JP2004261431A - Endoscope - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an endoscope wherein a curved posture of a curved portion can be maintained and released at anytime by locking an angle wire at a proximal end position of the curved portion even when the angle wire is broken. <P>SOLUTION: An outer ring 50 and an inner ring 52 are disposed at the proximal end position of the curved portion 18. The outer ring 50 is fixed to a proximal end sleeve 48, wherein a semicircular groove 50A is formed at the position where the angle wire 38 is inserted on an inner peripheral surface. The inner ring 52 is slidably disposed on the inner peripheral surface of the outer ring 50, wherein a semicircular groove 52A is formed at the position of the angle wire 38 on the outer peripheral surface. The angle wire 38 is inserted in a round hole formed of the groove 50A and the groove 52A, and is caught and locked between the groove 50A and the groove 52A when the inner ring 52 is turned. <P>COPYRIGHT: (C)2004,JPO&NCIPI

Description

[0001]
TECHNICAL FIELD OF THE INVENTION
The present invention relates to an endoscope, and more particularly to a medical endoscope that performs a surgical procedure using an endoscopic treatment tool such as a puncture treatment tool or a high-frequency snare.
[0002]
[Prior art]
A plurality of angle wires are inserted through the insertion portion of the medical endoscope. The distal end of each angle wire is fixed to the distal end of the insertion section, and the proximal end of each angle wire is wound around a pulley provided on the hand operation section. Therefore, when the angle knob connected to the pulley is rotated, the angle wire is pushed and pulled, and the bending portion is bent. A lock lever is provided in the hand operation unit. The angle wire is fixed by locking the pulley with the lock lever, and the bending portion is held in a desired bending posture (see Patent Document 1).
[0003]
By the way, in recent years, surgical treatment has been performed by pulling out a treatment tool from a distal end portion of an endoscope insertion portion while holding a bending portion of the endoscope in a desired bending posture. For example, in an ultrasonic endoscope, a puncture device is led out from the distal end of an insertion portion, and the distal end of the puncture device is inserted into a body cavity, thereby sampling a tissue, injecting a drug solution into an affected part, and collecting blood. A suction process is performed (see Patent Document 2).
[0004]
If the angle wire of the endoscope breaks during the surgical procedure, the bending portion of the endoscope returns from the curved posture to a linear natural posture due to its own rigidity and the rigidity of the treatment tool. There is a possibility that the treatment tool derived from the distal end of the part may damage the body cavity. For example, in a surgical treatment using the above-described puncture device, there is a possibility that the tip of the puncture device may cut through the body cavity. In particular, when a blood vessel is punctured by a color Doppler, there is a possibility that the blood vessel may be cut by a puncture treatment tool.
[0005]
Patent Literature 3 describes an endoscope in which a wire for adjusting flexibility is inserted through an insertion portion. According to this endoscope, the tension of the wire for flexibility adjustment is detected, and the traction of the wire is limited by the detected value, so that the wire breakage can be prevented.
[0006]
[Patent Document 1]
JP-A-9-220193
[Patent Document 2]
JP-A-11-276422
[Patent Document 3]
JP-A-2002-325723
[Problems to be solved by the invention]
However, Patent Literature 3 prevents breakage of the flexibility adjusting wire, and cannot prevent breakage of the angle wire. Further, even if the invention of Patent Document 3 is applied to the prevention of the breakage of the angle wire, the breakage of the angle wire having many sliding points cannot be completely prevented. When the angle wire is broken, the curved portion returns to the straight natural posture as described above, and there is a possibility that the treatment tool led out from the distal end portion of the insertion portion may damage the body cavity.
[0010]
From such a background, there is a demand to maintain the bending posture of the bending portion even when the angle wire is broken.
[0011]
On the other hand, if the holding of the curved posture is not released, there is a problem that the endoscope insertion portion cannot be pulled out from the body cavity. Therefore, there is a demand for an endoscope that has a function of maintaining a bending posture even when the angle wire is broken, and a function of arbitrarily releasing the holding of the bending posture.
[0012]
The present invention has been made in view of such circumstances, and even if the angle wire is broken, an endoscope that can hold the bending posture of the bending portion and can arbitrarily release the holding of the bending posture. The purpose is to provide.
[0013]
[Means for Solving the Problems]
In order to achieve the above object, the invention according to claim 1 is an endoscope provided with a bending mechanism for performing a bending operation on a bending section provided in the endoscope insertion section, when the bending mechanism breaks down. And a bending holding mechanism having a function of holding the bending posture of the bending portion and arbitrarily releasing the holding of the bending posture.
[0014]
According to the first aspect of the present invention, even when the bending mechanism breaks down, the bending posture can be held by the bending holding function, so that the surgical treatment using the treatment tool can always be performed in a safe state. . Further, according to the first aspect of the present invention, since the holding of the bending posture can be arbitrarily released by the bending holding function, the endoscope insertion portion can be smoothly pulled out from the body cavity, and the surgical operation can be performed. Processing can be safely terminated.
[0015]
According to a second aspect of the present invention, in order to achieve the above object, the bending section provided in the endoscope insertion section is operated by pushing and pulling a plurality of angle wires inserted through the endoscope insertion section. In the bending endoscope, a locking means for locking the angle wire at a base end position of the bending portion is provided.
[0016]
According to the invention described in claim 2, since the angle wire is locked at the base end position of the bending portion, even if the angle wire is disconnected at the base end side of the bending portion, the angle wire in the bending portion is fixed. I have. Therefore, even when the angle wire is broken, the bending posture of the bending portion can be maintained.
[0017]
According to a third aspect of the present invention, in the second aspect of the present invention, the lock means includes an outer ring fixed to a base end position of the curved portion, and an outer ring rotatably supported inside the outer ring. A surface is provided with an inner ring that slides on an inner peripheral surface of the outer ring, and the angle wire is sandwiched and locked between the outer ring and the inner ring. According to the third aspect of the present invention, by rotating the inner ring, the angle wire is locked to maintain the bending posture, or the angle wire is unlocked to release the bending posture. be able to.
[0018]
According to a fourth aspect of the present invention, in order to achieve the above object, the bending portion provided in the endoscope insertion portion is operated by pushing and pulling a plurality of angle wires inserted through the endoscope insertion portion. In the bending endoscope, a plurality of locking wires inserted through the bending portion, one end of which is fixed, and the other end of which is slidably supported, and the other of the plurality of locking wires. Locking means for locking the end.
[0019]
According to the fourth aspect of the present invention, since the other ends of the lock wires are fixed by fixing the other ends of the lock wires, the bending portion into which the plurality of lock wires are inserted has a bending posture. Will be retained. Therefore, even when the angle wire is broken, the bending posture of the bending portion can be maintained.
[0020]
According to a fifth aspect of the present invention, in the invention of the fourth aspect, the locking wire has a distal end fixed to a distal end position of the curved portion and a rear end slidable to a proximal end position of the curved portion. An outer ring fixed to a base end position of the curved portion, and an outer ring rotatably supported inside the outer ring and having an outer peripheral surface sliding on an inner peripheral surface of the outer ring. An inner ring is provided, and the locking wire is sandwiched and locked between the outer ring and the inner ring. According to the invention described in claim 5, by rotating the inner ring, the locking wire is locked to maintain the bending posture, or the locking wire is unlocked to release the holding of the bending posture. Or you can.
[0021]
According to a sixth aspect of the present invention, in the fifth aspect of the invention, the locking wire is made of the same type of wire material as the angle wire. The locking wire has only one end fixed and has less tension than an angle wire having both ends fixed. Therefore, if the same type of wire material is used for the lock wire and the angle wire, it is possible to prevent the disconnection of the lock wire having a small tension, and also to prevent the bending operability from being reduced by the lock wire.
[0022]
BEST MODE FOR CARRYING OUT THE INVENTION
Hereinafter, a preferred embodiment of an endoscope according to the present invention will be described in detail with reference to the accompanying drawings.
[0023]
FIG. 1 is a plan view showing an ultrasonic endoscope 10 to which the present invention is applied.
[0024]
As shown in FIG. 1, the ultrasonic endoscope 10 has a hand operation unit 12, and an insertion unit 14 is connected to the hand operation unit 12. The insertion section 14 includes a distal end portion 16, a bending portion 18, and a flexible portion 20, and the distal end portion 16 is provided with an observation mechanism unit 22 and an ultrasonic inspection mechanism unit 24. Further, a forceps port 26 is provided at the distal end portion 16, and the forceps port 26 communicates with a forceps insertion section 30 of the hand operation section 12 via a forceps tube 28. A treatment tool such as a forceps or a puncture treatment tool is inserted from the forceps insertion section 30 and is led out from the forceps port 26 of the distal end portion 16.
[0025]
An eyepiece 32 is provided at the base end of the hand operation unit 12, and a universal cord 34 is connected to the eyepiece 32. The distal end of the universal cord 34 is connected to a light source device (not shown).
[0026]
Further, the hand operation unit 12 is provided with a pair of angle knobs 36. By rotating the angle knobs 36, angle wires 38, 38, which will be described later, are pushed and pulled, and the bending portion 18 is bent. A lock lever 40 for holding the bending posture of the bending portion 18 is provided at the base end of the hand operation portion 12.
[0027]
FIG. 2 is a longitudinal sectional view showing the structure of the bending portion 18, and FIG. 3 is a sectional view taken along line 3-3 in FIG.
[0028]
As shown in FIG. 2, the bending portion 18 is configured by rotatably connecting a number of node rings 42, 42... With caulking pins 44, 44. Of the node rings 42, 42,..., The node ring 42 closest to the distal end is connected to the distal sleeve 46, and the distal sleeve 46 is connected to the distal end portion 16 (see FIG. 1). Further, the node ring 42 closest to the proximal end is connected to a proximal sleeve 48, and the flexible portion 20 (see FIG. 1) is connected to the proximal sleeve 48.
[0029]
Angle wires 38, 38,... Each of the angle wires 38 is arranged vertically, horizontally and one by one as shown in FIG. As shown in FIG. 2, each angle wire 38 is guided by a caulking pin 44, and the tip of each angle wire 38 is fixed to a tip sleeve 46. The proximal end of each angle wire 38 is inserted into a guide member 49 such as a close-contact coil spring, inserted through the flexible portion 20 in FIG. 1, and wound around a pulley (not shown) provided inside the hand operation portion 12. Can be The pulley is connected to an angle knob 36. By rotating the angle knob 36, the pulley is rotated, and the angle wire 38 is pushed and pulled. Reference numeral 43 in FIG. 2 is a covering member that covers the curved portion 18.
[0030]
Next, a lock mechanism of the angle wire 38, which is a feature of the present invention, will be described.
[0031]
As shown in FIGS. 2 and 3, the proximal sleeve 48 is provided with an outer ring 50 and an inner ring 52 that constitute a lock mechanism. The outer ring 50 is fixed to the proximal sleeve 48 while being inscribed in the proximal sleeve 48.
[0032]
The inner ring 52 is rotatably supported by the outer ring 50, and its outer peripheral surface slides in the circumferential direction with respect to the inner peripheral surface of the outer ring 50. A rack 54 is provided on the inner peripheral surface of the inner ring 52, and a pinion 56 is provided so as to mesh with the rack 54. A torque transmission wire 58 is connected to the pinion 56, and the torque transmission wire 58 is inserted through the flexible portion 20 in FIG. 1 and connected to the lock lever 40 of the hand operation unit 12. Therefore, by operating the lock lever 40, the pinion 56 is rotated, and the inner ring 52 is rotated.
[0033]
As shown in FIG. 3, grooves 50A, 50A,... Are formed on the inner peripheral surface of the outer ring 50 at the positions of the angle wires 38. Grooves 52A are formed on the outer peripheral surface of the inner ring 52 at the positions of the angle wires 38. The groove 50 </ b> A and the groove 52 </ b> A are formed in a semicircular shape as shown in FIG. 4, and the diameter is slightly larger than the diameter of the angle wire 38. As shown in FIG. 4, when the position of the groove 50A and the position of the groove 52A coincide with each other to form a round hole, the angle wire 38 is inserted into the round hole, so that the push-pull operation can be performed.
[0034]
When the inner ring 52 is rotated, the position of the groove 50A is shifted from the position of the groove 52A as shown in FIG. 5, and the angle wire 38 is locked by being sandwiched between the groove 50A and the groove 52A. This makes it impossible to push and pull the angle wire 38, and the bending posture of the bending portion 18 is maintained.
[0035]
Next, the operation of the ultrasonic endoscope 10 configured as described above will be described.
[0036]
When the bending portion 18 is bent, the position of the groove 50A of the outer ring 50 and the position of the groove 52A of the inner ring 52 match as shown in FIG. 4, and the angle wire 38 is connected to the groove 50A and the groove 52A. It is inserted through the round hole formed by. Therefore, when the angle knobs 36, 36 in FIG. 1 are rotated, the angle wire 38 is pushed and pulled freely, and the bending portion 18 is bent.
[0037]
When holding the bending posture of the bending portion 18, the inner ring 52 is rotated by operating the lock lever 40. As a result, the position of the groove 50A of the outer ring 50 and the position of the groove 52A of the inner ring 52 are shifted as shown in FIG. 5, and the angle wire 38 is locked by being sandwiched between the grooves 50A and 52A. Therefore, it becomes impossible to push and pull the angle wire 38, and the bending posture of the bending portion 18 is maintained. When performing a surgical procedure using a treatment tool such as a puncture treatment tool, the surgical procedure is performed with the angle wire 38 locked as described above.
[0038]
When locked as described above, the angle wire 38 is locked at the base end position of the bending portion 18. Therefore, even if the angle wire 38 is disconnected at the base end side of the bending portion 18, the angle wire 38 in the bending portion 18 is not pushed or pulled, and the bending portion 18 does not return to a straight posture. Accordingly, even when the angle wire 38 is broken in the flexible portion 20 occupying most of the insertion portion 14, the bending position of the bending portion 18 can be maintained, and the surgical procedure is always performed in a safe state. be able to.
[0039]
Further, according to the above-described embodiment, since the groove 50A and the groove 52A are formed in a semicircular shape, the contact between the angle wire 38 and the outer ring 50 or the inner ring 52 is surface contact. Therefore, damage to the angle wire 38 due to contact with the outer ring 50 and the inner ring 52 can be prevented.
[0040]
If the angle wire 38 breaks in the locked state as described above, the surgical procedure is immediately stopped or terminated. Then, after pulling out a treatment tool such as a puncture treatment tool, the inner ring 52 is rotated in the direction opposite to the locked state by operating the lock lever 40. As a result, the position of the groove 50A of the outer ring 50 matches the position of the groove 52A of the inner ring 52 as shown in FIG. 4, and the lock of the angle wire 38 is released. And the bending portion becomes free against external force. Therefore, the insertion section 14 can be safely pulled out from the body cavity, and the surgical procedure can be safely ended.
[0041]
In the above-described embodiment, the groove 50A of the outer ring 50 and the groove 52A of the inner ring 52 are formed in a semicircular shape. However, the shapes of the groove 50A and the groove 52A are not limited to this. Any shape may be used as long as the angle wire 38 can be sandwiched and fixed between the outer ring 50 and the inner ring 52 by rotating. Therefore, for example, as shown in FIG. 10, the grooves 50A and 52A having a taper may be formed, and the angle wire 38 may be sandwiched and fixed by the taper.
[0042]
In the above-described embodiment, the angle wire 38 is locked by the outer ring 50 and the inner ring 52. However, the locking mechanism of the angle wire 38 is not limited to this. What is necessary is just to lock at the base end position.
[0043]
FIG. 6 is a longitudinal sectional view showing the bending portion 18 of the second embodiment, and FIG. 7 is a sectional view taken along the line 7-7 in FIG.
[0044]
As shown in FIG. 6, locking wires 62 are inserted through the bending portion 18. Each locking wire 62 is guided by guide pins 64, 64... Erected on the node ring 42, and the distal end portion 62 </ b> A of each locking wire 62 is fixed to the distal sleeve 46. The rear end portion 62B of each locking wire 62 is inserted through a guide pin 66 erected on the proximal sleeve 48 for a predetermined length or more, and even when the bending portion 18 is bent, the guide pin 66 It does not fall off. Thus, the locking wire 62 has the front end 62A fixed and the rear end 62B slidably supported by the guide pin 66.
[0045]
As shown in FIG. 7, the lock wires 62, 62... Are arranged between the angle wires 38, 38. The locking wire 62 is made of the same type of wire material as the angle wire 38, that is, a wire of the same diameter and the same material.
[0046]
As shown in FIGS. 6 and 7, the proximal sleeve 48 is provided with an outer ring 67 and an inner ring 68. An outer ring 67 is fixed to the proximal sleeve 48, and an inner ring 68 is slidably supported by the outer ring 67. A rack 74 is provided on the inner peripheral surface of the inner ring 68, and a pinion 76 is provided so as to mesh with the rack 74. Therefore, by rotating the pinion 76, the inner ring 68 can be rotated. As a mechanism for rotating the pinion 76, a torque transmission wire 78 may be connected to the pinion 76, and the torque transmission wire 78 may be connected to the lock lever 40 of the hand operation unit 12 shown in FIG.
[0047]
Grooves 67A and 68A are formed on the inner peripheral surface of the outer ring 67 and the outer peripheral surface of the inner ring 68 at the positions of the locking wires 62, 62, respectively. As shown in FIG. 8, the groove 67A and the groove 68A are formed in a semicircular shape, and the diameter thereof is formed larger than the diameter of the locking wires 62. Therefore, when the position of the groove 67A matches the position of the groove 68A as shown in FIG. 8, the locking wire 62 is inserted into the round hole formed by the groove 67A and the groove 68A. Therefore, the rear end portion 62B of the lock wire 62 can be slid.
[0048]
When the position of the groove 68A is shifted from the position of the groove 67A by rotating the inner ring 68 as shown in FIG. 9, the locking wire 62 is locked by being sandwiched between the groove 67A and the groove 68A. You. Therefore, the rear end portion 62B of the locking wire 62 is fixed.
[0049]
As shown in FIG. 7, grooves 67B and 68B are formed at the positions of the angle wires 38 on the inner peripheral surface of the outer ring 67 and the outer peripheral surface of the inner ring 68, respectively. As shown in FIG. 8, the groove 67B is formed in a semicircular shape, and the diameter thereof is formed slightly larger than the outer diameter of the angle wire 38. The groove 68B of the inner ring 68 is formed larger than the groove 67B, and is formed so as to always be out of contact with the angle wire 38.
[0050]
According to the second embodiment configured as described above, by rotating the inner ring 68, the locking wire 62 is locked by being sandwiched between the groove 68A and the groove 67A. Accordingly, both the leading end 62A and the rear end 62B of each locking wire 62 are fixed. Accordingly, the bending portion 18 in which the plurality of locking wires 62, 62,.
[0051]
As described above, according to the second embodiment, the bending posture is maintained by the locking wires 62, 62. Therefore, the bending posture can be maintained even when the angle wire 38 is disconnected at any position.
[0052]
Further, according to the second embodiment, since the angle wire 38 is not in contact with the outer ring 67 and the inner ring 68, it is possible to prevent the angle wire 38 from breaking during locking.
[0053]
Further, according to the second embodiment, the locked state of the locking wire 62 is released by rotating the inner ring 68 in the direction opposite to the locking state, and the holding of the bending posture is released. It can be safely pulled out of the body cavity.
[0054]
Further, according to the second embodiment, since the lock wire 62 is made of the same type of wire material as the angle wire 38, disconnection of the lock wire 62 can be prevented, and the operation feeling is improved by the lock wire 62. Deterioration can be prevented. That is, since the tension of the locking wire 62 to which only the distal end portion 62A is fixed is smaller than that of the angle wire 38 to which both ends are fixed, the load when the bending operation is performed is small. Therefore, if the angle wire 38 and the lock wire 62 are made of the same type of wire material, disconnection of the lock wire 62 can be prevented, and at the same time, operability due to the lock wire 62 can be prevented from being deteriorated.
[0055]
In the above-described second embodiment, the distal end 62A of the lock wire 62 is fixed and the rear end 62B is slidably supported. However, the rear end 62B of the lock wire 62 is fixed. Alternatively, the distal end portion 62A may be slidably supported. In this case, the outer ring 67 and the inner ring 68 may be provided on the distal sleeve 46 to lock the distal end portion 62A of the locking wire 62.
[0056]
The number of the locking wires 62 is not limited to the above-described embodiment. For example, in the case of an endoscope in which the bending portion 18 bends in four directions, three or more locking wires 62 are inserted. It should just be. In the case of an endoscope in which the bending portion 18 bends only in two directions, it is sufficient that two or more locking wires 62 are inserted.
[0057]
Further, the insertion position of the lock wire 62 is not limited to the above-described embodiment, and may be disposed, for example, near the angle wire 38.
[0058]
Furthermore, the above-described embodiment is an example in which the present invention is applied to the ultrasonic endoscope 10, but the present invention can be applied to other medical endoscopes.
[0059]
【The invention's effect】
As described above, according to the endoscope according to the present invention, the angle wire is locked at the base end position of the bending portion, or the locking wire inserted through the bending portion is locked, so that the angle wire is locked. The bending posture of the bending portion can be held even when the wire is broken, and the holding of the bending posture can be arbitrarily released. Thus, a surgical procedure using a treatment tool such as a puncture treatment tool or a high-frequency snare can always be performed safely, and can be safely ended.
[Brief description of the drawings]
FIG. 1 is a plan view showing an ultrasonic endoscope to which the present invention is applied. FIG. 2 is a longitudinal sectional view showing a structure of a bending portion. FIG. 3 is a sectional view taken along line 3-3 in FIG. FIG. 5 is an enlarged view of a portion P in FIG. 3; FIG. 5 is a diagram showing a state in which the angle ring is locked by rotating the inner ring in FIG. 4; FIG. 6 is a longitudinal sectional view showing a structure of a bending portion in the second embodiment. 7 is a sectional view taken along the line 7-7 in FIG. 6 FIG. 8 is an enlarged view of a part of the outer ring and the inner ring in FIG. 7 FIG. 9 is a locking wire by rotating the inner ring in FIG. FIG. 10 is a view showing a state in which is locked. FIG. 10 is a view showing a groove shape different from FIG.
DESCRIPTION OF SYMBOLS 10 ... Ultrasonic endoscope, 12 ... Hand operation part, 14 ... Insertion part, 16 ... Tip part, 18 ... Bending part, 20 ... Soft part, 22 ... Observation mechanism part, 24 ... Ultrasonic inspection mechanism part, 26 ... Forceps port, 28 ... forceps tube, 30 ... forceps insertion part, 32 ... eyepiece, 34 ... universal cord, 36 ... angle knob, 38 ... angle wire, 40 ... lock lever, 42 ... node ring, 43 ... covering member, 44 ... caulking pin, 46 ... distal sleeve, 48 ... proximal sleeve, 49 ... guide member, 50 ... outer ring, 50A ... groove, 52 ... inner ring, 52A ... groove, 54 ... rack, 56 ... pinion, 58 ... torque transmission Wire, 62: Locking wire, 64, 66: Guide pin, 67: Outer ring, 67A, 67B: Groove, 68: Inner ring, 68A, 68B: Groove, 74: Rack, 76: Pinion, 78: Torque transmission Wire

Claims (6)

In an endoscope having a bending mechanism for performing a bending operation on a bending portion provided in the endoscope insertion portion,
An endoscope comprising: a bending holding mechanism having a function of holding a bending posture of the bending portion when the bending mechanism breaks down and arbitrarily releasing the holding of the bending posture. By pushing and pulling a plurality of angle wires inserted through the endoscope insertion portion, in the endoscope in which the bending portion provided in the endoscope insertion portion is operated to bend.
An endoscope provided with a lock means for locking the angle wire at a base end position of the bending portion. An outer ring fixed to a base end position of the curved portion; and an inner ring rotatably supported inside the outer ring and having an outer peripheral surface sliding on an inner peripheral surface of the outer ring. With
The endoscope according to claim 2, wherein the angle wire is locked between the outer ring and the inner ring. By pushing and pulling a plurality of angle wires inserted through the endoscope insertion portion, in the endoscope in which the bending portion provided in the endoscope insertion portion is operated to bend.
A plurality of locking wires inserted through the bending portion, one end of which is fixed, and the other end of which is slidably supported,
Locking means for locking the other ends of the plurality of locking wires;
An endoscope comprising: The locking wire has a distal end fixed to the distal end position of the bending portion, and a rear end portion is slidably supported at a proximal end position of the bending portion,
An outer ring fixed to a base end position of the curved portion; and an inner ring rotatably supported inside the outer ring and having an outer peripheral surface sliding on an inner peripheral surface of the outer ring. With
The endoscope according to claim 4, wherein the locking wire is sandwiched and locked between the outer ring and the inner ring. The endoscope according to claim 4, wherein the locking wire is made of the same type of wire material as the angle wire.

Images