WO2015136807A1 - 内視鏡及び内視鏡システム - Google Patents
内視鏡及び内視鏡システム Download PDFInfo
- Publication number
- WO2015136807A1 WO2015136807A1 PCT/JP2014/083310 JP2014083310W WO2015136807A1 WO 2015136807 A1 WO2015136807 A1 WO 2015136807A1 JP 2014083310 W JP2014083310 W JP 2014083310W WO 2015136807 A1 WO2015136807 A1 WO 2015136807A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- shaft
- distal end
- endoscope
- insertion portion
- moving
- Prior art date
Links
Images
Classifications
-
- G—PHYSICS
- G02—OPTICS
- G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
- G02B23/00—Telescopes, e.g. binoculars; Periscopes; Instruments for viewing the inside of hollow bodies; Viewfinders; Optical aiming or sighting devices
- G02B23/24—Instruments or systems for viewing the inside of hollow bodies, e.g. fibrescopes
- G02B23/2476—Non-optical details, e.g. housings, mountings, supports
-
- 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
- A61B1/00064—Constructional details of the endoscope body
- A61B1/00071—Insertion part of the endoscope body
- A61B1/0008—Insertion part of the endoscope body characterised by distal tip features
- A61B1/00087—Tools
-
- 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
- A61B1/00064—Constructional details of the endoscope body
- A61B1/00071—Insertion part of the endoscope body
- A61B1/0008—Insertion part of the endoscope body characterised by distal tip features
- A61B1/00089—Hoods
-
- 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
- A61B1/00064—Constructional details of the endoscope body
- A61B1/00071—Insertion part of the endoscope body
- A61B1/0008—Insertion part of the endoscope body characterised by distal tip features
- A61B1/00101—Insertion part of the endoscope body characterised by distal tip features the distal tip features being detachable
-
- 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
- A61B1/00131—Accessories for endoscopes
- A61B1/00137—End pieces at either end of the endoscope, e.g. caps, seals or forceps plugs
-
- 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
- A61B1/009—Flexible endoscopes with bending or curvature detection of the 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
- A61B1/018—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 for receiving instruments
-
- 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
- A61B1/04—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 combined with photographic or television appliances
- A61B1/05—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 combined with photographic or television appliances characterised by the image sensor, e.g. camera, being in the distal end portion
- A61B1/051—Details of CCD assembly
-
- 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
- A61B1/06—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 with illuminating arrangements
- A61B1/0661—Endoscope light sources
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/0218—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for minimally invasive surgery
-
- 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
- A61B2017/00238—Type of minimally invasive operation
- A61B2017/00269—Type of minimally invasive operation endoscopic mucosal resection EMR
-
- 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
- A61B2017/00296—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means mounted on an endoscope
Definitions
- the present invention relates to an endoscope for performing treatment by being inserted into a patient's body or the like, and an endoscope system including the endoscope.
- This application claims priority on March 12, 2014 based on Japanese Patent Application No. 2014-48870 for which it applied to Japan, and uses the content for it here.
- the endoscope described in Patent Document 1 includes an insertion unit, an operation unit, and a connector.
- the insertion part is a long part to be inserted into an examination part such as a body cavity, and has a tip part, an angle part, and a soft part.
- a CCD sensor At the distal end portion, a CCD sensor, an optical system for imaging an examination site by the CCD sensor, and a processing substrate for processing an output signal of the CCD sensor are arranged.
- the endoscope configured in this manner performs tissue sampling by inserting forceps into a test site through a channel in a procedure.
- the present invention has been made in view of such a problem, and an endoscope in which the trouble of washing the inside of a channel after use in a technique is reduced, and an endoscope system including the endoscope are provided.
- the purpose is to provide.
- An endoscope includes an insertion portion, an operation portion attached to a proximal end portion of the insertion portion, and is inserted into the insertion portion and the proximal end portion extends to the operation portion.
- a shaft-like member capable of moving back and forth with respect to the insertion portion, and a projectable portion provided at a distal end portion of the insertion portion, and the projectable portion is watertightly attached to an outer surface of the insertion portion.
- a fixed portion a moving portion that is provided in a state in which a tip is exposed to the outside, and is movable in a direction intersecting the outer surface by moving the shaft-like member forward and backward; and an elastically deformable and the fixed portion; And a connecting part for watertightly connecting the moving part.
- the second aspect of the present invention may include a distal end side restricting portion that restricts a range in which the shaft-like member moves toward the distal end side with respect to the insertion portion.
- the endoscope may further include a proximal-side regulating portion that regulates a range in which the shaft-shaped member moves to the proximal side with respect to the insertion portion. Good.
- the shaft-shaped member and the moving portion are separated from each other when the shaft-shaped member moves to the proximal end side, and the shaft-shaped member It may be configured such that the moving part is pushed to the tip side by the shaft-like member when the tip moves to the tip side.
- a proximal end portion of the moving portion is formed so as to protrude closer to a proximal end side than the connecting portion, and a base of the moving portion is formed.
- One of the end and the tip of the shaft-like member is provided with a connection portion, and the connection portion is provided on the other of the base end of the moving portion provided with the connection and the tip of the shaft-like member.
- a large-diameter portion larger than the outer diameter may be provided.
- a concave portion that is recessed in a direction away from the connection portion is formed on a surface of the large-diameter portion that faces the connection portion. May be.
- the shaft member and the moving part may be connected.
- An endoscope system includes an endoscope according to the first aspect, and a cap that can be attached to and detached from a distal end of an insertion portion that is the outer surface of the insertion portion of the endoscope.
- the cap is formed in a cylindrical shape, and a base end portion is attached to the insertion portion; the main body portion is movably attached; the main body portion is attached to the insertion portion; Moves in a direction intersecting the central axis of the main body when moving from the distal end of the insertion portion toward the proximal end to the distal end of the insertion portion. And a moving member that moves to a position closer to the tip than the main body.
- FIG. 1 is an overall view of an endoscope according to a first embodiment of the present invention. It is sectional drawing of the front-end
- FIG. 17 It is a perspective view of the attachment of the modification of 2nd Embodiment of this invention. It is a front view of a front-end
- FIG. 1 is an overall view of an endoscope 1 according to the first embodiment of the present invention.
- FIG. 2 is a cross-sectional view of the distal end portion of the insertion portion 10 of the endoscope 1 according to the first embodiment of the present invention.
- the endoscope 1 according to the present embodiment is a so-called flexible endoscope, and includes a long insertion portion 10, an operation portion 30, a drive wire (shaft-shaped member) 40, and the like. And a projectable portion 50.
- the operation unit 30 is attached to the proximal end portion of the insertion unit 10.
- the drive wire 40 is inserted into a first channel (channel) 11 formed in the insertion portion 10.
- the projectable portion 50 is provided at the distal end portion of the insertion portion 10.
- the insertion portion 10 is formed in a columnar shape as a whole, and includes a distal end hard portion 14, a bending portion 15, and a flexible tube portion 16.
- the distal end hard portion 14 is provided on the distal end side of the insertion portion 10.
- the bending portion 15 is attached to the proximal end side of the distal end hard portion 14 and is configured to be capable of bending operation.
- the flexible tube portion 16 is attached to the proximal end side of the bending portion 15.
- the distal end surface (outer surface) 14a of the distal end hard portion 14 is provided with the distal end portion of the light guide 17 and an imaging unit 18 having a CCD (not shown) exposed to the outside.
- the first channel 11 and the second channel 12 described above are formed in the insertion portion 10, and the distal end portions of these channels 11 and 12 are open to the distal end surface 14 a of the distal end hard portion 14.
- the channels 11 and 12 extend in the longitudinal direction D of the insertion portion 10, and the base end portions of the channels 11 and 12 extend to the operation portion 30.
- the first channel 11 is configured by a cylindrical base 21 provided on the distal end surface 14 a and an inner peripheral surface of a tube 22 connected to the base end side of the base 21. .
- the base 21 is formed with a reduced diameter portion 21 a protruding from the inner peripheral surface of the base 21 over the entire circumference of the base 21.
- the base 21 and the reduced diameter portion 21a are integrally formed of a metal such as stainless steel.
- the tube 22 is formed of a multi-strand coil. In addition to this, the tube 22 may be formed of, for example, a closely wound coil, a multi-strip coil, a resin tube, or the like.
- a distal end portion of the tube 22 is fixed to a step portion formed at a connection portion between the base 21 and the reduced diameter portion 21a by an adhesive, welding, or the like.
- the second channel 12 is constituted by an inner peripheral surface of a tube such as a coil.
- the drive wire 40 is formed of a flexible material such as a metal single wire or a stranded wire.
- the drive wire 40 is inserted into the first channel 11 so as to be able to advance and retreat in the longitudinal direction D with respect to the insertion portion 10.
- the outer diameter of the drive wire 40 is slightly smaller than the inner diameter of the tube 22 and the inner diameter of the reduced diameter portion 21a.
- the proximal end portion of the drive wire 40 extends to the operation unit 30.
- the protruding portion 50 is attached to the tip of the base 21.
- the projectable portion 50 includes a fixed portion 51, a shaft (moving portion) 52, and a connecting portion 53.
- the fixed part 51 is attached to the tip of the base 21 in a watertight manner.
- the shaft 52 is provided in a state where the tip is exposed to the outside in the base 21.
- the connecting portion 53 water-tightly connects the fixing portion 51 and the shaft 52.
- the fixing portion 51 and the connecting portion 53 are integrally formed in a disc shape with an elastically deformable material such as silicone.
- a through hole 53 a penetrating in the longitudinal direction D is formed at the center of the connecting portion 53.
- the shaft 52 is formed in a rod shape extending in the longitudinal direction D by a metal such as stainless steel or a thermoplastic resin.
- the shaft 52 is harder than the connecting portion 53.
- the distal end portion of the shaft 52 protrudes toward the distal end side from the connecting portion 53, and the proximal end portion of the shaft 52 protrudes toward the proximal end side from the connecting portion 53.
- the distal end portion of the shaft 52 protrudes further toward the distal end side than the distal end surface 14 a of the distal end hard portion 14.
- the through hole 53a of the connecting portion 53 and the shaft 52 are joined in a watertight manner by a known adhesive or the like.
- the shaft 52 and the drive wire 40 are disposed on the same axis along the longitudinal direction D.
- the shaft 52 and the drive wire 40 can be separated from each other.
- the drive wire 40 is moved (pushed) toward the distal end side with respect to the insertion portion 10
- the distal end portion of the drive wire 40 is placed at the proximal end portion of the shaft 52. Touch.
- the bending portion 15 includes a plurality of bending pieces that are arranged side by side in the longitudinal direction D and are connected to each other so as to be swingable. Of these bending pieces, the distal end portion of the operation wire is fixed to the one arranged on the most distal end side.
- a forceps port 32 is provided on the distal end side of the operation unit main body 31 constituting the operation unit 30.
- the proximal end portion of the second channel 12 is open to the forceps opening 32.
- an angle knob 33 for operating the above-described operation wire, a light source (not shown), a monitor, a switch 34 for operating the above-described imaging unit 18 and the like, and a drive wire 40 A lever 35 is provided for operating.
- the angle knob 33 By operating the angle knob 33, the bending portion 15 of the insertion portion 10 can be bent in a desired direction.
- the monitor and the imaging unit 18 are electrically connected by an electric wire (not shown) inserted into the insertion portion 10.
- FIG. 3 is a cross-sectional view of a main part of the operation unit 30.
- the lever 35 is connected to the operation unit main body 31 via a pin 36 provided at an intermediate portion in the longitudinal direction of the lever 35.
- the first end portion 35a of the lever 35 is provided with a hole (not shown), and the base end portion of the drive wire 40 is inserted into the hole and is rotatable in the circumferential direction of the hole 35. It is connected to the end 35a.
- the proximal end portion of the tube 22 extends to the vicinity of the first end portion 35 a of the lever 35.
- the endoscope 1 configured as described above can rotate the lever 35 around the pin 36 when the user operates the second end portion 35b of the lever 35 with a finger or the like.
- the drive wire 40 moves toward the distal end side and is pushed into the tube 22, and the proximal end surface of the shaft 52 The tip surface of the drive wire 40 comes into contact.
- the shaft 52 moves to the distal end side by pushing the proximal end portion of the shaft 52 toward the distal end side at the distal end portion of the drive wire 40.
- the shaft 52 moves from the distal end surface 14a of the insertion portion 10 toward the outside of the insertion portion 10 and protrudes to the distal end of the endoscope 1, and the connection portion 53 is elastically deformed.
- this state is referred to as a “protruding state”.
- the tube 22 is formed of a multi-strand coil, the tube 22 is difficult to extend when the drive wire 40 is pushed. Therefore, the length in which the drive wire 40 is pushed into the tube 22 on the proximal end side is substantially equal to the length in which the drive wire 40 moves relative to the tube 22 on the distal end side.
- the shaft 52 can be stably operated.
- the base 21 functions as a positioning portion that determines the position of the shaft 52 such that the distal end portion of the drive wire 40 pushes the proximal end portion of the shaft 52 when the drive wire 40 is pushed toward the distal end side.
- the shaft 52 is in the protruding state, it is preferable that a part of the shaft 52 and a part of the base 21 overlap in the longitudinal direction D.
- the protruding shaft 52 becomes integral with the base 21, that is, the distal end hard portion 14, and becomes hard, and the shaft 52 is not easily tilted so as to be inclined with respect to the longitudinal direction D.
- the drive wire 40 moves to the proximal end side (retracted) with respect to the tube 22 as shown in FIG.
- the connecting portion 53 is deformed by its own elastic force, and the fixing portion 51 and the connecting portion 53 return to a disk shape.
- the shaft 52 moves to the proximal end side from the distal end surface 14a of the insertion portion 10 toward the inside of the insertion portion 10 to be in a retracted state, and the drive wire 40 and the shaft 52 are separated from each other.
- the shaft 52 can be moved in the longitudinal direction D, that is, in a direction orthogonal to the distal end surface 14a.
- FIG. 5 is a diagram for explaining the operation of the endoscope 1.
- the lever 35 is operated outside the patient's body, the drive wire 40 is pulled back, and the shaft 52 is retracted.
- the drive wire 40 and the shaft 52 are separated from each other.
- the switch 34 of the operation unit 30 is operated to operate the light source, the illumination light emitted from the light source is guided to the light guide 17 and illuminates the front of the insertion unit 10.
- the image in front of the insertion unit 10 acquired by the imaging unit 18 is displayed on the monitor. While checking the image displayed on the monitor, the user inserts the insertion portion 10 of the endoscope 1 into the large intestine P1 through the anus of the patient as shown in FIG.
- the insertion part 10 is inserted along the large intestine, and the bending part 15 is bent by operating the angle knob 33 as necessary.
- the position of the drive wire 40 in the longitudinal direction D with respect to the first channel 11 may move by bending the bending portion 15 or bending the flexible tube portion 16. Even in this case, since the drive wire 40 and the shaft 52 are separated from each other, the shaft 52 is suppressed from being pushed by the drive wire 40. Since the projectable portion 50 is watertightly attached to the distal end surface 14 a of the insertion portion 10, body fluid or the like does not enter the first channel 11.
- the second end portion 35b of the lever 35 is operated to push the drive wire 40 toward the distal end side so that the shaft 52 is in a protruding state.
- the tip of the shaft 52 is pressed against the fold P2 formed on the inner surface of the large intestine P1, thereby reducing the height of the fold P2.
- the back side of the fold P2 lowered by the imaging unit 18 is observed by the imaging unit 18.
- the back side of the fold P2 is usually difficult to observe, but can be observed by pressing with the shaft 52 in this way.
- a treatment tool W1 such as forceps is inserted into the large intestine P1 from the forceps port 32 through the second channel 12, and appropriate treatment is performed.
- the projectable portion 50 is provided on the distal end surface 14 a of the insertion portion 10.
- the shaft 52 By placing the shaft 52 in the retracted state outside the patient's body and inserting the insertion portion 10 into the patient, the burden on the patient when the insertion portion 10 is inserted can be reduced.
- the shaft 52 is projected and the fold P2 or the like of the large intestine P1 is pressed by the shaft 52. Thereby, it is possible to easily observe the target portion with the endoscope 1.
- the projectable portion 50 is attached to the distal end surface 14a of the insertion portion 10 in a water-tight manner, body fluid or the like does not enter the first channel 11, and it is troublesome to clean the first channel 11 after being used in the procedure. Is reduced. Since the connection part 53 and the drive wire 40 do not contact directly, it can suppress that the connection part 53 wears out and can improve the durability of the connection part 53.
- the drive wire 40 When the drive wire 40 is pulled back, the drive wire 40 and the shaft 52 are separated from each other. When the drive wire 40 is pushed in, the shaft 52 is pushed toward the distal end side by the drive wire 40. Even when the position of the drive wire 40 in the longitudinal direction D with respect to the first channel 11 is moved, such as when the insertion portion 10 is bent, the drive wire 40 pushes the shaft 52 toward the distal end side so that the distal end from the distal end surface 14a of the insertion portion 10 It can suppress that the length which the shaft 52 protrudes to the side increases.
- the distal end of the drive wire 40 tends to move toward the proximal end with respect to the first channel 11 when the insertion portion 10 is bent rather than when the insertion portion 10 is straight. For this reason, it is preferable to adjust so that the drive wire 40 and the shaft 52 are in contact with each other when the insertion portion 10 is straight, or slightly separated. By not bringing the drive wire 40 and the shaft 52 into contact with each other more than necessary, it is advantageous for durability. Since the drive wire 40 has flexibility, the bending operation of the bending portion 15 is facilitated, and the flexible tube portion 16 can be easily bent.
- the drive wire is arranged not along the first channel but along the outer surface of the insertion portion, the outer diameter of the insertion portion and the drive wire as a whole becomes thicker, and the cross-sectional shape orthogonal to the longitudinal direction D is also present. It becomes difficult to become circular. For this reason, when the whole of the insertion portion and the drive wire is rotated around the longitudinal direction, the burden on the patient increases. However, in the endoscope 1 according to this embodiment, since the drive wire 40 is inserted into the insertion portion 10, the burden on the patient when the insertion portion 10 is rotated around the longitudinal direction D is reduced. Can do.
- the configuration of the endoscope 1 can be modified as described below.
- 6 to 11 are cross-sectional views of the distal end portion of the insertion portion in the endoscope according to the modified example of the first embodiment of the present invention.
- the fixing portion 61 and the connecting portion 62 of the projectable portion 60 are integrally formed by a bellows-like member formed in a cylindrical shape having a plurality of fold portions 63. May be.
- the fixed portion 61 and the connecting portion 62 are formed of an elastically deformable material such as resin.
- the fixing portion 61 is disposed on the proximal end side with respect to the connecting portion 62 and is water-tightly attached to the distal end portion of the base 21 with a known adhesive or the like.
- the shaft 52 is inserted into the connecting portion 62, and the tip end portion of the connecting portion 62 and the shaft 52 are attached in a watertight manner.
- the shaft 52 is retracted when the folds 63 are brought into close contact with the longitudinal direction D, and the shaft 52 is projected when the folds 63 are spread in the longitudinal direction D.
- the protruding length of the shaft 52 protruding from the distal end surface 14a of the insertion portion 10 to the distal end side is adjusted to a desired length when being in a protruding state. be able to. Since the bellows-like member has good stretchability, the projectable portion 60 of the present modification can increase the movement range of the shaft 52 in the longitudinal direction D.
- the distal end portion of the drive wire 40 and the proximal end portion of the shaft 52 are connected.
- a hole 52 a is formed in the base end surface of the shaft 52.
- the distal end portion of the drive wire 40 is fixed to the shaft 52 by an adhesive (not shown), brazing, soldering, or the like while being inserted into the hole 52a of the shaft 52.
- an adhesive not shown
- brazing, soldering, or the like while being inserted into the hole 52a of the shaft 52.
- a large diameter portion 66 larger than the outer diameter of the distal end portion (connecting portion) of the drive wire 40 may be provided at the proximal end portion of the shaft 52.
- a concave portion 66a that is recessed in a hemispherical shape toward the distal end side, that is, in a direction away from the distal end portion of the drive wire 40 may be formed.
- the outer diameter of the recess 66 a is larger than the outer diameter of the drive wire 40.
- the large-diameter portion 66 is formed integrally with the shaft 52 with the same material as the shaft 52.
- the shaft 52 and the drive wire 40 can be separated.
- the large-diameter portion 66 on the shaft 52 even when the axis line where the shaft 52 is arranged and the axis line where the drive wire 40 is arranged are deviated, the force pushing the drive wire 40 is reduced. It can be easily transmitted to the shaft 52 via 66.
- the recessed portion 66a is formed in the large-diameter portion 66, so that the distal end portion of the pushed drive wire 40 enters the recessed portion 66a. Therefore, the drive wire 40 that contacts the shaft 52 when the drive wire 40 is pushed in is prevented from falling off the shaft 52.
- a large-diameter portion 67 provided at the distal end portion of the drive wire 40 shown in FIG. 8 may be provided.
- the outer diameter of the large diameter portion 67 is larger than the outer diameter of the base end portion (connecting portion) of the shaft 52.
- a concave portion 67a that is recessed in a hemispherical shape toward the base end portion of the shaft 52, that is, toward the base end side, may be formed. . Even if comprised in this way, there can exist the same effect as the above-mentioned modification.
- the distal end of the shaft 52 is the end of the distal hard portion 14. You may comprise so that it may protrude in the front end side rather than the front end surface 14a.
- the fixing portion 51 and the connecting portion 53 are formed in a flat disk shape in a natural state.
- the distal end portion of the shaft 52 when the shaft 52 is in the retracted state, the distal end portion of the shaft 52 may be configured not to protrude further toward the distal end side than the distal end surface 14 a of the distal end hard portion 14.
- the fixed portion 51 and the connecting portion 53 are formed in a disk shape that is curved so that the center portion is recessed toward the proximal end side in a natural state. With this configuration, the distal end portion of the shaft 52 does not protrude from the distal end surface 14a of the distal end hard portion 14 when the insertion portion 10 is inserted, so that the burden on the patient can be further reduced.
- the enlarged diameter portion 71 provided at the proximal end portion of the shaft 52 and the drive wire 40 are coupled, and the reduced diameter portion of the base 21 of the drive wire 40.
- the outer diameter of the enlarged diameter portion 71 is larger than the inner diameter of the reduced diameter portion 21a.
- a hole 71 a is formed in the base end surface of the enlarged diameter portion 71.
- the enlarged diameter portion 71 is formed integrally with the shaft 52 with the same material as the shaft 52.
- the distal end portion of the drive wire 40 is fixed to the enlarged diameter portion 71 with an adhesive (not shown) while being inserted into the hole portion 71 a of the enlarged diameter portion 71.
- the stopper 72 is formed in a ring shape from metal or thermoplastic resin, and is fixed to the drive wire 40.
- the outer diameter of the stopper 72 is smaller than the inner diameter of the tube 22 and larger than the inner diameter of the reduced diameter portion 21a.
- the fixing portion 51 and the connecting portion 53 are formed in a flat disk shape in a natural state.
- the reduced diameter portion 21a and the stopper 72 constitute the distal end side restricting portion 73, and the reduced diameter portion 21a and the enlarged diameter portion 71 constitute the proximal end side restricting portion 74.
- These restricting portions 73 and 74 are preferably provided in the vicinity of the distal end of the insertion portion 10.
- the drive wire 40 is stretched by a tensile stress and its entire length changes, and the position of the tip of the drive wire 40 with respect to the insertion portion 10 changes depending on the shape of the insertion portion 10. For this reason, even if the restricting portions 73 and 74 are provided on the proximal end side of the insertion portion 10, the relative position between the projectable portion 50 and the distal end of the drive wire 40 is shifted.
- a step portion 21 b having an enlarged inner diameter is formed at the tip of the inner peripheral surface of the base 21.
- the fixing portion 51 of the projectable portion 50 is disposed in the stepped portion 21b.
- a ring-shaped lid member 76 is disposed on the tip surface of the base 21.
- the inner diameter of the lid member 76 is substantially equal to the inner diameter of the portion on the base end side of the base 21 where the reduced diameter portion 21a is not provided.
- the lid member 76 can be formed of the same material as the base 21.
- the fixing portion 51 is watertightly attached to the base 21 and the lid member 76 with a known adhesive or the like while being sandwiched in the longitudinal direction D by the surface of the base end side of the stepped portion 21 b and the lid member 76.
- the base 21 and the lid member 76 may be fixed by a screw member.
- the stopper 72 comes into contact with the reduced diameter portion 21a as shown in FIG. Moves into a protruding state.
- the range in which the drive wire 40 moves toward the distal end side with respect to the insertion portion 10 is restricted.
- the enlarged diameter portion 71 moves to the position Q1 shown in FIG. 12 and contacts the reduced diameter portion 21a, and the shaft 52 moves to the proximal end side and retracts. It becomes a state.
- the range in which the drive wire 40 moves to the distal end side is regulated by including the distal end side regulating portion 73, and the shaft 52 and the coupling portion 53 are brought to the distal end side. It is possible to prevent an excessive force from being applied.
- the base end side restricting portion 74 By providing the base end side restricting portion 74, the range in which the drive wire 40 moves to the base end side is restricted, and it is possible to prevent an excessive force toward the base end side from acting on the shaft 52 or the connecting portion 53.
- the endoscope 1B may be configured to include only one of the distal end side restricting portion 73 and the proximal end side restricting portion 74.
- the second channel 12 is formed in the endoscope 1
- the second channel 12 may not be provided.
- an insertion portion of another endoscope is inserted into the large intestine P1, and treatment is performed, or through the channel of the endoscope. Treatment may be performed with the inserted treatment tool.
- the first channel 11 may not be formed in the insertion portion 10.
- the drive wire 40 is inserted into the insertion portion 10 together with the above-described electric wire and the like.
- the drive wire 40 is preferably inserted through a coil in the insertion portion 10.
- the configuration is shown in which the distal end portion of the shaft 52 protrudes toward the distal end side with respect to the connecting portion 53, and the proximal end portion of the shaft 52 protrudes toward the proximal end side with respect to the connecting portion 53.
- the proximal end surface of the shaft 52 may be flush with the proximal end surface of the coupling portion 53, and the distal end surface of the shaft 52 may be flush with the distal end surface of the coupling portion 53.
- the base end portion of the first channel 11 may open to the forceps port 32, and the lever 35 may be rotatably supported by the forceps port 32 by the pin 36.
- FIG. 13 is an exploded perspective view of the distal end portion of the endoscope system 2 according to the present embodiment.
- FIG. 14 is a front view of the distal end portion of the endoscope system 2 according to the present embodiment.
- the endoscope system 2 according to the present embodiment includes the endoscope 1 according to the first embodiment and the distal end surface 14 a (the distal end of the insertion portion) of the insertion portion 10 of the endoscope 1. And a detachable attachment (cap) 3.
- the attachment 3 includes a main body 80 and a bar (moving member) 90.
- the main body 80 is formed in a cylindrical shape.
- the bar 90 is movably attached to the main body 80.
- a pair of through-holes 81 are formed in an intermediate portion in the longitudinal direction of the main body 80.
- the pair of through holes are formed so as to penetrate from the outer peripheral surface of the main body 80 to the inner peripheral surface at positions facing each other.
- a plate-like support member 82 that protrudes radially inward is provided on the proximal end side of the inner peripheral surface of the main body 80.
- the main body 80 and the support member 82 are integrally formed of a resin having biocompatibility such as polypropylene resin or polycarbonate resin.
- the inner diameter of the main body portion 80 is slightly larger than the outer diameter of the distal end hard portion 14 of the insertion portion 10. For this reason, the main-body part 80 can be press-fitted and fixed to the distal end hard part 14.
- the bar 90 includes a pair of shaft members 91, a pair of arm members 92, a connecting member 93, and a receiving member 94.
- the pair of shaft members 91 are inserted into the through holes 81 of the main body 80.
- the pair of arm members 92 extends from portions of the shaft members 91 that protrude from the outer peripheral surface of the main body 80.
- the connecting member 93 is connected to the tip of each arm member 92.
- the receiving member 94 extends from a portion of the one shaft member 91 protruding from the inner peripheral surface of the main body 80.
- Each arm member 92 extends in a direction substantially orthogonal to the shaft member 91 and obliquely forward of the main body 80.
- Each of the pair of shaft members 91 and the pair of arm members 92 is disposed on the first reference plane S1.
- the connecting member 93 is formed in a curved shape that is convex toward the tip side on a plane that intersects the first reference plane S1.
- the pair of arm members 92 and the receiving member 94 are disposed on the same side with respect to the second reference plane S ⁇ b> 2 including the axis of the pair of shaft members 91 and parallel to the longitudinal direction D. .
- the pair of shaft members 91, the pair of arm members 92, the connecting member 93, and the receiving member 94 are integrally formed by bending a wire formed of stainless steel, titanium, or the like having biocompatibility and elasticity.
- the bar 90 can rotate around the pair of through holes 81 with respect to the main body 80 as each shaft member 91 rotates in each through hole 81 of the main body 80.
- the connecting member 93 is disposed at a position closer to the distal end than the edge of the opening 80 a on the distal end side of the main body 80.
- the connecting member 93 is arranged so as to avoid the position on the front end side of the center part of the opening 80a of the main body 80, so that the visual field of the imaging unit 18 is not obstructed.
- a spring member 100 is provided between the end of the receiving member 94 opposite to the portion connected to the shaft member 91 and the support member 82.
- the spring member 100 a naturally wound helical spring is used, and extends in the axial direction of the main body 80.
- the distal end portion of the spring member 100 is attached to the receiving member 94, and the proximal end portion is attached to the support member 82.
- the attachment 3 When the attachment 3 configured as described above is attached to the distal end surface 14a of the insertion portion 10 with the shaft 52 retracted, the attachment 3 is positioned with respect to the distal end surface 14a of the insertion portion 10 as follows. That is, as shown in FIGS. 14 and 15, the insertion portion 10 is inserted through the opening on the proximal end side of the main body portion 80 of the attachment 3. The attachment 3 is rotated around the central axis C of the main body portion 80 with respect to the insertion portion 10 so that the receiving member 94 is disposed on the distal end side of the shaft 52 of the projectable portion 50. Thereby, the position in the circumferential direction of the attachment 3 with respect to the insertion portion 10 is defined (positioned).
- the attachment 3 is pushed into the insertion portion 10, and the distal end surface 14a of the insertion portion 10 is brought into contact with the proximal end surface of the support member 82 as shown in FIG. Thereby, the position of the attachment 3 with respect to the insertion part 10 in the longitudinal direction D of the insertion part 10 is defined. At this time, the distal end portion of the shaft 52 comes into contact with the outer surface on the proximal end side of the receiving member 94.
- the insertion part 10 to which the attachment 3 is attached is inserted from a natural opening such as a patient's mouth.
- the attachment 3 is inserted up to the lesion mucosa portion P6 shown in FIG.
- a known injection needle is inserted into the body cavity through the second channel 12, the injection needle projects beyond the attachment 3, and physiological saline is injected into the submucosa P7 of the lesion mucosa P6. Then, the lesion mucosa portion P6 may be raised. Thereafter, the injection needle is pulled out from the second channel 12 and removed.
- a high-frequency knife is inserted into the body cavity through the second channel 12 and protrudes more distally than the attachment 3. With the inserted high frequency knife, a part of the mucosa P8 around the lesion mucosa part P6 is incised. After this, the high frequency knife is pulled back into the second channel 12.
- the connecting member 93 of the bar 90 is inserted between the incised lesion mucosa portion P6 and the submucosa P7.
- the lever 35 of the endoscope 1 is operated to move the shaft 52 from the retracted state to the protruding state.
- each shaft member 91 rotates in each through hole 81 of the main body 80, and a pair of The arm member 92 and the connecting member 93 rotate around the pair of through holes 81.
- the connecting member 93 moves in a direction F intersecting the central axis C and moves to a position closer to the tip than the main body 80.
- the lesioned mucosa portion P6 supported by the connecting member 93 is peeled off (raised) from the submucosa P7. Thereafter, the high-frequency knife W2 in the second channel 12 is protruded to the tip side from the attachment 3, and the lesion mucosa portion P6 is excised.
- the bar 90 rotates about the pair of through holes 81 due to the elastic force of the spring member 100 and moves in a direction opposite to the direction F in which the connecting member 93 intersects. Then, the position returns to the position shown in FIG.
- the excised lesion mucosa portion P6 is collected with grasping forceps (not shown) inserted through the second channel 12.
- the insertion portion 10 of the endoscope 1 is pulled out from the patient's mouth, and necessary treatments are performed to complete a series of treatments.
- the first channel 11 of the endoscope 1 is sealed at the distal end side of the insertion portion 10, so The trouble of cleaning the inside of the first channel 11 of the endoscope 1 is reduced.
- the connecting member 93 of the bar 90 moves in the direction F intersecting the central axis C, so that the lesioned mucosa portion P6 supported by the connecting member 93 is peeled from the submucosa P7. can do.
- FIG. 17 is a perspective view of an attachment according to a modification of the present embodiment.
- FIG. 18 is a front view of the distal end portion when the attachment of FIG. 17 is attached to the insertion portion of the endoscope.
- a pair of protrusions 110 provided on the outer peripheral surface of the main body 80 may be provided instead of the support member 82 and the spring member 100 of the attachment 3 as in the attachment 3A shown in FIGS. Good.
- Each protrusion 110 is formed so that the interval between the portions in contact with each arm member 92 increases as the connecting member 93 moves in the intersecting direction F described above. That is, the overall width of the pair of protrusions 110 is wider (longer) than the distance between the pair of arm members 92 in the natural state.
- each arm member 92 comes into contact with the protrusion 110, and as shown in FIG.
- the arm member 92 is elastically deformed and moved so that the distance between the arm members 92 increases.
- the connecting member 93 is also elastically deformed and moved as indicated by the position Q3.
- FIG. 19 is a front view of the distal end portion of the endoscope system 2 according to a modification of the present embodiment.
- FIG. 20 is a perspective view in which a part of the attachment of the endoscope system according to the modified example of the present embodiment is broken. 19 and 20, when the attachment 3B is attached to the insertion portion 10, a through hole 82a through which the shaft 52 of the projectable portion 50 is inserted may be formed in the support member 82. If comprised in this way, the position of the circumferential direction of the attachment 3B with respect to the insertion part 10 can be easily prescribed
- the through hole 82a functions as a positioning index in the circumferential direction of the attachment 3B.
- this positioning index is not provided on the outer surface in a state where the attachment 3B is attached to the insertion portion 10, the insertability of the insertion portion 10 can be maintained.
- the concrete structure is not restricted to this embodiment, The structure of the range which does not deviate from the summary of this invention Changes, combinations, deletions, etc. are also included. Furthermore, it goes without saying that the configurations shown in the embodiments can be used in appropriate combinations.
- the outer surface of the insertion portion 10 is the distal end surface 14a of the distal end hard portion 14, but the outer surface may be a side surface of the insertion portion 10.
- the insertion portion 10 may be configured not to be provided with the bending portion 15.
- the flexible endoscope 1 has been exemplified, a so-called rigid endoscope having a hard insertion portion may be used. In this case, force transmission performance can be improved by using a non-flexible rod-shaped member as the shaft-shaped member.
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Physics & Mathematics (AREA)
- Optics & Photonics (AREA)
- Biomedical Technology (AREA)
- Medical Informatics (AREA)
- Radiology & Medical Imaging (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Engineering & Computer Science (AREA)
- Biophysics (AREA)
- Heart & Thoracic Surgery (AREA)
- Pathology (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Astronomy & Astrophysics (AREA)
- General Physics & Mathematics (AREA)
- Endoscopes (AREA)
Abstract
Description
例えば、特許文献1に記載された内視鏡は、挿入部、操作部、及びコネクタを有している。
先端部には、CCDセンサと、CCDセンサによって検査部位を撮像するための光学系と、CCDセンサの出力信号を処理する処理基板とが配置されている。
このように構成された内視鏡は、手技においてチャンネルを通して鉗子を検査部位に挿入し、組織の採取を行う。
以下、本発明に係る内視鏡システムの第1実施形態を、図1から図12を参照しながら説明する。図1は、本発明の第1実施形態に係る内視鏡1の全体図である。図2は、本発明の第1実施形態に係る内視鏡1の挿入部10の先端部の断面図である。
図1及び図2に示すように、本実施形態に係る内視鏡1はいわゆる軟性の内視鏡で、長尺の挿入部10と、操作部30と、駆動ワイヤ(軸状部材)40と、突出可能部50とを備えている。操作部30は、挿入部10の基端部に取付けられている。駆動ワイヤ40は、挿入部10に形成された第一のチャンネル(チャンネル)11内に挿通されている。突出可能部50は、挿入部10の先端部に設けられている。
先端硬質部14の先端面(外面)14aには、ライトガイド17の先端部、及び不図示のCCDを有する撮像ユニット18が外部に露出した状態で設けられている。
口金21には、口金21の内周面から突出した縮径部21aが口金21の全周にわたり形成されている。口金21及び縮径部21aは、ステンレス鋼等の金属により一体に形成されている。
チューブ22は、多条コイルで形成されている。チューブ22はこの他、例えば、密巻きされたコイルや、多条コイル、そして樹脂製チューブ等で形成されてもよい。チューブ22の先端部は、口金21と縮径部21aとの接続部分に形成された段部に、接着剤や溶接等により固定されている。
図示はしないが、第二のチャンネル12はコイルなどのチューブの内周面で構成されている。
駆動ワイヤ40の基端部は、操作部30まで延びている。
固定部51及び連結部53は、シリコーン等の弾性的に変形可能な材料で円板状に一体に形成されている。連結部53の中央部には、長手方向Dに貫通する貫通孔53aが形成されている。
シャフト52は、ステンレス鋼等の金属や熱可塑性樹脂により長手方向Dに延びる棒状に形成されている。シャフト52は連結部53よりも硬い。本実施形態では、シャフト52の先端部は連結部53よりも先端側に突出し、シャフト52の基端部は連結部53よりも基端側に突出している。シャフト52及び連結部53に外力が作用しない自然状態において、シャフト52の先端部は先端硬質部14の先端面14aよりも先端側に突出している。
口金21と固定部51との間、連結部53の貫通孔53aとシャフト52との間は、公知の接着剤等により水密に接合されている。
操作部本体31の基端側には、前述の操作ワイヤを操作するためのアングルノブ33、図示しない光源、モニタや、前述の撮像ユニット18等を操作するためのスイッチ34、及び、駆動ワイヤ40を操作するためのレバー35が設けられている。
アングルノブ33を操作することで、挿入部10の湾曲部15を所望の方向に湾曲させることができる。
モニタと撮像ユニット18とは、挿入部10内に挿通された図示しない電線により電気的に接続されている。
チューブ22の基端部は、レバー35の第一端部35aの近傍まで延びている。
チューブ22の基端部にレバー35の第一端部35aを接近させると、図4に示すように、チューブ22に対して駆動ワイヤ40が先端側に移動して押込まれ、シャフト52の基端面に駆動ワイヤ40の先端面が接触する。駆動ワイヤ40をさらに押込むと、駆動ワイヤ40の先端部でシャフト52の基端部を先端側に押すことでシャフト52が先端側に移動する。その結果、シャフト52が挿入部10の先端面14aから挿入部10の外側に向かうように移動して、内視鏡1の先端に突出するともに、連結部53が弾性的に変形する。以後、この状態を「突出状態」という。
シャフト52が突出状態になったときに、長手方向Dにおいてシャフト52の一部と口金21の一部とが重なることが好ましい。このように構成することで、突出状態のシャフト52が口金21、すなわち先端硬質部14と一体となって硬くなり、シャフト52が長手方向Dに対して傾くように倒れにくくなる。
このように、レバー35を操作することで、シャフト52を長手方向D、すなわち先端面14aに直交する方向に移動させることができる。
患者の体外においてレバー35を操作し、駆動ワイヤ40を引き戻してシャフト52を退避状態にする。駆動ワイヤ40とシャフト52とを離間させておく。
操作部30のスイッチ34を操作して光源を動作させると、光源から発せられた照明光はライトガイド17に導かれて挿入部10の前方を照明する。撮像ユニット18で取得された挿入部10の前方の画像は、モニタに表示される。使用者はモニタに表示された画像を確認しながら、図5に示すように内視鏡1の挿入部10を患者の肛門を通して大腸P1内に挿入する。
突出可能部50は挿入部10の先端面14aに水密に取付けられているため、体液等が第一のチャンネル11内に入ることはない。
必要に応じて、鉗子口32から第二のチャンネル12を通して鉗子等の処置具W1を大腸P1内に挿入し、適切な処置を行う。
突出可能部50は挿入部10の先端面14aに水密に取付けられているため、体液等が第一のチャンネル11内に入らず、手技で使用した後で第一のチャンネル11内を洗浄する手間が軽減される。
連結部53と駆動ワイヤ40とが直接接触しないため、連結部53が摩耗するのを抑え連結部53の耐久性を向上させることができる。
挿入部10が曲がったとき等、第一のチャンネル11に対する駆動ワイヤ40の長手方向Dの位置が移動した場合でも、駆動ワイヤ40がシャフト52を先端側に押して挿入部10の先端面14aから先端側にシャフト52が突出する長さが増加するのを抑制することができる。
駆動ワイヤ40が可撓性を有することで、湾曲部15の湾曲動作が容易となるとともに、可撓管部16を容易に曲げることができる。
しかし、本実施形態に係る内視鏡1では、挿入部10内に駆動ワイヤ40が挿通されているため、挿入部10を長手方向D周りに回転させたときに患者に与える負担を低減させることができる。
図6に示す変形例の内視鏡1Aのように、突出可能部60の固定部61及び連結部62を、複数のヒダ部63を有する筒状に形成された蛇腹状部材で一体に形成してもよい。
固定部61及び連結部62は、樹脂等の弾性的に変形可能な材料で形成されている。固定部61は、連結部62よりも基端側に配置され、口金21の先端部に公知の接着剤等により水密に取付けられている。シャフト52は連結部62内に挿通され、連結部62の先端部とシャフト52とが水密に取付けられている。
各ヒダ部63を長手方向Dに密着させたときがシャフト52の退避状態であり、各ヒダ部63を長手方向Dに広げたときがシャフト52の突出状態である。
連結部62が有するヒダ部63の数を調節することで、突出状態となったときに挿入部10の先端面14aから先端側へ突出するシャフト52の突出長さを所望の長さに調節することができる。
蛇腹状部材は伸縮性が良いため、本変形例の突出可能部60は、シャフト52の長手方向Dの移動範囲を大きくすることができる。
このように構成された変形例の内視鏡1Aによれば、駆動ワイヤ40とシャフト52とが離間しないため、駆動ワイヤ40を引き戻す力をシャフト52に作用させることができ、シャフト52の長手方向Dの移動範囲を大きくすることができる。
シャフト52に大径部66を設けることで、シャフト52が配置されている軸線と駆動ワイヤ40が配置されている軸線とがずれている場合でも、駆動ワイヤ40を押込む力を、大径部66を介してシャフト52に容易に伝達することができる。
本変形例では、大径部66に凹部66aが形成されていることで、押込まれた駆動ワイヤ40の先端部は凹部66a内に入る。したがって、駆動ワイヤ40を押込むときにシャフト52に接触した駆動ワイヤ40がシャフト52から脱落することが防止される。
このように構成されていても、前述の変形例と同様の効果を奏することができる。
拡径部71の外径は、縮径部21aの内径よりも大きい。拡径部71の基端面には、穴部71aが形成されている。拡径部71は、シャフト52と同一の材料でシャフト52と一体に形成されている。
駆動ワイヤ40の先端部は、拡径部71の穴部71aに挿入された状態で、不図示の接着剤により拡径部71に固定されている。
縮径部21a及びストッパ72で先端側規制部73を構成し、縮径部21a及び拡径部71で基端側規制部74を構成する。これら規制部73、74は、挿入部10の先端近傍に設けられていることが好ましい。駆動ワイヤ40は、引張り応力で伸びて全長が変化するし、挿入部10の形状によって挿入部10に対する駆動ワイヤ40の先端の位置が変化する。このため、規制部73、74を挿入部10の基端側に設けても、突出可能部50と駆動ワイヤ40の先端との相対的な位置がズレるからである。
固定部51は、段部21bの基端側の面と蓋部材76とにより長手方向Dに挟まれた状態で、公知の接着剤等により口金21及び蓋部材76に水密に取付けられている。口金21と蓋部材76とを、ネジ部材により固定してもよい。
一方で、図11に示す状態から駆動ワイヤ40を引き戻すと、拡径部71が図12に示す位置Q1に移動して縮径部21aに当接し、シャフト52が基端側に移動して退避状態になる。縮径部21aに拡径部71が当接することで、挿入部10に対して駆動ワイヤ40が基端側に移動する範囲が規制される。
固定部51は段部21b及び蓋部材76により挟まれているため、シャフト52が長手方向Dに移動しても、口金21の先端部と固定部51との間は確実に水密に保持される。
本変形例では、内視鏡1Bが先端側規制部73及び基端側規制部74の一方だけを備えるように構成してもよい。
挿入部10には第一のチャンネル11が形成されていなくてもよい。この場合、駆動ワイヤ40は、挿入部10内に前述の電線等とともに挿通される。駆動ワイヤ40は、挿入部10内でコイルに挿通されていることが好ましい。
本実施形態では、第一のチャンネル11の基端部が鉗子口32に開口するとともに、レバー35がピン36により鉗子口32に回転可能に支持されるように構成されてもよい。
次に、本発明の第2実施形態について図13から図20を参照しながら説明するが、前記実施形態と同一の部位には同一の符号を付してその説明は省略し、異なる点についてのみ説明する。
本体部80の長手方向の中間部には、一対の貫通孔81が形成されている。一対の貫通孔は、互いに対向する位置に、本体部80の外周面から内周面まで貫通して形成されている。本体部80の内周面の基端側には、径方向内方に突出する板状の支持部材82が設けられている。本体部80及び支持部材82は、ポリプロピレン樹脂やポリカーボネート樹脂等の生体適合性を有する樹脂で一体に形成されている。
本体部80の内径は、挿入部10の先端硬質部14の外径よりもわずかに大きい。このため、先端硬質部14に本体部80を圧入して固定することができる。
各腕部材92は、軸部材91に対してほぼ直交する方向且つ本体部80の斜め前方に向かって延びている。一対の軸部材91及び一対の腕部材92のそれぞれは、第一の基準平面S1上に配置されている。連結部材93は、第一の基準平面S1に交差する平面上で、先端側に向かって凸となる湾曲した形状に形成されている。
図15に示すように、一対の軸部材91の軸線を含み長手方向Dに平行な第二の基準平面S2に対して、一対の腕部材92と受け部材94とは同じ側に配置されている。
バー90は、各軸部材91が本体部80の各貫通孔81内で回転することで、本体部80に対して一対の貫通孔81を中心として回転することができる。
図15に示すように、自然状態において、連結部材93は、本体部80の先端側の開口80aの縁部よりも先端側の位置に配置されている。自然状態において連結部材93が本体部80の開口80aの中央部よりも先端側の位置を避けて配置されていることで、撮像ユニット18の視野を妨げないように構成されている。
バネ部材100の先端部は受け部材94に、基端部は支持部材82にそれぞれ取付けられている。
すなわち、図14及び図15に示すように、アタッチメント3の本体部80の基端側の開口から挿入部10を挿入する。挿入部10に対してアタッチメント3を本体部80の中心軸線C周りに回転させ、突出可能部50のシャフト52よりも先端側に受け部材94が配置されるようにする。これにより、挿入部10に対するアタッチメント3の周方向の位置が規定(位置決め)される。
挿入部10にアタッチメント3を押込み、図15に示すように支持部材82の基端面に挿入部10の先端面14aを接触させる。これにより、挿入部10に対するアタッチメント3の、挿入部10の長手方向Dの位置が規定される。このとき、受け部材94の基端側の外面にシャフト52の先端部が接触する。
患者の口等の自然開口から、アタッチメント3が取付けられた挿入部10を挿入する。アタッチメント3を、切除すべき目的部位である図15に示す病変粘膜部分P6まで挿入する。
図示はしないが、第二のチャンネル12を通して公知の注射針を体腔内に挿入し、アタッチメント3よりも先端側に注射針を突出させ、病変粘膜部分P6の粘膜下層P7に生理食塩水を注入して、その病変粘膜部分P6を***させてもよい。この後で、注射針を第二のチャンネル12から引き抜いて抜去しておく。
第二のチャンネル12を通して高周波ナイフを体腔内に挿入し、アタッチメント3よりも先端側に突出させる。挿入した高周波ナイフで、病変粘膜部分P6の周囲の粘膜P8の一部を切開する。この後で、高周波ナイフを第二のチャンネル12内に引き戻しておく。
連結部材93に支持された病変粘膜部分P6は、粘膜下層P7から剥離(挙上)される。この後、第二のチャンネル12内の高周波ナイフW2をアタッチメント3よりも先端側に突出させ、病変粘膜部分P6を切除する。
第二のチャンネル12を通して挿入した図示しない把持鉗子で、切除した病変粘膜部分P6を回収する。
患者の口から内視鏡1の挿入部10を引き抜き、必要な処置をして一連の処置を終了する。
シャフト52を退避状態から突出状態にしたときに、バー90の連結部材93が中心軸線Cに交差する方向Fに移動することで、連結部材93で支持した病変粘膜部分P6を粘膜下層P7から剥離することができる。
各突起110は、連結部材93が前述の交差する方向Fに移動するにしたがって、各腕部材92に接触する部分間の間隔が広がるように形成されている。すなわち、一対の突起110全体としての幅は、自然状態における一対の腕部材92間の距離よりも広い(長い)。
このように構成されたアタッチメント3Aを挿入部10に取付け、シャフト52を退避状態から突出状態にすると、各腕部材92は突起110に接触して、図18に位置Q2として示すように、一対の腕部材92間の距離が広がるように弾性的に変形するとともに移動する。このとき、連結部材93も位置Q3として示すように、弾性的に変形するとともに移動する。
シャフト52を退避状態にすると、一対の腕部材92及び連結部材93の弾性力によりバー90が一対の貫通孔81を中心として回転し、一対の腕部材92間の距離が図17に示す元の状態に戻る。
このように構成すると、支持部材82の貫通孔82aにシャフト52を挿通させることで、挿入部10に対するアタッチメント3Bの周方向の位置を容易に規定することができる。すなわち、貫通孔82aは、アタッチメント3Bの周方向の位置決め指標として機能する。この場合、挿入部10にアタッチメント3Bを取付けた状態の外面にこの位置決め指標が設けられないため、挿入部10の挿入性を維持することができる。
例えば、前記第1実施形態および第2実施形態では、挿入部10の外面は先端硬質部14の先端面14aである例を示したが、外面は挿入部10の側面であってもよい。
軟性の内視鏡1を例示したが、挿入部が硬い、いわゆる硬性の内視鏡であってもよい。この場合、軸状部材として可撓性のない棒状部材を用いることで、力の伝達性能を向上させることができる。
2 内視鏡システム
3、3A、3B アタッチメント(キャップ)
10 挿入部
14a 先端面(外面)
30 操作部
40 駆動ワイヤ(軸状部材)
50 突出可能部
51、61 固定部
52 シャフト(移動部)
53、62 連結部
66、67 大径部
66a、67a 凹部
73 先端側規制部
74 基端側規制部
80 本体部
90 バー(移動部材)
F 交差する方向
Claims (8)
- 挿入部と、
前記挿入部の基端部に取付けられた操作部と、
前記挿入部内に挿通されるとともに基端部が前記操作部まで延び、前記挿入部に対して進退可能な軸状部材と、
前記挿入部の先端部に設けられた突出可能部と、
を備え、
前記突出可能部は、
前記挿入部の外面に水密に取付けられた固定部と、
先端が外部に露出した状態に設けられ、前記軸状部材が進退することで前記外面に交差する方向に移動可能な移動部と、
弾性的に変形可能であって前記固定部と前記移動部とを水密に連結する連結部と、
を有する内視鏡。 - 前記挿入部に対して前記軸状部材が先端側に移動する範囲を規制する先端側規制部を備える請求項1に記載の内視鏡。
- 前記挿入部に対して前記軸状部材が基端側に移動する範囲を規制する基端側規制部を備える請求項1に記載の内視鏡。
- 前記軸状部材が基端側に移動したときに前記軸状部材と前記移動部とは離間し、
前記軸状部材が先端側に移動したときに前記軸状部材で前記移動部を先端側に押すように構成されている請求項1に記載の内視鏡。 - 前記移動部の基端部は、前記連結部よりも基端側に突出するように形成され、
前記移動部の基端部及び前記軸状部材の先端部の一方には接続部が設けられ、前記接続部が設けられた前記移動部の基端部または前記軸状部材の先端部の他方には、前記接続部の外径よりも大きな大径部が設けられている請求項4に記載の内視鏡。 - 前記大径部における前記接続部に対向する面には、前記接続部から離間する方向に向かって凹んだ凹部が形成されている請求項5に記載の内視鏡。
- 前記軸状部材と前記移動部とが連結されている請求項1に記載の内視鏡。
- 請求項1に記載の内視鏡と、
前記内視鏡の前記挿入部の前記外面である挿入部先端に着脱可能なキャップと、
を備え、
前記キャップは、
筒状に形成され、基端部が前記挿入部に取付けられる本体部と、
前記本体部に移動可能に取付けられ、前記挿入部に前記本体部を取付けて、前記移動部を前記挿入部先端から基端側に向かうように移動した状態から前記挿入部先端から先端側に向かうように移動した状態に移動させたときに、前記本体部の中心軸線に交差する方向に移動して前記本体部よりも先端側の位置に移動する移動部材と、
を有する内視鏡システム。
Priority Applications (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
CN201480055924.XA CN105636495B (zh) | 2014-03-12 | 2014-12-16 | 内窥镜和内窥镜*** |
EP14885494.6A EP3117756A4 (en) | 2014-03-12 | 2014-12-16 | Endoscope and endoscope system |
JP2015535266A JP5826981B1 (ja) | 2014-03-12 | 2014-12-16 | 内視鏡及び内視鏡システム |
US15/086,482 US20160206177A1 (en) | 2014-03-12 | 2016-03-31 | Endoscope and endoscope system |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP2014048870 | 2014-03-12 | ||
JP2014-048870 | 2014-03-12 |
Related Child Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US15/086,482 Continuation US20160206177A1 (en) | 2014-03-12 | 2016-03-31 | Endoscope and endoscope system |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2015136807A1 true WO2015136807A1 (ja) | 2015-09-17 |
Family
ID=54071272
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/JP2014/083310 WO2015136807A1 (ja) | 2014-03-12 | 2014-12-16 | 内視鏡及び内視鏡システム |
Country Status (5)
Country | Link |
---|---|
US (1) | US20160206177A1 (ja) |
EP (1) | EP3117756A4 (ja) |
JP (1) | JP5826981B1 (ja) |
CN (1) | CN105636495B (ja) |
WO (1) | WO2015136807A1 (ja) |
Families Citing this family (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN110799080B (zh) * | 2017-06-30 | 2021-11-19 | 奥林巴斯株式会社 | 内窥镜和放电控制部 |
Citations (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JP2000014631A (ja) * | 1998-07-02 | 2000-01-18 | Olympus Optical Co Ltd | 内視鏡システム |
JP2004065679A (ja) * | 2002-08-07 | 2004-03-04 | Olympus Corp | 内視鏡処置システム |
JP2006304830A (ja) * | 2005-04-26 | 2006-11-09 | Olympus Medical Systems Corp | 内視鏡装置 |
JP2010069003A (ja) * | 2008-09-18 | 2010-04-02 | Olympus Medical Systems Corp | 医療用進退量規制機構と医療用進退量規制方法 |
WO2010093042A1 (ja) * | 2009-02-16 | 2010-08-19 | オリンパスメディカルシステムズ株式会社 | カプセル型医療装置 |
Family Cites Families (8)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3899829A (en) * | 1974-02-07 | 1975-08-19 | Fred Storm Ind Designs Inc | Holder and actuator means for surgical instruments |
US6059719A (en) * | 1997-08-06 | 2000-05-09 | Olympus Optical Co., Ltd. | Endoscope system |
JP3923022B2 (ja) * | 2003-02-28 | 2007-05-30 | オリンパス株式会社 | 内視鏡用処置具 |
US8377044B2 (en) * | 2007-03-30 | 2013-02-19 | Ethicon Endo-Surgery, Inc. | Detachable end effectors |
US8167845B2 (en) * | 2009-06-02 | 2012-05-01 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Catheter having distal sealing member |
US9763567B2 (en) * | 2010-10-20 | 2017-09-19 | Covidien Lp | Endoscope wiper blade cleaner |
JP5343102B2 (ja) * | 2011-03-25 | 2013-11-13 | 富士フイルム株式会社 | 内視鏡用処置具 |
US9661987B2 (en) * | 2011-06-07 | 2017-05-30 | Boston Scientific Scimed, Inc. | Disposable sheath |
-
2014
- 2014-12-16 WO PCT/JP2014/083310 patent/WO2015136807A1/ja active Application Filing
- 2014-12-16 JP JP2015535266A patent/JP5826981B1/ja not_active Expired - Fee Related
- 2014-12-16 EP EP14885494.6A patent/EP3117756A4/en not_active Withdrawn
- 2014-12-16 CN CN201480055924.XA patent/CN105636495B/zh active Active
-
2016
- 2016-03-31 US US15/086,482 patent/US20160206177A1/en not_active Abandoned
Patent Citations (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JP2000014631A (ja) * | 1998-07-02 | 2000-01-18 | Olympus Optical Co Ltd | 内視鏡システム |
JP2004065679A (ja) * | 2002-08-07 | 2004-03-04 | Olympus Corp | 内視鏡処置システム |
JP2006304830A (ja) * | 2005-04-26 | 2006-11-09 | Olympus Medical Systems Corp | 内視鏡装置 |
JP2010069003A (ja) * | 2008-09-18 | 2010-04-02 | Olympus Medical Systems Corp | 医療用進退量規制機構と医療用進退量規制方法 |
WO2010093042A1 (ja) * | 2009-02-16 | 2010-08-19 | オリンパスメディカルシステムズ株式会社 | カプセル型医療装置 |
Non-Patent Citations (1)
Title |
---|
See also references of EP3117756A4 * |
Also Published As
Publication number | Publication date |
---|---|
US20160206177A1 (en) | 2016-07-21 |
JPWO2015136807A1 (ja) | 2017-04-06 |
CN105636495A (zh) | 2016-06-01 |
EP3117756A4 (en) | 2018-01-10 |
JP5826981B1 (ja) | 2015-12-02 |
CN105636495B (zh) | 2018-01-30 |
EP3117756A1 (en) | 2017-01-18 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US5632717A (en) | Penetrating endoscope | |
US20140336456A1 (en) | Method and apparatus for steerable, rotatable, microendoscope with tool for cutting, coagulating, desiccating and fulgurating tissue | |
JP4794564B2 (ja) | 内視鏡用処置具 | |
JP6084338B2 (ja) | 内視鏡的粘膜下層剥離術用デバイス及び内視鏡システム | |
JP6266755B2 (ja) | 内視鏡用外科手術装置、処置具、及びガイド部材 | |
JPH08275950A (ja) | 超音波切開凝固装置 | |
JP6266756B2 (ja) | 外装管及び内視鏡用外科手術装置 | |
JP5159968B2 (ja) | 内視鏡処置具 | |
JP6013672B1 (ja) | 内視鏡システム | |
JP5178369B2 (ja) | 内視鏡用処置具 | |
JP2006187471A (ja) | 内視鏡用処置具 | |
WO2016147787A1 (ja) | 挿入機器の挿入部装着具、挿入システム | |
JP5826981B1 (ja) | 内視鏡及び内視鏡システム | |
JP3805652B2 (ja) | 内視鏡鉗子口用アダプタ | |
US20170303953A1 (en) | Surgical Instruments with Selectively Rotating Handles | |
WO2020080236A1 (ja) | 内視鏡、及び処置具チャンネルユニット | |
JP2006087609A (ja) | 生体組織採取装置 | |
US20170215709A1 (en) | Assist device and endoscopic system | |
JP3766674B2 (ja) | 超音波切開凝固装置 | |
JP2005329078A (ja) | 内視鏡用穿刺針装置 | |
JP7459311B2 (ja) | 処置具 | |
JP6531174B2 (ja) | 内視鏡用外科手術装置及び案内装置 | |
JP2023067805A (ja) | 内視鏡用処置具 | |
JP4257189B2 (ja) | 超音波切開凝固装置 | |
JP2024505222A (ja) | 一体型可視化装置を有する円形ステープリングデバイス |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
ENP | Entry into the national phase |
Ref document number: 2015535266 Country of ref document: JP Kind code of ref document: A |
|
121 | Ep: the epo has been informed by wipo that ep was designated in this application |
Ref document number: 14885494 Country of ref document: EP Kind code of ref document: A1 |
|
NENP | Non-entry into the national phase |
Ref country code: DE |
|
REEP | Request for entry into the european phase |
Ref document number: 2014885494 Country of ref document: EP |
|
WWE | Wipo information: entry into national phase |
Ref document number: 2014885494 Country of ref document: EP |
|
REEP | Request for entry into the european phase |
Ref document number: 2014885494 Country of ref document: EP |