DE4313843A1 - Device for endoscopic exploration of the body - Google Patents

Description

The invention relates to a device for endoscopic exploration of the Body, more precisely the human body or animal body.

Endoscopy is a branch of medicine that is becoming increasingly important. So far endoscopic explorations are carried out almost exclusively with endoscopes leads, which essentially consists of an elongated endoscope shaft and an endo scope head exist. The endoscope shaft is a semi-rigid, flexible structure, often with a diameter of 1 to 2.5 cm. The endoscope head contains a light source and either an optical system or a camera chip. Using the endoscope Optical information is captured either by means of fiber optic cables or converted into electrical signals by an electrical conductor in the endoscope shaft run, transferred to the outside. The endoscope usually contains a bow the traction device with which the foremost area of the endoscope is relative to the Endoscope shaft can bend in several directions. Finally, the endo contains Usually a working channel through which fluids are released into a fluid occurs in the area of the endoscope head and can promote small medicines can use "tools" in the area in front of the endoscope head, e.g. B. Sample Extraction pliers, needles, cutting wires for removing tissue, coagulation electrodes and the like.

Conventional endoscopes are moved into body cavities in that the Doctor on the part of the endoscope protruding from an insertion body opening exerts a pushing pressure. If a bend an elongated Body cavity is manageable, you can do this by bending the foremost Lighten the endoscope area in the appropriate direction. Overall, the introduction conventional endoscopes, however, is a laborious and time-consuming procedure,  the space requirement of the endoscope shaft and its necessarily limited Flexibility especially with body canals with numerous and / or narrow bends gene, e.g. B. in the intestine, represent very aggravating circumstances.

The invention has for its object to make a device available with which is the endoscopic exploration of the body especially in body canals can be carried out much more easily with tight and / or numerous bends.

To achieve this object, the invention relates to a device for endo scopic exploration of the body, marked by:

• a) a base on which the body to be explored can be placed;
• b) a coil device for generating a magnetic field which comprises a first partial Coil device with a first axis and a second part Has coil device with a second axis, the first and the second axis are at an angle to each other and the power supply to the two partial coil devices is adjustable so that a magnetic field ge desired orientation results;
• c) movability of the base ( 4 ) and the coil device ( 14 , 16 ) relative to one another in the three spatial directions;
• d) an endoscopic probe which is so equipped with magnetically responsive material ( 48 , 50 ) that it aligns itself along the magnetic field and experiences a force effect in its longitudinal direction in the magnetic field; and
• e) rotatability of the base ( 4 ) and the coil device ( 14 , 16 ) relative to each other about an axis.

The device according to the invention is basically for exploration of all interiors adequate size of the body. Particularly suitable interiors Spaces are the trachea, the esophagus, the stomach, the intestine, the urinary system pathways to the kidney, the abdomen after air insufflation and large blood vessels to the heart and including this. As a particularly preferred area of application the intestine is viewed, the Device a push into the small intestine appears possible.  

The pad on which the body to be explored can be placed can be quite be flat-table-like. For certain types of examination, however, there is also more chair-like underlay.

Due to the coil device in the Ve purely with the probe designed according to the invention, it is possible to align the Probe in the body in an electro-magnetic way without mechanical movement change or, in other words, rotate the probe around a specific axis. The Example to be described below will show that one makes more sense arranges the two sub-coil devices so that the axis of the probe, around which it can be rotated electro-magnetically, one for the alignment of the Is particularly often required axis of rotation.

The probe is preferably connected to at least one flexible strand, which at probe inserted into the body from an opening in the body. This strand can in particular a safety line or an electrical line or a hose be or can have at least one of these elements. The - only from one derar existing element or several such elements - flexible strand is in front preferably much thinner and more flexible than a conventional endoscope shaft, what Difficulties of the type described above when inserting the probe in Ver avoids the introduction of a conventional endoscope or at least we considerably reduced.

The probe preferably contains a transmitter for transmitting data, especially of image data obtained, to the outside. One within the scope of the invention Another possible alternative is that the image information is based on the above addressed electrical conductor that forms the strand or is part of the strand, is transmitted to the outside. The version with the transmitter has the advantage that a in many cases there is no need for an electrical conductor connection to the probe, because you B. the light source, the camera chip and the transmitter in the probe via a Can supply battery or an accumulator with electricity. The further from in the zu connection with the line mentioned safety rope is only a precautionary  Measure to get the probe out of the body using this line if necessary to be able to pull. Especially with probes that are less problematic Body cavities as the intestines are to be examined can be the safety line can also be dispensed with, since the probe can be returned using the same mechanisms can move out of the body as it has been introduced forward.

The probe preferably contains a space for accommodating a strand supply de rart that from this supply strand length can be delivered continuously while the probe moves further and further into the body. In this way, the Do not probe a possibly quite large strand length by possibly number draw rich bends around behind. The alternative execution that single Lich the front end of the strand is attached to the probe and that the probe is in moving into the body pulls the strand, but is also possible.

Moving the probe into the body, especially along the explorer the elongated body channel z. B. the intestine, is done in practice so that the Probe and the body are moved relative to each other such that the probe is longitudinal of the body channel. The movements in the three spatial directions or the Movement in a translational direction that consists of one, two, or three Spatial directions is made up by the relative mobility of Un Support and coil device, which holds the probe as it were. That invented According to the intended rotation of the probe about two axes is done electrically magnetically through the coil device as well as by physically turning the coil leneinrichtung about an axis. A rotation of the probe around the third conceivable spatial axis This is not necessary because it coincides with the longitudinal axis of the probe.

Carrying out the required relative movement between the probe and the to exploratory bodies in the most general case require translational displacement Exercise in the three spatial directions, an electrical-magnetic rotation around an axis and rotation of the coil means. For this purpose, the device can five Commander, one for each of the shifts and Dre hunger. The doctor performing the exploration either operates the row after or partially simultaneously these five commanders so that the probe is along  of the body canal in front of the probe, as far as possible in its zen persistent, moved. It should be noted that if the probe of some is exactly aligned with the longitudinal direction of the body canal and if the Body channel has a reasonably straight section, this movement is pure Translation movement with a maximum of three components. If a bend of the Body canal is to be mastered, is either a pure rotary movement by maximum two axes or a rotary movement combined with a certain translational movement to accomplish.

In particular, the described movement of the probe along a straight section of the body canal can be easily automated. From the orientation of the magnetic field the coil device (which is based on the size of the power supply lines to the two Coil devices result), the device "knows" how the probe accordingly is aligned with the magnetic field. From this, an electronic calculator can easily calculate the required motion components in the three spatial directions, which the pad and the coil device must perform relative to each other so that the probe moves along the straight section.

Furthermore, an even more automated control is possible, in which the data from the son de captured image information about the progress of the body channel in front of her in a tax Information for the movements and the electro-magnetic adjustment or ver position of the coil device of the device can be implemented. In the intestinal explora tion essentially takes up the optical system or the camera chip of the probe symmetrical image of a circle true, its brightness from outside to inside if the probe is aligned longitudinally in the intestine approximately at its center located. The control of the movements and the coil currents can be programmed in this way be that the five components of the movement mentioned take place in combination in such a way that the probe while maintaining this image perception as possible moved forward.

It is pointed out that the device according to the invention also for explora tion of the cavities or channels of technical products, e.g. B. the internal examination of heat exchangers with a complicated fluid channel structure.  

The hose mentioned earlier in connection with the strand can in particular which are used to pass a gas to the probe for e.g. B. local filling of the intestine to eject with gas. The hose can also be used to flush a rinse Inject liquid against the intestinal wall.

The safety line mentioned above can also be used as a guide line use that - pulled through the working channel of a conventional endoscope - des Sen insertion along the body canal much easier. With this endoscope you can then make any necessary medical interventions.

It is expressly pointed out that the endoscopic cal probe in combination with an arbitrarily designed coil device for magnetic "holding" or moving the probe as a separate invention will see. In this invention, the two partial Coil devices with intersecting axes are present.

The invention and embodiments of the invention are described below with reference to a schematically illustrated embodiment illustrated in more detail. It shows:

Fig. 1 shows a device according to the invention in plan view illustrative in Example endoscopic exploration of the intestine;

Figure 2 shows the device of Figure 1 in side view;

Fig. 3 shows the probe provided in the device of FIG. 1 in a substantially enlarged scale, in longitudinal section.

The endoscopic apparatus 2 shown in Fig. 1 and 2, a table-like, horizontal surface 4 to the base 4 is gen GETRA of a flat-carriage-like base 6 by means of a höhenbewegbaren column 8 at the head end of the base 4. The base 4 is horizontally movable at its head end in a direction perpendicular to the longitudinal direction of the base 4 . On the top of the base 6 , a carriage 10 movable in the longitudinal direction of the base 4 is attached. The carriage 10 carries on its upper side a large, hollow cylindrical tube 12 with an inner diameter of approximately 1 m, the longitudinal axis of the tube 12 extending horizontally in the longitudinal direction of the base 4 .

A first partial coil device 14 and a second partial coil device 16 are fastened to the inside of the tube 12 . The first partial coil device 14 has an axis 18 , and the second partial coil device 16 has an axis 20 . The two Spu lenachsen 18 , 20 extend at right angles to each other in the illustrated embodiment and intersect at a point 22 slightly above the top of the base 4 , being positioned at about 22 in an endoscopic intestinal examination of the underside of a patient 24 . The two partial coil devices 14 , 16 surround the base 4 with the patient lying thereon in a ring.

Each of the partial coil devices 14 , 16 consists of a coil, but can also consist of several coils placed axially next to one another. In the interior of each partial coil device 14 or 16 , an axially directed magnetic field is generated when power is supplied.

With axis 18 or 20 of the respective partial coil device 14 or 16 is denjeni ge straight line that coincides with the central cylinder axis in the case of a cylindrical partial coil device. If you imagine a partial coil device with an elliptical frontal view in the front view, it is the axis going through the center of the ellipse that is perpendicular to the plane of the ellipse.

The two partial coil devices 14 , 16 together form the (total coil device for generating a magnetic field. In the side view of FIG. 2, the two partial coil devices 14 , 16 optically coincide. Each partial coil device 14 , 16 is in the exemplary embodiment shown circular in frontal view, so that because of the inclination of the axes 18 , 20 relative to the longitudinal axis of the base 4, it does not lie along its entire circumference on the inside of the tube 12. Each of the axes 18 , 20 extends at an angle of in the illustrated exemplary embodiment 45 ° relative to the longitudinal central axis 26 of the base 4. The partial coil devices 14 , 16 can also be elliptical.

If both partial coil devices 14 , 16 - the same winding structure is required - current of the same amperage is supplied, a common magnetic field is created, the direction of the magnetic field lines parallel to the longitudinal axis 26 of the base 4 . To the extent that the current through z. B. the second partial coil device 16 is reduced and the current through the first partial coil device 14 is increased to compensate, the direction of the magnetic field lines rotates away from the axis 26 in the direction more towards the first axis 18 of the first partial coil device 14 , and vice versa. It is good if the currents through the two partial coil devices 14 , 16 are always adjusted so that the strength of the magnetic field is always the same regardless of the orientation of the magnetic field. With the described arrangement of the partial coil devices 14 , 16 and the type of power supply to be described, one thus has an instrument which rotates the orientation of the magnetic field by 360 ° (possibility of reversing the direction of current flow through the coils) about an axis which extends at right angles to the axes 18 , 20 through their intersection 22 .

The tube 12 , which serves as a holder for the partial coil devices 14 , 16, can be rotated through 360 ° with a horizontal axis of rotation relative to the slide 10 and thus relative to the base 4 as a result of a bearing 28 .

To simplify the further description, it is assumed that there is a probe to be described later in more detail at the interface 22 of the axes 18 , 20 , specifically in the direction of the first axis 18 of the first partial coil device 14 . Thus, the described endoscopy device 2 has three translational possibilities of the relative movement between the patient 24 and the coil device, namely longitudinally-horizontally by means of the carriage 10 , vertically by means of the column 8 and transversely-horizontally by means of the support 4 relative to the column 8 , and the Rotation speed of the probe relative to the patient 24 by rotating the tube 12 about the horizontal longitudinal axis, and the rotational orientation of the probe relative to the patient 24 about the described axis of rotation, which is perpendicular to the axes 18 , 20 , by adjusting len a different ratio of the currents through the first partial coil device 14 and the second partial coil device 16 .

In Fig. 3 the previously mentioned probe 30 is shown in more detail. Overall, the probe 30 has the configuration of an elongated circular cylinder with a rounded front end 32 and a rounded rear end 34 . The front end 32 is transparent, and on the inside of a lens or a lens system and a light source, together designated 36 , are arranged. A camera chip 38 is located on the back of the lens. A camera electronics 40 is located on the back of the camera chip 38 . Further on the back from the camera electronics 40 is a module 42 which contains a transmitter and a power supply. The rest of the interior of the probe 30 is formed by a receiving space 44 for a strand 46 , in the present example a safety line.

Subsequent to the rounded front area 32 , a hollow cylindrical permanent magnet 48 is provided on the outside of the probe 30 , the longitudinal axis of which coincides with the longitudinal axis of the probe 30 . The permanent magnet 48 has, for. B. on its front, circular annular face a north pole and on its rear, annular end face a south pole. The permanent magnet 48 takes up about a quarter of the length of the probe 30 . Subsequent to the rear end face of the permanent magnet 48 , a hollow cylindrical soft iron part 50 is provided, which takes up about half the length of the probe 30 . The strand 46 is loosely inserted in a suitable manner in the storage space 44 , so that the strand 46 is gradually pulled out of the storage space 44 as the probe 30 moves into the intestine of the patient 24 .

Due to the described equipment of the probe 30 with the permanent magnet 48 and the soft iron part 50 , the probe 30 is always aligned with its longitudinal axis corresponding to the direction of the magnetic field of the coil device described further above. Furthermore, the probe 30 experiences a magnetic force effect in the longitudinal direction of this magnetic field until it reaches its end region at an axial end of the coil device. The permanent magnet 48 is not absolutely necessary.

A control device 52 and a receiver / monitor 54 are also shown in FIG. 1.

The doctor who endoscopically explores the intestine of the patient 24 , after inserting the probe 30 into the anus of the patient 24 , proceeds to monitor the image of the intestinal section in front of the probe front area 32 on the monitor 54 by means of the described transmitter observed. On the control unit 52 , he operates control buttons 56 in order to move the patient 24 or the tube 52 holding the coil device in a combination of linear movements in the three spatial directions so that the probe 30 (which is caused by the magnetic field of the coil device " tied "stationary or essentially stationary at the interface 22 remains) along the intestinal section of the patient in front of the probe 30 moved relative to this. If a bowel bow has to be overcome, the doctor must use other of the operating heads 56 to rotate the support tube 12 about its longitudinal axis and / or the ratio of the currents through the partial coil devices 14 , 16 so that the probe 30 changes into the Direction of the subsequent section of the intestine rotates. It goes without saying that the three translational movement components and the one rotational rotation are carried out with external force, for example with the aid of electric motors.

The three translational movement possibilities and the one rotational movement movement possibility can be divided arbitrarily between the base 4 and the coil device 14 , 16 . So you could e.g. B. make the table 10 longitudinally, transversely and vertically ver. Or one could use the support 4 to rotate about the longitudinal axis 26 instead of the coil device 14 , 16 .

The probe 30 may include sampling tongs that can be deployed on command and can pinch a tissue sample from the intestinal wall.

Claims (6)

1. Device for endoscopic exploration of the body, characterized by :

• a) a base ( 4 ) on which the body ( 24 ) to be explored can be placed;
• b) a coil device ( 14 , 16 ) for generating a magnetic field, which has a first partial coil device ( 14 ) with a first axis ( 18 ) and a second partial coil device ( 16 ) with a second axis ( 20 ) , wherein the first and second axes are at an angle to one another and wherein the current supply to the two partial coil devices is adjustable so that a magnetic field results in the desired orientation;
• c) movability of the base ( 4 ) and the coil device ( 14 , 16 ) relative to one another in the three spatial directions;
• d) an endoscopic probe ( 30 ) which is so equipped with magnetically responsive material ( 48 , 50 ) that it aligns itself along the magnetic field and experiences a force effect in its longitudinal direction in the magnetic field; and
• e) rotation of the support (4) and the coil means (14,16) relative to each other about an axis.

2. Device according to claim 1, characterized in that the probe ( 30 ) is connected to at least one flexible strand ( 46 ) which leads out of a body opening when the probe ( 30 ) is inserted. 3. Apparatus according to claim 2, characterized in that the strand ( 46 ) is a safety line or an electrical line or a hose or has at least one of these elements. 4. Apparatus according to claim 2 or 3, characterized in that the probe ( 30 ) contains a space ( 44 ) for accommodating a strand supply in a continuously extractable manner. 5. The device according to at least one of claims 1 to 4, characterized in that the probe ( 30 ) has a transmitter ( 42 ) for transmitting data to the outside. 6. The device according to at least one of claims 1 to 5, characterized by a control device ( 52 ) with which a command "forward movement Son de" in an axis-combined relative movement of the base ( 4 ) and Spu leneinrichtung can be implemented.