JP2002159508A - Identifying system of lesion in digestive organ - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an identifying system of a lesion in a digestive organ capable of speedily and accurately identifying a lesion in an excising operation of the lesion in the digestive organ without increasing a load on a patient and improving reliability of the operation. SOLUTION: This identifying system has a step of inserting an endoscope into the digestive organ and searching a lesion with the endoscope, a step of mounting a magnet on or near the searched lesion, a step of pulling the endoscope out of the digestive organ leaving the mounted magnet as a mark of the lesion, and a step of identifying the magnet mounted part with a magnetic sensor from the outside of the digestive organ. The identified magnet mounted part is considered as the lesion of the digestive organ.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a digestive organ lesion site identification system for identifying the location of a lesion in the digestive organ from outside the digestive organ.

[0002]

2. Description of the Related Art Generally, in tumor excision surgery for a digestive organ such as the stomach or the large intestine, or for other digestive organ surgery requiring excision surgery, the location of a lesion can be visually determined from outside the digestive organ. If it is expected that it is difficult to confirm tactilely, an endoscope is inserted into the digestive organ in advance before the operation, and the lesion or its vicinity (hereinafter, may be collectively referred to as the vicinity of the lesion). Mark the spot with a dye, clip, etc.
At the time of surgery, the site of the lesion is visually or tactilely confirmed using the mark, and the resection site is determined.

[0003] However, in many cases, the lesion cannot be confirmed at the time of surgery by this general method. In such a case, the endoscope is inserted again to search for the lesion, and the endoscope is inserted from the tip of the endoscope. The resection site was determined by visually confirming the illumination light from outside the digestive organ or by confirming the position of the clip by fluoroscopy.

In the method of re-inserting the endoscope and visually recognizing the illumination light from the distal end of the endoscope, it is difficult to make a clear check because it is visible through the digestive organ wall, and the operation time is prolonged. Insertion of the endoscope takes about 10 to 40 minutes), insertion of the endoscope or prolongation of the operation time greatly increases the burden on the patient, and deteriorates the visual field during the operation (for example, using the endoscope, When inserted into the stomach, the intestinal tract is dilated to send gas to widen the field of view of the endoscope, and the space between the abdominal wall and the intestine, which is the operating field for laparoscopic surgery, becomes narrow. .

In the method of confirming the position of the clip by X-ray fluoroscopy, it is necessary to take measures so that the patient and the operator's body are not harmed by the X-ray, and the operator's actions are restricted, so that rapid operation is required. There was a problem that hindered surgery. Also, the use of X-ray equipment in clean areas where surgery is performed is problematic from a sanitary point of view.

[0006] In the method of marking the dye, when the dye is injected into the digestive tract, the dye becomes invisible when the needle is pierced into the digestive organ shallowly, and there is a danger of causing peritonitis when the needle is pierced deeply and penetrates the peritoneum. There was also the problem of being large (colectomy surgery causes peritonitis every three times).

As a solution to the above-mentioned drawbacks of the prior art, a technique of combining a clip attached near a lesion of a digestive organ and a luminous body and confirming the lesion by looking at a clip shining from outside the digestive organ (practical use) There is a new model No. 3027808 (shining marking clip), but it is difficult to make a clear confirmation because it is visible through the digestive organ wall.

Further, an endoscope inserted into the digestive tract, a treatment tool outside the digestive tract inserted into the body cavity, and means for detecting the relative positions of the endoscope and the treatment tool (for example, permanent Technology provided with a magnet and a magnetic sensor (Japanese Patent Laid-Open No. 06-285042)
Body cavity position detection system). This technique involves inserting an endoscope into the digestive tract immediately before surgery, and further performing the operation with the endoscope inserted, and then inserting the endoscope again and illuminating light from the endoscope tip. Similar to how to view,
There are problems such as a long operation time, a great increase in the burden on the patient, and a poor field of view during the operation, which is practically difficult to carry out.

[0009]

SUMMARY OF THE INVENTION The present invention has been made in view of the above circumstances, and enables the location of a lesion in a gastrointestinal lesion excision operation to be quickly and accurately identified without increasing the burden on the patient. An object is to provide a digestive organ lesion site identification system that can improve reliability.

[0010]

In order to achieve the above-mentioned object, the present invention comprises a step of inserting an endoscope into a digestive organ to search for a lesion, and a step of attaching a magnet to or near the searched lesion. Extracting the endoscope from the digestive organ while leaving the attached magnet as a mark of a lesion, and identifying the magnet installation site with a magnetic sensor from outside the digestive organ, It is a digestive organ lesion site identification system as a lesion site. The magnet as a mark of the lesion site is desirably a permanent magnet.

Further, the magnet is a magnet which has been subjected to a surface treatment in order to improve affinity with a human body, and is preferably a magnet which has been subjected to a surface treatment with titanium.

Further, the present invention includes a data processing section for processing a signal from the magnetic sensor, and the data processing section has a function of visually displaying a signal detected by the magnetic sensor, such as a numerical value or light, and a function of detecting the signal. This is a digestive organ lesion site identification system having a function of giving a warning by a buzzer, blinking of a lamp, or the like when a signal exceeds a predetermined magnitude.

[0013]

DESCRIPTION OF THE PREFERRED EMBODIMENTS The present invention uses a magnet as a marker for a lesion in a digestive organ, and detects a leakage magnetic field of the magnet by a magnetic sensor from outside the digestive organ. Before the digestive organ resection operation, an endoscope is inserted into the digestive organ in advance to search for a lesion, a magnet is attached near the searched lesion to mark the lesion, and the endoscope is pulled out from the digestive organ. That is, before the operation, a magnet serving as a mark is attached near the lesion in the digestive organ of the patient. In addition, the insertion of the magnet as a mark may be performed after searching for a lesion, by inserting into the endoscope in a state where it is attached to the distal end of the operation tube or the like, or may be inserted together with the endoscope first. Although it is not intended to limit the present invention, the method of inserting the endoscope after searching for a lesion is preferable from the viewpoint that the diameter of the endoscope can be reduced and the burden on the patient can be reduced.

At the time of surgery, the leaked magnetic field of the magnet attached near the affected part in the digestive organ is detected by a magnetic sensor from outside the digestive organ, thereby identifying the magnet attachment site. As the site, a resection site is determined and surgery is performed. Note that the resection site is determined including the identified digestive organ lesion site and data such as the size of the lesion site confirmed at the time of insertion of the endoscope and the relative relationship between the lesion site and the magnet attachment portion.

The magnet to be used may be an electromagnet provided with an extremely small power supply or an electromagnet provided with an electric wire for supplying electric power from outside the body, but a permanent magnet is preferred in order to make the magnet as small as possible.

The magnet of the present invention is to be inserted into the digestive organ of a living body and attached to the digestive organ as a mark of a lesion, and one of the important issues is to consider the affinity with the human body. Therefore, the present invention improves the affinity with the human body by using a surface-treated magnet, preferably a magnet surface-treated with titanium.

At the time of surgery, the operator has a function of a data processing unit for processing a signal (a signal indicating a relative position between the magnet and the magnetic sensor) which detects a leakage magnetic field of a magnet attached near the lesion by a magnetic sensor. The position of the magnet can be searched while visually confirming the relative position of the magnet and the magnetic sensor using numerical values, light, etc., and the buzzer or lamp generated when the detected signal exceeds a predetermined magnitude The warning such as blinking allows the magnet attachment site to be identified more quickly and accurately.

As described above, according to the present invention, a magnet previously mounted near the lesion in the digestive tract is used as a mark, and at the time of surgery, the leakage magnetic field of this magnet is detected by a magnetic sensor from outside the digestive tract. Gastrointestinal lesions can be identified quickly and accurately.

In addition to the quick and accurate identification, there is no need for a procedure such as X-ray fluoroscopy that restricts the operation of the operator, so that the operation time can be shortened.

As a result, the digestive organ lesion site identification system of the present invention does not require re-insertion of the endoscope, X-ray fluoroscopy, injection of dye into the digestive organ, etc. The lesion area can be minimized, and the burden on the patient does not increase. Furthermore, the ability to quickly and accurately identify gastrointestinal lesions, shorten the operation time, and minimize the extent of resected lesions, including the psychological effects that occur to the surgeon, improves the reliability of surgery. Let it.

The magnetic sensor may be, for example, a Hall element, but may be any as long as it can detect the leakage magnetic field of the magnet attached near the lesion from outside the digestive organ. It is not limited.

[0022]

DESCRIPTION OF THE PREFERRED EMBODIMENTS Embodiments of the present invention will be described below in detail with reference to the accompanying drawings, with reference to an example of a system for identifying a tumor site in the large intestine.

FIG. 1 is a schematic configuration diagram showing an embodiment of a process for identifying a magnet attachment site from outside the digestive tract by a magnetic sensor using the digestive organ lesion site identification system of the present invention.
In FIG. 1, reference numeral 1 denotes a magnetic field detection probe, which has a built-in magnetic sensor (not shown). Reference numeral 2 denotes a permanent magnet treated with titanium, 3 denotes a clip for attaching the permanent magnet 2, 4 denotes a tumor, 5 denotes a large intestine, 6 denotes an optical viewing tube, 7 denotes an introduction tube such as a trocar, 8 denotes an abdominal wall, and 9 denotes an abdominal wall. The abdominal cavity 10 is a data processing unit.

FIG. 2 is a schematic structural view showing an embodiment of a process of attaching a magnet to a lesion in a digestive organ or its vicinity by the digestive organ lesion site identification system of the present invention. In FIG. 2, the same components as those in FIG. 1 are denoted by the same reference numerals. In FIG. 2, reference numeral 11 denotes an endoscope, and others are the same as those in FIG.

FIG. 3 is a photograph showing an embodiment of a magnet attached to or near a lesion in the digestive organ by the digestive organ lesion site identification system of the present invention. FIG. 3 (a) shows a permanent magnet attached to a clip. (B) is a state in which the clip is connected to the operation tube and is being pulled into the cladding tube, and (c) is a state where the clip is pulled into the cladding tube.

Next, the operation of this embodiment will be described.

First, prior to the colectomy operation, a procedure is performed in advance to attach a permanent magnet as a mark near the tumor in the colon of the patient.

Specifically, first, as shown in FIG.
A permanent magnet is attached to the clip, the clip is connected to the operation pipe, and this is pulled into the cladding pipe (hereinafter, this state may be collectively referred to as a permanent magnet). This preparation is important in order to be able to subsequently insert a permanent magnet or the like after searching for a tumor with an endoscope. After preparing a permanent magnet or the like, the endoscope is inserted into the large intestine to search for a tumor, and after searching for a tumor, the prepared permanent magnet or the like is inserted through the endoscope. Next, a permanent magnet is attached as a mark of the tumor part near the searched tumor part. FIG. 2 shows a state in which a permanent magnet is being attached near the tumor part. That is, FIG. 2 shows a cladding tube (not shown) for attaching the permanent magnet 2 near the tumor 4.
The permanent magnet 2 is attached to the clip 3, connected to the operation tube, and inserted through the endoscope 11. The endoscope 11 is inserted into the large intestine 5.

The permanent magnet 2 is positioned near the tumor 4 by the clip 3.
Is attached, the clip 3 is detached from the operation tube, the permanent magnet 2 and the clip 3 are left near the tumor 4, and the endoscope 11 is pulled out from the large intestine together with the operation tube. This completes the attachment of the permanent magnet serving as a mark to the vicinity of the tumor.

At the time of surgery, as shown in FIG. 1, the probe 1 having a built-in magnetic sensor is inserted into the abdominal cavity 9 through the abdominal wall 8 through the introducing tube 7 such as a trocar, and the abdominal cavity 9 is introduced through the introducing tube 7 such as a trocar. Under observation of the optical viewing tube 6 inserted in
While the leakage magnetic field of the permanent magnet 2 is detected by a magnetic sensor built in the probe 1, the attachment site of the permanent magnet 2 is identified.
At this time, the signal detected by the magnetic sensor is transmitted to the data processing unit 1.
0, the relative position between the permanent magnet 2 and the magnetic sensor is visually displayed by numerical values, light, and the like, and when a detected signal exceeds a predetermined magnitude, such as a buzzer or blinking of a lamp. A warning is issued. This allows
The surgeon can more quickly and accurately identify the permanent magnet 2 attachment site.

After identifying the permanent magnet 2 attachment site, the identified permanent magnet attachment site is regarded as a colorectal tumor site, and includes data such as the size of the tumor 4 and the relative relationship between the tumor 4 and the permanent magnet 2 attachment. Determine the resection site and perform surgery.

According to the present embodiment, a permanent magnet previously attached to the vicinity of a tumor in the large intestine is used as a mark, and the leakage magnetic field of the permanent magnet is detected from outside the large intestine by a magnetic sensor at the time of surgery, so that the tumor in the large intestine can be identified. It can be identified quickly and accurately. In addition to the quick and accurate identification, there is no need for a procedure such as X-ray fluoroscopy that restricts the operation of the operator, so that the operation time can be reduced. This eliminates the need for re-insertion of the endoscope, X-ray fluoroscopy, injection of dyes into the digestive organs, etc., as well as shortening the operation time and minimizing the resection range, increasing the burden on the patient. Nothing. Furthermore, the ability to quickly and accurately identify the colorectal tumor site, reduce the operation time, and minimize the resection range, including the psychological effects that occur to the operator, improves the reliability of the operation.

While the embodiments of the present invention have been described above, it is to be understood that various changes may be made in form and detail without departing from the spirit and scope of the invention as defined in the appended claims. it is obvious.

For example, in the present embodiment, the magnet is attached to the vicinity of the tumor with a clip. For example, a thread may be attached to the magnet and the magnet may be attached with this thread. Instead, the magnet may be directly attached to the tumor, and the method of attaching the magnet and the attaching position of the magnet are not limited to the present invention.

In the present embodiment, the probe and the data processing section are separated from each other, but may be of an integral type and do not limit the present invention.

Further, in this embodiment, the permanent magnet is attached to the clip, the clip is connected to the operation tube, and the permanent magnet is drawn into the cladding tube. Any mechanism may be used as long as it can be inserted in the vicinity, has a function of attaching the inserted magnet to the vicinity of the lesion, and pulling out the remaining magnet while leaving the attached magnet, and the detailed mechanism and structure do not limit the present invention.

[0037]

According to the present invention, a magnet previously attached near a lesion in the digestive tract is used as a mark, and the leakage magnetic field of the magnet is detected by a magnetic sensor from outside the digestive tract during surgery, so that the lesion in the digestive tract can be reduced. There is an effect that the site can be identified quickly and accurately.

In addition to the quick and accurate identification, there is no need for a procedure such as X-ray fluoroscopy that restricts the operation of the operator, so that the operation time can be shortened. Therefore, the present invention
It does not require re-insertion of the endoscope, X-ray fluoroscopy, injection of dye into the digestive organs, etc.In addition, shortening of the operation time and minimization of the resected lesion area are possible, so that the burden on the patient is not increased This has the effect.

Furthermore, the ability to quickly and accurately identify a lesion site in the digestive organ, shorten the operation time, and minimize the range of the resected lesion includes the psychological effects that occur to the operator,
This has the effect of improving the reliability of surgery.

[Brief description of the drawings]

FIG. 1 is a schematic configuration diagram showing an embodiment of a process for identifying a magnet attachment site from outside the digestive tract with a magnetic sensor by the digestive organ lesion site identification system of the present invention.

FIG. 2 is a schematic configuration diagram showing an embodiment of a step of attaching a magnet to a lesion in a digestive organ or its vicinity by the digestive organ lesion site identification system of the present invention.

FIG. 3 is a photograph showing an example of a magnet attached to or near a lesion in a digestive organ by the digestive organ lesion site identification system of the present invention.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... Probe for magnetic field detection incorporating a magnetic sensor 2 ... Permanent magnet surface-treated with titanium 3 ... Clip for attaching a permanent magnet 4 ... Tumor 5 ... Large intestine 6 ... Optical viewing tube 7 ... Introduction tube for trocar etc. 8 ... abdominal wall 9 ... abdominal cavity 10 ... data processing unit 11 ... endoscope

 ────────────────────────────────────────────────── ─── Continuing on the front page (72) Inventor Akira Tanguro 1-1-1, Minamikogushi, Ube City, Yamaguchi Prefecture Yamaguchi University School of Medicine (72) Inventor Shoichi Yasu 1-1-1, Minamikogushi, Ube City, Yamaguchi Prefecture Yamaguchi Faculty of Medicine (72) Inventor Keisuke Yoneda 2-16-1 Tokiwadai, Ube City, Yamaguchi Prefecture Yamaguchi University Graduate School of Science and Engineering F-term (reference) 4C060 MM26

Claims (5)

[Claims] 1. A step of inserting an endoscope into a digestive organ to search for a lesion, a step of attaching a magnet to the searched lesion or its vicinity, and leaving the attached magnet as a mark of the lesion. A step of withdrawing the endoscope from the digestive organ, and a step of identifying the magnet attachment site with a magnetic sensor from outside the digestive organ, wherein the identified magnet attachment site is a digestive organ lesion site. Organ lesion site identification system. 2. The digestive organ lesion site identification system according to claim 1, wherein the magnet is a permanent magnet. 3. The digestive organ lesion site identification system according to claim 1, wherein the magnet is a surface-treated magnet for improving affinity with a human body. 4. The digestive organ lesion site identification system according to claim 3, wherein the surface-treated magnet is a magnet surface-treated with titanium. 5. A data processing unit for processing a signal from the magnetic sensor, wherein the data processing unit visually displays a signal detected by the magnetic sensor, such as a numerical value or light,
The digestive organ lesion site according to any one of claims 1 to 4, further comprising a function of giving a warning by a buzzer or blinking of a lamp when the detected signal exceeds a predetermined magnitude. Identification system.