JP5472875B2

JP5472875B2 - Lighting device

Info

Publication number: JP5472875B2
Application number: JP2008173382A
Authority: JP
Inventors: 寿光小林; 直幸内藤; 邦利池田; 晃義松原
Original assignee: Hoya Corp; National Cancer Center Japan
Current assignee: Hoya Corp; National Cancer Center Japan
Priority date: 2008-07-02
Filing date: 2008-07-02
Publication date: 2014-04-16
Anticipated expiration: 2028-07-02
Also published as: JP2010011960A

Description

本発明は、内視鏡とは別体であり、内視鏡を利用して患者の体内に配置することが可能な照明装置に関する。 The present invention relates to an illumination device that is separate from an endoscope and can be placed in a patient's body using the endoscope.

一般的に内視鏡は内視鏡とは別体である照明装置（画像処理装置を内蔵するプロセッサ）に接続され、さらに内視鏡の挿入部の先端面には照明レンズが設けてある。そのため、照明装置の内部に設けたランプを発光させると、ランプで発光した光は内視鏡の内部を通って照明レンズから内視鏡の外部に照射される。従って、術者が挿入部の先端部の向きを調整してこの照明光を患者の体内の患部に照射することにより、術者は患部の観察や処置を行うことができる。
特開平９−０２６５４８公報 In general, an endoscope is connected to an illumination device (a processor incorporating an image processing device) that is separate from the endoscope, and an illumination lens is provided on the distal end surface of the insertion portion of the endoscope. For this reason, when the lamp provided inside the illumination device emits light, the light emitted from the lamp passes through the endoscope and is irradiated from the illumination lens to the outside of the endoscope. Therefore, when the surgeon adjusts the direction of the distal end of the insertion portion and irradiates the affected area with the illumination light, the surgeon can observe and treat the affected area.
Japanese Patent Laid-Open No. 9-026548

しかし、挿入部の先端面に設けた処置具用開口と照明レンズの距離が近いので、処置具用開口から処置具を突出させた場合は、この処置具によって照明レンズから照射された照明光の一部が遮られ、患部に影が出来てしまうことがある。
また、内視鏡の挿入部の先端部に設けた観察窓（レンズ）を通して得られた観察像をモニタに表示すると、モニタの周辺部に映し出された観察像が中央部に映し出された観察像に比べて暗くなり易いという問題もある。 However, since the distance between the treatment instrument opening provided on the distal end surface of the insertion portion and the illumination lens is short, when the treatment instrument protrudes from the treatment instrument opening, the illumination light emitted from the illumination lens by the treatment instrument is reduced. Part of it may be blocked and shadows may appear on the affected area.
In addition, when the observation image obtained through the observation window (lens) provided at the distal end of the insertion portion of the endoscope is displayed on the monitor, the observation image displayed on the periphery of the monitor is displayed on the center. There is also a problem that it tends to be darker than.

本発明は、内視鏡から照射される照明光とは別の方向から対象物を照明することにより、術者が対象物を従来より確実に視認できるようにした照明装置を提供することを目的とする。 An object of the present invention is to provide an illuminating device that enables an operator to visually recognize an object more reliably than before by illuminating the object from a direction different from the illumination light emitted from the endoscope. And

本発明の照明装置は、内視鏡を利用することにより対象物内部に設置可能な、上記内視鏡とは別体の照明装置であって、本体部と、該本体部に固定した、該本体部の外部に向かって照明光を発射する発光部と、を備え、上記本体部の内部空間に、ＬＥＤ、ランプ、レーザー光源、マイクロ波光源のいずれかからなる上記発光部、該発光部に電力を供給するバッテリ、及び、上記発光部と電気的に接続すると共に上記バッテリの端子と対向する接触端子、を設け、上記本体部の表面に上記発光部で発生した照明光を外部に照射するための照射部を設け、上記本体部に形成した上記内部空間と本体部の外部とを連通する貫通孔に、内側端部が上記内部空間に位置し、かつ外側端部が本体部の外部に位置する絶縁部材を挿入し、該絶縁部材は、上記内側端部が上記接触端子と上記バッテリの端子の間に位置することにより該バッテリから上記発光部への電力の供給を遮断し、全体が上記貫通孔から外部に引き抜かれることにより、上記接触端子が上記バッテリの端子に接触して上記バッテリから発光部に電力が供給されるのを許容することを特徴としている。 The illuminating device of the present invention is an illuminating device separate from the endoscope, which can be installed inside an object by using an endoscope, and is fixed to the main body, the main body, A light emitting unit that emits illumination light toward the outside of the main body, and in the internal space of the main body, the light emitting unit including any one of an LED, a lamp, a laser light source, and a microwave light source, and the light emitting unit A battery for supplying power and a contact terminal that is electrically connected to the light emitting unit and is opposed to the terminal of the battery are provided, and illumination light generated by the light emitting unit is radiated to the surface of the main body. A through hole that communicates the internal space formed in the main body with the outside of the main body, the inner end is located in the inner space, and the outer end is outside the main body. Inserting the insulating member positioned, the insulating member Since the side end portion is located between the contact terminal and the battery terminal, the supply of electric power from the battery to the light emitting portion is cut off, and the entire contact terminal is pulled out from the through hole. Is allowed to contact the terminal of the battery and allow power to be supplied from the battery to the light emitting unit .

本発明の照明装置は、別の態様によると、内視鏡を利用することにより対象物内部に設置可能な、上記内視鏡とは別体の照明装置であって、本体部と、該本体部に固定した、該本体部の外部に向かって照明光を発射する発光部と、を備え、上記本体部に可撓性を有する連結部材の一端を接続し、該連結部材の他端に上記対象物を把持可能な把持部材を接続し、上記本体部の内部空間に、ＬＥＤ、ランプ、レーザー光源、マイクロ波光源のいずれかからなる上記発光部、該発光部に電力を供給するバッテリ、上記発光部と電気的に接続する導電板、及び、上記バッテリの端子と電気的に接続する板ばねからなるスイッチ片、を設け、上記本体部の表面に上記発光部で発生した照明光を外部に照射するための照射部を設け、上記本体部に形成した上記内部空間と本体部の外部とを連通するスライド軸孔にスライド可能に嵌合し、その内側端部が上記板ばねに接続し、かつ、外側端部が上記連結部材に接続するスライド部材を設け、上記スイッチ片は、自由状態となることにより上記導電板から離間し、かつ、スライド部材が上記本体部の外側に引かれることにより上記導電板に接触するまで弾性変形することを特徴としている。 According to another aspect, the illuminating device of the present invention is an illuminating device that is separate from the endoscope and can be installed inside an object by using an endoscope. A light emitting part that emits illumination light toward the outside of the main body part, and one end of a flexible connecting member is connected to the main body part, and the other end of the connecting member is A gripping member capable of gripping an object is connected, and in the internal space of the main body portion, the light emitting portion consisting of any of an LED, a lamp, a laser light source, and a microwave light source, a battery for supplying power to the light emitting portion, A conductive plate electrically connected to the light emitting part and a switch piece made of a leaf spring electrically connected to the battery terminal are provided, and illumination light generated by the light emitting part is externally provided on the surface of the main body part. An irradiation unit for irradiation was provided and formed on the main body. A slide member that is slidably fitted into a slide shaft hole that communicates the internal space with the outside of the main body, has an inner end connected to the leaf spring, and an outer end connected to the connecting member. provided, the switch piece is separated from the conductive plate by a free state, and the sliding member is characterized in that elastically deformed to contact with the conductive plate by being pulled to the outside of the body portion .

本発明の照明装置は内視鏡とは別体なので、内視鏡の挿入部の先端から発射される照明光とは別の方向から対象物を照明できる。そのため、例えば内視鏡の先端から処置具を突出させた場合であっても、この処置具によって影が出来ないように対象物を照明することが可能である。
また、内視鏡の挿入部の先端からの照明光では照明できない（あるいは明るさが十分でない）部分を照明できるので、観察像をモニタに表示した場合にモニタに映し出された観察像全体を明るくすることが可能である。
従って、術者は対象物を従来より確実に視認できるようになる。 Since the illumination device of the present invention is separate from the endoscope, the object can be illuminated from a direction different from the illumination light emitted from the distal end of the insertion portion of the endoscope. Therefore, for example, even when the treatment tool protrudes from the distal end of the endoscope, it is possible to illuminate the object so that no shadow is formed by the treatment tool.
In addition, since the illumination light from the distal end of the insertion portion of the endoscope can be illuminated (or the brightness is not sufficient), the entire observation image displayed on the monitor is brightened when the observation image is displayed on the monitor. Is possible.
Therefore, the operator can visually recognize the object more reliably than before.

以下、本発明の第１の実施形態を、図１から図６を参照しながら詳しく説明する。
本実施形態の照明装置１０Ａは、内視鏡３０の内部に挿入した把持鉗子５０に把持された状態で患者Ａの体内に運ばれ、かつ患者Ａの体外に配置した磁気式誘導装置６０の磁力によって吸引制御されるものである。
図１及び図２に示すように、照明装置１０Ａは強磁性体（例えば、純鉄、鉄合金のほか、プラチナマグネット、希土類磁石、テルビウム・ディスプロシウム・鉄合金などの磁石）からなりかつ略三角錐形状をなす本体部１１を備えている。本体部１１には、その頂点部から内部に向かって凹む収納凹部１２が形成してあり、さらに本体部１１の周面には環状凹部（被把持部）１３が凹設してある。収納凹部１２の開口端部には照明レンズ（照射部）１４が嵌合してあり、さらに照明レンズ１４の外面及び周面を覆う透光性材料からなるカバー（照射部）１５の一対の係止爪１６が収納凹部１２の内面に係止している。
さらに図２に示すように、収納凹部１２の内部には２つのバッテリ１７（２つのバッテリ１７は互いに電気的に導通している）とＬＥＤ（発光部）１８が重ねた状態で配設してある。ＬＥＤ１８の回路基板１９の端子２０は一方のバッテリ１７の端子に接触しており、回路基板１９から延びるリード線２１の端部に固定した接触端子２２が他方のバッテリ１７の端子に接触している。従って、本実施形態の照明装置１０Ａは、収納凹部１２にバッテリ１７、ＬＥＤ１８（回路基板１９、リード線２１、接触端子２２）を収納した後に、カバー１５を介して照明レンズ１４を本体部１１に固定すると、照明レンズ１４がＬＥＤ１８に当接することにより、回路基板１９の端子２０と一方のバッテリ１７の端子が接触し、かつ接触端子２２と他方のバッテリ１７の端子が接触するので、ＬＥＤ１８が点灯し照明レンズ１４及びカバー１５から外部に向けて照明光が照射される。 Hereinafter, a first embodiment of the present invention will be described in detail with reference to FIGS.
The illuminating device 10 A of the present embodiment is carried into the body of the patient A while being gripped by the gripping forceps 50 inserted into the endoscope 30, and the magnetic force of the magnetic guidance device 60 disposed outside the body of the patient A. Is controlled by suction.
As shown in FIGS. 1 and 2, the lighting device 10A is made of a ferromagnetic material (for example, pure iron, iron alloy, platinum magnet, rare earth magnet, magnet of terbium, dysprosium, iron alloy, etc.) and is substantially A main body 11 having a triangular pyramid shape is provided. The main body part 11 is formed with a storage concave part 12 that is recessed from the apex part toward the inside, and an annular concave part (a gripped part) 13 is provided on the peripheral surface of the main body part 11. An illumination lens (irradiation unit) 14 is fitted to the opening end of the housing recess 12, and a pair of engagements of a cover (irradiation unit) 15 made of a translucent material that covers the outer surface and the peripheral surface of the illumination lens 14. A pawl 16 is engaged with the inner surface of the storage recess 12.
Further, as shown in FIG. 2, two batteries 17 (the two batteries 17 are electrically connected to each other) and an LED (light emitting part) 18 are arranged in the storage recess 12 in an overlapping manner. is there. The terminal 20 of the circuit board 19 of the LED 18 is in contact with the terminal of one battery 17, and the contact terminal 22 fixed to the end of the lead wire 21 extending from the circuit board 19 is in contact with the terminal of the other battery 17. . Therefore, in the lighting device 10A of the present embodiment, the battery 17 and the LED 18 (the circuit board 19, the lead wire 21, and the contact terminal 22) are stored in the storage recess 12, and then the lighting lens 14 is attached to the main body 11 via the cover 15. When fixed, the illumination lens 14 comes into contact with the LED 18 so that the terminal 20 of the circuit board 19 and the terminal of the one battery 17 come into contact with each other, and the contact terminal 22 and the terminal of the other battery 17 come into contact with each other. Illumination light is emitted from the illumination lens 14 and the cover 15 to the outside.

図３は照明装置１０Ａを患者Ａの体内に運ぶための内視鏡３０を示している。
内視鏡３０は、術者が把持する操作部３１と、操作部３１から延びる挿入部３２と、操作部３１から挿入部３２と反対側に向かって延び、端部にプロセッサ（光源装置兼画像処理装置。図示略）に接続するためのコネクタ部３４を有するユニバーサルチューブ３３と、を具備している。図１に示すように、挿入部３２の先端面３５には、一対の照明レンズ照明レンズ３６と、直後（挿入部３２の先端部内）に対物レンズと撮像素子（共に図示略）が位置する観察窓３７と、処置具挿通路の出口開口３８と、エア及び洗浄水を送るための送気送水孔３９と、が設けてある。処置具挿通路の基端側開口部は、操作部３１に突設した処置具挿通用突部４０の端面に形成してある。
内視鏡３０の上記処置具挿通路にはその基端側開口部（処置具挿通用突部４０に装着したゴムキャップ４１のスリット）から図１に示した把持鉗子５０を挿入可能である。図示するように、把持鉗子５０の先端部には開閉可能な一対の把持片５１が設けてあり、この把持片５１は把持鉗子５０の基端部に設けた操作部（図示略）によって開閉操作可能である。 FIG. 3 shows an endoscope 30 for carrying the illumination device 10A into the patient A's body.
The endoscope 30 includes an operation unit 31 held by an operator, an insertion unit 32 extending from the operation unit 31, and extends from the operation unit 31 toward the opposite side of the insertion unit 32, and has a processor (light source device / image) at the end. And a universal tube 33 having a connector portion 34 for connection to a processing apparatus (not shown). As shown in FIG. 1, a pair of illumination lenses 36 and an objective lens and an imaging device (both not shown) are positioned on the distal end surface 35 of the insertion portion 32 and immediately after (in the distal end portion of the insertion portion 32). A window 37, an outlet opening 38 of the treatment instrument insertion passage, and an air / water supply hole 39 for sending air and washing water are provided. The proximal end side opening of the treatment instrument insertion passage is formed on the end surface of the treatment instrument insertion protrusion 40 that protrudes from the operation section 31.
The grasping forceps 50 shown in FIG. 1 can be inserted into the treatment instrument insertion passage of the endoscope 30 from the base end side opening (the slit of the rubber cap 41 attached to the treatment instrument insertion protrusion 40). As shown in the drawing, a pair of gripping pieces 51 that can be opened and closed are provided at the distal end portion of the grasping forceps 50, and the gripping pieces 51 are opened and closed by an operation portion (not shown) provided at the proximal end portion of the grasping forceps 50. Is possible.

次に、図４及び図５を用いて、患者Ａの体外において照明装置１０Ａを吸引制御する磁気式誘導装置６０の構成について説明する。
患者Ａを載せるベッド６１の両側部には、一対のＸＹステージ６２が配設してある。この一対のＸＹステージ６２は、床面上をベッド６１の長手方向に沿って同期しながら直線的にスライド（往復移動）するものであり、両ＸＹステージ６２の該長手方向の位置は常に一致する。さらに、ベッド６１の上方には、ベッド６１の長手方向と直交する平面内において互いに平行をなす、正面視略逆Ｕ字形の二つのレール６４、レール６５からなるフレーム／レール６３が配設してあり、このフレーム／レール６３の両端部は、左右のＸＹステージ６２にそれぞれ固定してある。内側のレール６４には、照明装置１０Ａを患者Ａの体外において吸引制御する（本体部１１に磁力を及ぼす）磁気誘導部材（磁力発生装置）６６が摺動自在に装着してある。磁気誘導部材６６は、その基体６８に鉄心にコイルを巻いた構造の電磁石６７を固定したものであり、電磁石６７は常に患者Ａ側を向いている（図４参照）。 Next, the configuration of the magnetic guidance device 60 that controls the illumination device 10A by suction outside the body of the patient A will be described with reference to FIGS.
A pair of XY stages 62 are disposed on both sides of the bed 61 on which the patient A is placed. The pair of XY stages 62 slide linearly (reciprocate) on the floor surface in synchronization with the longitudinal direction of the bed 61, and the longitudinal positions of both XY stages 62 always coincide. . Further, above the bed 61, there is disposed a frame / rail 63 composed of two rails 64 and rails 65 which are substantially U-shaped in a front view and are parallel to each other in a plane orthogonal to the longitudinal direction of the bed 61. The both ends of the frame / rail 63 are fixed to the left and right XY stages 62, respectively. The inner rail 64 is slidably mounted with a magnetic induction member (magnetic force generating device) 66 that controls the illumination device 10 A outside the body of the patient A (applies a magnetic force to the main body 11). The magnetic induction member 66 is obtained by fixing an electromagnet 67 having a structure in which a coil is wound around an iron core on a base body 68, and the electromagnet 67 is always facing the patient A side (see FIG. 4).

フレーム／レール６３の外側のレール６５には、フレーム／レール６３全体の重量バランスを保つためのカウンターウェイト６９が摺動自在に装着してある。カウンターウェイト６９は、磁気誘導部材６６の位置に応じて、その位置を変更する。例えば、磁気誘導部材６６が患者Ａの正面側に位置するときは、カウンターウェイト６９は患者Ａの背面側に位置し、磁気誘導部材６６が患者Ａの背面側に位置するときは、カウンターウェイト６９は患者Ａの正面側に位置する。
そして、以上説明したＸＹステージ６２、フレーム／レール６３及び磁気誘導部材６６が磁気式誘導装置６０の構成要素である。 A counterweight 69 is slidably mounted on the rail 65 outside the frame / rail 63 so as to maintain the weight balance of the entire frame / rail 63. The counterweight 69 changes its position according to the position of the magnetic induction member 66. For example, when the magnetic guiding member 66 is located on the front side of the patient A, the counterweight 69 is located on the back side of the patient A, and when the magnetic guiding member 66 is located on the back side of the patient A, the counterweight 69 Is located in front of patient A.
The XY stage 62, the frame / rail 63, and the magnetic induction member 66 described above are components of the magnetic induction device 60.

次に、患者Ａの病変部Ｘの切除要領について説明する。
切除術の実施に先立っては、まず、図４及び図５に示すように、局所麻酔を施した患者Ａをベッド６１上に横たわらせる。このとき、ＸＹステージ６２を操作して、磁気誘導部材６６をフレーム／レール６３に沿って切除術開始時位置に移動させる（図４及び図５参照）。
次いで、あらかじめ図示を省略した可撓性を有するオーバーチューブを、内視鏡３０の挿入部３２の手元側に装着した状態で、図１に示すように、（上記プロセッサで発生した光を照明レンズ３６から外部に照射した状態の）内視鏡３０の上記処置具挿通路に把持鉗子５０を挿入して把持片５１を出口開口３８から外部に突出させ、さらに把持鉗子５０の上記操作部を操作して一対の把持片５１で照明装置１０Ａの環状凹部１３を把持する。そして、内視鏡３０を患者Ａの口から挿入し、挿入部３２の先端部を臓器Ｂの内部に位置させる。この状態で、上記オーバーチューブを挿入部３２に沿って患者Ａの口から所定位置まで挿入する。次いで、把持鉗子５０の把持片５１を開いて把持鉗子５０による照明装置１０Ａの把持状態を解除することにより、図６に示すように臓器Ｂの底部に照明装置１０Ａを載置する。 Next, the procedure for excision of the lesion X of the patient A will be described.
Prior to performing the resection, first, as shown in FIGS. 4 and 5, the patient A subjected to local anesthesia is laid on the bed 61. At this time, the XY stage 62 is operated to move the magnetic guiding member 66 along the frame / rail 63 to the excision start position (see FIGS. 4 and 5).
Next, in a state where a flexible overtube (not shown in advance) is attached to the proximal side of the insertion portion 32 of the endoscope 30, as shown in FIG. The grasping forceps 50 is inserted into the treatment instrument insertion path of the endoscope 30 (in a state irradiated from the outside 36 to the outside), the grasping piece 51 is projected to the outside from the outlet opening 38, and the operation portion of the grasping forceps 50 is further operated. Then, the annular recess 13 of the lighting device 10 A is gripped by the pair of gripping pieces 51. Then, the endoscope 30 is inserted from the mouth of the patient A, and the distal end portion of the insertion portion 32 is positioned inside the organ B. In this state, the overtube is inserted along the insertion portion 32 from the mouth of the patient A to a predetermined position. Next, by opening the gripping piece 51 of the grasping forceps 50 and releasing the gripping state of the illumination device 10A by the grasping forceps 50, the illumination device 10A is placed on the bottom of the organ B as shown in FIG.

このように内視鏡３０の挿入部３２の先端を臓器Ｂ内に挿入すると、一対の照明レンズ３６から照射された照明光によって臓器Ｂの内部が照明されるので、挿入部３２の先端面３５に設けた観察窓３７から得られた臓器Ｂの観察像が、上記プロセッサに接続したテレビモニタ（図示）に写し出される。しかし、照明レンズ３６からの照明光だけでは臓器Ｂの内壁全体を明るく照明できないので、テレビモニタの周辺部に映し出された観察像が中央部に映し出された観察像に比べて暗くなることがある。
そこで、臓器Ｂの内部に配置した照明装置１０Ａの臓器Ｂ内における位置及び向きを調整して、照明レンズ３６から照射される照明光とは別の方向から照明装置１０Ａの照明光を臓器Ｂの内壁に照射する。この照明装置１０Ａの位置調整と方向調整は磁気式誘導装置６０を用いて行う。具体的には、磁気式誘導装置６０の磁気誘導部材６６の発生磁界を強めたり位置を変え、本体部１１を磁気誘導部材６６側に吸引（移動）する。
このようにして照明装置１０Ａを所望の位置及び向きとなるように調整すると、照明レンズ３６からの照明光だけでは照明できない（あるいは明るさが十分でない）部分を照明できるので、テレビモニタに映し出された観察像全体が明るくなる。そのため、テレビモニタの周辺部に映し出された観察像も明瞭に視認できるようになり、術者は臓器Ｂの内壁に出来ている病変部Ｘを容易に発見できるようになる。
このように病変部Ｘを発見したら、内視鏡３０の上記処置具挿通路に高周波メス７０を挿入し、高周波メス７０の先端部７１を出口開口３８から臓器Ｂの内部に突出させる。一対の照明レンズ３６と出口開口３８の距離が近いので、仮に臓器Ｂの内部に照明装置１０Ａを配設せずに一対の照明レンズ３６からの照明光のみで臓器Ｂの内部を照明する場合は、照明レンズ３６から照射された光の一部が高周波メス７０によって遮られ、その結果、病変部Ｘやその周辺部に影が出来ることがある。しかし、本実施形態のように照明装置１０Ａからの照明光を照明レンズ３６の照明光とは異なる方向から臓器Ｂの内壁に照射する場合は、病変部Ｘやその周辺部に影が出来ることがないので、術者は高周波メス７０によって病変部Ｘとその周辺の粘膜を確実に切除できる。 When the distal end of the insertion portion 32 of the endoscope 30 is inserted into the organ B in this way, the interior of the organ B is illuminated by the illumination light emitted from the pair of illumination lenses 36, and therefore the distal end surface 35 of the insertion portion 32. An observation image of the organ B obtained from the observation window 37 provided in FIG. 6 is displayed on a television monitor (shown) connected to the processor. However, since only the illumination light from the illumination lens 36 cannot illuminate the entire inner wall of the organ B, the observation image projected on the peripheral portion of the television monitor may be darker than the observation image projected on the central portion. .
Therefore, the position and orientation of the illuminating device 10A arranged inside the organ B in the organ B are adjusted, and the illuminating light of the illuminating device 10A is transmitted from the illuminating device 36 in a direction different from the illumination light irradiated from the illumination lens 36. Irradiate the inner wall. The position adjustment and the direction adjustment of the illumination device 10 A are performed using the magnetic guidance device 60. Specifically, the magnetic field generated by the magnetic induction member 66 of the magnetic induction device 60 is strengthened or the position is changed, and the main body 11 is attracted (moved) to the magnetic induction member 66 side.
When the lighting device 10A is adjusted to have a desired position and orientation in this manner, a portion that cannot be illuminated only by the illumination light from the illumination lens 36 (or that the brightness is not sufficient) can be illuminated, and is thus displayed on the television monitor. The entire observed image becomes brighter. Therefore, the observation image displayed on the periphery of the television monitor can be clearly seen, and the surgeon can easily find the lesion X formed on the inner wall of the organ B.
When the lesioned part X is found in this way, the high-frequency knife 70 is inserted into the treatment instrument insertion path of the endoscope 30, and the distal end portion 71 of the high-frequency knife 70 is protruded from the outlet opening 38 into the organ B. When the distance between the pair of illumination lenses 36 and the outlet opening 38 is short, the interior of the organ B is illuminated only with illumination light from the pair of illumination lenses 36 without providing the illumination device 10A inside the organ B. A part of the light emitted from the illumination lens 36 is blocked by the high-frequency knife 70, and as a result, a shadow may be formed on the lesion X or its peripheral part. However, when the illumination light from the illumination device 10A is applied to the inner wall of the organ B from a direction different from the illumination light of the illumination lens 36 as in the present embodiment, a shadow can be formed on the lesion X or its peripheral part. Therefore, the surgeon can reliably remove the lesion X and the surrounding mucous membrane with the high-frequency knife 70.

以上のようにして病変部Ｘの切除作業を終えたら、高周波メス７０を内視鏡３０から引き抜き、代わりに把持鉗子５０を内視鏡３０の上記処置具挿通路に挿入し、把持鉗子５０の把持片５１で切り取った病変部Ｘ及び粘膜を把持し、内視鏡３０を患者Ａの体内から外部に回収する。さらに、内視鏡３０に挿入した把持鉗子５０を利用して照明装置１０Ａを把持し、内視鏡３０を患者Ａの体外に引き出すことにより照明装置１０Ａを回収する。そして最後に、切除した部分の縫合、消毒などの処置を行う。
以上説明したように、本実施形態のように照明装置１０Ａを利用して内視鏡３０の照明レンズ３６とは別の方向から臓器Ｂの内壁を照明すれば、術者は従来に比べて臓器Ｂの内部の観察及び病変部Ｘの処置を簡単かつ確実に行うことができる。 When the excision of the lesioned part X is completed as described above, the high-frequency knife 70 is pulled out from the endoscope 30, and instead, the grasping forceps 50 is inserted into the treatment instrument insertion path of the endoscope 30, and the grasping forceps 50 is removed. The lesioned part X and mucous membrane cut out by the gripping piece 51 are gripped, and the endoscope 30 is recovered from the body of the patient A to the outside. Furthermore, the illumination device 10 A is gripped using the grasping forceps 50 inserted into the endoscope 30, and the illumination device 10 A is recovered by pulling the endoscope 30 out of the body of the patient A. Finally, treatments such as suturing and disinfection of the excised part are performed.
As described above, when the inner wall of the organ B is illuminated from a direction different from the illumination lens 36 of the endoscope 30 by using the illumination device 10A as in the present embodiment, the operator can compare the organ with the conventional one. Observation inside B and treatment of lesion X can be performed easily and reliably.

次に、本発明の第２の実施形態について図７を参照しながら説明する。
なお、第１の実施形態と同じ部材には同じ符号を付すに止めて、その詳細な説明は省略する。
本実施形態の照明装置１０Ｂの特徴は、本体部１１を互いに分離可能な３つの部材から構成した点にある。即ち本体部１１は、筒状をなす基部１１Ａと、基部１１Ａの内部に着脱可能に嵌合する筒状の内側筒状部１１Ｂと、基部１１Ａ及び内側筒状部１１Ｂの端部に着脱可能に接続する蓋部１１Ｃと、を具備している。内側筒状部１１Ｂには照明レンズ１４及びカバー１５を着脱可能に取り付けてあり、さらに内側筒状部１１Ｂの内部に形成した収納凹部１２には一対のバッテリ１７とＬＥＤ１８（回路基板１９、リード線２１、接触端子２２）が収納してある。
また、接触端子２２と対向するバッテリ１７の端子と、接触端子２２との間には絶縁性かつ可撓性の材料からなる絶縁テープ（絶縁部材）８０の一端（内側端部）が挟み込んであり、絶縁テープ８０の他端（外側端部）は内側筒状部１１Ｂに形成した貫通孔（図示略）を通って基部１１Ａの外側に突出している。
そして、内側筒状部１１Ｂの端部に形成した一対の係止爪１１Ｂ１を蓋部１１Ｃの内面に形成した係止凹部１１Ｃ１に係止すれば、基部１１Ａ及び内側筒状部１１Ｂのカバー１５側と反対側の端部に蓋部１１Ｃが接続する（このとき、絶縁テープ８０の中間部が基部１１Ａと蓋部１１Ｃの間の隙間（貫通孔）に位置する）。 Next, a second embodiment of the present invention will be described with reference to FIG.
The same members as those in the first embodiment are designated by the same reference numerals, and detailed description thereof is omitted.
The illuminating device 10B of this embodiment is characterized in that the main body 11 is composed of three members that can be separated from each other. That is, the main body 11 is detachably attached to the cylindrical base 11A, the cylindrical inner cylindrical part 11B that is detachably fitted into the base 11A, and the ends of the base 11A and the inner cylindrical part 11B. 11 C of lid parts to connect. An illumination lens 14 and a cover 15 are detachably attached to the inner cylindrical portion 11B, and a pair of battery 17 and LED 18 (circuit board 19, lead wire) are provided in the housing recess 12 formed inside the inner cylindrical portion 11B. 21 and contact terminals 22) are accommodated.
One end (inner end) of an insulating tape (insulating member) 80 made of an insulating and flexible material is sandwiched between the terminal of the battery 17 facing the contact terminal 22 and the contact terminal 22. The other end (outer end portion) of the insulating tape 80 protrudes outside the base portion 11A through a through hole (not shown) formed in the inner cylindrical portion 11B.
If the pair of locking claws 11B1 formed at the end of the inner cylindrical portion 11B is locked to the locking recess 11C1 formed on the inner surface of the lid portion 11C, the base 11A and the inner cylindrical portion 11B on the cover 15 side The lid 11C is connected to the opposite end (the intermediate portion of the insulating tape 80 is located in the gap (through hole) between the base 11A and the lid 11C).

このような構造の照明装置１０Ｂは、図７に示すように絶縁テープ８０の内側端部が接触端子２２とバッテリ１７の端子の間に挟み込まれている状態にあっては、バッテリ１７からＬＥＤ１８に電力が供給されないので消灯状態となる。一方、絶縁テープ８０を引っ張って基部１１Ａと蓋部１１Ｃの接合部の隙間から絶縁テープ８０を照明装置１０Ｂの外部に引き抜くと、接触端子２２とバッテリ１７の端子が接触するのでＬＥＤ１８が点灯する。
従って、照明装置１０Ｂから絶縁テープ８０を引き抜かない状態で内視鏡３０に挿入した把持鉗子５０で照明装置１０Ｂを把持すれば、照明装置１０Ｂを消灯した状態で患者Ａの体内に運ぶことが出来る。そして、臓器Ｂの内部に運んだ後に、例えば把持鉗子５０の把持片５１で絶縁テープ８０の外側端部を掴み絶縁テープ８０を照明装置１０Ｂの外部に引き抜けば、臓器Ｂの内部において照明装置１０Ｂ（ＬＥＤ１８）を点灯させることができる。 In the lighting device 10B having such a structure, when the inner end portion of the insulating tape 80 is sandwiched between the contact terminal 22 and the terminal of the battery 17 as shown in FIG. Since no power is supplied, the light is turned off. On the other hand, when the insulating tape 80 is pulled and the insulating tape 80 is pulled out of the lighting device 10B from the gap between the base portion 11A and the lid portion 11C, the LED 18 is turned on because the contact terminal 22 and the terminal of the battery 17 are in contact.
Therefore, if the illuminating device 10B is gripped by the grasping forceps 50 inserted into the endoscope 30 without pulling out the insulating tape 80 from the illuminating device 10B, the illuminating device 10B can be carried into the patient A with the light turned off. . Then, after being transported to the inside of the organ B, for example, the gripping piece 51 of the gripping forceps 50 grips the outer end of the insulating tape 80 and pulls the insulating tape 80 out of the lighting device 10B. 10B (LED 18) can be turned on.

続いて、本発明の第３の実施形態を図８から図１９を参照しながら詳しく説明する。
なお、従前の実施形態と同じ部材には同じ符号を付すに止めて、その詳細な説明は省略する。
本実施形態の照明装置１０Ｃは把持部材１００と一体化したものであり、かつ、内視鏡３０の処置具挿通路３０Ａに挿入した操作装置１２０を介して内視鏡３０に接続するものである。 Next, a third embodiment of the present invention will be described in detail with reference to FIGS.
It should be noted that the same members as those of the previous embodiment are designated by the same reference numerals, and detailed description thereof is omitted.
The illuminating device 10 C of the present embodiment is integrated with the gripping member 100 and is connected to the endoscope 30 via the operation device 120 inserted into the treatment instrument insertion passage 30 A of the endoscope 30. .

まず図８及び図９を参照して、照明装置１０Ｃ、連結ひも（連結部材）９９、及び把持部材１００からなる把持手段付照明装置９０の構造について説明する。
照明装置１０Ｃの形状は照明装置１０Ｂと異なるが、基本構造は照明装置１０Ｂと同じである。即ち、照明装置１０Ｃの本体部９１（材質は本体部１１と同じ）は、基部１１Ａに相当する基部９２と、内側筒状部１１Ｂに相当する内側筒状部９３と、蓋部１１Ｃに相当する蓋部９４と、を備えている。図示するように内側筒状部９３の内部にはバッテリ１７及びＬＥＤ１８（回路基板１９、リード線２１、接触端子２２）が配設してあり、かつその開口端部にはカバー１５に相当するカバー（照射部）９６を介して照明レンズ１４に相当する照明レンズ（照射部）９５が設けてある。
蓋部９４は略三角錐形状をなすものであり、その係止凹部９７に内側筒状部９３に設けた一対の係止爪９８を係止することにより基部９２及び内側筒状部９３と一体化している。 First, with reference to FIG. 8 and FIG. 9, the structure of the illumination device 90 with gripping means including the illumination device 10 C, the connection string (connection member) 99, and the grip member 100 will be described.
Although the shape of the illumination device 10C is different from that of the illumination device 10B, the basic structure is the same as that of the illumination device 10B. That is, the main body 91 (the material is the same as that of the main body 11) of the lighting device 10C corresponds to the base 92 corresponding to the base 11A, the inner cylindrical portion 93 corresponding to the inner cylindrical portion 11B, and the lid portion 11C. A lid 94. As shown in the drawing, the battery 17 and the LED 18 (the circuit board 19, the lead wire 21, and the contact terminal 22) are disposed inside the inner cylindrical portion 93, and a cover corresponding to the cover 15 is provided at the opening end. An illumination lens (irradiation unit) 95 corresponding to the illumination lens 14 is provided via an (irradiation unit) 96.
The lid portion 94 has a substantially triangular pyramid shape, and is engaged with the base portion 92 and the inner cylindrical portion 93 by locking a pair of locking claws 98 provided on the inner cylindrical portion 93 to the locking recess portion 97. It has become.

蓋部９４の端部に形成した凹部には、柔軟性を有しかつ全体として環状をなす連結ひも９９の一部が接続（固定）してある。連結ひも９９としては、例えば、手術用縫合糸、釣糸、金属製ワイヤを利用可能である。さらに、この連結ひも９９には金属等の弾性材料からなる把持部材１００が接続してある。
把持部材１００は一対の開閉片１０１を具備している。一対の開閉片１０１は共に、略平行な基端部１０２と、基端部１０２に連なる中間部１０３と、中間部１０３に連なる先端把持部１０４と、を具備している。中間部１０３における基端部１０２に連なる部分は第１傾斜部１０５となっており、先端把持部１０４における中間部１０３に連なる部分は第２傾斜部１０６となっている。さらに、両先端把持部１０４の先端には互いに対向する把持爪１０７が設けてある。なお、把持部材１００を３枚以上の開閉片１０１から構成することも可能である。
図示するように、把持部材１００の一対の開閉片１０１の間の隙間には、全体として環状をなしかつ可撓性を有する金属製のループワイヤ１０９が通してある。このループワイヤ１０９は、所定の切断力以上の強い力で牽引したときに切断するものである。 A part of the connecting string 99 that is flexible and has a ring shape as a whole is connected (fixed) to the recess formed at the end of the lid 94. As the connecting string 99, for example, a surgical suture, a fishing line, and a metal wire can be used. Further, a gripping member 100 made of an elastic material such as metal is connected to the connecting string 99.
The gripping member 100 includes a pair of opening / closing pieces 101. Each of the pair of opening and closing pieces 101 includes a base end portion 102 that is substantially parallel, an intermediate portion 103 that is continuous with the base end portion 102, and a tip gripping portion 104 that is continuous with the intermediate portion 103. A portion of the intermediate portion 103 connected to the base end portion 102 is a first inclined portion 105, and a portion of the distal end grip portion 104 connected to the intermediate portion 103 is a second inclined portion 106. Further, gripping claws 107 facing each other are provided at the distal ends of the both-end gripping portions 104. Note that the gripping member 100 may be composed of three or more open / close pieces 101.
As shown in the drawing, a metal loop wire 109 having a ring shape and flexibility is passed through the gap between the pair of opening and closing pieces 101 of the gripping member 100. The loop wire 109 is to be cut when it is pulled with a strong force greater than a predetermined cutting force.

収納筒部材１１０は連結ひも９９、把持部材１００及びループワイヤ１０９の一部を収納するための部材であり、両端が開口する円筒形をなしている。収納筒部材１１０は大径部１１１と小径部１１２を具備している。大径部１１１側の開口縁部はテーパ面１１３となっており、大径部１１１と小径部１１２に跨る部分には一本のスリット１１４が設けてある。さらに、収納筒部材１１０の内部孔１１５の内径はその全長にわたって一定である。この収納筒部材１１０は、例えばステンレスやプラスチックや超弾性合金により成形することができる。
以上構成の把持手段付照明装置９０の各構成部品を組み付けるには、まずスリット１１４を利用して照明装置１０Ｃと一体化した連結ひも９９を収納筒部材１１０の内部に通し、テーパ面１１３の内側を通して収納筒部材１１０の外部に引き出す。そして、ループワイヤ１０９と一体化させた把持部材１００の一対の開閉片１０１の隙間に連結ひも９９を通し、さらに収納筒部材１１０の小径部１１２側の端面開口部から紐あるいは先端にフック部を備える硬質部材からなる棒を挿入し、紐あるいはフック部を収納筒部材１１０のテーパ面１１３側の開口部から突出させる。そして、この紐あるいはフック部をループワイヤ１０９に引っ掛け、紐あるいは棒を小径部１１２側の端面方向に引っ張る。すると、図８に示すように把持手段付照明装置９０が完成する。 The storage cylinder member 110 is a member for storing a part of the connecting cord 99, the gripping member 100, and the loop wire 109, and has a cylindrical shape with both ends open. The storage cylinder member 110 includes a large diameter portion 111 and a small diameter portion 112. The opening edge on the large diameter portion 111 side is a tapered surface 113, and a single slit 114 is provided in a portion straddling the large diameter portion 111 and the small diameter portion 112. Further, the inner diameter of the inner hole 115 of the storage cylinder member 110 is constant over its entire length. The storage cylinder member 110 can be formed of, for example, stainless steel, plastic, or a superelastic alloy.
In order to assemble the components of the illumination device 90 with gripping means configured as described above, first, the connecting string 99 integrated with the illumination device 10C is passed through the inside of the storage cylinder member 110 using the slit 114, and the inside of the tapered surface 113 And is pulled out of the storage cylinder member 110. Then, a connecting cord 99 is passed through the gap between the pair of opening and closing pieces 101 of the gripping member 100 integrated with the loop wire 109, and a hook portion is attached from the end surface opening on the small diameter portion 112 side of the storage cylinder member 110 to the string or tip. The stick | rod which consists of a hard member with which it is equipped is inserted, and a string or a hook part is protruded from the opening part by the side of the taper surface 113 of the storage cylinder member 110. FIG. Then, the string or hook part is hooked on the loop wire 109, and the string or bar is pulled in the direction of the end face on the small diameter part 112 side. Then, the illumination device 90 with gripping means is completed as shown in FIG.

把持手段付照明装置９０が図８及び図９に示す状態にあるとき、把持部材１００は一対の把持爪１０７が互いに接触する全閉状態となる。
この状態からループワイヤ１０９を把持爪１０７と反対方向に上記切断力より小さい力で引くと、図１０に示すように、把持部材１００の一対の第１傾斜部１０５がテーパ面１１３に接触することにより互いに近づく方向に弾性変形し、一対の中間部１０３が内部孔１１５内に収納される。すると、一対の中間部１０３が内部孔１１５の周面に接触することにより互いに近づく方向に弾性変形するので、この動きに連動して一対の先端把持部１０４が開き、把持部材１００は図１０に示す全開状態となる。
この状態からループワイヤ１０９を上記切断力より小さい力でさらに引くと、図１１に示すように把持部材１００の一対の第２傾斜部１０６が収納筒部材１１０の内部に引き込まれる。第２傾斜部１０６が内部孔１１５（テーパ面１１３）に接触することにより互いに近づく方向に弾性変形すると、図１１に示すように一対の把持爪１０７が互いに接近するので、把持部材１００は再度全閉状態となる。 When the illumination device 90 with gripping means is in the state shown in FIGS. 8 and 9, the gripping member 100 is in a fully closed state in which the pair of gripping claws 107 are in contact with each other.
When the loop wire 109 is pulled with a force smaller than the cutting force in the opposite direction to the gripping claw 107 from this state, the pair of first inclined portions 105 of the gripping member 100 come into contact with the tapered surface 113 as shown in FIG. Accordingly, the pair of intermediate portions 103 are accommodated in the inner hole 115. Then, the pair of intermediate portions 103 are elastically deformed in a direction approaching each other by coming into contact with the peripheral surface of the inner hole 115, so that the pair of tip gripping portions 104 are opened in conjunction with this movement, and the gripping member 100 is shown in FIG. It will be in the fully open state shown.
When the loop wire 109 is further pulled with a force smaller than the cutting force from this state, the pair of second inclined portions 106 of the gripping member 100 are pulled into the storage cylinder member 110 as shown in FIG. When the second inclined portion 106 comes into contact with the internal hole 115 (tapered surface 113) and elastically deforms in a direction approaching each other, the pair of gripping claws 107 approach each other as shown in FIG. Closed.

図１２等に示した操作装置１２０は、内視鏡３０の処置具挿通用突部４０（ゴムキャップ４１のスリット）から処置具挿通路３０Ａの内部に挿入するものであり、挿入管１２１、挿入コイル１２２、規制管１２３及び操作ワイヤ１２９を具備している。
挿入管１２１は可撓性を有する筒状部材であり、挿入コイル１２２は挿入管１２１の内部に相対移動可能に挿入してある。規制管１２３は前部をなす大径部１２４と、後部をなしかつ挿入コイル１２２の先端部に嵌合固定される小径部１２５と、を備えている。大径部１２４の外径は挿入管１２１の内径より小さく、かつ、挿入コイル１２２の外径とほぼ同一に設定してある。さらに、大径部１２４の内径は小径部１２５の内径及び収納筒部材１１０の小径部１１２の外径より大きく設定してあり、大径部１２４の内周面と小径部１２５の内周面の接続部には環状段部１２６が形成してある。
挿入コイル１２２の内側には、先端にフック部材１２８を固定した操作ワイヤ１２９が相対移動可能に配設してある。さらに、挿入管１２１、挿入コイル１２２及び操作ワイヤ１２９の各基端部は、図示を省略した基端側操作部によって互いに軸方向に相対移動可能として結合してある。 The operating device 120 shown in FIG. 12 or the like is inserted into the treatment instrument insertion passage 30A from the treatment instrument insertion protrusion 40 (the slit of the rubber cap 41) of the endoscope 30. A coil 122, a restriction tube 123, and an operation wire 129 are provided.
The insertion tube 121 is a flexible cylindrical member, and the insertion coil 122 is inserted into the insertion tube 121 so as to be relatively movable. The restriction tube 123 includes a large-diameter portion 124 that forms the front portion, and a small-diameter portion 125 that forms the rear portion and is fitted and fixed to the distal end portion of the insertion coil 122. The outer diameter of the large diameter portion 124 is smaller than the inner diameter of the insertion tube 121 and is set substantially the same as the outer diameter of the insertion coil 122. Further, the inner diameter of the large-diameter portion 124 is set to be larger than the inner diameter of the small-diameter portion 125 and the outer diameter of the small-diameter portion 112 of the storage cylinder member 110, and the inner peripheral surface of the large-diameter portion 124 and the inner peripheral surface of the small-diameter portion 125. An annular step 126 is formed at the connecting portion.
Inside the insertion coil 122, an operation wire 129 having a hook member 128 fixed to the tip is disposed so as to be relatively movable. Further, the base end portions of the insertion tube 121, the insertion coil 122, and the operation wire 129 are coupled to each other so as to be relatively movable in the axial direction by a base end side operation portion (not shown).

次に、患者Ａの病変部Ｘの切除要領について説明する。
まず、患者Ａの体外において内視鏡３０に把持手段付照明装置９０と操作装置１２０を次の手順で取り付ける。
まず、内視鏡３０の処置具挿通路３０Ａに操作装置１２０を挿通し、挿入管１２１の先端部を挿入部３２の出口開口３８から外部に僅かに突出させ、さらに規制管１２３の先端部を挿入管１２１の先端部から僅かに突出させる（図１２参照）。次いで、上記基端側操作部を操作することにより操作ワイヤ１２９の先端部に固着したフック部材１２８を規制管１２３の前方に突出させる（図１２参照）。
次いで、フック部材１２８の直前に把持手段付照明装置９０のループワイヤ１０９を位置させ、フック部材１２８をループワイヤ１０９に引っ掛ける。そして、上記基端側操作部を操作することによりフック部材１２８を操作ワイヤ１２９の基端側に引っ張る。すると把持部材１００の一対の第１傾斜部１０５が収納筒部材１１０のテーパ面１１３に接触するので、操作ワイヤ１２９の牽引力が収納筒部材１１０に及び、収納筒部材１１０の小径部１１２が環状段部１２６に当接するまで大径部１２４の内部に引き込まれる（図１３参照）。このようにして規制管１２３の内部に小径部１１２を収納しても、収納筒部材１１０のスリット１１４の前端部は規制管１２３の大径部１２４より前方に位置するので（図１３等参照）、連結ひも９９をスリット１１４の前端部から外部へ引き出すことができる。
続いて、上記基端側操作部を操作することにより挿入管１２１を前方に押し出すと、図１４に示すように把持部材１００及び収納筒部材１１０が挿入管１２１の内部に収納され、かつ照明装置１０Ｃ（本体部９１）の端部が挿入管１２１の先端部に嵌合する。
そして、最後に上記状態を保持したまま基端側操作部を操作することにより挿入管１２１、挿入コイル１２２及び操作ワイヤ１２９を基端側に引くと、図１４に示すように照明装置１０Ｃが処置具挿通路３０Ａの出口開口３８に嵌合するので、把持手段付照明装置９０及び操作装置１２０が内視鏡３０と一体になる。 Next, the procedure for excision of the lesion X of the patient A will be described.
First, the illumination device 90 with grip means and the operation device 120 are attached to the endoscope 30 outside the body of the patient A in the following procedure.
First, the operating device 120 is inserted into the treatment instrument insertion passage 30A of the endoscope 30, the distal end portion of the insertion tube 121 is slightly protruded from the outlet opening 38 of the insertion portion 32, and the distal end portion of the restriction tube 123 is further extended. It protrudes slightly from the tip of the insertion tube 121 (see FIG. 12). Next, by operating the proximal end side operation portion, the hook member 128 fixed to the distal end portion of the operation wire 129 is projected forward of the restriction tube 123 (see FIG. 12).
Next, the loop wire 109 of the illumination device 90 with gripping means is positioned immediately before the hook member 128, and the hook member 128 is hooked on the loop wire 109. Then, the hook member 128 is pulled toward the base end side of the operation wire 129 by operating the base end side operation portion. Then, since the pair of first inclined portions 105 of the gripping member 100 comes into contact with the tapered surface 113 of the storage cylinder member 110, the pulling force of the operation wire 129 reaches the storage cylinder member 110, and the small diameter portion 112 of the storage cylinder member 110 is an annular step. It is drawn into the large diameter portion 124 until it abuts on the portion 126 (see FIG. 13). Even if the small-diameter portion 112 is housed inside the regulation tube 123 in this way, the front end portion of the slit 114 of the housing cylinder member 110 is positioned in front of the large-diameter portion 124 of the regulation tube 123 (see FIG. 13 and the like). The connecting string 99 can be pulled out from the front end of the slit 114.
Subsequently, when the insertion tube 121 is pushed forward by operating the proximal end side operation portion, the gripping member 100 and the storage cylinder member 110 are stored in the insertion tube 121 as shown in FIG. The end portion of 10C (main body portion 91) is fitted to the distal end portion of the insertion tube 121.
Finally, when the insertion tube 121, the insertion coil 122, and the operation wire 129 are pulled toward the proximal side by operating the proximal side operation unit while maintaining the above state, the illuminating device 10C performs treatment as shown in FIG. Since it fits into the outlet opening 38 of the tool insertion passage 30A, the illumination device 90 with gripping means and the operation device 120 are integrated with the endoscope 30.

次いで、把持手段付照明装置９０及び操作装置１２０と一体となった内視鏡３０の挿入部３２の手元側にオーバーチューブを装着し、挿入部３２の先端部及び照明装置１０Ｃを臓器Ｂ内に挿入する。そして、図１５に示すように、内視鏡３０の操作部３１に回転可能に設けた回転操作レバーＬ（図３参照）を回転させることにより挿入部３２の先端部近傍を構成する湾曲部を湾曲させ、挿入部３２の先端部を臓器Ｂの上部に接近させる。この状態で、上記オーバーチューブを挿入部３２に沿って患者Ａの口から所定位置まで挿入する。さらに、挿入管１２１を先端側方向に移動させて、挿入管１２１及び照明装置１０Ｃを内視鏡３０から離間させる。さらに、挿入コイル１２２と操作ワイヤ１２９を操作することによって規制管１２３と共に収納筒部材１１０を挿入管１２１に対して上方に相対移動させると、この動作にともなって把持部材１００が収納筒部材１１０と一緒に上方に移動するので、把持部材１００の先端（把持爪１０７）が照明装置１０Ｃの端面に当接する。収納筒部材１１０をさらに上方に移動させると、挿入管１２１の先端部に嵌合している照明装置１０Ｃが把持部材１００（把持爪１０７）によって上方に押し出され（挿入管１２１から外れ）、かつ収納筒部材１１０が挿入管１２１の上方に突出する（図１５参照）。 Next, an overtube is attached to the proximal side of the insertion portion 32 of the endoscope 30 integrated with the illumination device 90 with the gripping means and the operation device 120, and the distal end portion of the insertion portion 32 and the illumination device 10C are placed in the organ B. insert. Then, as shown in FIG. 15, the bending portion constituting the vicinity of the distal end portion of the insertion portion 32 is rotated by rotating a rotation operation lever L (see FIG. 3) rotatably provided on the operation portion 31 of the endoscope 30. The distal end portion of the insertion portion 32 is brought close to the upper portion of the organ B. In this state, the overtube is inserted along the insertion portion 32 from the mouth of the patient A to a predetermined position. Further, the insertion tube 121 is moved in the distal direction, and the insertion tube 121 and the illumination device 10 C are separated from the endoscope 30. Further, when the storage tube member 110 is moved relative to the insertion tube 121 together with the restriction tube 123 by operating the insertion coil 122 and the operation wire 129, the gripping member 100 and the storage tube member 110 are moved along with this operation. Since it moves together, the front-end | tip (grip claw 107) of the holding member 100 contact | abuts to the end surface of 10 C of illuminating devices. When the storage cylinder member 110 is further moved upward, the lighting device 10C fitted to the distal end portion of the insertion tube 121 is pushed upward (disengaged from the insertion tube 121) by the grip member 100 (grip claw 107), and The storage cylinder member 110 protrudes above the insertion tube 121 (see FIG. 15).

次いで、（上記切断力より小さい力で）操作ワイヤ１２９を基端側に引っ張ると、ループワイヤ１０９及び把持部材１００が収納筒部材１１０に対して下方に相対移動するので、図１０に示すように把持部材１００の一対の開閉片１０１が全開状態になる。
次いで、挿入コイル１２２、規制管１２３及び操作ワイヤ１２９を一体的に上方に移動させることにより全開状態となった把持部材１００を臓器Ｂの上部に近づけて、把持部材１００の把持爪１０７が所望の位置に来たところで操作ワイヤ１２９を（上記切断力より小さい力で）挿入コイル１２２及び規制管１２３に対して相対的に基端側に移動させる。すると、図１１及び図１６に示すように把持部材１００が全閉状態となるので、把持部材１００の一対の把持爪１０７が臓器Ｂの上部を把持する（図１６参照）。
この状態で、操作ワイヤ１２９を上記切断力以上の強い力で引くと、図１７に示すようにループワイヤ１０９が切断する。そのため、把持手段付照明装置９０が内視鏡３０から完全に分離する（図１８参照）。
次いで、内視鏡３０の処置具挿通路３０Ａから操作装置１２０を引き抜き、代わりに把持鉗子５０を処置具挿通路３０Ａに挿入する。そして、一対の把持片５１で照明装置１０Ｃの絶縁テープ８０の外側端部を把持し、絶縁テープ８０を照明装置１０Ｃから引き抜く。すると、照明装置１０Ｃの内部において接触端子２２とバッテリ１７の端子が接触するので、バッテリ１７からＬＥＤ１８に電力が供給され、ＬＥＤ１８で発生した照明光が照明レンズ９５及びカバー９６から照明装置１０Ｃの外部に照射される。 Next, when the operation wire 129 is pulled to the proximal end side (with a force smaller than the cutting force), the loop wire 109 and the gripping member 100 move downward relative to the storage cylinder member 110, so that as shown in FIG. The pair of opening / closing pieces 101 of the gripping member 100 are fully opened.
Next, the gripping member 100 that has been fully opened by moving the insertion coil 122, the restriction tube 123, and the operation wire 129 integrally is moved closer to the upper part of the organ B, so that the gripping claws 107 of the gripping member 100 are in a desired state. When the position is reached, the operation wire 129 is moved to the proximal end side relative to the insertion coil 122 and the restriction tube 123 (with a force smaller than the cutting force). Then, since the grasping member 100 is fully closed as shown in FIGS. 11 and 16, the pair of grasping claws 107 of the grasping member 100 grasps the upper part of the organ B (see FIG. 16).
In this state, when the operation wire 129 is pulled with a force stronger than the cutting force, the loop wire 109 is cut as shown in FIG. Therefore, the illumination device 90 with gripping means is completely separated from the endoscope 30 (see FIG. 18).
Next, the operation device 120 is pulled out from the treatment instrument insertion path 30A of the endoscope 30, and the grasping forceps 50 is inserted into the treatment instrument insertion path 30A instead. And the outer side edge part of the insulating tape 80 of the illuminating device 10C is gripped by the pair of gripping pieces 51, and the insulating tape 80 is pulled out from the illuminating device 10C. Then, since the contact terminal 22 and the terminal of the battery 17 are in contact with each other inside the illumination device 10C, electric power is supplied from the battery 17 to the LED 18, and illumination light generated by the LED 18 is transmitted from the illumination lens 95 and the cover 96 to the outside of the illumination device 10C. Is irradiated.

続いて、図１９に示した磁気誘導部材６６の発生磁界を強めることによって、照明装置１０Ｃを磁気誘導部材６６側に吸引すると、連結ひも９９全体が緊張し、かつ照明装置１０Ｃが磁気誘導部材６６側に移動する。すると、照明装置１０Ｃの照明光が内視鏡３０の照明レンズ３６とは異なる方向から臓器Ｂの内面を照射するので、テレビモニタに映し出された観察像全体が明るくなる。
また、図１９に示すように把持鉗子５０の代わりに内視鏡３０の処置具挿通路３０Ａに挿入した高周波メス７０によって病変部Ｘを臓器Ｂから切除する際に、病変部Ｘやその周辺部に影が出来るのを防止できる。
従って、術者は高周波メス７０によって病変部Ｘとその周辺の粘膜を確実に切除できる。
切除が終わったら、内視鏡３０の処置具挿通路３０Ａに把持鉗子５０を挿入し、把持鉗子５０の把持片５１によって把持手段付照明装置９０（例えば照明装置１０Ｃの連結ひも９９）を把持して把持部材１００を臓器Ｂから引き離し、内視鏡３０を患者Ａの体外に引き出すことにより照明装置１０Ｃを回収する。 Subsequently, by strengthening the magnetic field generated by the magnetic induction member 66 shown in FIG. 19, when the illuminating device 10 C is attracted toward the magnetic induction member 66, the entire connecting string 99 is tensioned, and the illuminating device 10 C is urged by the magnetic induction member 66. Move to the side. Then, since the illumination light of the illuminating device 10C irradiates the inner surface of the organ B from a different direction from the illumination lens 36 of the endoscope 30, the entire observation image displayed on the television monitor becomes bright.
Further, as shown in FIG. 19, when the lesioned part X is excised from the organ B with the high-frequency knife 70 inserted into the treatment instrument insertion passage 30A of the endoscope 30 instead of the grasping forceps 50, the lesioned part X or its peripheral part is obtained. It is possible to prevent shadows from appearing on the screen.
Therefore, the surgeon can reliably remove the lesion X and the surrounding mucous membrane with the high-frequency knife 70.
When the resection is completed, the grasping forceps 50 is inserted into the treatment instrument insertion passage 30A of the endoscope 30, and the illumination device 90 with grasping means (for example, the connecting string 99 of the illumination device 10C) is grasped by the grasping piece 51 of the grasping forceps 50. Then, the grasping member 100 is pulled away from the organ B, and the endoscope 30 is pulled out of the body of the patient A to collect the illumination device 10C.

以上、本発明の第３の実施形態について説明したが、複数の把持手段付照明装置９０を臓器Ｂに取り付けてもよい。
図２０はその一例であり、２つの把持手段付照明装置９０の把持部材１００で臓器Ｂの内壁を把持し、磁気誘導部材６６の磁力を利用して２つの照明装置１０Ｃの照明光を病変部Ｘ側に向けて照射している。
このように複数の照明装置１０Ｃを用いると、臓器Ｂの内部をより明るく照明できるので、術者は臓器Ｂの内部の観察や処置をより正確に行うことが可能になる。
また、図２１に示すように発光部としてＬＥＤ１８の代わりにレーザー光源（図示略）を内蔵する照明装置１０Ｄを備える把持手段付照明装置９０’を臓器Ｂに取り付けて、レーザー光ＬＲを病変部Ｘに照射するようにしてもよい。このようにすれば単に照明するだけでなく、加温療法を行えるようになる。さらに、レーザー光源の代わりにマイクロ波光源を内臓させてもよい。また、ＰＤＴ、ハイパーサーミア、赤外線観察、ＮＢＩなどの光源となるものを利用してもよい。この場合も磁気誘導によるアンカー固定により所望の箇所を照明/照射できる。 Although the third embodiment of the present invention has been described above, a plurality of illumination devices 90 with grasping means may be attached to the organ B.
FIG. 20 shows an example, and the inner wall of the organ B is grasped by the grasping member 100 of the two illumination devices 90 with grasping means, and the illumination light of the two illumination devices 10C is transmitted using the magnetic force of the magnetic induction member 66. Irradiating toward the X side.
When the plurality of illumination devices 10C are used in this manner, the inside of the organ B can be illuminated more brightly, so that the operator can observe and treat the inside of the organ B more accurately.
Further, as shown in FIG. 21, an illuminating device 90 ′ with a grasping means including an illuminating device 10 D incorporating a laser light source (not shown) instead of the LED 18 as a light emitting unit is attached to the organ B, and the laser beam LR is transmitted to the lesioned part X. May be irradiated. In this way, not only lighting but also warming therapy can be performed. Further, a microwave light source may be incorporated instead of the laser light source. Moreover, you may utilize what becomes light sources, such as PDT, hyperthermia, infrared observation, and NBI. In this case as well, a desired location can be illuminated / irradiated by anchoring by magnetic induction.

以上、本発明について上記各実施形態を利用して説明したが、本発明は様々な変更を施しながら実施可能である。
例えば、複数の照明装置１０Ａや複数の照明装置１０Ｂを臓器Ｂの内部に配置したり、照明装置１０Ａや照明装置１０Ｂの内部にレーザー光源やマイクロ波光源を設けても良い。
また、照明装置１０Ａ、１０Ｂ、１０Ｃに内蔵する光源として、バッテリ１７から供給される電力によって点灯するランプを用いてもよい。
さらに、照明装置１０Ｃや照明装置１０Ｄに環状凹部１３を形成してもよい。このようにすれば、切除術終了後に把持鉗子５０によって照明装置１０Ｃや照明装置１０Ｄの環状凹部１３を把持できるので、照明装置１０Ｃ（把持手段付照明装置９０）や照明装置１０Ｄ（把持手段付照明装置９０’）の回収作業が容易になる。 As mentioned above, although this invention was demonstrated using said each embodiment, this invention can be implemented, giving various changes.
For example, a plurality of illumination devices 10A and a plurality of illumination devices 10B may be arranged inside the organ B, or a laser light source or a microwave light source may be provided inside the illumination device 10A or the illumination device 10B.
Moreover, you may use the lamp | ramp which turns on with the electric power supplied from the battery 17 as a light source incorporated in illuminating device 10A, 10B, 10C.
Furthermore, you may form the annular recessed part 13 in 10C of illuminating devices, or 10D of illuminating devices. In this manner, the illumination device 10C and the annular recess 13 of the illumination device 10D can be grasped by the grasping forceps 50 after the resection is completed. The collection operation of the apparatus 90 ') is facilitated.

さらに、図２２及び図２３に示す構造の照明装置１０Ｅを採用することも可能である。この照明装置１０Ｅはの形状は照明装置１０Ｃと異なるが基本構造は同じである。即ち、照明装置１０Ｃの本体部９１に相当する本体部１３０（材質は本体部１１と同じ）と、内側筒状部９３に相当する内側筒状部１３１と、照明レンズ１３２と、を備えている。図示するように内側筒状部１３１の内部にはバッテリ１７及びＬＥＤ１８（回路基板１９）が内蔵してあり、リード線２１の回路基板１９と反対側の端部は本体部１３０の収納凹部１３０ａの底部に固定した導電板１３５に接続している。また、導電板１３５と対向するバッテリ１７の端子には板ばねからなるスイッチ片１３６の一端が固定してある。
さらに、本体部１３０の小径側端部の端面には、該端面と収納凹部１３０ａを接続する円柱形状の軸孔１３０ｂが形成してあり、この軸孔１３０ｂには、スライド部材１３８のスライド軸１３９がスライド可能に嵌合している。スライド軸１３９の外形は収納凹部１３０ａと略同一であり、その内側端部には導電板１３５の貫通孔（図示略）を貫通してスイッチ片１３６に接続する接続突部１４０が一体的に設けてある。また、スライド軸１３９の外側端部にはスライド軸１３９より大径の大径部１４１が一体的に設けてあり、この大径部１４１に連結ひも９９が接続している。
スイッチ片１３６は自身の弾性力によって図２２に示す自由状態に復帰しようとするので、連結ひも９９に張力が掛からないとき、スライド部材１３８はスイッチ片１３６の弾性力によってバッテリ１７側に付勢され図２２に示す非点灯位置に位置する。このとき、大径部１４１が本体部１３０の小径側端面に当接し、スイッチ片１３６と導電板１３５は非接触となる。従って、この状態では照明装置１０Ｅは非点灯状態となる。
一方、本体部１３０が磁気誘導部材６６の磁力によって吸引されるなどして連結ひも９９に張力が掛かると、本体部１３０がスライド部材１３８に対してスライドするので、本体部１３０とスライド部材１３８の相対位置は図２３の状態になる。すると、接続突部１４０と接続したスイッチ片１３６が弾性変形して導電板１３５に接触するので、照明装置１０Ｅは点灯状態となる。 Furthermore, it is also possible to employ an illuminating device 10E having the structure shown in FIGS. Although the shape of the illumination device 10E is different from that of the illumination device 10C, the basic structure is the same. That is, a main body portion 130 (the material is the same as that of the main body portion 11) corresponding to the main body portion 91 of the lighting device 10C, an inner cylindrical portion 131 corresponding to the inner cylindrical portion 93, and an illumination lens 132 are provided. . As shown in the drawing, the battery 17 and the LED 18 (circuit board 19) are built in the inner cylindrical portion 131, and the end of the lead wire 21 opposite to the circuit board 19 is formed in the housing recess 130a of the main body 130. It is connected to a conductive plate 135 fixed to the bottom. One end of a switch piece 136 made of a leaf spring is fixed to the terminal of the battery 17 facing the conductive plate 135.
Further, a cylindrical shaft hole 130b that connects the end surface and the housing recess 130a is formed on the end surface of the small-diameter side end of the main body 130, and the slide shaft 139 of the slide member 138 is formed in the shaft hole 130b. Are slidably fitted. The outer shape of the slide shaft 139 is substantially the same as that of the housing recess 130a, and a connecting projection 140 that penetrates a through hole (not shown) of the conductive plate 135 and is connected to the switch piece 136 is integrally provided at the inner end thereof. It is. A large-diameter portion 141 having a larger diameter than the slide shaft 139 is integrally provided at the outer end portion of the slide shaft 139, and a connecting string 99 is connected to the large-diameter portion 141.
Since the switch piece 136 attempts to return to the free state shown in FIG. 22 by its own elastic force, the slide member 138 is urged toward the battery 17 by the elastic force of the switch piece 136 when no tension is applied to the connecting cord 99. It is located at the non-lighting position shown in FIG. At this time, the large diameter portion 141 comes into contact with the end surface on the small diameter side of the main body portion 130, and the switch piece 136 and the conductive plate 135 are not in contact with each other. Therefore, in this state, the illumination device 10E is in a non-lighting state.
On the other hand, when the main body 130 is attracted by the magnetic force of the magnetic induction member 66 and tension is applied to the connecting string 99, the main body 130 slides with respect to the slide member 138. The relative position is as shown in FIG. Then, the switch piece 136 connected to the connection protrusion 140 is elastically deformed and comes into contact with the conductive plate 135, so that the lighting device 10E is turned on.

また、上記各実施形態の各本体部を非磁性体によって構成してもよい。この場合、照明装置は磁気式誘導装置６０によって移動制御することができないが、各照明装置の向きを調整しながら各照明装置を患者の体内に載置すれば、この照明装置によっても、内視鏡３０の照明レンズ３６とは別の方向から患者の体内を照明可能である。 Moreover, you may comprise each main-body part of said each embodiment with a nonmagnetic material. In this case, the illuminating device cannot be moved and controlled by the magnetic guidance device 60. However, if each illuminating device is placed in the patient's body while adjusting the orientation of each illuminating device, the illuminating device can also be used for endoscopy. The inside of the patient can be illuminated from a direction different from the illumination lens 36 of the mirror 30.

本発明の第１の実施形態の照明装置と内視鏡の先端部の斜視図である。It is a perspective view of the tip part of the illuminating device and endoscope of the 1st Embodiment of this invention. 照明装置の縦断面図である。It is a longitudinal cross-sectional view of an illuminating device. 内視鏡の全体図である。1 is an overall view of an endoscope. 磁気式誘導装置を患者の頭部側から見た図である。It is the figure which looked at the magnetic guidance device from the patient's head side. 磁気式誘導装置の側面図である。It is a side view of a magnetic guidance device. 臓器内に照明装置を配置した状態を示す図である。It is a figure which shows the state which has arrange | positioned the illuminating device in an organ. 本発明の第２の実施形態の照明装置の縦断面図である。It is a longitudinal cross-sectional view of the illuminating device of the 2nd Embodiment of this invention. 本発明の第３の実施形態の照明装置と把持装置の縦断面図である。It is a longitudinal cross-sectional view of the illuminating device and the holding | grip apparatus of the 3rd Embodiment of this invention. 図８のXI−XI矢線に沿う把持装置の断面図である。It is sectional drawing of the holding | gripping apparatus which follows the XI-XI arrow line of FIG. 把持部材が全開状態にあるときの図９と同様の断面図である。FIG. 10 is a cross-sectional view similar to FIG. 9 when the gripping member is in a fully open state. 把持部材が全閉状態になったときの図６と同様の断面図である。It is sectional drawing similar to FIG. 6 when a holding member will be in a fully closed state. 挿入部の先端から、挿入管、挿入コイル、及びフック部材が突出した状態を示す、内視鏡先端部の拡大縦断側面図である。It is an expansion vertical side view of the endoscope front-end | tip part which shows the state which the insertion tube, the insertion coil, and the hook member protruded from the front-end | tip of an insertion part. 照明装置及び把持装置を操作装置に接続した状態を示す拡大縦断側面図である。It is an expanded vertical side view which shows the state which connected the illuminating device and the holding | gripping apparatus to the operating device. 照明装置及び把持装置の内視鏡の挿入部への装着が完了したときの挿入部、照明装置、把持装置、操作装置及び内視鏡先端部の拡大縦断側面図である。It is an enlarged vertical side view of the insertion portion, the illumination device, the gripping device, the operation device, and the endoscope distal end when the mounting of the illumination device and the gripping device to the insertion portion of the endoscope is completed. 臓器内において、照明装置及び把持装置を挿入管から外部に押し出し、かつ把持部材を開いた状態を示す図１４と同様の拡大縦断側面図である。FIG. 15 is an enlarged longitudinal side view similar to FIG. 14 showing a state in which the illumination device and the grasping device are pushed out from the insertion tube to the outside and the grasping member is opened in the organ. 把持部材が患部を把持したときの図１４と同様の拡大縦断側面図である。FIG. 15 is an enlarged longitudinal side view similar to FIG. 14 when a gripping member grips an affected area. ループワイヤが切断したときの図１４と同様の拡大縦断側面図であるである。It is an enlarged vertical side view similar to FIG. 14 when a loop wire is cut. 照明装置及び把持装置が内視鏡から完全に切り離されたときの臓器、照明装置、及び把持装置の拡大縦断側面図である。It is an enlarged vertical side view of the organ, the illumination device, and the grasping device when the illumination device and the grasping device are completely separated from the endoscope. 把持部材が臓器の内壁を把持した状態で照明装置を用いて病変部の照明と処置を行っている状態を示す拡大縦断側面図である。It is an expanded vertical side view which shows the state which is illuminating and treating a lesioned part using an illuminating device in the state which the holding member hold | gripped the inner wall of the organ. 第３の実施形態の変形例の図１９と同様の拡大縦断側面図である。It is an enlarged vertical side view similar to FIG. 19 of the modification of 3rd Embodiment. 第３の実施形態の別の変形例の図１９と同様の拡大縦断側面図である。It is an enlarged vertical side view similar to FIG. 19 of another modification of the third embodiment. 本発明の第４の実施形態の照明装置の消灯状態の縦断面図である。It is a longitudinal cross-sectional view of the light extinction state of the illuminating device of the 4th Embodiment of this invention. 同じく点灯状態の縦断面図である。It is the longitudinal cross-sectional view of a lighting state similarly.

Explanation of symbols

１０Ａ１０Ｂ１０Ｃ１０Ｄ１０Ｅ照明装置
１１本体部
１１Ａ基部
１１Ｂ内側筒状部
１１Ｂ１係止爪
１１Ｃ蓋部
１１Ｃ１係止凹部
１２収納凹部
１３環状凹部（被把持部）
１４照明レンズ（照射部）
１５カバー（照射部）
１６係止爪
１７バッテリ
１８ＬＥＤ（発光部）
１９回路基板
２０端子
２１リード線
２２接触端子
３０内視鏡
３０Ａ処置具挿通路
３１操作部
３２挿入部
３３ユニバーサルチューブ
３４コネクタ部
３５先端面
３６照明レンズ
３７観察窓
３８処置具挿通路の出口開口
３９送気送水孔
４０処置具挿通用突部
５０把持鉗子
５１把持片
６０磁気式誘導装置
６１ベッド
６２ＸＹステージ
６３フレーム／レール（一平面内動機構）
６４６５レール
６６磁気誘導部材（磁力発生装置）
６７電磁石
６８基体
６９カウンターウェイト
７０高周波メス
７１先端部
８０絶縁テープ（絶縁部材）
９０９０’ 把持手段付照明装置
９１本体部
９２基部
９３内側筒状部
９４蓋部
９５照明レンズ（照射部）
９６カバー（照射部）
９７係止凹部
９８係止爪
９９連結ひも（連結部材）
１００把持部材
１０１開閉片
１０２基端部
１０３中間部
１０４先端把持部
１０５第１傾斜部（第１接触部）
１０６第２傾斜部
１０７把持爪
１０９ループワイヤ
１１０収納筒部材
１１１大径部
１１２小径部
１１３テーパ面
１１４スリット
１１５内部孔
１２０操作装置
１２１挿入管
１２２挿入コイル
１２３規制管
１２４大径部
１２５小径部
１２６環状段部
１２８フック部材
１２９操作ワイヤ（牽引部材）
１３０本体部
１３０ａ収納凹部
１３０ｂ軸孔
１３１内側筒状部
１３２照明レンズ（照射部）
１３５導電板
１３６スイッチ片
１３８スライド部材
１３９スライド軸
１４０接続突部
１４１大径部
Ａ患者（対象物）
Ａ１頭部
Ｂ臓器
ＬＲレーザー光
Ｘ病変部（対象部位） 10A 10B 10C 10D 10E Illuminating device 11 Main body 11A Base 11B Inner cylindrical portion 11B1 Locking claw 11C Lid 11C1 Locking recess 12 Storage recess 13 Annular recess (gripped portion)
14 Illumination lens (irradiation part)
15 Cover (irradiation part)
16 Locking claw 17 Battery 18 LED (light emitting part)
19 circuit board 20 terminal 21 lead wire 22 contact terminal 30 endoscope 30A treatment instrument insertion path 31 operation part 32 insertion part 33 universal tube 34 connector part 35 distal end surface 36 illumination lens 37 observation window 38 outlet opening 39 of treatment instrument insertion path Air supply / water supply hole 40 Projection tool insertion protrusion 50 Grip forceps 51 Grip piece 60 Magnetic induction device 61 Bed 62 XY stage 63 Frame / rail (one-plane in-plane movement mechanism)
64 65 rail 66 magnetic induction member (magnetic force generator)
67 Electromagnet 68 Base 69 Counterweight 70 High-frequency knife 71 Tip 80 Insulating tape (insulating member)
90 90 'Illuminating device with grip means 91 Main body part 92 Base part 93 Inner cylindrical part 94 Lid part 95 Illumination lens (irradiation part)
96 Cover (irradiation part)
97 Locking recess 98 Locking claw 99 Connection string (connection member)
100 Grasping member 101 Opening / closing piece 102 Base end portion 103 Intermediate portion 104 Tip gripping portion 105 First inclined portion (first contact portion)
106 Second inclined portion 107 Holding claw 109 Loop wire 110 Storage cylinder member 111 Large diameter portion 112 Small diameter portion 113 Tapered surface 114 Slit 115 Internal hole 120 Operation device 121 Insertion tube 122 Insertion coil 123 Restriction tube 124 Large diameter portion 125 Small diameter portion 126 Annular step 128 Hook member 129 Operation wire (traction member)
130 Main body portion 130a Storage recess portion 130b Shaft hole 131 Inner cylindrical portion 132 Illumination lens (irradiation portion)
135 Conductive plate 136 Switch piece 138 Slide member 139 Slide shaft 140 Connection protrusion 141 Large diameter portion A Patient (object)
A1 head B organ LR laser beam X lesion (target site)

Claims

An illuminating device separate from the endoscope, which can be installed inside an object by using an endoscope,
The main body,
A light emitting part that emits illumination light toward the outside of the main body, fixed to the main body;
With
In the internal space of the main body, the light-emitting unit composed of any one of an LED, a lamp, a laser light source, and a microwave light source, a battery that supplies power to the light-emitting unit, A contact terminal facing the battery terminal;
An irradiation unit for irradiating illumination light generated by the light emitting unit to the outside is provided on the surface of the main body unit,
An insulating member having an inner end located in the inner space and an outer end located outside the main body is inserted into a through-hole that communicates the inner space formed in the main body with the outside of the main body. ,
The insulating member is located between the contact terminal and the battery terminal so that the power supply from the battery to the light emitting unit is interrupted, and the insulating member is entirely pulled out from the through hole. By this, the said contact terminal contacts the terminal of the said battery, and accept | permits that electric power is supplied to the light emission part from the said battery .

An illuminating device separate from the endoscope, which can be installed inside an object by using an endoscope,
The main body,
A light emitting part that emits illumination light toward the outside of the main body, fixed to the main body;
With
One end of a flexible connecting member is connected to the main body,
A gripping member capable of gripping the object is connected to the other end of the connecting member;
In the internal space of the main body part, the light emitting part composed of any one of an LED, a lamp, a laser light source and a microwave light source, a battery for supplying power to the light emitting part, a conductive plate electrically connected to the light emitting part, and A switch piece made of a leaf spring electrically connected to the battery terminal,
An irradiation unit for irradiating illumination light generated by the light emitting unit to the outside is provided on the surface of the main body unit,
The inner space formed in the main body and the outside of the main body are slidably fitted in a slide shaft hole, the inner end thereof is connected to the leaf spring, and the outer end is connected to the connecting member. Provide a slide member to connect to
The switch piece is separated from the conductive plate by being in a free state, and is elastically deformed until the slide member contacts the conductive plate by being pulled outside the main body. .