystectomy described above are solved.
  • An elastic tube according to the present invention includes an elastic tube main body having an elongated hollow cylindrical shape, a fixing portion provided at one sealed end of the elastic tube main body to which a medical instrument can be attached, and a length of the elastic tube main body.
  • a non-stretchable body having a flexible portion fixed in the axial direction, and the pressure of the liquid injected into the elastic tube main body is controlled so that the opposite side of the non-stretchable body It is used for a medical device characterized by expanding or contracting.
  • a liquid for example, water
  • the elastic tube is bent using the pressure of the liquid. Even if it comes into contact with the organ), the elastic tube is deformed and absorbs the shock caused by the contact, so that it is safe without damaging the medical treatment site.
  • the structure of the elastic tube is simple, it can be manufactured at a low cost, and can be easily made disposable, thereby maintaining cleanliness.
  • water pressure is used as the force for bending the tube, so that there is an advantage that the medical treatment site is not contaminated even if water leaks from the elastic tube.
  • a non-expanded elastic tube is used as a thin tube to be inserted into a medical treatment site (inside the body) during a medical treatment, the diameter of the distal end portion of a medical device (for example, an endoscope) can be reduced.
  • a surgeon camera assistant
  • the present invention while adopting a simple structure that can be manufactured easily and inexpensively, has much superior convenience in the medical field in terms of being disposable and not invading the human body. It is expected to spread widely in the medical field.
  • FIG. 4 is a cross-sectional view of the elastic tube taken along line BB in FIG. 3. It is sectional drawing which shows a syringe and a piston part. It is a figure which shows the hysteresis characteristic of the elastic tube which concerns on embodiment of this invention. It is a front view which shows the condition of medical treatment (surgery). It is a front view which shows the condition of the conventional medical treatment (surgery).
  • FIG. 1 is a diagram illustrating a configuration of an endoscope apparatus as an example of a medical device including an elastic tube according to an embodiment of the present invention.
  • an endoscope apparatus 100 (medical device) includes an endoscope unit (medical device unit) 10 and a control device 20.
  • the control device 20 drives and controls the endoscope unit 10. Details of the control device 20 will be described later.
  • the endoscope unit 10 has an elongated hollow cylindrical shape and an inflatable elastic tube 1 in which water (liquid) W is sealed, and an inner end fixed to the distal end of the elastic tube 1.
  • a non-expandable tube 3 having a hollow cylindrical shape connected to the other end side of the endoscope camera (medical instrument) 2 and the elastic tube 1 and filled with water W (not shown), and the longitudinal direction of the elastic tube 1 And a non-stretchable body 4 having flexibility.
  • the elastic tube 1 in FIG. 1 is in an expanded state due to the pressure of the water W injected from the control device 20. The expansion and contraction in the elastic tube 1 will be described later with reference to FIGS.
  • the elastic tube 1 has an elastic tube main body 11, a fixing part 12 and a fixing part 13.
  • the elastic tube body 11 is a main member that constitutes the elastic tube 1, and the distal end on the side where the endoscope camera 2 is fixed is sealed.
  • the fixing portion 12 is provided at the sealed tip of the elastic tube main body 11 so that a medical instrument can be attached to the elastic tube 1.
  • the medical instrument attached to the fixing unit 12 is not limited to the endoscope camera 2 and may be a catheter, a laser knife, or the like.
  • the fixing portion 13 is provided in the major axis direction of the elastic tube 1 and enables the non-stretchable body 4 to be fixed.
  • the fixing portion 12 and the fixing portion 13 are part of the elastic tube 1 and are made of the same material as the elastic tube 1.
  • FIG. 2A is a perspective view showing the endoscope unit 10 of the endoscope apparatus 100 in FIG.
  • FIG. 3 is a cross-sectional view taken along line AA of the endoscope unit 10 in FIG.
  • the elastic tube main body 11 shown in FIG. 3 is composed of, for example, a silicone (polydimethylsiloxane added with a reinforcing agent such as silicon oxide) tube having an outer diameter of 2 mm, an inner diameter of 1 mm, and a length of 5 mm. From the control device 20 (see FIG. 1). It expands and contracts due to the pressure of water W injected into the elastic tube body 11.
  • the shape of the elastic tube 1 is linear as shown by a solid line in FIG. Further, by increasing the pressure of the water W sealed in the elastic tube main body 11, the elastic tube main body 11 expands as shown by a broken line in FIG.
  • an LED lamp for illumination (not shown) can be attached adjacent to the fixed portion 12 to which the endoscope camera 2 is attached.
  • illustration of the adhering part 13 is abbreviate
  • the non-stretchable body 4 functions to prevent the elastic tube body 11 from expanding. That is, due to an increase in the pressure of the water W enclosed in the elastic tube main body 11, the elastic tube main body 11 is opposite to the fixing portion 13 to which the non-stretchable body 4 is attached and fixed (the elasticity on the (a) in FIG. 2). Even if the middle upper side of the tube main body 11 expands (indicated by P in the figure), it does not expand on the fixing part 13 side. Therefore, as indicated by a broken line in FIG. 2A, the elastic tube 1 can be curved downward in the figure (opposite side of the expansion portion P). For this reason, the bending angle of the elastic tube 1 can be arbitrarily changed by changing the pressure of the water W in the elastic tube main body 11. Details of the bending angle of the elastic tube 1 will be described later with reference to FIG.
  • the stretchability of the non-stretchable body 4 only needs to be lower than that of the elastic tube main body 11.
  • the elastic tube main body 11 is inflated on the side opposite to the fixing portion 13 and the elastic tube main body 11 is not expanded on the fixing portion 13 side. That's fine.
  • a non-stretchable thread fishing line
  • silicone of the same material as the elastic tube 1 may be used.
  • non-stretchable body 4 may be shared with a cable connected to a medical instrument.
  • the non-stretchable body 4 shown in FIG. 2A may also be used as an electric cord that supplies power to the endoscope camera 2.
  • the non-stretchable body 4 shown in FIG. 1 can also be used as a cable connecting the endoscope camera 2 and the camera monitor 6 along the endoscope unit 10.
  • the non-expandable tube 3 is made of a linear hard hollow body having the same shape as the elastic tube main body 11, that is, about 30 cm in length having the same outer diameter and inner diameter as the elastic tube main body 11, and can be made of acrylic resin. .
  • connection tube 5 is a tube that connects the endoscope unit 10 and the control device 20.
  • the connection tube 5 is a hollow cylindrical tube having flexibility and non-expandability connected to the non-expansion tube 3.
  • the connection tube 5 has substantially the same shape and length of about 2 m as the non-expandable tube 3, communicates with the elastic tube 1 and the non-expandable tube 3, and contains water W as shown in FIG. 3.
  • 2A to 2C are provided on the side of the connection tube 5 of the non-expandable tube 3. Details of the flexible stand 7 will be described later with reference to FIG.
  • FIG. 2 (b) is a perspective view showing a medical device section 10a as an example when a catheter is attached as a medical instrument.
  • the non-stretchable body 4 can be used as a cord that sends air to the catheter 2a.
  • the balloon 2b of the catheter 2a is inflated by the air sent to the catheter 2a.
  • the catheter 2a may be a guide wire type.
  • the elastic tube 1 is used instead of the guide wire for guiding the direction in which the catheter advances. That is, a catheter 2 a is connected to the non-expandable tube 3 without the elastic tube 1, and the other end of the catheter 2 a on the side opposite to the non-expandable tube 3 is connected to the elastic tube 1 (on the side opposite to the fixed portion 12). One end) is connected.
  • the liquid enclosed in the elastic tube main body 11 shall be inject
  • FIG. 2 is a perspective view showing a medical device section 10b as an example when a laser knife is attached as a medical instrument.
  • the non-stretchable body 4 can also be used as a cord for sending a signal for controlling the laser emitted from the laser knife 2c.
  • the medical instrument attached to the elastic tube 1 may be an electric knife.
  • the elastic tube 1 and the non-expandable tube 3 are integrated by bonding, and the hollow portion is in communication.
  • water W is sealed in the elastic tube 1 via the non-expandable tube 3 from the connection tube 5 side by the control device 20.
  • FIG. 4 is a cross-sectional view of the elastic tube taken along line BB in FIG.
  • the non-stretchable body 4 is very thin as compared with the elastic tube main body 11.
  • the outer diameter of the cross section of the elastic tube main body 11 is 1 cm
  • the outer diameter of the cross section of the non-stretchable body 4 is 0.5 mm. Degree.
  • the cross section of the non-stretchable body 4 is not limited to a circular shape, and if it is chamfered so as not to damage the human body when inserted into the body, or has a small size, It may be a polygonal shape such as a triangle or a quadrangle.
  • the fixing portion 13 is not shown in the elastic tube 1 shown in FIG.
  • the non-stretchable body 4 (electric cord) is fixed to the elastic tube 1.
  • the non-stretchable body 4 (electric cord) is fixed to the elastic tube 1.
  • it is also adhered to the side surface of the non-expandable tube 3 (see FIG. 1) and led out of the endoscope unit 10.
  • the control device 20 includes a piston (hydraulic pressure variable portion) 21 and a syringe 22 (FIG. 5) that change the pressure of the water (liquid) W in the elastic tube 1, a water pressure sensor 23 that detects the pressure of the water W, and a piston. 21 is operated in the syringe 22 to change the water pressure in the elastic tube 1, a piston driving unit (hydraulic pressure varying unit) 24, a microphone (instruction receiving unit) 25 for inputting an operator's voice (instruction), and a microphone A piston control unit (hydraulic pressure variable unit) 26 that inputs the audio signal input at 25 and the detection signal of the water pressure sensor 23 and controls the piston drive unit 24 is provided.
  • the liquid enclosed in the elastic tube 1 is not limited to water, and may be any liquid as long as it does not contaminate the medical treatment site.
  • the piston 21, the piston driving unit 24, and the piston control unit 26 are used as an example of the hydraulic pressure variable unit, but a hydraulic pressure adjusting valve (not shown) or the like may be used instead.
  • a hydraulic pressure adjusting valve (not shown) or the like may be used instead.
  • the microphone 25 is used as an example of the instruction receiving unit, a foot switch (not shown) or the like may be used instead.
  • FIG. 7 is a front view showing a medical treatment (surgery) situation (an example).
  • the piston driving unit 24 is controlled by the piston control unit 26 based on the voice of the operator 105 detected by the microphone 25, and the water pressure in the elastic tube 1 is adjusted using the piston 21 and the syringe 22. Change. Details of the piston 21 and the syringe 22 will be described later with reference to FIG.
  • the endoscope camera 2 can be bent upward or downward on the display screen of the camera monitor 6, when the operator 105 utters the voice “up”, the display screen of the camera monitor 6 is displaying. Start moving to show the top direction of the image. Then, the movement of the display screen on the camera monitor 6 is stopped by the voice “stop” by the operator 105. When the voice of the operator 105 is “down”, the display screen on the camera monitor 6 moves downward in the displayed image.
  • the position of the flexible stand 7 needs to be adjusted in advance so that the bending direction of the elastic tube 1 is in the left-right direction.
  • the endoscope unit 10 is maintained at a predetermined position by a flexible stand 7 attached to the operating table 8, and the position is manually adjusted by the operator 105.
  • the elastic tube 1 used in the medical procedure shown in FIG. 7 can be replaced with a new elastic tube 1 (disposable). Alternatively, after the medical treatment is completed, the used elastic tube 1 can be reused (reused) by cleaning and disinfecting it.
  • the elastic tube 1 is reused, in order to prevent the use of the deteriorated elastic tube 1, the upper limit number of times of use or the upper limit number of bending of the elastic tube 1 is set in advance in the control device 20, The elastic tube 1 exceeding the number of times needs to be unusable.
  • FIG. 5 shows a specific structure of the piston 21 and the syringe 22 for variably controlling the water pressure, and the piston 21 is slidably inserted into the syringe 22 connected to the connection tube 5.
  • the piston driving part 24 is a screw part 27 having one end side (left side in the figure) fixed to the mounting part 29 of the base 28 and the other end side (right side in the figure) connected to the piston driving part 24.
  • the screw portion 27 is screwed.
  • the screw portion 27 is rotated forward or backward, whereby the piston 21 moves in the left-right direction in the drawing.
  • the piston controller 24 controls the forward or reverse rotation and the rotational speed of the piston drive unit 24.
  • FIG. 6 is a diagram showing hysteresis characteristics of the elastic tube according to the embodiment of the present invention.
  • the horizontal axis in FIG. 6 is the pressure (P [kPa]) of the water W in the elastic tube body 11, and the vertical axis represents the bending angle ( ⁇ [°]) of the elastic tube body 11.
  • P [kPa] the pressure of the water W in the elastic tube body 11
  • ⁇ [°] the bending angle
  • the bending angle ⁇ of the elastic tube 1 gradually increases monotonously according to the increase of the water pressure up to the pressure of about 188 kPa. .
  • the pressure P passes around 188 kPa
  • the bending angle ⁇ of the elastic tube 1 increases rapidly as the pressure P increases.
  • the pressure P of the water W in the elastic tube main body 11 is decreased (during depressurization)
  • the bending angle ⁇ of the elastic tube 1 corresponds to the decrease in the pressure P until the pressure P reaches around 168 kPa. Slowly and monotonously decrease.
  • the elastic tube main body 11 is moved so that the display image displayed on the camera monitor 6 moves at a constant rate.
  • the bending angle can be changed.
  • the elastic tube 1 may be configured to be automatically operated.
  • the endoscope camera 2 shown in FIG. 1 when used as a medical instrument, an image photographed by the endoscope camera 2 is simultaneously displayed while an image photographed by the endoscope camera 2 is displayed on the camera monitor 6. It is good also as a structure (not shown) acquired and analyzed in the apparatus 20.
  • FIG. The control device 20 automatically adjusts the pressure of the liquid sealed in the elastic tube body 11 according to the analyzed information. Therefore, the bending angle of the endoscope camera 2 can be automatically changed. It is assumed that the control device 20 stores in advance image data indicating the progress of the medical procedure. Further, the control device 20 may change the bending angle of the endoscope camera 2 by using the hysteresis characteristic shown in FIG.
  • the elastic tube 1 may be manually operated using a tablet terminal (not shown).
  • a tablet terminal for example, when an assistant (not shown) of a surgeon performing medical treatment (for example, the surgeon 105 in FIG. 7) operates the tablet terminal to change the bending angle of the medical device, the assistant is at a position away from the surgeon.
  • the tablet terminal can be operated. For this reason, the operation of the assistant does not interfere with the medical treatment action of the surgeon, and the surgeon can concentrate on the medical treatment.
  • an operator for example, the operator 105 in FIG. 7 may operate the tablet terminal to change the bending angle of the medical device. In this case, an actual medical procedure can be performed by a robot (not shown) instead of the operator.
  • the present invention can also be expressed as follows.
  • the endoscope apparatus has an elongated hollow cylindrical shape and an inflatable elastic tube filled with water, and the distal end portion of the elastic tube portion is sealed and fixed to the distal end portion.
  • a non-expanding tube having a hollow cylindrical shape connected to the other end side of the elastic tube portion and sealed with water, and a non-expandable tube fixed to the elastic tube portion in the length direction.
  • a telescopic body a flexible and non-expandable hollow cylindrical connection tube connected to the non-expandable tube portion, and variably controlling the water pressure in the elastic tube via the connection tube and the non-expandable tube
  • a control unit that controls the water pressure in the elastic tube, and the water pressure causes the elastic tube to expand and contract on the opposite side of the non-stretchable body.
  • the elastic tube can be expressed as an endoscope apparatus for bending at any angle.
  • the control unit changes a water pressure in the elastic tube, a piston and a syringe, a water pressure sensor that detects the water pressure
  • the piston is operated in the syringe to change the water pressure
  • the microphone for inputting the operator's voice
  • the voice signal inputted by the microphone and the detection signal of the water pressure sensor are inputted
  • the piston a piston control unit that controls the drive unit, and the piston control unit is controlled by the piston control unit according to an operator's voice to change the water pressure in the elastic tube.
  • the non-stretchable body may be made of a polyamide fiber in the endoscope apparatus having the above configuration.
  • the endoscope apparatus according to the present invention may be an electric cord in which the non-stretchable body supplies power to the camera in the endoscope apparatus having the above configuration.
  • An elastic tube (1) according to the first aspect of the present invention is provided with an elastic tube body (11) having an elongated hollow cylindrical shape and a sealed one end of the elastic tube body, and a medical instrument (endoscopic camera). 2, a fixing part (12) to which the catheter 2a and the laser knife 2c) can be attached, and a fixing part (13) to which a flexible non-stretchable body (4) can be fixed in the major axis direction of the elastic tube main body.
  • the medical device endoscope apparatus 100
  • the convenience in the medical field is remarkably superior in that it is disposable and does not invade the human body. It is expected to spread widely.
  • the fixing portion may fix the cable connected to the medical device to the elastic tube body as the non-stretchable body.
  • the cable connected to the medical instrument is fixed to the elastic tube body.
  • the elastic tube can be bent by using an object used during medical treatment. Therefore, the elastic tube has a simple structure that does not have a new non-stretchable body, and can be manufactured easily and inexpensively.
  • the elastic tube (1) according to aspect 3 of the present invention is the elastic tube (1) according to aspect 1, wherein the fixing portion fixes the non-stretchable body made of a material having lower elasticity than the elastic tube main body to the elastic tube main body. May be.
  • the non-stretchable body made of a material having lower elasticity than the elastic tube main body is fixed to the elastic tube main body.
  • the non-stretchable body of the silicone material is easily fixed to the elastic tube body.
  • a polyamide fiber is used for the non-stretchable body, it is difficult to adhere to an elastic tube made of a silicone material. Therefore, this is effective when the non-stretchable body is easily removed from the elastic tube.
  • the control device (20) according to aspect 4 of the present invention is a control device that controls expansion and contraction of the elastic tube according to aspect 1, and includes an instruction receiving unit (microphone) that receives an instruction to expand or contract the elastic tube. 25) and a hydraulic pressure variable section (piston 21, piston drive section 24, piston control section) that varies the pressure of the liquid injected into the hollow inside of the elastic tube body based on the instruction received by the instruction receiving section. 26).
  • an instruction receiving unit microphone
  • a hydraulic pressure variable section piston 21, piston drive section 24, piston control section
  • the distal end portion of the medical device is operated by the control device, a surgeon (camera assistant 104) for operating the distal end portion of the medical device is unnecessary, and the surgeon (assistant 104) operates. Does not interfere with medical procedures (surgery) performed by another surgeon (surgeon 105). Therefore, the surgeon (operator 105) can concentrate on the medical procedure (surgery).
  • the hydraulic pressure variable unit may be automatically operated according to information acquired by the medical instrument.
  • the elastic tube is automatically bent by the automatic operation of the hydraulic pressure variable unit.
  • an image taken by the endoscopic camera is displayed on the camera monitor (6), and at the same time, an image taken by the endoscopic camera is acquired and analyzed by the control device.
  • the configuration is as follows. Then, according to the analysis information of the control device, the fluid pressure variable part is automatically operated, and the pressure of the liquid sealed in the elastic tube body is automatically adjusted to automatically change the bending angle of the endoscope camera. Can be made. It is assumed that image data indicating the progress of the medical procedure is stored in the control device in advance.
  • the medical instrument is automatically moved, so that the surgeon can concentrate on the medical procedure.
  • the medical device (100) according to aspect 6 of the present invention may include the elastic tube in aspect 1 and the control device in aspect 4.
  • the medical device (100) according to the seventh aspect of the present invention may include the endoscope camera (2), the catheter (2a), the laser knife (2c), or the electric knife as the medical instrument in the sixth aspect. .
  • a medical device having both the advantages of the elastic tube according to the present invention and the advantages of the control device according to the present invention can be provided.
  • the present invention can be suitably used for an elastic tube, a control device, and a medical device.
  • it can be used for medical devices equipped with an endoscope camera, a catheter, a laser knife, and an electric knife in a medical field.

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Abstract

The present invention comprises: an expandable elastic tube (1) in which water is sealed; a medical instrument (endoscope camera (2)) which is affixed to the front end of the elastic tube (1); a non-expandable tube (3) which is connected in a communicating manner to the other end side of the elastic tube (1) and in which water is sealed; a non-stretchable and non-shrinkable body (4) which is flexible and which is secured to the elastic tube (1) in the longitudinal axis direction; a hollow cylindrical connection tube (5) which is flexible and non-expandable and which is connected to the non-expandable tube (3); and a control device (control unit (20)) which variably controls liquid pressure within the elastic tube (1). The control device (control unit (20)) controls the liquid pressure to expand and contract the elastic tube (1) on the side opposite to the non-stretchable and non-shrinkable body (4), thereby bending the elastic tube (1) to an arbitrary angle.

Description

弾性チューブ、制御装置および医療機器Elastic tube, control device and medical device
　本発明は、弾性チューブ、制御装置および医療機器に関する。特に、医療処置を行う場合、患者を手術する際において患部の撮影等を行う内視鏡装置、例えば、単孔式腹腔鏡下胆嚢摘出術に利用して好適な内視鏡装置としての医療機器に関する。また、例えば、医療器具としてカテーテル、レーザメスまたは電気メスを備える医療機器に関する。 The present invention relates to an elastic tube, a control device, and a medical device. In particular, when a medical procedure is performed, an endoscope apparatus that performs imaging of an affected area when operating a patient, for example, a medical device as an endoscope apparatus suitable for use in single-hole laparoscopic cholecystectomy About. For example, the present invention relates to a medical device including a catheter, a laser knife, or an electric knife as a medical instrument.
　単孔式腹腔鏡下胆嚢摘出術とは、患者の臍に１ヵ所の15ｍｍ程度の小さな孔を開けて、その孔から鉗子（医療器具）と内視鏡カメラとを挿入して、胆嚢を切除する方法である。図８は、従来の手術の状況を示す正面図である。図８に示すように、外科医（カメラ助手）１０４が内視鏡カメラ１０３を操作し、患者１０１の体内の様子をカメラモニタ６に映し出す。カメラ助手１０４とは別の外科医（術者）１０５がカメラモニタ６を見ながら、右手と左手にそれぞれ1本ずつ、計２本の鉗子１０２を操って手術を行う。内視鏡カメラ１０３は鉗子１０２の上から回り込んで患者１０１の患部を映す。８は患者１０１を載せた手術台である。 With single-hole laparoscopic cholecystectomy, a small hole of about 15 mm is opened in the patient's navel, and forceps (medical instrument) and an endoscopic camera are inserted through the hole to remove the gallbladder. It is a method to do. FIG. 8 is a front view showing a state of conventional surgery. As shown in FIG. 8, the surgeon (camera assistant) 104 operates the endoscope camera 103 to project the state of the patient 101 inside the camera monitor 6. A surgeon (operator) 105 other than the camera assistant 104 operates the two forceps 102, one for each of the right hand and the left hand, while looking at the camera monitor 6. The endoscopic camera 103 wraps around the forceps 102 and reflects the affected area of the patient 101. Reference numeral 8 denotes an operating table on which a patient 101 is placed.
　単孔式腹腔鏡下胆嚢摘出術では、傷口が臍にしかないので以下の利点がある。
（１）キズが目立たないため美容的に優れている。
（２）手術後の痛みが少ない。
（３）回復が早いため従来の手術方法より短い入院期間（２～３日）で退院できる。よって医療費が抑制できる。
（４）身体への負担が少ないため体力が低下した患者（高齢者）でも安全に手術が受けられる。 Single-hole laparoscopic cholecystectomy has the following advantages because the wound is only in the navel.
(1) It is cosmetically superior because scratches are not noticeable.
(2) Less pain after surgery.
(3) Because recovery is fast, the patient can be discharged in a shorter hospitalization period (2 to 3 days) than the conventional surgical method. Therefore, medical expenses can be suppressed.
(4) Even a patient (elderly) whose physical strength has decreased because the burden on the body is small, the operation can be safely performed.
　他方、従来の単孔式腹腔鏡下胆嚢摘出術における問題点として以下の点があげられる。
（１）体外で人同士、手術器具同士が接触し邪魔しあう。
（２）術者とカメラ助手の接触。
（３）鉗子と内視鏡カメラの接触。 On the other hand, the following points are raised as problems in conventional single-hole laparoscopic cholecystectomy.
(1) People and surgical instruments come into contact with each other outside the body.
(2) Contact between the surgeon and the camera assistant.
(3) Contact between the forceps and the endoscope camera.
　上記の問題点を解決するために、内視鏡装置の先端部分は、腹腔内の施術箇所を撮影するために、湾曲自在な構造とされる必要がある。この湾曲構造は一般的に複数の関節と関節とを引っ張って操作するワイヤにて構成される。またこの湾曲構造として、内部に流体を供給しその流体圧によって膜を膨張させ、膜に生じた引っ張り応力によって曲がり運動をさせるものも知られている（特許文献１）。より具体的には、伸びによって生じる引っ張り応力が異なる２枚の膜体を組み合わせたバルーンアクチュエータであり、一方の膜体を凹状形成することにより、当該２枚の膜体の間には部分的に複数の空間を形成する構成が開示されている。 In order to solve the above-described problems, the distal end portion of the endoscope apparatus needs to have a bendable structure in order to image the treatment site in the abdominal cavity. This curved structure is generally composed of a plurality of joints and wires operated by pulling the joints. Also known as this curved structure is a structure in which a fluid is supplied to the inside, the membrane is expanded by the fluid pressure, and a bending motion is caused by the tensile stress generated in the membrane (Patent Document 1). More specifically, it is a balloon actuator in which two film bodies having different tensile stresses caused by elongation are combined, and by forming one film body in a concave shape, a portion between the two film bodies is partially formed. A configuration for forming a plurality of spaces is disclosed.
　また、例えば特許文献２には、筒状弾性体と、筒状弾性体に比べて弾性変形しにくい補強部材とからなる筒体の内部の圧力を調整することにより、湾曲動作を行う構成が開示されている。特許文献３には、空気袋、空気袋を取り巻く組みひも、および空気袋と組みひもとの間に配置された弓状に屈曲した背柱を備える構成が開示されている。 Further, for example, Patent Document 2 discloses a configuration in which a bending operation is performed by adjusting the pressure inside a cylindrical body that includes a cylindrical elastic body and a reinforcing member that is less elastically deformed than the cylindrical elastic body. Has been. Patent Document 3 discloses a configuration including an air bag, a braid surrounding the air bag, and a back column bent in an arc shape disposed between the air bag and the braid.
日本国公開特許公報「特開２００６‐２０４６１２号（２００６年８月１０日公開）」Japanese Patent Publication “Japanese Patent Laid-Open No. 2006-204612 (Released on August 10, 2006)” 日本国公開特許公報「特開平２‐１１３１０４号（１９９０年４月２５日公開）」Japanese Patent Publication “Japanese Patent Laid-Open No. 2-113104 (published on April 25, 1990)” 日本国公開特許公報「特開平６‐２０１９５８号（１９９４年７月２２日公開）」Japanese Patent Publication "JP-A-6-201958 (published July 22, 1994)"
　しかしながら、特許文献１に開示された構成は、２枚の膜体を組み合わせ、一方の膜体を凹状形成するという複雑な構成であるため、容易に製造できるものではない。また、特許文献２に開示された構成では、補強部材は筒状弾性体の底面を完全に覆う大きさであるため、湾曲動作を行う場合に、補強部材の側面における角により人体の侵襲を引き起こす虞がある。また、特許文献３に開示された構成は、異なる複数の素材からなるため、容易に製造できるものではない。 However, since the configuration disclosed in Patent Document 1 is a complex configuration in which two film bodies are combined and one film body is formed in a concave shape, it cannot be easily manufactured. Further, in the configuration disclosed in Patent Document 2, since the reinforcing member has a size that completely covers the bottom surface of the cylindrical elastic body, the corners on the side surfaces of the reinforcing member cause invasion of the human body when performing a bending operation. There is a fear. Moreover, since the structure disclosed by patent document 3 consists of a several different raw material, it cannot manufacture easily.
　本発明は、内視鏡装置等の医療機器の先端部分における湾曲操作に新規な構造を採用することにより、簡易な構造で安全な装置を実現するとともに、湾曲操作を制御装置にて自動操作可能とすることにより、例えば上述した従来の単孔式腹腔鏡下胆嚢摘出術における問題点を解決するものである。 The present invention adopts a novel structure for bending operation at the distal end portion of a medical device such as an endoscope apparatus, thereby realizing a safe device with a simple structure, and the bending operation can be automatically operated by a control device. Thus, for example, the problems in the conventional single-hole laparoscopic cholecystectomy described above are solved.
　本発明に係る弾性チューブは、細長い中空円筒形を有する弾性チューブ本体と、前記弾性チューブ本体の密封された一方の先端に設けられ、医療器具を取り付け可能な固定部と、前記弾性チューブ本体の長軸方向に、可撓性を有する非伸縮体を固着可能な固着部とを有し、前記弾性チューブ本体の内部に注入された液体の圧力が制御されることにより、前記非伸縮体の反対側において膨張または収縮することを特徴とする、医療機器に用いられるものである。 An elastic tube according to the present invention includes an elastic tube main body having an elongated hollow cylindrical shape, a fixing portion provided at one sealed end of the elastic tube main body to which a medical instrument can be attached, and a length of the elastic tube main body. A non-stretchable body having a flexible portion fixed in the axial direction, and the pressure of the liquid injected into the elastic tube main body is controlled so that the opposite side of the non-stretchable body It is used for a medical device characterized by expanding or contracting.
　本発明によれば、やわらかい弾性チューブ内に液体（例えば、水）を封入し、当該液体の圧力を利用して弾性チューブを湾曲させる構造としたものであるから、弾性チューブが医療処置部位（例えば、臓器）に接触したとしても、弾性チューブが変形して、接触による衝撃を吸収するので医療処置部位を傷つけることがなく安全である。また、弾性チューブの構造が簡単であるため、安価に製造でき、気軽にディスポーザブル（使い捨て）とすることができ、これにより清潔さを維持することができる。 According to the present invention, a liquid (for example, water) is sealed in a soft elastic tube, and the elastic tube is bent using the pressure of the liquid. Even if it comes into contact with the organ), the elastic tube is deformed and absorbs the shock caused by the contact, so that it is safe without damaging the medical treatment site. Moreover, since the structure of the elastic tube is simple, it can be manufactured at a low cost, and can be easily made disposable, thereby maintaining cleanliness.
　またチューブを湾曲させる力として例えば水による圧力を使うので、弾性チューブから水漏れしても医療処置部位を汚染しないという利点がある。さらに、医療処置時には、医療処置部位（体内）に挿入する細いチューブとして、膨張していない弾性チューブを使うので医療機器（例えば、内視鏡）の先端部分の細径化を図ることができる。さらに、医療機器の先端部分は自動操作可能なので、医療機器の先端部分を操作するための外科医（カメラ助手）は不要であり、当該外科医の操作が外科医（術者）の行う医療処置（手術）の邪魔になることはない。 Also, for example, water pressure is used as the force for bending the tube, so that there is an advantage that the medical treatment site is not contaminated even if water leaks from the elastic tube. Furthermore, since a non-expanded elastic tube is used as a thin tube to be inserted into a medical treatment site (inside the body) during a medical treatment, the diameter of the distal end portion of a medical device (for example, an endoscope) can be reduced. Furthermore, since the distal end portion of the medical device can be automatically operated, a surgeon (camera assistant) for operating the distal end portion of the medical device is unnecessary, and a medical procedure (surgery) performed by the surgeon (operator) is performed by the surgeon. Will not get in the way.
　以上のように、本発明は、簡単で安価に製造できるシンプルな構造を採用しながらも、ディスポーザブルとされている点や人体を侵襲しない点などにおいて医療現場における利便性が格段に優れており、医療現場において広く普及することが期待されるものである。 As described above, the present invention, while adopting a simple structure that can be manufactured easily and inexpensively, has much superior convenience in the medical field in terms of being disposable and not invading the human body. It is expected to spread widely in the medical field.
本発明実施の形態に係る弾性チューブを備えた医療機器（内視鏡装置）の構成を示す図である。It is a figure which shows the structure of the medical device (endoscope apparatus) provided with the elastic tube which concerns on this Embodiment. 図１における内視鏡装置（医療機器）の内視鏡部（医療機器部）を示す斜視図である。It is a perspective view which shows the endoscope part (medical equipment part) of the endoscope apparatus (medical equipment) in FIG. 図２の（ａ）における内視鏡部のＡ‐Ａ線断面図である。It is the sectional view on the AA line of the endoscope part in (a) of Drawing 2. 図３における弾性チューブのＢ‐Ｂ線断面図である。FIG. 4 is a cross-sectional view of the elastic tube taken along line BB in FIG. 3. シリンジ及びピストン部分を示す断面図である。It is sectional drawing which shows a syringe and a piston part. 本発明実施の形態に係る弾性チューブのヒステリシス特性を示す図である。It is a figure which shows the hysteresis characteristic of the elastic tube which concerns on embodiment of this invention. 医療処置（手術）の状況を示す正面図である。It is a front view which shows the condition of medical treatment (surgery). 従来の医療処置（手術）の状況を示す正面図である。It is a front view which shows the condition of the conventional medical treatment (surgery).
　図１は、本発明実施の形態に係る弾性チューブを備えた医療機器の一例として、内視鏡装置の構成を示す図である。図１において、内視鏡装置１００（医療機器）は、内視鏡部（医療機器部）１０および制御装置２０を備える。制御装置２０は、内視鏡部１０を駆動制御する。制御装置２０の詳細については、後述する。 FIG. 1 is a diagram illustrating a configuration of an endoscope apparatus as an example of a medical device including an elastic tube according to an embodiment of the present invention. In FIG. 1, an endoscope apparatus 100 (medical device) includes an endoscope unit (medical device unit) 10 and a control device 20. The control device 20 drives and controls the endoscope unit 10. Details of the control device 20 will be described later.
　内視鏡部１０は、図２～４に示すように、細長い中空円筒形を有するとともに水（液体）Ｗが封入された膨張可能な弾性チューブ１と、弾性チューブ１の先端に固定された内視鏡カメラ（医療器具）２と、弾性チューブ１の他端側に連通接続され、水Ｗ（不図示）が封入された中空円筒形を有する非膨張チューブ３と、弾性チューブ１の長軸方向に固着された可撓性を有する非伸縮体４とを有する。なお、図１における弾性チューブ１は、制御装置２０から注入される水Ｗの圧力により、膨張している状態である。弾性チューブ１における膨張および収縮については、図２および図６にて後述する。 As shown in FIGS. 2 to 4, the endoscope unit 10 has an elongated hollow cylindrical shape and an inflatable elastic tube 1 in which water (liquid) W is sealed, and an inner end fixed to the distal end of the elastic tube 1. A non-expandable tube 3 having a hollow cylindrical shape connected to the other end side of the endoscope camera (medical instrument) 2 and the elastic tube 1 and filled with water W (not shown), and the longitudinal direction of the elastic tube 1 And a non-stretchable body 4 having flexibility. Note that the elastic tube 1 in FIG. 1 is in an expanded state due to the pressure of the water W injected from the control device 20. The expansion and contraction in the elastic tube 1 will be described later with reference to FIGS.
　弾性チューブ１は、弾性チューブ本体１１、固定部１２および固着部１３を有する。弾性チューブ本体１１は、弾性チューブ１を構成する主要部材であり、内視鏡カメラ２を固定する側の先端は密封されている。固定部１２は、弾性チューブ本体１１の密封された先端に施されており、医療器具を弾性チューブ１に取り付け可能とするものである。固定部１２に取り付けられる医療器具は、内視鏡カメラ２に限定されるものでなく、カテーテル、レーザメス等であってもよい。固着部１３は、弾性チューブ１の長軸方向に施されており、非伸縮体４を固着可能とするものである。なお、固定部１２および固着部１３は、弾性チューブ１の一部であり、弾性チューブ１と同一素材からなるものである。 The elastic tube 1 has an elastic tube main body 11, a fixing part 12 and a fixing part 13. The elastic tube body 11 is a main member that constitutes the elastic tube 1, and the distal end on the side where the endoscope camera 2 is fixed is sealed. The fixing portion 12 is provided at the sealed tip of the elastic tube main body 11 so that a medical instrument can be attached to the elastic tube 1. The medical instrument attached to the fixing unit 12 is not limited to the endoscope camera 2 and may be a catheter, a laser knife, or the like. The fixing portion 13 is provided in the major axis direction of the elastic tube 1 and enables the non-stretchable body 4 to be fixed. The fixing portion 12 and the fixing portion 13 are part of the elastic tube 1 and are made of the same material as the elastic tube 1.
　ここで、図２および図３を用いて弾性チューブ本体１１の膨張について説明する。図２の（ａ）は、図１における内視鏡装置１００の内視鏡部１０を示す斜視図である。図３は、図２の（ａ）における内視鏡部１０のＡ‐Ａ線断面図である。図３に示す弾性チューブ本体１１は、例えば外径２mm、内径１mm、長さ５mmのシリコーン（酸化ケイ素等の強化剤を添加したポリジメチルシロキサン）チューブよりなり、制御装置２０（図１参照）から弾性チューブ本体１１内に注入される水Ｗの圧力によって膨張および収縮する。弾性チューブ本体１１内に封入されている水Ｗの圧力が常圧（１気圧）の場合、弾性チューブ１の形状は、図２の（ａ）において実線で示されるように、直線状である。また、弾性チューブ本体１１内に封入された水Ｗの圧力を増加させることにより、図２の（ａ）において破線で示されるように、弾性チューブ本体１１は膨張する。 Here, the expansion of the elastic tube body 11 will be described with reference to FIGS. 2 and 3. FIG. 2A is a perspective view showing the endoscope unit 10 of the endoscope apparatus 100 in FIG. FIG. 3 is a cross-sectional view taken along line AA of the endoscope unit 10 in FIG. The elastic tube main body 11 shown in FIG. 3 is composed of, for example, a silicone (polydimethylsiloxane added with a reinforcing agent such as silicon oxide) tube having an outer diameter of 2 mm, an inner diameter of 1 mm, and a length of 5 mm. From the control device 20 (see FIG. 1). It expands and contracts due to the pressure of water W injected into the elastic tube body 11. When the pressure of the water W enclosed in the elastic tube main body 11 is normal pressure (1 atm), the shape of the elastic tube 1 is linear as shown by a solid line in FIG. Further, by increasing the pressure of the water W sealed in the elastic tube main body 11, the elastic tube main body 11 expands as shown by a broken line in FIG.
　なお、内視鏡カメラ２を取付けた固定部１２には隣接して照明用のＬＥＤランプ（不図示）を取り付けることができる。また、図３に示す弾性チューブ１において、説明の便宜上、固着部１３の図示を省略する。 Note that an LED lamp for illumination (not shown) can be attached adjacent to the fixed portion 12 to which the endoscope camera 2 is attached. Moreover, in the elastic tube 1 shown in FIG. 3, illustration of the adhering part 13 is abbreviate | omitted for convenience of explanation.
　図２の（ａ）において、非伸縮体４は、弾性チューブ本体１１の膨張を阻止する作用をなすものである。すなわち、弾性チューブ本体１１内に封入されている水Ｗの圧力上昇により、弾性チューブ本体１１の、非伸縮体４を貼り付け固定した固着部１３とは反対側（図２の（ａ）における弾性チューブ本体１１の中上側）が膨張（図中Ｐで示す）しても、固着部１３側では膨張しない。それゆえ、図２の（ａ）において破線で示すように、弾性チューブ１は、図中下方（膨張部分Ｐの反対側）へ湾曲することが可能となる。このため、弾性チューブ本体１１内における水Ｗの圧力を変化させることで、弾性チューブ１の湾曲角度を任意に変更することができる。なお、弾性チューブ１の湾曲角度の詳細については、図６にて後述する。 2 (a), the non-stretchable body 4 functions to prevent the elastic tube body 11 from expanding. That is, due to an increase in the pressure of the water W enclosed in the elastic tube main body 11, the elastic tube main body 11 is opposite to the fixing portion 13 to which the non-stretchable body 4 is attached and fixed (the elasticity on the (a) in FIG. 2). Even if the middle upper side of the tube main body 11 expands (indicated by P in the figure), it does not expand on the fixing part 13 side. Therefore, as indicated by a broken line in FIG. 2A, the elastic tube 1 can be curved downward in the figure (opposite side of the expansion portion P). For this reason, the bending angle of the elastic tube 1 can be arbitrarily changed by changing the pressure of the water W in the elastic tube main body 11. Details of the bending angle of the elastic tube 1 will be described later with reference to FIG.
　非伸縮体４の伸縮性は、弾性チューブ本体１１よりも低ければよく、固着部１３の反対側では弾性チューブ本体１１を膨張させるとともに、固着部１３側では弾性チューブ本体１１を膨張させない程度であればよい。非伸縮体４の素材として、例えばグラスファイバまたはポリアミド繊維等の非伸縮性糸（釣糸）が使用されてもよいし、弾性チューブ１と同じ素材のシリコーンを用いてもよい。 The stretchability of the non-stretchable body 4 only needs to be lower than that of the elastic tube main body 11. The elastic tube main body 11 is inflated on the side opposite to the fixing portion 13 and the elastic tube main body 11 is not expanded on the fixing portion 13 side. That's fine. As the material of the non-stretchable body 4, for example, a non-stretchable thread (fishing line) such as glass fiber or polyamide fiber may be used, or silicone of the same material as the elastic tube 1 may be used.
　また、非伸縮体４は、医療器具に接続されたケーブルで兼用してもよい。例えば、図２の（ａ）に示す非伸縮体４は、内視鏡カメラ２へ電源を供給する電気コードで兼用してもよい。また、図１に示す非伸縮体４は、内視鏡部１０に沿って内視鏡カメラ２とカメラモニタ６とを接続するケーブルで兼用させることもできる。 Further, the non-stretchable body 4 may be shared with a cable connected to a medical instrument. For example, the non-stretchable body 4 shown in FIG. 2A may also be used as an electric cord that supplies power to the endoscope camera 2. Further, the non-stretchable body 4 shown in FIG. 1 can also be used as a cable connecting the endoscope camera 2 and the camera monitor 6 along the endoscope unit 10.
　非膨張チューブ３は、弾性チューブ本体１１と同一形状、すなわち弾性チューブ本体１１と同一外径及び内径を有する長さ約３０cmの直線状の硬質中空体よりなり、アクリル樹脂にて構成することができる。 The non-expandable tube 3 is made of a linear hard hollow body having the same shape as the elastic tube main body 11, that is, about 30 cm in length having the same outer diameter and inner diameter as the elastic tube main body 11, and can be made of acrylic resin. .
　図１において、接続チューブ５は、内視鏡部１０と制御装置２０とを接続するチューブである。図２に示すように、接続チューブ５は、非膨張チューブ３に接続された可撓性かつ非膨張性を有する中空円筒形のチューブである。接続チューブ５は、非膨張チューブ３とほぼ同じ形状、長さは約２mであり、弾性チューブ１及び非膨張チューブ３に連通し、図３に示されるように水Ｗが封入されている。なお、図２の（ａ）～（ｃ）における可撓性スタンド７は、非膨張チューブ３の接続チューブ５側に備えられている。可撓性スタンド７の詳細については、図６にて後述する。 1, the connection tube 5 is a tube that connects the endoscope unit 10 and the control device 20. As shown in FIG. 2, the connection tube 5 is a hollow cylindrical tube having flexibility and non-expandability connected to the non-expansion tube 3. The connection tube 5 has substantially the same shape and length of about 2 m as the non-expandable tube 3, communicates with the elastic tube 1 and the non-expandable tube 3, and contains water W as shown in FIG. 3. 2A to 2C are provided on the side of the connection tube 5 of the non-expandable tube 3. Details of the flexible stand 7 will be described later with reference to FIG.
　図２の（ｂ）は、医療器具としてカテーテルが取り付けられた場合の一例として、医療機器部１０ａを示す斜視図である。カテーテル２ａが固定部１２に取り付けられた場合、非伸縮体４は、カテーテル２ａに空気を送るコードで兼用できる。図２の（ｂ）に示すように、カテーテル２ａに送られた空気によりカテーテル２ａのバルーン２ｂが膨らむ。 FIG. 2 (b) is a perspective view showing a medical device section 10a as an example when a catheter is attached as a medical instrument. When the catheter 2a is attached to the fixed portion 12, the non-stretchable body 4 can be used as a cord that sends air to the catheter 2a. As shown in FIG. 2B, the balloon 2b of the catheter 2a is inflated by the air sent to the catheter 2a.
　また、図示はしていないが、カテーテル２ａはガイドワイヤタイプであってもよい。この場合、カテーテルの進む方向を誘導するためのガイドワイヤの代わりに、弾性チューブ１を用いる。すなわち、非膨張チューブ３には、弾性チューブ１を介さずにカテーテル２ａが接続され、非膨張チューブ３とは反対側におけるカテーテル２ａの他端には、弾性チューブ１（固定部１２とは反対側の一端）が接続される。弾性チューブ本体１１内に封入される液体は、カテーテル２ａを介して非膨張チューブ３より注入されるものとする。これにより、弾性チューブ本体１１内に封入された液体の圧力を調節することにより、弾性チューブ１はカテーテルの進む方向を誘導できる。 Although not shown, the catheter 2a may be a guide wire type. In this case, the elastic tube 1 is used instead of the guide wire for guiding the direction in which the catheter advances. That is, a catheter 2 a is connected to the non-expandable tube 3 without the elastic tube 1, and the other end of the catheter 2 a on the side opposite to the non-expandable tube 3 is connected to the elastic tube 1 (on the side opposite to the fixed portion 12). One end) is connected. The liquid enclosed in the elastic tube main body 11 shall be inject | poured from the non-expansion tube 3 via the catheter 2a. Thereby, by adjusting the pressure of the liquid sealed in the elastic tube main body 11, the elastic tube 1 can guide the advancing direction of the catheter.
　図２の（ｃ）は、医療器具としてレーザメスが取り付けられた場合の一例として、医療機器部１０ｂを示す斜視図である。レーザメス２ｃが固定部１２に取り付けられた場合、非伸縮体４は、レーザメス２ｃから発射されるレーザを制御する信号を送るコードで兼用できる。また、図示はしていないが、弾性チューブ１に取り付けられる医療器具は電気メスであってもよい。 (C) of FIG. 2 is a perspective view showing a medical device section 10b as an example when a laser knife is attached as a medical instrument. When the laser knife 2c is attached to the fixed portion 12, the non-stretchable body 4 can also be used as a cord for sending a signal for controlling the laser emitted from the laser knife 2c. Although not shown, the medical instrument attached to the elastic tube 1 may be an electric knife.
　図３に示すように、弾性チューブ１および非膨張チューブ３は接着により一体化され、中空部分は連通している。当該中空部分は、制御装置２０により、接続チューブ５側から非膨張チューブ３を介して弾性チューブ１に水Ｗが封入されている。 As shown in FIG. 3, the elastic tube 1 and the non-expandable tube 3 are integrated by bonding, and the hollow portion is in communication. In the hollow portion, water W is sealed in the elastic tube 1 via the non-expandable tube 3 from the connection tube 5 side by the control device 20.
　図４は、図３における弾性チューブのＢ‐Ｂ線断面図である。非伸縮体４は、弾性チューブ本体１１と比較して非常に細いものであり、例えば、弾性チューブ本体１１における断面の外径が１ｃｍの場合、非伸縮体４における断面の外径は０．５ｍｍ程度である。なお、非伸縮体４における断面は、円形状に限定されるものではなく、体内に挿入された際に人体を傷つけないように角の面取りが施されていたり、小さなサイズのものであれば、三角形または四角形など多角形の形状であってもよい。なお、説明の便宜上、図４に示す弾性チューブ１において、固着部１３の図示を省略する。 FIG. 4 is a cross-sectional view of the elastic tube taken along line BB in FIG. The non-stretchable body 4 is very thin as compared with the elastic tube main body 11. For example, when the outer diameter of the cross section of the elastic tube main body 11 is 1 cm, the outer diameter of the cross section of the non-stretchable body 4 is 0.5 mm. Degree. In addition, the cross section of the non-stretchable body 4 is not limited to a circular shape, and if it is chamfered so as not to damage the human body when inserted into the body, or has a small size, It may be a polygonal shape such as a triangle or a quadrangle. For convenience of explanation, the fixing portion 13 is not shown in the elastic tube 1 shown in FIG.
　また、非伸縮体４として、図４に示すように、医療器具に接続されたケーブル（例えば電気コード等）が兼用された場合、非伸縮体４（電気コード）は、弾性チューブ１における固着部１３のほか非膨張チューブ３（図１参照）の側面にも接着されて、内視鏡部１０の外部へ導出される。 Further, as shown in FIG. 4, when the cable (for example, an electric cord) connected to a medical instrument is also used as the non-stretchable body 4, the non-stretchable body 4 (electric cord) is fixed to the elastic tube 1. In addition to 13, it is also adhered to the side surface of the non-expandable tube 3 (see FIG. 1) and led out of the endoscope unit 10.
　図１において、制御装置２０について説明する。制御装置２０は、弾性チューブ１内の水（液体）Ｗの圧力を変更するピストン（液圧可変部）２１及びシリンジ２２（図５）と、水Ｗの圧力を検知する水圧センサ２３と、ピストン２１をシリンジ２２内で作動させ、弾性チューブ１内の水圧を可変するピストン駆動部（液圧可変部）２４と、術者の音声（指示）を入力するマイクロフォン（指示受付部）２５と、マイクロフォン２５にて入力された音声信号及び水圧センサ２３の検知信号を入力し、ピストン駆動部２４を制御するピストン制御部（液圧可変部）２６とを備えている。なお、弾性チューブ１内に封入される液体は、水に限定されず、医療処置部位を汚染しない液体であればどのようなものでもよい。 In FIG. 1, the control device 20 will be described. The control device 20 includes a piston (hydraulic pressure variable portion) 21 and a syringe 22 (FIG. 5) that change the pressure of the water (liquid) W in the elastic tube 1, a water pressure sensor 23 that detects the pressure of the water W, and a piston. 21 is operated in the syringe 22 to change the water pressure in the elastic tube 1, a piston driving unit (hydraulic pressure varying unit) 24, a microphone (instruction receiving unit) 25 for inputting an operator's voice (instruction), and a microphone A piston control unit (hydraulic pressure variable unit) 26 that inputs the audio signal input at 25 and the detection signal of the water pressure sensor 23 and controls the piston drive unit 24 is provided. In addition, the liquid enclosed in the elastic tube 1 is not limited to water, and may be any liquid as long as it does not contaminate the medical treatment site.
　本実施形態では、液圧可変部の一例として、ピストン２１・ピストン駆動部２４・ピストン制御部２６を用いているが、液圧調整弁（不図示）等で代用してもよい。また、指示受付部の一例として、マイクロフォン２５を用いているが、フットスイッチ（不図示）等で代用してもよい。 In this embodiment, the piston 21, the piston driving unit 24, and the piston control unit 26 are used as an example of the hydraulic pressure variable unit, but a hydraulic pressure adjusting valve (not shown) or the like may be used instead. Further, although the microphone 25 is used as an example of the instruction receiving unit, a foot switch (not shown) or the like may be used instead.
　図７は、医療処置（手術）状況を示す正面図である（一例）。図７に示すように、マイクロフォン２５にて検知された術者１０５の音声により、ピストン制御部２６にてピストン駆動部２４を制御し、ピストン２１およびシリンジ２２を用いて弾性チューブ１内の水圧を変化させる。なお、ピストン２１およびシリンジ２２の詳細については、図５にて後述する。 FIG. 7 is a front view showing a medical treatment (surgery) situation (an example). As shown in FIG. 7, the piston driving unit 24 is controlled by the piston control unit 26 based on the voice of the operator 105 detected by the microphone 25, and the water pressure in the elastic tube 1 is adjusted using the piston 21 and the syringe 22. Change. Details of the piston 21 and the syringe 22 will be described later with reference to FIG.
　例えば、カメラモニタ６の表示画面において上又は下方向に、内視鏡カメラ２が湾曲可能な場合、術者１０５が音声「上」と発すると、カメラモニタ６の表示画面は、表示している画像の上方向を表示するように移動し始める。そして、術者１０５による「ストップ」という音声により、カメラモニタ６における表示画面の移動は停止する。また、術者１０５による音声が「下」である場合には、カメラモニタ６における表示画面は、表示している画像の下方向に移動する。 For example, when the endoscope camera 2 can be bent upward or downward on the display screen of the camera monitor 6, when the operator 105 utters the voice “up”, the display screen of the camera monitor 6 is displaying. Start moving to show the top direction of the image. Then, the movement of the display screen on the camera monitor 6 is stopped by the voice “stop” by the operator 105. When the voice of the operator 105 is “down”, the display screen on the camera monitor 6 moves downward in the displayed image.
　カメラモニタ６の表示画面を左右方向に移動させる場合は、弾性チューブ１の湾曲方向を左右方向となるように、可撓性スタンド７の位置を予め調節しておく必要がある。なお、内視鏡部１０は、手術台８に取り付けられた可撓性スタンド７により、所定位置に維持され、その位置は術者１０５により手操作で調整される。 When moving the display screen of the camera monitor 6 in the left-right direction, the position of the flexible stand 7 needs to be adjusted in advance so that the bending direction of the elastic tube 1 is in the left-right direction. The endoscope unit 10 is maintained at a predetermined position by a flexible stand 7 attached to the operating table 8, and the position is manually adjusted by the operator 105.
　図７に示す医療処置等で使用した弾性チューブ１は、新しい弾性チューブ１に取り換える（ディスポーザブル）ことができる。または、医療処置が終了した後に、使用済みの弾性チューブ１を洗浄・消毒することにより、再度使用（リユース）することができる。弾性チューブ１を再使用する場合には、劣化した弾性チューブ１を使用することを防ぐために、弾性チューブ１における使用の上限回数または湾曲の上限回数を制御装置２０に予め設定しておき、当該上限回数を超えた弾性チューブ１は使用不可能としておく必要がある。 The elastic tube 1 used in the medical procedure shown in FIG. 7 can be replaced with a new elastic tube 1 (disposable). Alternatively, after the medical treatment is completed, the used elastic tube 1 can be reused (reused) by cleaning and disinfecting it. When the elastic tube 1 is reused, in order to prevent the use of the deteriorated elastic tube 1, the upper limit number of times of use or the upper limit number of bending of the elastic tube 1 is set in advance in the control device 20, The elastic tube 1 exceeding the number of times needs to be unusable.
　図５は、水圧を可変制御するピストン２１及びシリンジ２２の具体的な構造を示し、接続チューブ５に接続されたシリンジ２２内にピストン２１が摺動可能に挿入されている。ピストン駆動部２４は、基台２８の取付部２９に一端側（図中左側）が固定され、他端側（図中右側）がピストン駆動部２４に連結されたネジ部２７で、ピストン２１は、このネジ部２７に螺合されている。ピストン駆動部２４にて、ネジ部２７が正回転又は逆回転され、これによりピストン２１は図中左右方向に移動する。このピストン駆動部２４の正回転又は逆回転及びその回転数はピストン制御部２６にて制御される。 FIG. 5 shows a specific structure of the piston 21 and the syringe 22 for variably controlling the water pressure, and the piston 21 is slidably inserted into the syringe 22 connected to the connection tube 5. The piston driving part 24 is a screw part 27 having one end side (left side in the figure) fixed to the mounting part 29 of the base 28 and the other end side (right side in the figure) connected to the piston driving part 24. The screw portion 27 is screwed. In the piston drive unit 24, the screw portion 27 is rotated forward or backward, whereby the piston 21 moves in the left-right direction in the drawing. The piston controller 24 controls the forward or reverse rotation and the rotational speed of the piston drive unit 24.
　図６は、本発明実施の形態に係る弾性チューブのヒステリシス特性を示す図である。図６における横軸は、弾性チューブ本体１１内にある水Ｗの圧力（Ｐ［ｋＰａ］）であり、縦軸は弾性チューブ本体１１の湾曲角度（θ［°］）を表す。図６に示されるように、圧力Ｐと湾曲角度θとの関係は、非線形特性である。 FIG. 6 is a diagram showing hysteresis characteristics of the elastic tube according to the embodiment of the present invention. The horizontal axis in FIG. 6 is the pressure (P [kPa]) of the water W in the elastic tube body 11, and the vertical axis represents the bending angle (θ [°]) of the elastic tube body 11. As shown in FIG. 6, the relationship between the pressure P and the bending angle θ is a non-linear characteristic.
　例えば、弾性チューブ本体１１内の水Ｗの圧力Ｐを増加させていく場合（加圧時）、弾性チューブ１の湾曲角度θは、圧力１８８ｋＰａ付近までは水圧の増加に応じて緩やかに単調増加する。圧力Ｐが１８８ｋＰａ付近を過ぎると、圧力Ｐの増加に対して弾性チューブ１の湾曲角度θは急激に増加する。また、弾性チューブ本体１１内の水Ｗの圧力Ｐを減少させていく場合（減圧時）、弾性チューブ１の湾曲角度θは、圧力Ｐが１６８ｋＰａとなる付近までは、圧力Ｐの減少に応じて緩やかに単調減少する。圧力Ｐが１６８ｋＰａ付近を過ぎると、圧力Ｐが１２８ｋＰａとなる付近までは、圧力Ｐの減少に対して弾性チューブ本体１１の湾曲角度θは急激に減少する。そして、圧力Ｐが１２８ｋＰａ付近を過ぎると弾性チューブ本体１１の湾曲角度θは、再び圧力Ｐの減少に応じて緩やかに単調減少する。 For example, when the pressure P of the water W in the elastic tube main body 11 is increased (at the time of pressurization), the bending angle θ of the elastic tube 1 gradually increases monotonously according to the increase of the water pressure up to the pressure of about 188 kPa. . When the pressure P passes around 188 kPa, the bending angle θ of the elastic tube 1 increases rapidly as the pressure P increases. Further, when the pressure P of the water W in the elastic tube main body 11 is decreased (during depressurization), the bending angle θ of the elastic tube 1 corresponds to the decrease in the pressure P until the pressure P reaches around 168 kPa. Slowly and monotonously decrease. When the pressure P exceeds about 168 kPa, the bending angle θ of the elastic tube main body 11 rapidly decreases as the pressure P decreases until the pressure P reaches about 128 kPa. When the pressure P passes around 128 kPa, the bending angle θ of the elastic tube main body 11 gently and monotonously decreases as the pressure P decreases again.
　図６に示すような弾性チューブ本体１１の湾曲特性を、ピストン制御部２６に予め設定しておけば、カメラモニタ６において表示される表示画像が一定の割合で移動するように、弾性チューブ本体１１の湾曲角度を変化させることができる。 If the bending characteristics of the elastic tube main body 11 as shown in FIG. 6 are set in the piston control unit 26 in advance, the elastic tube main body 11 is moved so that the display image displayed on the camera monitor 6 moves at a constant rate. The bending angle can be changed.
　また、弾性チューブ１は、自動操作される構成であってもよい。例えば、医療器具として図１に示す内視鏡カメラ２を用いる場合、内視鏡カメラ２によって撮影された画像をカメラモニタ６に表示すると同時に、内視鏡カメラ２によって撮影された画像を、制御装置２０において取得および解析する構成（不図示）としてもよい。制御装置２０は、解析した情報に応じて、弾性チューブ本体１１内に封入された液体の圧力を自動調整する。それゆえ、内視鏡カメラ２の湾曲角度を自動で変化させることができる。なお、制御装置２０には、医療処置の進み具合を示す画像データ等が予め格納されているものとする。また、制御装置２０は、図６に示すヒステリシス特性を用いて、内視鏡カメラ２の湾曲角度を変化させてもよい。 The elastic tube 1 may be configured to be automatically operated. For example, when the endoscope camera 2 shown in FIG. 1 is used as a medical instrument, an image photographed by the endoscope camera 2 is simultaneously displayed while an image photographed by the endoscope camera 2 is displayed on the camera monitor 6. It is good also as a structure (not shown) acquired and analyzed in the apparatus 20. FIG. The control device 20 automatically adjusts the pressure of the liquid sealed in the elastic tube body 11 according to the analyzed information. Therefore, the bending angle of the endoscope camera 2 can be automatically changed. It is assumed that the control device 20 stores in advance image data indicating the progress of the medical procedure. Further, the control device 20 may change the bending angle of the endoscope camera 2 by using the hysteresis characteristic shown in FIG.
　また、弾性チューブ１は、タブレット端末（不図示）を用いてマニュアル操作されてもよい。例えば、医療処置を行う術者（例えば図７における術者１０５）の助手（不図示）がタブレット端末を操作し、医療機器の湾曲角度を変化させる場合、助手は術者から離れた位置にてタブレット端末を操作することができる。このため、助手の操作は、術者の医療処置行為の邪魔とならず、術者は医療処置に専念できる。また、例えば、術者（例えば、図７における術者１０５）がタブレット端末を操作し、医療機器の湾曲角度を変化させてもよい。この場合、術者の代わりにロボット（不図示）に実際の医療処置を行わせることができる。 The elastic tube 1 may be manually operated using a tablet terminal (not shown). For example, when an assistant (not shown) of a surgeon performing medical treatment (for example, the surgeon 105 in FIG. 7) operates the tablet terminal to change the bending angle of the medical device, the assistant is at a position away from the surgeon. The tablet terminal can be operated. For this reason, the operation of the assistant does not interfere with the medical treatment action of the surgeon, and the surgeon can concentrate on the medical treatment. Further, for example, an operator (for example, the operator 105 in FIG. 7) may operate the tablet terminal to change the bending angle of the medical device. In this case, an actual medical procedure can be performed by a robot (not shown) instead of the operator.
　なお、本発明は以下のように表現することも可能である。 The present invention can also be expressed as follows.
　すなわち、本発明に係る内視鏡装置は、細長い中空円筒形を有するとともに水が封入された膨張可能な弾性チューブと、該弾性チューブ部の先端部が密封されるとともに、その先端部に固定されたカメラと、前記弾性チューブ部の他端側に連通接続され、水が封入された中空円筒形を有する非膨張チューブと、前記弾性チューブ部に長さ方向に固着された可撓性を有する非伸縮体と、前記非膨張チューブ部に接続された可撓性かつ非膨張性を有する中空円筒形の接続チューブと、該接続チューブ及び前記非膨張チューブを介して前記弾性チューブ内の水圧を可変制御する制御部とを備え、該制御部にて前記弾性チューブ内の水圧を制御し、その水圧により前記弾性チューブを、前記非伸縮体の反対側において膨張、収縮させ、これにより前記弾性チューブを任意の角度に湾曲させる内視鏡装置としても表現できる。 That is, the endoscope apparatus according to the present invention has an elongated hollow cylindrical shape and an inflatable elastic tube filled with water, and the distal end portion of the elastic tube portion is sealed and fixed to the distal end portion. A non-expanding tube having a hollow cylindrical shape connected to the other end side of the elastic tube portion and sealed with water, and a non-expandable tube fixed to the elastic tube portion in the length direction. A telescopic body, a flexible and non-expandable hollow cylindrical connection tube connected to the non-expandable tube portion, and variably controlling the water pressure in the elastic tube via the connection tube and the non-expandable tube A control unit that controls the water pressure in the elastic tube, and the water pressure causes the elastic tube to expand and contract on the opposite side of the non-stretchable body. The elastic tube can be expressed as an endoscope apparatus for bending at any angle.
　また、本発明に係る内視鏡装置は、前記構成の内視鏡装置において、前記制御部が、前記弾性チューブ内の水圧を変更するピストン及びシリンジと、前記水圧を検知する水圧センサと、前記ピストンを前記シリンジ内で作動させ、水圧を可変するピストン駆動部と、術者の音声を入力するマイクロフォンと、該マイクロフォンにて入力された音声信号及び前記水圧センサの検知信号を入力し、前記ピストン駆動部を制御するピストン制御部とを備え、術者の音声により、前記ピストン制御部にて前記ピストン駆動部を制御し、前記弾性チューブ内の水圧を変化させる構成であってもよい。 In the endoscope apparatus according to the present invention, in the endoscope apparatus having the above configuration, the control unit changes a water pressure in the elastic tube, a piston and a syringe, a water pressure sensor that detects the water pressure, The piston is operated in the syringe to change the water pressure, the microphone for inputting the operator's voice, the voice signal inputted by the microphone and the detection signal of the water pressure sensor are inputted, and the piston And a piston control unit that controls the drive unit, and the piston control unit is controlled by the piston control unit according to an operator's voice to change the water pressure in the elastic tube.
　また、本発明に係る内視鏡装置は、前記構成の内視鏡装置において、前記非伸縮体がポリアミド繊維よりなる構成であってもよい。 In the endoscope apparatus according to the present invention, the non-stretchable body may be made of a polyamide fiber in the endoscope apparatus having the above configuration.
　また、本発明に係る内視鏡装置は、前記構成の内視鏡装置において、前記非伸縮体が前記カメラへ電源を供給する電気コードであってもよい。 Also, the endoscope apparatus according to the present invention may be an electric cord in which the non-stretchable body supplies power to the camera in the endoscope apparatus having the above configuration.
　〔まとめ〕
　本発明の態様１に係る弾性チューブ（１）は、細長い中空円筒形を有する弾性チューブ本体（１１）と、前記弾性チューブ本体の密封された一方の先端に設けられ、医療器具（内視鏡カメラ２、カテーテル２ａ、レーザメス２ｃ）を取り付け可能な固定部（１２）と、前記弾性チューブ本体の長軸方向に、可撓性を有する非伸縮体（４）を固着可能な固着部（１３）とを有し、前記弾性チューブ本体の内部に注入された液体の圧力が制御されることにより、前記非伸縮体の反対側において膨張または収縮することを特徴とする、医療機器（内視鏡装置１００）に用いられるものである。 [Summary]
An elastic tube (1) according to the first aspect of the present invention is provided with an elastic tube body (11) having an elongated hollow cylindrical shape and a sealed one end of the elastic tube body, and a medical instrument (endoscopic camera). 2, a fixing part (12) to which the catheter 2a and the laser knife 2c) can be attached, and a fixing part (13) to which a flexible non-stretchable body (4) can be fixed in the major axis direction of the elastic tube main body. The medical device (endoscope apparatus 100) is characterized by expanding or contracting on the opposite side of the non-stretchable body by controlling the pressure of the liquid injected into the elastic tube main body. ).
　本発明によれば、簡単で安価に製造できるシンプルな構造を採用しながらも、ディスポーザブルとされている点や人体を侵襲しない点などにおいて医療現場における利便性が格段に優れており、医療現場において広く普及することが期待されるものである。 According to the present invention, while adopting a simple structure that can be easily and inexpensively manufactured, the convenience in the medical field is remarkably superior in that it is disposable and does not invade the human body. It is expected to spread widely.
　本発明の態様２に係る弾性チューブ（１）は、上記態様１において、前記固着部は、前記医療器具に接続されたケーブルを、前記非伸縮体として前記弾性チューブ本体に固着してもよい。 In the elastic tube (1) according to aspect 2 of the present invention, in the above aspect 1, the fixing portion may fix the cable connected to the medical device to the elastic tube body as the non-stretchable body.
　上記構成によれば、医療器具に接続されたケーブルを弾性チューブ本体に固着させる。このため、医療処置時に使用される物を利用して、弾性チューブの湾曲が可能となる。それゆえ、弾性チューブは、新たに非伸縮体を設ける構成ではないシンプルな構造となるため、簡単で安価に製造できる。 According to the above configuration, the cable connected to the medical instrument is fixed to the elastic tube body. For this reason, the elastic tube can be bent by using an object used during medical treatment. Therefore, the elastic tube has a simple structure that does not have a new non-stretchable body, and can be manufactured easily and inexpensively.
　本発明の態様３に係る弾性チューブ（１）は、上記態様１において、前記固着部は、前記弾性チューブ本体よりも伸縮性が低い素材からなる前記非伸縮体を、前記弾性チューブ本体に固着してもよい。 The elastic tube (1) according to aspect 3 of the present invention is the elastic tube (1) according to aspect 1, wherein the fixing portion fixes the non-stretchable body made of a material having lower elasticity than the elastic tube main body to the elastic tube main body. May be.
　上記構成によれば、弾性チューブ本体よりも伸縮性が低い素材からなる非伸縮体を弾性チューブ本体に固着させる。例えば、弾性チューブと同一の素材としてシリコーンを非伸縮体に用いた場合、シリコーン素材の非伸縮体は弾性チューブ本体に固着させやすい。このため、シリコーン素材の非伸縮体を固着した弾性チューブ本体に、医療処置時の接触による不意の衝撃があったとしても、弾性チューブからシリコーン素材の非伸縮体が外れることを防げる。また、例えば、非伸縮体にポリアミド繊維を用いた場合、シリコーン素材の弾性チューブに固着させにくい。このため、非伸縮体を弾性チューブから簡単に取り外しを行う場合には有効である。 According to the above configuration, the non-stretchable body made of a material having lower elasticity than the elastic tube main body is fixed to the elastic tube main body. For example, when silicone is used for the non-stretchable body as the same material as the elastic tube, the non-stretchable body of the silicone material is easily fixed to the elastic tube body. For this reason, even if there is an unexpected impact due to contact during medical treatment on the elastic tube body to which the silicone material non-stretchable body is fixed, it is possible to prevent the silicone material non-stretchable body from coming off the elastic tube. For example, when a polyamide fiber is used for the non-stretchable body, it is difficult to adhere to an elastic tube made of a silicone material. Therefore, this is effective when the non-stretchable body is easily removed from the elastic tube.
　本発明の態様４に係る制御装置（２０）は、上記態様１に係る弾性チューブの膨張および収縮を制御する制御装置であって、前記弾性チューブの膨張または収縮させる指示を受け付ける指示受付部（マイクロフォン２５）と、前記指示受付部で受け付けた前記指示に基づいて、前記弾性チューブ本体の中空内部に注入された液体の圧力を可変させる液圧可変部（ピストン２１、ピストン駆動部２４、ピストン制御部２６）とを備えていてもよい。 The control device (20) according to aspect 4 of the present invention is a control device that controls expansion and contraction of the elastic tube according to aspect 1, and includes an instruction receiving unit (microphone) that receives an instruction to expand or contract the elastic tube. 25) and a hydraulic pressure variable section (piston 21, piston drive section 24, piston control section) that varies the pressure of the liquid injected into the hollow inside of the elastic tube body based on the instruction received by the instruction receiving section. 26).
　上記構成によれば、医療機器の先端部分は制御装置にて操作されるので、医療機器の先端部分を操作するための外科医（カメラ助手１０４）は不要であり、当該外科医（助手１０４）の操作が別の外科医（術者１０５）の行う医療処置（手術）の邪魔になることはない。それゆえ、外科医（術者１０５）は、医療処置（手術）に専念することができる。 According to the above configuration, since the distal end portion of the medical device is operated by the control device, a surgeon (camera assistant 104) for operating the distal end portion of the medical device is unnecessary, and the surgeon (assistant 104) operates. Does not interfere with medical procedures (surgery) performed by another surgeon (surgeon 105). Therefore, the surgeon (operator 105) can concentrate on the medical procedure (surgery).
　本発明の態様５に係る制御装置（２０）は、上記態様４において、前記液圧可変部は、前記医療器具が取得した情報に従って自動操作されていてもよい。 In the control device (20) according to aspect 5 of the present invention, in the aspect 4, the hydraulic pressure variable unit may be automatically operated according to information acquired by the medical instrument.
　上記構成によれば、液圧可変部の自動操作により、弾性チューブが自動で湾曲される。例えば、医療器具として内視鏡カメラを用いる場合、内視鏡カメラによって撮影された画像をカメラモニタ（６）に表示すると同時に、内視鏡カメラによって撮影された画像を制御装置にて取得および解析する構成とする。そして、制御装置の解析情報に応じて、液圧可変部が自動操作され、弾性チューブ本体内に封入された液体の圧力が自動調整されることで、内視鏡カメラの湾曲角度を自動で変化させることができる。なお、制御装置には、医療処置の進み具合を示す画像データ等が予め格納されているものとする。 According to the above configuration, the elastic tube is automatically bent by the automatic operation of the hydraulic pressure variable unit. For example, when an endoscopic camera is used as a medical instrument, an image taken by the endoscopic camera is displayed on the camera monitor (6), and at the same time, an image taken by the endoscopic camera is acquired and analyzed by the control device. The configuration is as follows. Then, according to the analysis information of the control device, the fluid pressure variable part is automatically operated, and the pressure of the liquid sealed in the elastic tube body is automatically adjusted to automatically change the bending angle of the endoscope camera. Can be made. It is assumed that image data indicating the progress of the medical procedure is stored in the control device in advance.
　それゆえ、医療処置を行う術者が医療器具の移動を指示しなくても、医療器具は自動で移動されるため、当該術者は医療処置に専念できる。 Therefore, even if the surgeon performing the medical procedure does not instruct the movement of the medical instrument, the medical instrument is automatically moved, so that the surgeon can concentrate on the medical procedure.
　本発明の態様６に係る医療機器（１００）は、上記態様１における弾性チューブと、上記態様４における制御装置とを備えていてもよい。 The medical device (100) according to aspect 6 of the present invention may include the elastic tube in aspect 1 and the control device in aspect 4.
　本発明の態様７に係る医療機器（１００）は、上記態様６において、前記医療器具として、内視鏡カメラ（２）、カテーテル（２ａ）、レーザメス（２ｃ）または電気メスを備えていてもよい。 The medical device (100) according to the seventh aspect of the present invention may include the endoscope camera (2), the catheter (2a), the laser knife (2c), or the electric knife as the medical instrument in the sixth aspect. .
　上記構成によれば、本発明に係る弾性チューブの利点と、本発明に係る制御装置の利点とを併せ持つ医療機器を提供することができる。 According to the above configuration, a medical device having both the advantages of the elastic tube according to the present invention and the advantages of the control device according to the present invention can be provided.
　特に、内視鏡カメラ・カテーテル・レーザメス・電気メスを用いた医療処置は、頻繁に行われる傾向がある。そのため、本発明の医療機器において、医療器具として内視鏡カメラ、カテーテル、レーザメスまたは電気メスを設けることにより、本発明の利点をより広くの医療現場において提供することが可能となる。 In particular, medical procedures using an endoscopic camera, a catheter, a laser knife, and an electric knife tend to be frequently performed. Therefore, in the medical device of the present invention, by providing an endoscope camera, a catheter, a laser knife, or an electric knife as a medical instrument, the advantages of the present invention can be provided in a wider medical field.
　本発明は、弾性チューブ、制御装置および医療機器に好適に利用できる。特に、医療現場において、内視鏡カメラ・カテーテル・レーザメス・電気メスを備える医療機器に利用できる。 The present invention can be suitably used for an elastic tube, a control device, and a medical device. In particular, it can be used for medical devices equipped with an endoscope camera, a catheter, a laser knife, and an electric knife in a medical field.
　１　　　　弾性チューブ
　２　　　　内視鏡カメラ（医療器具）
　２ａ　　　カテーテル（医療器具）
　２ｂ　　　バルーン
　２ｃ　　　レーザメス（医療器具）
　３　　　　非膨張チューブ
　４　　　　非伸縮体
　５　　　　接続チューブ
　６　　　　カメラモニタ
　７　　　　可撓性スタンド
　８　　　　手術台
１０　　　　内視鏡部（医療機器部）
１０ａ，１０ｂ　　　医療機器部
１１　　　　弾性チューブ本体
１２　　　　固定部
１３　　　　固着部
２０　　　　制御装置
２１　　　　ピストン（液圧可変部）
２２　　　　シリンジ
２３　　　　水圧センサ
２４　　　　ピストン駆動部（液圧可変部）
２５　　　　マイクロフォン（指示受付部）
２６　　　　ピストン制御部（液圧可変部）
２７　　　　ネジ部
１００　　　内視鏡装置（医療機器）
  1 Elastic tube 2 Endoscopic camera (medical instrument)
2a Catheter (medical device)
2b Balloon 2c Laser knife (medical instrument)
3 Non-inflatable tube 4 Non-stretchable body 5 Connection tube 6 Camera monitor 7 Flexible stand 8 Operating table 10 Endoscope part (medical equipment part)
10a, 10b Medical equipment part 11 Elastic tube main body 12 Fixing part 13 Adhering part 20 Control device 21 Piston (hydraulic pressure variable part)
22 Syringe 23 Water pressure sensor 24 Piston drive part (hydraulic pressure variable part)
25 Microphone (Instruction reception unit)
26 Piston control part (hydraulic pressure variable part)
27 Screw part 100 Endoscope device (medical equipment)

Claims (7)

  1. 　細長い中空円筒形を有する弾性チューブ本体と、
    　前記弾性チューブ本体の密封された一方の先端に設けられ、医療器具を取り付け可能な固定部と、
    　前記弾性チューブ本体の長軸方向に、可撓性を有する非伸縮体を固着可能な固着部とを有し、
    　前記弾性チューブ本体の内部に注入された液体の圧力が制御されることにより、前記非伸縮体の反対側において膨張または収縮することを特徴とする、医療機器に用いられる弾性チューブ。     An elastic tube body having an elongated hollow cylindrical shape;
    A fixing portion provided at one end of the sealed elastic tube body, to which a medical instrument can be attached;
    In the major axis direction of the elastic tube main body, and having a fixing part capable of fixing a flexible non-stretchable body,
    An elastic tube used for a medical device, wherein the elastic tube expands or contracts on the opposite side of the non-stretchable body by controlling the pressure of the liquid injected into the elastic tube main body.
  2. 　前記固着部は、前記医療器具に接続されたケーブルを、前記非伸縮体として前記弾性チューブ本体に固着するものであることを特徴とする請求項１に記載の弾性チューブ。 2. The elastic tube according to claim 1, wherein the fixing portion fixes a cable connected to the medical device as the non-stretchable body to the elastic tube main body.
  3. 　前記固着部は、前記弾性チューブ本体よりも伸縮性が低い素材からなる前記非伸縮体を、前記弾性チューブ本体に固着するものであることを特徴とする請求項１に記載の弾性チューブ。 2. The elastic tube according to claim 1, wherein the fixing portion fixes the non-stretchable body made of a material having lower elasticity than the elastic tube main body to the elastic tube main body.
  4. 　請求項１に記載の弾性チューブの膨張および収縮を制御する制御装置であって、
    　前記弾性チューブの膨張または収縮させる指示を受け付ける指示受付部と、
    　前記指示受付部で受け付けた前記指示に基づいて、前記弾性チューブ本体の中空内部に注入された液体の圧力を可変させる液圧可変部とを備えることを特徴とする制御装置。     A control device for controlling expansion and contraction of the elastic tube according to claim 1,
    An instruction receiving unit for receiving an instruction to expand or contract the elastic tube;
    A control apparatus comprising: a fluid pressure varying unit configured to vary the pressure of the liquid injected into the hollow inside of the elastic tube body based on the instruction received by the instruction accepting unit.
  5. 　前記液圧可変部は、前記医療器具が取得した情報に従って自動操作されることを特徴とする請求項４に記載の制御装置。 The control device according to claim 4, wherein the fluid pressure variable unit is automatically operated according to information acquired by the medical instrument.
  6. 　請求項１に記載の弾性チューブと、請求項４に記載の制御装置とを備えた医療機器。 A medical device comprising the elastic tube according to claim 1 and the control device according to claim 4.
  7. 　前記医療器具として、内視鏡カメラ、カテーテル、レーザメスまたは電気メスを備えた請求項６に記載の医療機器。 The medical device according to claim 6, comprising an endoscopic camera, a catheter, a laser knife, or an electric knife as the medical instrument.
PCT/JP2014/051725 2013-09-24 2014-01-27 Elastic tube, control device, and medical equipment WO2015045429A1 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
JP2013197558A JP2014076348A (en) 2012-09-24 2013-09-24 Elastic tube, control device and medical apparatus
JP2013-197558 2013-09-24

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Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3773034A (en) * 1971-11-24 1973-11-20 Itt Research Institute Steerable catheter
JPS6335225A (en) * 1986-07-30 1988-02-15 オリンパス光学工業株式会社 Apparatus for bending insert part of endoscope
JPH02113104A (en) * 1988-10-19 1990-04-25 Toshiba Corp Actuator
JPH11405A (en) * 1997-04-15 1999-01-06 Terumo Corp Balloon for medical treatment tube
JP2003320031A (en) * 2002-02-26 2003-11-11 Buaayu:Kk Balloon catheter
JP2004180764A (en) * 2002-11-29 2004-07-02 Tohoku Techno Arch Co Ltd Active tubule
WO2009054491A1 (en) * 2007-10-27 2009-04-30 Kaneka Corporation Catheter
JP2009522072A (en) * 2006-01-06 2009-06-11 コーディス・コーポレイション Medical delivery system for delivery of medically useful payload

Patent Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3773034A (en) * 1971-11-24 1973-11-20 Itt Research Institute Steerable catheter
JPS6335225A (en) * 1986-07-30 1988-02-15 オリンパス光学工業株式会社 Apparatus for bending insert part of endoscope
JPH02113104A (en) * 1988-10-19 1990-04-25 Toshiba Corp Actuator
JPH11405A (en) * 1997-04-15 1999-01-06 Terumo Corp Balloon for medical treatment tube
JP2003320031A (en) * 2002-02-26 2003-11-11 Buaayu:Kk Balloon catheter
JP2004180764A (en) * 2002-11-29 2004-07-02 Tohoku Techno Arch Co Ltd Active tubule
JP2009522072A (en) * 2006-01-06 2009-06-11 コーディス・コーポレイション Medical delivery system for delivery of medically useful payload
WO2009054491A1 (en) * 2007-10-27 2009-04-30 Kaneka Corporation Catheter

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