JP2004180830A - Endoscope apparatus and its slave endoscope or catheter - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To operate a bent part of a slave endoscope to erect without being damaged in an endoscope apparatus erecting the tip projecting part of the slave endoscope inserted in a working channel of a side-view type master endoscope. <P>SOLUTION: The master endoscope 10 is adjacently disposed with the tip opening of the working channel, an emission part of a lighting optical system and an observation window of an observation optical system in its tip circumferential side face, so that the tip projecting part of the slave endoscope 20 can be observed not only when being erected by an erection device 19 but also being non-erected. An insertion part 22 and armor tubes 22a and 23a of the bent part 23 of the endoscope 20 are classified by color from each other. <P>COPYRIGHT: (C)2004,JPO&NCIPI

Description

[0001]
TECHNICAL FIELD OF THE INVENTION
The present invention relates to an endoscope apparatus including a side endoscope-type parent endoscope and a child endoscope or a catheter inserted into a working channel of the endoscope. The present invention relates to an endoscope apparatus that can be erected by an endoscope erection apparatus.
[0002]
[Prior art]
The inner diameter of a pancreatic duct extending from the pancreas to the duodenum is only about 2 mm in a healthy person. It is only recently that a small-diameter endoscope or pancreatoscope which can be inserted into the endoscope has been produced. This has enabled endoscopic examination of the pancreas, which has contributed to early detection of pancreatic cancer and the like.
In an endoscopy of the pancreas, a duodenoscopy (parent endoscope) is inserted from the oral cavity to the duodenum. A pancreatoscope (endoscopy) is inserted into the working channel of the duodenoscope, and the tip of the pancreatoscope is protruded from the working channel. Thereafter, the protruding portion of the pancreatoscope is raised by the raising device housed at the distal end of the working channel and inserted into the pancreatic duct.
[0003]
On the other hand, in a pancreatoscope, a curved portion is connected to the distal end of a flexible insertion portion, like a general endoscope. As is well known, the bending portion is configured by connecting a plurality of joint rings made of short tubular metal in a line, and can be bent by remote control. If the user operates the erecting device in a state where the bending portion does not completely come out of the working channel of the duodenoscope, the bending portion is bent beyond the original bendable angle, and the joint rings are deformed or the joint rings are connected. May be damaged, such as becoming defective. At present, determination of whether or not the curved portion has completely protruded must rely on the experience of the surgeon. Thus, a pancreatoscope without a curved portion may be used, but it is not easy to direct the panorama in the intended direction.
[0004]
By the way, although different from a pancreatic ductoscope, for example, in the field of an ultrasonic diagnostic apparatus that performs an ultrasonic diagnosis by passing an ultrasonic probe through a working channel of an endoscope and protruding from a distal end opening thereof, in the field of an ultrasonic probe near the distal end thereof There is known a technique for checking a protruding state from a working channel by providing a sensor on a base station or attaching a marker to a base end side (see Patent Document 1).
[0005]
[Patent Document 1]
JP-A-8-10262 (Page 1, FIG. 1, FIG. 7)
[0006]
[Problems to be solved by the invention]
However, the sensor disclosed in Patent Document 1 requires a signal processing circuit, resulting in high cost. On the other hand, the marker is marked at the position corresponding to the forceps port at the base end of the working channel when it is in an appropriate protruding state, so be careful not to overlook the marker entering the forceps port. In addition, it cannot be applied to endoscopes having different working channel lengths.
[0007]
[Means for Solving the Problems]
In order to solve the above-mentioned problems, the present invention provides a side-viewing parent endoscope having a working channel accommodating an upright device at a distal end thereof, a flexible insertion portion inserted into the working channel, A curved portion extending from the distal end and protruding from the distal opening of the working channel (a portion including a joint ring arranged in a row and a connecting ring at a proximal end, which may be damaged when directly subjected to the force of an upright device). A child endoscope or a catheter having a child endoscope or a catheter, wherein the protruding portion of the child endoscope or the catheter from the working channel tip opening is erected by the erecting device. On the peripheral side surface of the component, the emission part of the illumination system and the observation window of the observation system are located adjacent to the distal end opening of the working channel, and the child endoscope or the catheter. The protruding portion is arranged so as to be observable not only when standing by the standing device but also when not standing, and the insertion portion and the curved portion of the child endoscope or the catheter are color-coded on their outer surfaces. It is characterized in that it can be distinguished by appearance. In addition, a flexible insertion portion to be inserted into the working channel of the side-viewing parent endoscope, and a curved portion extending from the distal end of the insertion portion and projecting from the distal end opening of the working channel are provided. The protruding portion from the working channel tip opening is operated by the erecting device accommodated at the tip of the working channel, and can be observed by the parent endoscope not only at the time of standing but also at the time of non-standing. In the child endoscope or the catheter, the insertion portion and the curved portion are distinguishable from each other in appearance, for example, by being colored.
[0008]
This makes it possible to easily and surely observe with the parent endoscope whether or not the bending portion of the child endoscope or the catheter has completely protruded from the distal end opening of the working channel. Then, by operating the erecting device at the stage when it is confirmed that the bending portion has completely protruded, it is possible to reliably prevent the bending portion from being damaged. Moreover, if only the observation using the parent endoscope is performed, the curved portion and the insertion portion appear in the observation field of view so that the curved portion and the insertion portion can be distinguished from each other (for example, the forceps port at the base end of the working channel of the parent endoscope). It is not necessary to pay attention to how much the proximal end of the child endoscope or the catheter has entered), and the burden of the work of adjusting the amount of protrusion can be reduced. Further, the same child endoscope or catheter can be applied to another working channel or parent endoscope having a different length. Further, since a sensor or a signal processing circuit for grasping the amount of protrusion is not required, manufacturing costs can be reduced.
[0009]
As means for enabling the insertion portion and the curved portion to be distinguished from each other by appearance, a boundary discrimination means such as marking is applied to the border between the two, and the appearance itself of both may be the same. It is therefore more desirable that each can be distinguished from the other only by its own appearance. This makes it possible to distinguish between a state in which the boundary between the insertion portion and the curved portion has not yet come out of the working channel and a state in which the boundary is too far out of the viewing field of view of the parent endoscope, making it easier to adjust the amount of protrusion. Can be
As the color-coding means, a colored paint may be applied to the outer surfaces of the outer tube of the insertion portion and the curved portion, respectively.However, the outer tube of the insertion portion and the curved portion are formed with components of different colors from each other and are connected. Is more desirable. As a result, not only can the colors be easily distinguished, but there is no fear of discoloration.
[0010]
It is preferable that the parent endoscope can be inserted into the duodenum, and the child endoscope or the catheter can be inserted into the pancreatic duct. Thus, the child endoscope or the catheter is protruded from the parent endoscope inserted to the duodenum, and is raised and inserted into the pancreatic duct, whereby the examination and operation of the pancreas can be performed.
[0011]
BEST MODE FOR CARRYING OUT THE INVENTION
Hereinafter, an embodiment of the present invention will be described with reference to the drawings.
FIG. 1 shows an endoscope apparatus 1. The endoscope apparatus 1 includes a duodenoscope 10 (parent endoscope) of a side view type and a pancreatic ductoscope 20 (child endoscope). The duodenoscope 10 includes a main body 11, a flexible insertion portion 12 extending from the main body 11, a bending portion 13 connected to a tip of the insertion portion 12, and a bending portion 13, similarly to a known endoscope. 13 and a leading end component 14. The insertion section 12, the bending section 13, and the distal end configuration section 14 can be inserted from the oral cavity of the human body to the duodenum.
The bending section 13 is configured to be bent by a bending operation knob 11b of the main body section 11.
[0012]
A ride guide 15, an image guide 16, and a working channel 17 are accommodated in the main body 11 and the insertion section 12, respectively.
The light guide 15 constituting the illumination system is composed of a bundle of optical fibers, and a base end thereof is optically connected to the illumination light source 3 via a light cable 18. As shown in FIGS. 1 and 2, the distal end portion of the light guide 15 is passed through the curved portion 13 and the distal end portion 14, and the distal end surface 15 a (emission portion) is formed on the peripheral side portion of the distal end portion 14. Facing the flattened surface 14x. Thus, the illumination light from the illumination light source 3 is emitted to the side of the distal end component 14 via the light guide 15.
[0013]
The image guide 16 is composed of a bundle of optical fibers. The base end is optically connected to the eyepiece 11 a of the main body 11, and the tip is passed through the bending portion 13 and the tip component 14. An observation window 14a is provided on the flat surface 14x of the distal end component 14. Light incident on the observation window 14a is taken into the image guide 16 via a lens or the like (not shown), and the eyepiece is formed. It is sent to the unit 11a. The "observation system" in the claims is constituted by the eyepiece 11a, the image guide 16, the objective lens (not shown), the observation window 14a, and the like.
Note that the parent endoscope 10 may use an electronic endoscope having a solid-state imaging device as a main component of the “observation system” instead of the image guide 16.
[0014]
The proximal end of the working channel 17 is continuous with the forceps port 11c of the main body 11, and the distal end is open to the flat surface 14x of the distal end component 14. The distal opening 17 a of the working channel 17 has an elongated shape along the axis of the distal end component 14.
[0015]
As shown in FIGS. 2 and 4, an erecting device 19 for erecting a distal end protruding portion of a pancreatic ductoscope 20 described later is orthogonal to the axis of the distal end component 14 inside the working channel 17 near the distal end opening 17 a. It is provided to be rotatable around an axis. The upright device 19 is configured such that the angle between the first position (FIGS. 4 and 6), which is slightly tilted toward the distal end by the upright operating knob 11d of the main body 11, and the axis of the distal end component 14 from the first position. The turning operation is performed between the steep second position (FIG. 8). As shown in FIGS. 4 and 6, when the erecting device 19 is in the first position, the distal end protruding portion of the pancreatic ductoscope 20 forms a relatively small angle with respect to the axis of the distal end component 24. It is designed to be in an "unstanding state" extending diagonally forward. As shown in FIG. 8, when the upright device 19 is in the second position, the protruding portion of the distal end of the pancreatic ductoscope 20 is in an “upright state” that is substantially orthogonal to the axis of the distal end component 14 (at a relatively large angle). It is supposed to be.
[0016]
As shown in FIG. 2, the flat surface 14 x of the distal end component 14 is close to the lateral side of the elongated opening 17 a of the working channel 17 in the lateral direction, and the distal exit surface 15 a of the light guide 15 and the observation window. 14a. In particular, the observation window 14a is arranged on the side of a place where the pancreatic ductoscope 20 is led out from the opening 17a. A front end emission surface 15a of the light guide 15 is arranged on a front end side of the observation window 14a. Due to the positional relationship between the opening 17a, the exit surface 15a, and the observation window 14a, the duodenoscope 10 can observe the distal end protruding portion of the pancreatic ductoscope 20 not only when the upright device 19 is upright, but also when it is not upright. (See FIGS. 5, 7, and 9).
[0017]
Next, the pancreatoscope 20 will be described.
As shown in FIG. 1, the pancreatoscope 20 includes a main body 21, a flexible insertion portion 22 extending from the main body 21, a curved portion 23 connected to the distal end of the insertion portion 22, and a curved portion 23. And a continuous distal end component 24. The insertion section 22, the bending section 23, and the distal end configuration section 24 have an outer diameter of about 2 mm, and are thin enough to be inserted into a pancreatic duct of a human body. Needless to say, the working channel 17 can be inserted into the working channel 17 from the forceps port 11c of the duodenoscope 10 and has a length capable of sufficiently protruding from the distal end opening 17a of the working channel 17.
[0018]
A ride guide 25, an image guide 26, and a working channel 27 are accommodated in the main body 21 and the insertion section 22. A base end of the light guide 25 made of an optical fiber is passed through a common cable 30 extending from the main body 21 and a light cable 31 branched from the common cable 30, and is optically connected to the illumination light source 2 via a light plug 32. Have been. As shown in FIG. 3, the distal end portion of the light guide 25 is passed through the bending portion 23 and the distal end configuration portion 24, and the distal end emission surface faces the distal end surface of the distal end configuration portion 24. Thus, the illumination light from the illumination light source 2 passes through the light guide 25 and is emitted forward from the distal end surface of the distal end component 24.
[0019]
As shown in FIG. 1, the base end of the image guide 26 made of an optical fiber passes through a common cable 30 and an image cable 33 branched from the common cable 30, and is optically connected to an eyepiece 34. . As shown in FIG. 3, the distal end of the image guide 26 is passed through the bending portion 23 and the distal end component 24. An observation window 24 a is provided on the distal end surface of the distal end component 24, and incident light from the observation window 24 a is captured by the image guide 26 and transmitted to the eyepiece 34.
[0020]
As shown in FIGS. 1 and 3, the base end of the working channel 27 is continuous with the forceps port 21 c at the base end of the main body 21, and the front end is formed through the bending portion 23 and the front end configuration portion 24, It is open at the tip end surface of the part 24.
[0021]
As shown in FIG. 3, the bending portion 23 is configured by connecting a plurality of joint rings 23 b made of a short tubular metal in a line, and covering the outside thereof with an outer tube 23 a made of, for example, a fluororesin. The bending operation is performed by a bending operation knob 21b (FIG. 1) of the section 21. The proximal end of the exterior tube 23a protrudes proximally from a connection ring 23c made of a short tubular metal disposed on the most proximal side of the joint ring 23b, and is connected to the exterior tube 22a of the insertion portion 22 by, for example, sewing. ing. The proximal connection ring 23c is for connecting a shape maintaining coil of the insertion portion 22, a guide coil for a bending operation wire (neither is shown), and the like.
[0022]
The most characteristic part of the present invention will be described.
In the pancreatoscope 20, the insertion section 22 and the curved section 23 are color-coded. That is, the outer tube 23a made of fluororesin of the curved portion 23 is black. On the other hand, the outer tube 22a of the insertion portion 22 is made of, for example, urethane resin kneaded with a yellow colorant, and is yellow.
[0023]
An operation method of the endoscope apparatus 1 configured as described above will be described.
First, the duodenoscope 10 is inserted from the mouth of the subject to the duodenum. Next, the tip of the pancreatic ductoscope 20 inserted into the working channel 17 of the duodenoscope 10 is made to protrude from the opening 17a. At this time, the upright device 19 at the tip of the working channel 17 is kept at the first position. Thereby, as shown in FIG. 4, the pancreatic ductoscope 20 can be protruded in a non-standing state. As shown in FIG. 5, the protruding portion of the pancreatic ductoscope 20 at this time grazes the corner of the field of view 10R of the duodenoscope 10, and the eyepiece 11a (or a television connected thereto via a camera control unit or the like). Monitor). As shown in FIGS. 4 and 5, when the curved portion 23 of the pancreatic ductoscope 20 is still protruding only halfway, only the black color of the curved portion 23 appears in the field of view 10R of the duodenoscope 10. At this stage, the operator further inserts the pancreatoscope 20 without operating the erecting device 19.
[0024]
As shown in FIG. 6, when the entire curved portion 23 protrudes from the working channel 17 and further the distal end portion of the insertion portion 22 slightly protrudes, the curved portion 23 is bent into the field of view 10R of the duodenoscope 10 as shown in FIG. Not only the black color of the portion 23 but also the yellow color of the insertion portion 22 appear. Thereby, the surgeon can know that the bending portion 23 has completely protruded from the working channel 17. In addition, if the duodenum is observed with the duodenoscope 20, the yellow color of the insertion portion 22 appears in the observation field of view 10R, so that the other part (for example, how much the proximal end of the pancreatic ductoscope 20 has entered the forceps opening 11c). You do not need to be careful. Therefore, it is only necessary to concentrate on observation of the duodenum (field of view 10R), and the burden can be reduced. Further, when the black color of the curved portion 23 becomes invisible from the observation visual field 10R and only the yellow color of the insertion portion 22 becomes visible, it is possible to grasp that the projection is excessive. As a result, the amount of protrusion can be adjusted to an appropriate value. Then, the upright device 19 is raised by the knob 11d and is positioned at the second position. As a result, as shown in FIG. 8, the vicinity of the distal end of the flexible insertion portion 22 is bent by the erecting device 19, and the protruding portion is made to erect therefrom. At this time, the bending portion 23 is not bent. As a result, it is possible to reliably prevent the joint ring 23b and the proximal connecting ring 23c of the bending portion 23 from being damaged.
[0025]
As shown in FIG. 9, the entire distal end protruding portion of the pancreatic ductoscope 20 erected by the erection device 19 enters the visual field 10 </ b> R of the duodenoscope 10. This allows the distal end protruding portion of the pancreatic ductoscope 20 to be inserted into the pancreatic duct from the duodenum while observing with the duodenoscope 10. Then, an endoscopic examination of the pancreas and the like can be performed by the pancreatic ductoscope 20.
[0026]
According to the endoscope apparatus 1, regardless of how far the base end side of the pancreatic ductoscope 20 has been inserted into the forceps port 11 c of the duodenoscope 10, the protruding state of the curved portion 23 can be known. The 20 can be applied to another working channel of the same duodenoscope 10 having a different length, or to another duodenoscope.
It is only necessary to color-code the outer tubes 22a and 23a, and the sensor and the signal processing circuit described in Patent Document 1 are not required, so that the manufacturing cost can be reduced.
The outer tubes 22a and 23a can be easily color-coded by using materials of different colors from each other. In addition, since the exterior tubes 22a and 23a have a predetermined color not only on the surface but also on the entire interior, there is no fear of discoloration or the like.
[0027]
The present invention is not limited to the above embodiment, but can adopt various modes.
For example, the parent endoscope is not limited to the duodenum, and the child endoscope is not limited to the pancreatic duct or pancreas.
As the child endoscope, an electronic endoscope having a solid-state imaging device may be used instead of the image guide 26.
Instead of the child endoscope, a catheter having a curved portion may be used.
Instead of color-coding the insertion portion and the bending portion of the child endoscope or the catheter, the insertion portion and the bending portion may be divided into patterns, and marking may be performed at the boundary between the insertion portion and the bending portion.
[0028]
【The invention's effect】
As described above, according to the present invention, whether or not the bending portion of the child endoscope has completely protruded from the distal end opening of the working channel can be easily and reliably observed by the parent endoscope, By operating the erecting device at the stage when it is confirmed that the protruding portion has completely protruded, it is possible to reliably prevent the bending portion from being damaged. Moreover, if only the observation using the parent endoscope is performed, the curved portion and the insertion portion appear in the observation field of view so that the curved portion and the insertion portion can be distinguished from each other (for example, the forceps port at the base end of the working channel of the parent endoscope). It is not necessary to pay attention to how much the proximal end of the child endoscope or the catheter has entered), and the burden of the work of adjusting the amount of protrusion can be reduced. Further, the same child endoscope or catheter can be applied to another working channel or parent endoscope having a different length. Further, since a sensor or a signal processing circuit for grasping the amount of protrusion is not required, manufacturing costs can be reduced.
[Brief description of the drawings]
FIG. 1 is a side view showing an endoscope apparatus according to an embodiment of the present invention, in which a duodenoscope and a pancreatoscope are separated.
FIG. 2 is a plan view of a distal end portion of the duodenoscope.
FIG. 3 is a plan view of a distal end portion of the pancreatoscope.
FIG. 4 is a side view showing a state in which a part of the curved portion of the pancreatoscope is protruded from the distal end of the working channel of the duodenoscope.
5 is a diagram showing an image observed with a duodenum in the state of FIG. 4;
FIG. 6 is a side view showing a state where the distal end of the pancreatoscope is protruded by an appropriate length from the distal end of the working channel of the duodenoscope, and has not yet been raised.
FIG. 7 is a diagram showing an image observed with a duodenum in the state of FIG. 6;
FIG. 8 is a side view showing a state in which a distal end protruding portion of the pancreatic duct is erected.
FIG. 9 is a diagram showing an image observed with a duodenum in the state of FIG. 8;
[Explanation of symbols]
1 endoscope device 10 duodenoscopy (parent endoscope)
14a Observation window 15a Emission surface of light guide tip (emission part)
17 Working Channel 17a Opening of Tip of Working Channel 19 Standing Device 20 Pancreatoscope (Endoscope)
22 Insertion part 22a Exterior tube 23 of insertion part Curved part 23a Exterior tube of curved part

Claims (6)

A side-viewing parent endoscope having a working channel accommodating an erecting device at a distal end thereof, a flexible insertion portion inserted into the working channel, and extending from the distal end thereof and protruding from a distal end opening of the working channel. A child endoscope or a catheter having a curved portion to be provided, wherein the projecting portion of the child endoscope or the catheter from the working channel tip opening is erected by the erecting device,
On the peripheral side surface of the distal end component of the parent endoscope, an emission part of an illumination system and an observation window of an observation system are disposed adjacent to the distal end opening of the working channel, and the projection of the child endoscope or the catheter is performed. The part is arranged so that it can be observed not only when standing by the above-mentioned standing device, but also when not standing,
An endoscope apparatus wherein an insertion portion and a curved portion of the child endoscope or the catheter can be distinguished from each other by appearance. The endoscope apparatus according to claim 1, wherein the insertion portion and the bending portion are color-coded. The endoscope apparatus according to claim 2, wherein the outer tubes of the insertion portion and the curved portion are formed of components of different colors from each other and are connected. The endoscope apparatus according to any one of claims 1 to 3, wherein the parent endoscope can be inserted up to the duodenum, and the child endoscope or the catheter can be inserted into a pancreatic duct. A flexible insertion portion to be inserted into the working channel of the side-viewing parent endoscope, and a curved portion extending from the distal end of the insertion portion and projecting from the distal end opening of the working channel, The protruding portion from the working channel tip opening is operated by the erecting device housed at the tip of the working channel, and the child endoscope can be observed by the parent endoscope not only at the time of standing but also at the time of non-standing. In an endoscope or catheter,
A child endoscope or a catheter inserted into a parent endoscope, wherein the insertion portion and the bending portion are color-coded. 6. The child endoscope or catheter inserted into a parent endoscope according to claim 5, wherein the outer tubes of the insertion portion and the curved portion are formed of components of different colors from each other and are connected. .

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