JP4727158B2 - 内視鏡システム - Google Patents
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- JP4727158B2 JP4727158B2 JP2004084438A JP2004084438A JP4727158B2 JP 4727158 B2 JP4727158 B2 JP 4727158B2 JP 2004084438 A JP2004084438 A JP 2004084438A JP 2004084438 A JP2004084438 A JP 2004084438A JP 4727158 B2 JP4727158 B2 JP 4727158B2
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- 238000011282 treatment Methods 0.000 claims description 219
- 230000002093 peripheral effect Effects 0.000 claims description 10
- 241000617482 Kiwa Species 0.000 claims description 7
- 238000001839 endoscopy Methods 0.000 claims 1
- 238000003780 insertion Methods 0.000 description 178
- 230000037431 insertion Effects 0.000 description 178
- 238000000605 extraction Methods 0.000 description 28
- 230000007246 mechanism Effects 0.000 description 17
- 230000005540 biological transmission Effects 0.000 description 11
- 238000010586 diagram Methods 0.000 description 4
- 238000005286 illumination Methods 0.000 description 2
- 239000011347 resin Substances 0.000 description 2
- 229920005989 resin Polymers 0.000 description 2
- 230000004308 accommodation Effects 0.000 description 1
- 239000000470 constituent Substances 0.000 description 1
- 210000001035 gastrointestinal tract Anatomy 0.000 description 1
- 238000003384 imaging method Methods 0.000 description 1
- 239000004615 ingredient Substances 0.000 description 1
- 238000007689 inspection Methods 0.000 description 1
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- 238000000034 method Methods 0.000 description 1
- 230000003287 optical effect Effects 0.000 description 1
- 230000000149 penetrating effect Effects 0.000 description 1
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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
- A61B1/012—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
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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
- A61B1/00131—Accessories for endoscopes
- A61B1/00133—Drive units for endoscopic tools inserted through or with the endoscope
Description
この発明は、このような事情に鑑みてなされたものであり、その目的とするところは、処置具を機械的に挿抜させる内視鏡システムにおいて、処置具の回転を容易に行えるようにすることである。
この内視鏡システムは、駆動手段の向きを変向させる変向手段を備え、駆動手段を第一の方向に向けた状態で稼動させると、処置具がチャンネルに挿抜される。処置具をその軸線回りに回転させる場合には、処置具をチャンネルに挿通させた状態で、駆動手段の向きを第一の方向から90度変向させ、第二の方向に設定する。この状態で駆動手段を駆動させると処置具が回転する。
この内視鏡システムでは、第一の方向から駆動手段を90度変向させた向きが第二の方向になる。このため、処置具を直交する2通りの方向に駆動させることが可能になる。
この内視鏡システムは、ローラを用いることで、簡単な構成で確実に挿入部を駆動させる。
この内視鏡システムは、切替手段を有し、複数のローラを用いて挿入部を駆動させる際に、その駆動方向に合わせてローラの回転方向を設定する。このため、処置具の挿抜や回転を確実に行えるようになる。
この内視鏡システムは、ローラに凹凸を設けたので、挿入部とローラとの間の滑りが防止される。このため、処置具の挿抜や回転を確実に行えるようになる。
この内視鏡システムは、ガイド部材によって挿入部の位置が規制されるので、駆動手段を変向させたときでも、挿入部と駆動手段との接触を保ちやすい。
この内視鏡システムは、挿入部の表面に凹凸が設けられているので、駆動手段を変向させたときでも、挿入部と駆動手段との接触を保ちやすい。
この内視鏡システムは、挿入部の断面が多角形状になっているので、駆動手段を変向させたときでも、挿入部と駆動手段との接触を保ちやすい。
この内視鏡システムは、ローラと内視鏡挿入部との接触部分を回転軸として駆動手段が回転するので、第一の方向と第二の方向とに変向する際に、ローラと挿入部との接触状態が保持される。
この内視鏡システムは、駆動手段と、ワイヤ駆動手段とを備え、挿入部とワイヤとをそれぞれ駆動させる。また、変向手段によって駆動手段及びワイヤ駆動手段を変向させることができる。駆動手段及びワイヤ駆動手段を第一の方向に向けた状態で稼動させると、処置具がチャンネルに挿抜される。また、駆動手段及びワイヤ駆動手段を第二の方向に向けた状態で駆動させると、処置具がその軸線回りに回転させられる。
この内視鏡システムは、ワイヤが挿通される操作管をワイヤ駆動手段で駆動させることで、ワイヤを進退させたり、回転させたりする。
この内視鏡システムは、第一の駆動モードが選択されたときには、挿入部及びワイヤが同期して同じ方向に駆動される。これに対して、第二の駆動モードが選択されたときには、挿入部を停止させた状態で、ワイヤのみが駆動される。
この内視鏡システムは、駆動手段が挿入部をチャンネルの軸線方向に沿って駆動させる。挿入部をチャンネルに挿通させた状態で、駆動手段を回転させると、駆動手段と共に挿入部がチャンネルの軸線回りに回転し、その結果として、処置具がその軸線回りに回転する。
図1に第1の実施の形態における内視鏡システムの概略構成を示す。
図1に示すように、内視鏡1は、施術者などの内視鏡操作者が操作する操作部2を有し、操作部2の先端には体腔内に挿入される可撓性の挿入部3が設けられている。挿入部3の先端には、不図示の撮像装置や照明用の光学系などが設けられると共に、処置具4を挿通させる処置具チャンネル5の先端開口6が形成されている。処置具チャンネル5は、挿入部3の先端から操作部2の基端に至るまで、内視鏡1内を貫通しており、操作部2の基端側に処置具4を挿入する挿入口8が形成されている。そして、操作部2の基端には、処置具挿抜装置9を介して処置具4の収容装置10が取り付けられている。
操作ワイヤ25は、処置具挿入部21内を挿通しており、操作ワイヤ25及び処置具挿入部21は、処置具チャンネル7を通り、その基端側の挿入口8から引き出され、処置具挿抜装置9を通った後に、収容装置10に巻き取られている。
さらに、ローラ33の回転軸36には、伝達機構39が連結されている。この伝達機構39は、ギヤなどから構成されており、モータ40の回転を減速させつつ、回転軸36に伝達するようになっている。同様に、ローラ34の回転軸37には、伝達機構41が連結されている。この伝達機構41は、モータ42の回転を減速させつつ、回転軸37に伝達するようになっている。各モータ40,42及び各伝達機構39,41は、ローラ支持部38に固定されている。各モータ40,42からは、通電用の端子43,44が延設されている。この端子43,44はその先端がローラ支持部38の外側に突出し、不図示の電源ケーブルによって電源に接続されている。
ここで、図3に示すように、他方の側面46bの前面46c側の部分は、貫通溝45の閉塞端に相当する部分が切り欠かれている。この切欠部47の幅は、貫通溝45の幅と略等しく、その長さは、ローラ支持部38の前面46cから各ローラ33,34の回転軸36,37までの距離よりも長く、前面46cから背面46dまでの距離よりは短い。
変向手段50は、回転軸48,49と、回転軸49を回転させる伝達機構51及びモータ52とから構成されている。回転軸48,49は、所定の直線上に配置されている。所定の直線とは、ローラ33とローラ34のそれぞれが処置具挿入部21に接する部分を通り、かつ各ローラ33,34の径方向に沿った直線である。回転軸48は、ベアリング(不図示)などを介してハウジング31に回転自在に支持されている。回転軸49は、伝達機構51を介してモータ52に連結されている。伝達機構51は、ギヤなどから構成され、モータ52の回転を減速させつつ、回転軸49に伝達するようになっている。モータ52は、ハウジング31に固定されており、回転軸49を回転駆動させることで、ローラ支持部38や、ローラ33,34などからなる挿入部駆動手段35を、回転軸48,49の軸線回りに約90度回転させるようになっている。
内視鏡1の操作部2に設けられたスイッチ11に、挿入部駆動手段35の各ローラ33,34を駆動させる駆動スイッチ11aと、変向手段50のモータ52を駆動させる旋回スイッチ11bとが含まれている。駆動スイッチ11aは、「挿通」、「抜去」、「前進」、「後退」が設定可能なスイッチであって、操作部2内に設けられた制御部55の駆動制御部(ドライバ回路)56と、変向制御部(ドライバ回路)58とに接続されている。
また、旋回スイッチ11bは、「右回転」、「左回転」が設定可能なスイッチであって、制御部55の駆動制御部56と、変向制御部58とに接続されている。
なお、制御部55は、挿入部駆動手段35の構成要素であって、処置具挿抜装置9内に設けられることが好ましいが、内視鏡1の操作部2内に設けても良い。
収容装置10は、処置具挿抜装置9の基端側の開口を覆うように取り付けられるリールカバー61を有し、リールカバー61内には、リール62が回転自在に支持されている。
リール62の回転軸63は、処置具チャンネル7の軸線からオフセットされた位置で、かつ軸線と略直交する向きに配置されている。回転軸63を処置具チャンネル7に対してオフセットしてあるのは、リール62に巻き取られた処置具4を、スムーズに処置具挿抜装置9に送り出すためで、この実施の形態では、処置具チャンネル7の軸線を基準にして、ユニバーサルケーブル13側とは反対側となる位置に、回転軸63が配置されている。
また、リール62は、回転軸63の長さ方向の両縁部が拡径され、つば部64が形成されている。そして、2つのつば部64で区画されるリール62の外周面62aには、処置具4の処置具挿入部21が巻き取られている。
挿入部駆動手段35で処置具4を処置具チャンネル7から抜去するときには、駆動スイッチ11aを抜去方向に設定する。各ローラ33,34が前述とは逆方向に回転し、処置具挿入部21が引き戻され、その先端部分を除いて収容装置10内に巻き取られる。
なお、処置具チャンネル7に処置具4を挿通させた状態で、処置部22を体腔内の目的部位に対して前進又は後退させる場合は、それぞれ挿通又は抜去と同様に操作で行うことができる。
すなわち、変向制御部58(図4参照)からモータ52に駆動信号を出力させ、挿入部駆動手段35を回転軸48,49回りに回転させる。これにより、ガイド部材32及び処置具挿入部21の位置は変わらずに、処置具挿入部21とローラ33,34との接触部分を中心にして、ローラ支持部38が回転する。
また、変向手段50は、各ローラ33,34と処置具挿入部21とが接触する部分を中心にして、ローラ33,34を変向させるようにしたので、各ローラ33,34と処置具挿入部21との接触を確実に維持させることができる。さらに、処置具挿入部21をガイド部材32内に挿通させるようにしたので、ローラ33,34の変向過程において処置具挿入部21がローラ33,34の間から外れることはない。
例えば、図7に示すように、ローラ71の外表面に沿って等間隔に凸部72を形成する。この凸部72は、ローラ71の幅方向に延びている。さらに、凸部72に、周方向に沿った溝を数条設けても良い。これらのように、ローラ71の外周面に凹凸を設けることで、ローラ71の外周面と処置具挿入部21との間の摩擦を増大させることができる。
また、図8に示すように、処置具挿入部21は、凹凸を有する樹脂製の素線を密巻きにしたコイル74から構成しても良い。処置具挿入部21の外表面に凹凸のパターンを設けることで、ローラ33,34の外周面との摩擦を増大させることができる。
また、図10に示すように、円筒形の外面を多角形に削っても良い。このような処置具挿入部78は、ローラ33,34の外周面が、多角形状により形成される平面78a,78bのそれぞれに当接するように配置すると良い。
これらの手段(ガイド部材32を含む)の少なくとも一つを備えることで、ローラ33,34の回転を確実に伝達し、処置具挿入部を所望の方向に駆動できるようになる。
この実施の形態は、2組のローラを有し、処置具挿入部と操作ワイヤとを独立に回転させることができることを特徴とする。
ワイヤ駆動手段91は、挿入部駆動手段90よりも所定長だけ操作部82の基端側に配置され、処置具挿入部85の挿抜と、操作ワイヤ25の駆動とを行う手段であり、第二変向手段93により操作部82内に回転自在に支持されている。ワイヤ駆動手段91及び第二変向手段93の構成は、第1の実施の形態におけるそれぞれ挿抜駆動手段35及び変向手段50と同様である。なお、区別のために、ワイヤ駆動手段91及び第二変向手段93の構成要素の符号には、「a」を付してある。ここで、モータ40a及びモータ42aは、ブレーキ(例えば、電磁ブレーキ)付きのモータである。また、ワイヤ駆動手段91と挿入部駆動手段90との間の距離は、処置具84を処置具チャンネル88に挿通させた状態で、挿入部駆動手段90のローラ33,34が処置具挿入部85に圧接し、ワイヤ駆動手段91のローラ33a,33bが操作管86に圧接するような距離である。
駆動スイッチ11aは、「挿通」、「抜去」、「前進」、「後退」が設定可能なスイッチであって、制御部95の駆動制御部96と、変向制御部97とに接続されている。
旋回スイッチ11bは、「右回転」、「左回転」が設定可能なスイッチだって、制御部95の駆動制御部96と、変向制御部97とに接続されている。
モード切替スイッチ11cは、操作部82のスイッチ11の一つである。このモード切替スイッチ11cは、挿入部駆動手段90とワイヤ駆動手段91とを同時に駆動させる第一の駆動モードと、ワイヤ駆動手段91のみを駆動させる第二の駆動モードと、挿入部駆動手段90のみを駆動させる第三の駆動モードとが選択できるようになっている。モード切替スイッチ11cは、モード設定部98に接続されており、モード設定部98は、モードに応じた信号を駆動制御部96に受け渡すようになっている。
変向制御部97は、電源57と、2つのモータ52,52aとに接続されている。さらに、変向制御部97からは、挿入部駆動手段90の向きの情報、及びワイヤ駆動手段91の向きの情報が駆動制御部96に受け渡されるようになっている。
また、処置具84を処置具チャンネル88から抜去する際には、駆動スイッチ11aを抜去方向に設定する。各ローラ33,34,33a,34aが、前述の方向とはそれぞれ逆方向に回転し、処置具挿入部85が引き戻され、その先端部分を除いて収容装置10内に巻き取られる。
なお、処置具4を前進又は後退させる場合には、それぞれ挿通又は抜去と同様の操作で行うことができる。
さらに、操作ワイヤ25を固定し、処置具挿入部85を回転させる場合には、モード切替スイッチ11cを第三の駆動モードに設定してから駆動スイッチ11aを右回転又は左回転に設定する。これにより、挿入部駆動手段90によって、処置具挿入部85が回転する。ワイヤ駆動手段91のモータ40a,42aにはブレーキが掛けられるので、操作ワイヤ25は回転しない。
さらに、第一変向手段92及び第二変向手段93が第二の方向を向いているときに、駆動スイッチ11aを操作すると、変向制御部96が変向手段51,51aのモータ52,52aを稼動させて、第一変向手段92及び第二変向手段93を第一の方向に変向させる。第一変向手段92及び第二変向手段93の変向が終了したら、続いて駆動制御部96が稼動し、ローラ33,34,33a,34aを必要な方向に回転させる。
図14に示すように、この実施の形態では、挿入部駆動手段100を手動で回転させる回転連結手段101を備えている。
係合部103は、処置具挿抜装置102の軸線に沿って伸び、その先端部103aが、前記軸線と略直交する方向で、かつ外側に屈曲されている。係合部103は処置具挿入部21を挿通可能な間隔を置いて配置されており、処置具挿抜装置102を処置具チャンネル7の軸線を中心軸として回転させるようになっている。
また、被係合部107は、係合部103を回転自在に嵌合可能な凹形状になっている。
処置具挿入部21を処置具チャンネル7に挿通させた状態で、処置具4をその軸線回りに回転させるときには、モータ40,42を停止させ、処置具挿抜装置102を操作部106に対して手動で回転させる。処置具挿抜装置102は、回転連結手段101によって、処置具チャンネル7の軸線回りに回転し、処置具挿抜装置102に固定されている挿入部駆動手段100も処置具チャンネル7の軸線回りに回転する。このとき、各モータ40,42には、ブレーキが掛けられているので、挿入部駆動手段100の一対のローラ33,34に挟持されている処置具挿入部21が、処置具挿抜装置102と一緒に回転する。処置具4の軸線と処置具チャンネル7の軸線とは略一致しているので、挿入部駆動手段100が回転することで、処置具4がその軸線回りに回転する。
ここにおいて、処置具挿抜装置102は、内側から操作部106に回転自在に係合しているが、操作部106の外側面を覆うようにして回転自在に係合しても良い。
また、回転連結手段101は、係合部103の外周に歯車を形成し、この歯車と噛み合うモータを操作部106内に設けても良い。このように構成すると、モータの回転によって処置具挿抜装置102を操作部106に対して回転駆動させることが可能になる。
さらに、処置具挿抜装置102は、図11に示すような挿入部駆動手段90及びワイヤ駆動手段91をハウジング31に直接固定した構成でも良い。この場合には、処置具84の挿抜及び操作ワイヤ25の進退が可能になると共に、回転連結手段106によって処置具84をその軸線回りに回転させることが可能になる。
例えば、第1の実施の形態において、ガイド部材32を有しなくても良い。また、第2の実施の形態及び第3の実施の形態において、ガイド部材32を設けても良い。
第1の実施の形態において、処置具挿抜装置9は、操作部2に一体的に固定されても良いし、操作部2に着脱自在であっても良い。着脱自在である場合には、処置の内容に応じて、処置具を交換することが可能になる。
各駆動手段35,90,91,100において、モータ40,42,40a,42aを、ローラ33,34,33a,34aの回転軸36,37,36a,37aに直結させても良い。
さらに、各駆動手段35,90,91,100は、ガイド部材32に押し付けて摩擦を利用しても良い。
4,84 処置具(内視鏡用処置具)
7,88 処置具チャンネル
21,75,76,77,85 処置具挿入部
22 処置部
31 ハウジング
32 ガイド部材
32a,32b 開口
33,34,71 ローラ
35,100 挿入部駆動手段
50 変向手段
55 制御部(切替手段)
72 凸部
74 シース
86 操作管
90 挿入部駆動手段
91 ワイヤ駆動手段
92 第一変向手段(変向手段)
93 第二変向手段(変向手段)
101 回転連結手段
Claims (13)
- チャンネルを有する内視鏡と、
前記チャンネルに挿通される可撓性の挿入部と、
前記挿入部の先端に設けられ、目的部位を処置する処置部を有する処置具と、
前記挿入部に当接して前記挿入部を所定の駆動方向に駆動させる駆動手段と、
前記駆動手段の向きを第一の方向と第二の方向とに変向させる変向手段とを備え、
前記第一の方向は、前記挿入部をその軸線方向に駆動させる方向であり、前記第二の方向は、前記挿入部を前記軸線回りに回転させる方向であることを特徴とする内視鏡システム。 - 前記変向手段は、前記駆動手段を軸線方向に関して90度変向させる手段であることを特徴とする請求項1に記載の内視鏡システム。
- 前記駆動手段は、前記挿入部に当接するローラを有することを特徴とする請求項1又は請求項2に記載の内視鏡システム。
- 前記駆動手段は、複数の前記ローラと、前記ローラのうちの少なくとも1つの回転方向を前記ローラの変向に伴って切り替える切替手段とを有することを特徴とする請求項3に記載の内視鏡システム。
- 前記ローラの周面に凹凸を設けたことを特徴とする請求項3又は請求項4に記載の内視鏡システム。
- 前記駆動手段を変向自在に支持するハウジングと、
前記ハウジングに固定され、前記挿入部を内部に挿通させるガイド部材とを備え、
前記ガイド部材には、前記駆動手段と前記挿入部とが当接可能な開口が設けられていることを特徴とする請求項1から請求項5のいずれか一項に記載の内視鏡システム。 - 前記挿入部は、前記駆動手段が当接する部分の表面に凹凸が設けられていることを特徴とする請求項1から請求項6のいずれか一項に記載の内視鏡システム。
- 前記挿入部は、前記駆動手段が当接する部分の断面形状が多角形であることを特徴とする請求項1から請求項7のいずれか一項に記載の内視鏡システム。
- 前記変向手段の回転軸は、前記ローラと前記挿入部との接触部分を通り、かつ前記ローラの径方向に沿う線上に設けられていることを特徴とする請求項3に記載の内視鏡システム。
- チャンネルを有する内視鏡と、
前記チャンネルに挿通される可撓性の挿入部と、
前記挿入部の先端に設けられ、前記挿入部内を通るワイヤにより操作されて目的部位を処置する処置部を有する処置具と、
前記挿入部に当接して前記挿入部を所定の駆動方向に駆動させる駆動手段と、
前記ワイヤを所定の駆動方向に駆動させるワイヤ駆動手段と、
前記駆動手段及び前記ワイヤ駆動手段の向きを第一の方向と第二の方向とに変向させる変向手段とを備え、
前記第一の方向は、前記挿入部及び前記ワイヤをそれぞれの軸線方向に駆動させる方向であり、前記第二の方向は、前記挿入部及び前記ワイヤをそれぞれの前記軸線回りに回転させる方向であることを特徴とする内視鏡システム。 - 前記挿入部の基端に連結された管を有し、前記管内には前記ワイヤが挿通されると共に、前記管に前記ワイヤ駆動手段を当接させたことを特徴とする請求項10に記載の内視鏡システム。
- 前記駆動手段及び前記ワイヤ駆動手段の駆動制御を行う制御手段を備え、
前記制御手段は、前記駆動手段及び前記ワイヤ駆動手段を同期して駆動させる第一の駆動モードと、前記駆動手段を停止させる一方で前記ワイヤ駆動手段を駆動させる第二の駆動モードとが選択可能であることを特徴とする請求項10に記載の内視鏡システム。 - チャンネルを有する内視鏡と、
前記チャンネルに挿通される可撓性の挿入部と、
前記挿入部の先端に設けられ、目的部位を処置する処置部を有する処置具と、
前記挿入部に当接して前記挿入部を前記チャンネルの軸線方向に沿って駆動させる駆動手段と、
前記駆動手段を前記チャンネルの軸線回りに回転自在に前記内視鏡に係合させる回転連結手段と、を備える内視鏡システム。
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US20080103358A1 (en) | 2008-05-01 |
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