JP2005021576A - Endoscope magnetic anchor teleguiding system and endoscopic treatment method using magnetic anchor teleguiding system - Google Patents

Endoscope magnetic anchor teleguiding system and endoscopic treatment method using magnetic anchor teleguiding system Download PDF

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JP2005021576A
JP2005021576A JP2003270395A JP2003270395A JP2005021576A JP 2005021576 A JP2005021576 A JP 2005021576A JP 2003270395 A JP2003270395 A JP 2003270395A JP 2003270395 A JP2003270395 A JP 2003270395A JP 2005021576 A JP2005021576 A JP 2005021576A
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magnetic
member
endoscope
gripping member
anchor
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Takushi Gotoda
Tadao Kakizoe
Hiroyuki Kanda
Hisamitsu Kobayashi
Kenichi Ohara
忠生 垣添
健一 大原
寿光 小林
卓志 後藤田
裕幸 神田
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National Cancer Center-Japan
Pentax Corp
ペンタックス株式会社
国立がんセンター総長
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<P>PROBLEM TO BE SOLVED: To provide an endoscope magnetic anchor teleguiding system and an endoscopic treatment method using the magnetic anchor teleguiding system quickly and easily treating an object part, when generating a magnetic field from the magnetic anchor teleguiding device, surely drawing the object part retained by the retaining member, and facilitating the assembling work. <P>SOLUTION: The endoscope magnetic anchor teleguiding system is provided with a magnetic retaining member 11 composed of a magnetic body capable of retaining the object part inside the object; and a magnetic anchor teleguiding device 46 disposed outside the object and generating the magnetic field. This endoscope magnetic anchor teleguiding system moves the magnetic retaining member retaining the object part by a magnetic force from the magnetic field generated by the magnetic anchor teleguiding device and moving the object part in the prescribed direction. <P>COPYRIGHT: (C)2005,JPO&NCIPI

Description

本発明は、内視鏡観察下で病変部を切除する際に用いる、内視鏡用磁気アンカー遠隔誘導システム及び磁気アンカー遠隔誘導システムを用いた内視鏡による処置方法に関する。 The present invention is used when excising lesion under endoscopic observation, a method for treatment by an endoscope using an endoscope magnetic anchoring remote guide systems and magnetic anchoring remote guide systems for.

従来、通常の手術において人体内部の病変部を切除する場合においては、把持鉗子を用いて病変部を持ち上げることにより病変部と隣接する正常組織との間隔を広げ、その状態で病変部と正常組織との間を切除している。 Conventionally, in the case of ablating human body lesions in normal surgery, the space between it and the normal tissues adjacent to the lesion by lifting the lesion using a grasping forceps, normal and diseased portion in this state organization It is excised between. しかし、例えば内視鏡的粘膜切除術(EMR)では、体内には内視鏡を一台しか挿入できないため、病変部を持ち上げることができず、注射針で病変部の周囲の正常粘膜に生理食塩水等を注入して病変部を浮き上がらせ、その状態で高周波ナイフやスネアなどを用いて病変部と正常粘膜の間の切除を行っていた。 However, for example, in the endoscopic mucosal resection (EMR), since only be inserted a single endoscope in the body, it is impossible to lift the lesion, the physiological normal mucosa surrounding the lesion with a needle the saline or the like injected to lifted the lesion, using a high-frequency knife or snare was resected between the lesion and the normal mucosa in that state.

しかし、このような従来の方法では、病変部を十分な位置まで持ち上げることができなかったため、病変部と正常組織との境界の切除部分を十分確保することができなかった。 However, in such conventional methods, it was not possible to lift the lesion to a sufficient position, can not be sufficiently ensured cutting portion of the boundary between the lesion and normal tissue.
また、病変部が扁平な形状である場合は、切除部分を作りだすことができないこともあった。 Also, if the lesion is a flat shape, there may not be able to create a cutting portion.

さらに、切除作業中において、すでに切除した病変部が正常組織上に落ち込むことにより内視鏡による視界を妨げることがあり、特に病変部が大きい場合に顕著であった。 Furthermore, during the ablation working, can interfere with visibility endoscopic by lesions already cut falls on normal tissue, was remarkable particularly when a large lesion. そのため、切除部分を見ることができず、盲目的に切除するために正常部分を損傷して穿孔などの合併症が発生したり、血管を損傷して大出血をきたし、また出血時も出血部位の確認ができず止血できないことから重篤な合併症を来すことも考えられ、より安全な装置や処置方法が求められていた。 Therefore, it is impossible to see the cut portion, blindly complications such as perforation damage the normal portions may occur to ablate, damaged blood vessels Kitaichi the hemorrhage, also when bleeding bleeding site it is also believed to cause serious complications from the fact that the confirmation can not be hemostasis can not be, safer equipment and treatment methods has been demanded.

そこで本出願人は、これらの問題点を解決すべく、人体の臓器内部の病変部を把持する把持部材と、把持部材に接続された磁性体からなる磁気アンカーと、把持部材と磁気アンカーとを連結するひも状の連結部材と、人体の外部に配置され、磁界を発生して磁気アンカーに動力を与える磁気アンカー誘導装置と、を備え、磁気アンカー誘導装置が発生する磁界によって磁気アンカーに動力を与えて、把持部材によって把持された病変部を持ち上げることを特徴とする磁気磁気アンカー遠隔誘導システムを提案し、特許出願している(特願2002−268239号)。 The present applicant, in order to solve these problems, a gripping member for gripping a lesion of the internal body organs, and magnetic anchor made from a connected magnetic body gripping member, the gripping member and the magnetic anchor a string-shaped connecting member connecting, disposed the exterior of the human body, and the magnetic anchor guiding device to power the magnetic anchor to generate a magnetic field, comprising a power to the magnetic anchor by the magnetic field by the magnetic anchor induction device generates given, it proposed a magnetic magnetic anchoring remote guide systems, characterized in that lifting the lesion that has been gripped by the gripping member, and filed a patent application (Japanese Patent application No. 2002-268239).

本発明の目的は、上記特許出願の発明をさらに改良し、対象部位の処置を迅速かつ容易に行うことができるとともに、磁気アンカー誘導装置から磁界を発生させれば、把持部材によって把持された対象部位を確実に牽引でき、しかも組み立て作業が容易な内視鏡用磁気アンカー遠隔誘導システム、及び磁気アンカー遠隔誘導システムを用いた内視鏡による処置方法を提供することにある。 Target object of the present invention is to further improve the invention described in patent application, it is possible to perform the treatment of sites quickly and easily, if a magnetic field is generated from the magnetic anchor guiding device, which is gripped by the gripping member site can be reliably towing, yet to provide assembly work easy endoscope magnetic anchoring remote guide systems for, and a treatment method with the endoscope using the magnetic anchoring remote guidance systems.

本発明の内視鏡用磁気アンカー遠隔誘導システムは、対象物内部の対象部位を把持可能な磁性体からなる磁性把持部材と、上記対象物外部に配置され、磁界を発生する磁気アンカー誘導装置と、を具備し、該磁気アンカー誘導装置が発生する磁界からの磁力により、上記対象部位を把持している上記磁性把持部材を移動させて、上記対象部位を所定方向に移動させることを特徴としている。 Magnetic anchoring remote guide system for an endoscope of the present invention, a magnetic gripping member comprising an object inside the target part from the graspable magnetic material is disposed on the object outside the magnetic anchor guidance device for generating a magnetic field , comprising a, by a magnetic force from the magnetic field by the magnetic anchor induction device generates, by moving the magnetic gripping member that grips the target region, is characterized by moving the target region in a predetermined direction .

上記磁性把持部材が開閉自在な複数の爪部を有しており、さらに、両端が開口する筒状をなし、上記磁性把持部材が挿脱可能な筒状締付部材と、該筒状締付部材と上記磁性把持部材の相対位置を変化させることにより、上記爪部を開閉させる開閉手段と、を具備するのが実際的である。 The magnetic gripping member has a plurality of claw portions that openably further a cylindrical shape with both ends open, and the magnetic gripping members removably inserted a tubular with shaped fastening member, with the tubular clamping by changing the relative position of the member and the magnetic gripping member, it is practical to anda closing means for opening and closing the claw portion.

上記開閉手段は、内視鏡の鉗子チャンネル内に挿通され操作部側から牽引操作可能な操作ワイヤと、この操作ワイヤと、上記鉗子チャンネル内に挿入されている上記磁性把持部材とを接続する、操作ワイヤに加える操作力で切断可能な牽引分離部材と、上記鉗子チャンネル内にあって、上記操作ワイヤの牽引力に抗して磁性把持部材を保持する、該磁性把持部材を押し出し可能な押出部材と、を備えているのが好ましい。 It said switching means connects the inserted through traction operable operating wire from the operating portion in the endoscope forceps in the channel, and the operation wire, and the magnetic gripping member which is inserted into the forceps channel, traction separating member cleavable by an operating force applied to the operation wire, be within the forceps channel, for holding the magnetic gripping member against the pulling force of the operation wire, and the pushing member that can push out the magnetic gripping member preferably comprises a.

上記磁気アンカー誘導装置は、発生する磁界によって磁力を生じさせて、該磁力によって、上記磁気アンカーを所定方向に移動させる磁気誘導部材と、該磁気誘導部材を特定の一平面内に配置したU字状のフレーム部材に沿って移動させる一平面内移動機構と、上記U字状のフレーム部材を上記一平面と直交する方向に相対移動させる一方向移動機構と、を有するのが実際的である。 The magnetic anchor induction device is caused magnetic force by the magnetic field generated by the magnetic force, the magnetic induction member for moving the magnetic anchor in a predetermined direction, U-shaped placing the magnetic induction member within one particular plane and a plane in the moving mechanism for moving along the Jo of the frame member, has a, a one-way moving mechanism that relatively moves the U-shaped frame member in a direction perpendicular to the one plane is practical.

本発明の磁気アンカー遠隔誘導システムを用いた内視鏡による処置方法は、対象物内部の対象部位を把持可能な磁性体からなる磁性把持部材を上記対象物内部に配設するステップ、該磁性把持部材により、上記対象物内部の対象部位を把持する把持ステップ、及び上記対象物外部に配置された磁気アンカー誘導装置から磁界を発生させ、該磁界から生じる磁力により上記磁性把持部材を移動させて、上記磁性把持部材に把持された対象部位を所定方向に移動させる移動ステップ、を有することを特徴としている。 Treatment method according to an endoscope using the magnetic anchoring remote guide system of the present invention, the step of disposing a magnetic gripping member comprising an object inside the target part from the graspable magnetic material inside the object, the magnetic gripper the member, the grasping step grasps the target site within the object, and to generate a magnetic field from the magnetic anchor guiding device which is arranged on the object outside the magnetic force generated from the magnetic field by moving the magnetic gripping member, It is characterized by having a moving step of moving the target part which is gripped by the magnetic gripper member in a predetermined direction.

上記磁性把持部材が開閉自在な複数の爪部を有しており、さらに、両端が開口する筒状をなし、上記磁性把持部材が挿脱可能な筒状締付部材と、該筒状締付部材と上記磁性把持部材の相対位置を変化させることにより、上記爪部を開閉させる開閉手段と、を具備するのが実際的である。 The magnetic gripping member has a plurality of claw portions that openably further a cylindrical shape with both ends open, and the magnetic gripping members removably inserted a tubular with shaped fastening member, with the tubular clamping by changing the relative position of the member and the magnetic gripping member, it is practical to anda closing means for opening and closing the claw portion.

上記開閉手段は、内視鏡の鉗子チャンネル内に挿通され操作部側から牽引操作可能な操作ワイヤと、この操作ワイヤと、上記鉗子チャンネル内に挿入されている上記磁性把持部材とを接続する、操作ワイヤに加える操作力で切断可能な牽引分離部材と、上記鉗子チャンネル内にあって、上記操作ワイヤの牽引力に抗して磁性把持部材を保持する、該磁性把持部材を押し出し可能な押出部材と、を備えているのが好ましい。 It said switching means connects the inserted through traction operable operating wire from the operating portion in the endoscope forceps in the channel, and the operation wire, and the magnetic gripping member which is inserted into the forceps channel, traction separating member cleavable by an operating force applied to the operation wire, be within the forceps channel, for holding the magnetic gripping member against the pulling force of the operation wire, and the pushing member that can push out the magnetic gripping member preferably comprises a.

本発明によると、対象部位の処置を迅速かつ容易に行うことができるとともに、磁気アンカー誘導装置から磁界を発生させれば、把持部材によって把持された対象部位を確実に牽引でき、しかも組み立て作業が容易になる。 According to the present invention, it is possible to perform the treatment of sites quickly and easily, if a magnetic field is generated from the magnetic anchor induction device can reliably towing the target portion which is gripped by the gripping member, yet the assembly work It becomes easier.

以下、本発明の一実施形態を、図1から図12を参照しながら説明する。 Hereinafter, an embodiment of the present invention will be described with reference to FIGS. 1 to 12.
本実施形態の磁気アンカー遠隔誘導システムは、磁気アンカー装置10(磁性把持部材11、牽引分離部材14、筒状締付部材15からなる)と、磁気アンカー装置10の内視鏡20からの分離操作等を行う操作装置30と、磁気アンカー装置10を体外において吸引制御する(磁性把持部材11に磁力を及ぼす)磁気アンカー誘導装置40とからなるものである。 Magnetic anchoring remote guide system of the present embodiment, a magnetic anchoring device 10 (magnetic gripping member 11, pulling the separation member 14, consisting of tubular clamping member 15), separation from the endoscope 20 of the magnetic anchoring device 10 such an operation device 30 for, (exerts a magnetic force to the magnetic gripping member 11) to a magnetic anchor apparatus 10 for suction control in vitro is made of a magnetic anchor guiding device 40.

まず、図1から図3を参照して、磁気アンカー装置10の構成について説明する。 First, with reference to FIGS. 1 to describe the configuration of a magnetic anchor apparatus 10.
対称形状をなす磁性把持部材11は、強磁性材料板を折曲加工した弾性部材であり、自由状態においてその両側部の先端が接触するCリング状の基部12と、基部12の先端から前方に延びつつ拡開する一対の傾斜片13a、13aと、両傾斜片13a、13aの先端から延びる中間片13b、13bと、両中間片13b、13bの先端部を折曲して形成した爪部13c、13cとを具備している。 Magnetic gripping member 11 symmetrical shape, the ferromagnetic material plates are processed resilient member bent, the C-ring-shaped base portion 12 which contacts the tip of its sides in a free state, forward from the base portion 12 pair of inclined pieces 13a which widens while extending, 13a and, both inclined pieces 13a, an intermediate segment 13b extending from the distal end of 13a, 13b and both the intermediate piece 13b, the pawl portion 13c formed by bending the tip of 13b , and a 13c. さらに、基部12の後端部には挿入孔12aが穿設されている。 Further, the rear end of the base portion 12 insertion hole 12a is drilled. 強磁性材料の具体例としては、純鉄、鉄合金のほか、プラチナマグネット、希土類磁石、テルビウム・ディスプロシウム・鉄合金などの磁石がある。 Specific examples of the ferromagnetic material, pure iron, other iron alloy, platinum magnet, rare earth magnet, there is a magnet, such as terbium, dysprosium-iron alloy.

牽引分離部材(開閉手段)14は棒状の部材であり、その先端には、磁性把持部材11の挿入孔12aを貫通する一対の挿入片14aと、挿入片14aの先端に設けられた、基部12の内面に係合して、挿入片14aが基部12から抜け出すのを防止する抜け止め部14bとが設けられている。 Traction separating member (switching means) 14 is a rod-shaped member, in its front end, a pair of insertion pieces 14a penetrating the insertion hole 12a of the magnetic gripping member 11, provided at a distal end of the insertion piece 14a, the base portion 12 engage the inner surface, and a retaining portion 14b insert 14a to prevent slipping out from the base 12 is provided. さらに、牽引分離部材14の基端部には鈎部14cが形成されている。 Further, the proximal end portion of the pulling separating member 14 is a hook portion 14c is formed. 牽引分離部材14は、プラスチックやSUS等の金属材料から成形されており、所定の切断力以上の強い力を受けると切断される程度の強度である。 Pulling the separation member 14 is formed from a metal material such as plastic or SUS, is a strength that is cut and subjected to a strong force of more than predetermined cutting force.

図1から図3等に示す両端が開口する筒状締付部材15は、可撓性のある材料からなるものである。 Tubular clamping member 15 having both ends opened shown in FIGS. 1 to 3 or the like is made of a flexible material. この筒状締付部材15の内径は、磁性把持部材11の基部12が嵌合可能な寸法となっている。 The inner diameter of the tubular clamping member 15, the base 12 of the magnetic gripping member 11 is in the fittable dimensions.

図1に示す状態(磁性把持部材11が筒状締付部材15内に嵌合していない状態)から、筒状締付部材15に対して牽引分離部材14を相対的に後方に引くと、図2に示すように、磁性把持部材11の基部12が内向きに弾性変形しながら筒状締付部材15の内部に引き込まれる。 From the state shown in FIG. 1 (state where magnetic gripping member 11 is not fitted to the cylindrical fastening member 15), when pulling the pulling separating member 14 relatively rearward with respect to the tubular clamping member 15, as shown in FIG. 2, it is drawn into the cylindrical fastening member 15 while being elastically deformed inwardly the base 12 of the magnetic gripping member 11. すると、基部12が弾性変形しながらその径が小さくなり、両傾斜片13aと両中間片13bが互いに離れる開状態となる。 Then, the diameter is reduced while the base 12 is elastically deformed, an open state in which both inclined pieces 13a and both the intermediate piece 13b away from each other.
図3に示すように、筒状締付部材15に対して牽引分離部材14をさらに相対的に後方に引くと、磁性把持部材11が内向きに弾性変形しながら筒状締付部材15の内部にさらに引き込まれ、その傾斜片13aが筒状締付部材15の先端開口部に接触し、両傾斜片13aと両中間片13bと両爪部13cが互いに接近する閉状態となる。 As shown in FIG. 3, the cylindrical further pulled relatively backward traction separation member 14 with respect to fastening member 15, the tubular clamping member 15 while being elastically deformed inwardly magnetic gripping member 11 further retracted, the inclined piece 13a is in contact with the front end opening of the tubular clamping member 15, a closed state where both inclined pieces 13a and both the intermediate piece 13b and Ryotsume portion 13c approach each other to.

図4は、磁気アンカー遠隔誘導システムを用いた切除術の実施に用いる内視鏡20を示している。 Figure 4 shows an endoscope 20 used in resection embodiment using a magnetic anchor remote guidance systems.
内視鏡20は周知のように、柔軟で可撓性を有し体内に挿入される挿入部21を有しており、その先端面22には、エア及び洗浄水を送るための送気送水ノズル(図示略)、切除部及びその周辺を照らすための照明窓(図示略)、直後に対物レンズと撮像素子が配置された、切除部及びその周辺を観察するための観察窓、並びに、図7等に示された鉗子チャネルCの出口23が設けられている。 As the endoscope 20 is well known, has an insertion portion 21 inserted into the body has a flexible flexible, in its distal end surface 22, air and water supply for sending air and washing water nozzle (not shown), cutouts and illumination windows for illuminating the periphery thereof (not shown), an objective lens and the imaging device is placed immediately after an observation window for observing the cut portion and the periphery thereof, and FIG. forceps channel C of the outlet 23 shown in 7, and the like. 鉗子チャンネルCは挿入部21内に形成されており、その入口24aは鉗子口24の端面に形成されており、さらに、その出口23は、先端側が拡径するテーパ状となっている。 Forceps channel C is formed in the insertion portion 21, an inlet 24a is formed in the end surface of the forceps port 24, further, the outlet 23 has a tapered tip end is expanded.

次に、図7を参照しながら、内視鏡20の鉗子チャンネルC内に挿入される操作装置30について説明する。 Next, referring to FIG. 7, the operation device 30 that is inserted into the endoscope 20 forceps in channel C will be described.
挿入管31は可撓性を有する筒状の部材であり、内視鏡20の鉗子口24の入口24aから鉗子チャンネルCに挿通可能である。 Insertion tube 31 is a tubular member having flexibility can be inserted from the inlet 24a of the forceps channel 24 of the endoscope 20 to the forceps channel C. さらに、その内径は、筒状締付部材15を挿入可能な寸法となっている。 Moreover, its inner diameter has a insertable dimensions tubular clamping member 15. 挿入管31の内部には、挿入管31に対して相対移動可能な筒状の挿入コイル(押出部材)(開閉手段)32が挿通されている。 Inside the insertion tube 31, movable relative tubular insert coil (pushing member) (switching means) 32 is inserted to the insertion tube 31. 挿入コイル32の先端部には、大径部33aと小径部33bとからなる規制管(押出部材)(開閉手段)33の小径部33bが嵌合され、接着剤、はんだ、ロウなどによって、小径部33bが挿入コイル32の先端部に固着されている。 The distal end of the insertion the coil 32, the small diameter portion 33b of the restriction tube (pushing member) (switching means) 33 composed of a large diameter portion 33a and a small diameter portion 33b is fitted, adhesive, solder, or the like wax, small diameter part 33b is fixed to the distal end of the insertion the coil 32.

大径部33aの外径は挿入管31の内径より小さく、かつ、挿入コイル32の外径とほぼ同一に設定されている。 The outer diameter of the large diameter portion 33a is smaller than the inner diameter of the insertion tube 31, and is set to be substantially the same as the outer diameter of the insertion coil 32. さらに、大径部33aの内径は小径部33bの内径より大きく、筒状締付部材15の外形と略同一に設定されており、大径部33a内面の小径部33b内面との接続部には、規制管33の軸線に対して直交する環状段部33a1が形成されている(図7等参照)。 Further, the inner diameter of the large-diameter portion 33a is larger than the inner diameter of the small diameter portion 33b, is set to be substantially the same as the outer shape of the tubular clamping member 15, the connecting portion between the small diameter portion 33b the inner surface of the large diameter portion 33a inner surface , annular step 33a1 perpendicular to the axis of the restricting tube 33 is formed (see FIG. 7, etc.).

鉗子チャンネルCに挿入された挿入コイル32の内側には、先端にフック部34が設けられた操作ワイヤ(開閉手段)35が、挿入コイル32と規制管33に対して相対移動可能に挿入されている。 Inside the insertion coil 32 inserted into the forceps channel C, the operating wire (switching means) 35 for hook 34 is provided at the front end is inserted to be movable relative to the insertion coil 32 and the regulating tube 33 there. フック部34は、接着剤、はんだ、ロウ等によって、その基端部が操作ワイヤ35の先端部に固着されている。 Hook 34, adhesive, solder, by wax or the like, a base end portion is fixed to the distal end portion of the operation wire 35.
さらに、挿入管31、挿入コイル32、及び操作ワイヤ35の各基端部は、操作装置30の操作部(図示略)に連結されており、互いに軸方向に相対移動可能となっている。 Furthermore, the proximal end of the insertion tube 31, inserted coils 32, and the operation wire 35 is connected to the operating section of the control device 30 (not shown), and can move relative to each other in the axial direction.
以上説明した、挿入管31、挿入コイル32、規制管33、フック部34、操作ワイヤ35、及び操作部により操作装置30が構成されている。 Described above, the insertion tube 31, inserted coil 32, restricting tube 33, the hook portion 34, the operating wire 35 operating device 30, and the operation unit is constituted.

次に、図5及び図6を用いて、患者Aの体外において磁性把持部材11を吸引制御する磁気アンカー誘導装置40の構成について説明する。 Next, with reference to FIGS. 5 and 6, description will be given of a configuration of a magnetic anchor guiding device 40 for suction control of the magnetic gripping member 11 in the outside of the patient's body A.
患者Aを載せる床板41aを具備するベッド41の両側部には、一対のXYステージ(一方向移動機構)42、42が配設されている。 On both sides of the bed 41 having a floor plate 41a for placing the patient A, a pair of XY stage (one-way moving mechanism) 42 is disposed. この一対のXYステージ42は、ベッド41の長手方向に沿って、両者42、42の該長手方向位置が常時同じになるように、直線的に往復移動するものである。 The pair of XY stage 42, along the longitudinal direction of the bed 41, as longitudinal position of both 42 and 42 is always the same, but that linearly reciprocates. さらに、ベッド41の上方には、ベッド41の長手方向と直交する平面内において互いに平行をなす、正面視略逆U字形の二つのレール44、45からなるフレーム/レール(一平面内移動機構)43が配設されており、このフレーム/レール43の両端部は、左右のXYステージ42にそれぞれ固定されている。 Furthermore, above the bed 41, to be parallel to each other in a plane perpendicular to the longitudinal direction of the bed 41, a frame / rail consisting of two rails 44, 45 of the front view generally inverted U-shape (a plane in the moving mechanism) 43 is disposed, both ends of the frame / rail 43 is fixed on the left and right of the XY stage 42. 内側のレール44には、磁性把持部材11を体外において吸引制御する(磁性把持部材11に磁力を及ぼす)磁気誘導部材46が摺動自在に装着されており、磁気誘導部材46は左右のXYステージ42の間を、レール45に沿って移動することができる。 Inside the rail 44, a magnetic gripping member 11 to the suction control in vitro (on the magnetic force to the magnetic gripping member 11) magnetic induction member 46 is mounted slidably, magnetic induction member 46 right and left of the XY stage 42 between, can be moved along the rail 45. 磁気誘導部材46は、鉄心にコイルを巻いた構造の電磁石47を基体48上に固定したものであり、その電磁石47は常時、患者A側を向いている(図5参照)。 Magnetic induction member 46 is obtained by fixing an electromagnet 47 having a structure in which a coil wound around an iron core on the substrate 48, the electromagnet 47 is always facing the patient A side (see Fig. 5). なお、磁気誘導部材46は、永久磁石と電磁石の組み合わせでもよく、また、永久磁石と電磁石を2個以上組み合わせたものでも良い。 The magnetic induction member 46 may be a combination of permanent magnets and electromagnets, or may be a combination of permanent magnets and electromagnets 2 or more.

フレーム/レール43の外側のレール45には、フレーム/レール43全体の重量バランスを保つためのカウンターウエイト49がレール45に摺動自在に装着されている。 The outer rail 45 of the frame / rail 43, the counterweight 49 for keeping the weight balance of the entire frame / rail 43 is slidably mounted to the rail 45. カウンターウエイト49は、磁気誘導部材46の位置に応じて、その位置が変化する。 Counterweight 49, depending on the position of the magnetic induction member 46, its position changes. 例えば、磁気誘導部材46が患者Aの正面側に位置するときは、カウンターウエイト49は患者Aの背面側に位置し、磁気誘導部材46が患者Aの背面側にあるときは、カウンターウエイト49は患者Aの正面側に位置して、フレーム/レール43全体の重量バランスをとっている。 For example, when the magnetic induction member 46 is positioned on the front side of the patient A, the counterweight 49 is located on the back side of the patient A, when the magnetic induction member 46 on the back side of the patient A, the counterweight 49 located on the front side of the patient a, taking the weight balance of the entire frame / rail 43.
そして、以上説明した磁気誘導部材46、XYステージ42、フレーム/レール43により磁気アンカー誘導装置40が構成されている。 The magnetic induction member 46, XY stage 42 described above, the magnetic anchor guiding device 40 is constituted by the frame / rail 43.

次に、磁気アンカー遠隔誘導システムを用いた病変部Xの切除要領について説明する。 Next, a description will be given ablation procedure lesion portion X using a magnetic anchor remote guidance systems.
磁気アンカー遠隔誘導システムを用いた切除術の実施に先立っては、まず、図5及び図6に示すように、局所麻酔を施した患者Aをベッド41の床板41a上に横たわらせる。 Prior to resection embodiment using a magnetic anchor remote guidance system, first, as shown in FIGS. 5 and 6, to lie down a patient A which has been subjected to local anesthesia on floor plate 41a of the bed 41. このとき、XYステージ42を操作して、フレーム/レール43のベッド41の長手方向位置を、患者Aの頭部A1とほぼ同じ位置にしておき、さらに、磁気誘導部材46及びカウンターウエイト49を所定の場所に位置させておく。 At this time, by operating the XY stage 42, the longitudinal position of the bed 41 of the frame / rail 43, leave at substantially the same position as the head A1 of the patient A, further, the predetermined magnetic induction member 46 and the counterweight 49 allowed to position in place.
次に、XYステージ42を操作してフレーム/レール43を患者Aの正面側に配置させ、さらに、磁気誘導装置46をフレーム/レール43に沿って移動させて、磁気誘導部材46を切除術開始時位置に位置させる(図6参照)。 Next, the frame / rail 43 by operating the XY stage 42 is disposed on the front side of the patient A, further, by moving along the magnetic guidance device 46 to the frame / rail 43, resection initiate magnetic induction member 46 is located at position (see FIG. 6).

次いで、図示を省略した可撓性を有するオーバーチューブを、患者Aの口から体内に挿入する。 Then, the overtube having flexibility which is not shown, is inserted into the body from the mouth of the patient A. 続いて、内視鏡20の挿入部21をオーバーチューブ内に挿入し、挿入部21の先端部をオーバーチューブの先端から突出させ、臓器(対象物)B(図8から図12参照)の病変部(対象部位)Xに近接させる(図示略)。 Subsequently, by inserting the insertion portion 21 of the endoscope 20 in the overtube, protrudes the distal end portion of the insertion portion 21 from the distal end of the overtube, the lesion organ (object) B (see Figures 8-12) parts is close to the (target site) X (not shown). このように、内視鏡20の挿入部21の先端を臓器B内に挿入すると、内視鏡20の挿入部21の先端面22に設けられた観察窓から得られた臓器B内の観察像が、図示を省略したテレビモニタに写し出される。 Thus, the endoscope when the distal end of the insertion portion 21 of the mirror 20 is inserted into the organ B, the observation image of the endoscope in an organ B obtained from the observation window provided in the distal end surface 22 of the insertion portion 21 of 20 but, it is projected on the TV monitor (not shown).

次いで、鉗子口24の入口24aから、先端部に注射針を具備するチューブ状の処置具(図示略)を鉗子チャンネルCに挿入して、その注射針を鉗子チャンネルCの出口23から突出させる。 Then, from the inlet 24a of the forceps opening 24, tubular treatment instrument having a needle at the distal end (not shown) is inserted into the forceps channel C, to project the needle from the forceps channel C of the outlet 23. そして、注射針を病変部Xの周辺から臓器壁の粘膜下層B1に挿入して生理食塩水等を注入し、病変部Xを固有筋層B2から浮き上がらせておく(図8から図12参照)。 Then, the injection needle to inject saline or the like is inserted from the periphery of the lesion portion X to the submucosal layer B1 organ wall, previously lifted lesions X from muscularis propria B2 (see Figures 8-12) .

続いて、鉗子チャンネルCから該処置具を取り出す。 Then, take out the treatment instrument from the forceps channel C. 次に、挿入管31、挿入コイル32、規制管33、フック部34、操作ワイヤ35、及び操作部を一体化した操作装置30を、鉗子口24から鉗子チャンネルCに挿入する。 Next, the insertion tube 31, inserted coil 32, restricting tube 33, the hook portion 34, the operating wire 35 operating device 30, and integrated with the operation unit, inserted from the forceps opening 24 to the forceps channel C.
この際、鉗子チャンネルCに操作装置30を挿入すると、操作装置30の操作部及び、挿入管31と挿入コイル32と操作ワイヤ35の基端部が鉗子口24の後方に突出する(図示略)。 In this case, when inserting the operating device 30 into the forceps channel C, the operating portion of the operating device 30 and the proximal end of the insertion tube 31 and the insertion coil 32 and the operating wire 35 protrudes to the rear of the forceps port 24 (not shown) .
また、筒状締付部材15は可撓性を有する材料から成形されており、かつ、挿入コイル32は屈曲自在なので、挿入部21が屈曲していても、これらの部材は鉗子チャンネルC内をスムーズに移動することができる。 Further, the tubular clamping member 15 is molded from a flexible material, and the insertion coil 32 is freely bent, even the insertion portion 21 is not bent, these members within the forceps channel C it can move smoothly.

操作装置30の先端が鉗子チャンネルCの先端部に到達したら、鉗子口24から突出している操作ワイヤ35の基端部を掴んで、操作ワイヤ35を操作してフック部34のみを内視鏡20の先端面22から突出させ、このフック部34に牽引分離部材14の鈎部14cを係合して、操作ワイヤ35を操作部側に引く。 Once the tip of the operating device 30 reaches the distal end of the forceps channel C, by grasping the proximal end of the operating wire 35 which protrudes from the forceps port 24, the endoscope by operating the operation wire 35 only hook 34 20 the protruded from the distal end surface 22, engages the hook portion 14c of pulling separating member 14 on the hook portion 34, pulling the operating wire 35 on the operation unit side. すると、図7に示すように、筒状締付部材15の基端部が規制管33の大径部33aに嵌合するとともに、牽引連結部材14、筒状締付部材15、及び磁性把持部材11の基部12が鉗子チャンネルC内に引き込まれ、磁気アンカー装置10と操作装置30が一体化する。 Then, as shown in FIG. 7, the base end portion of the tubular clamping member 15 is fitted into the large diameter portion 33a of the restricting tube 33, pulling the connecting member 14, the tubular clamping member 15, and the magnetic gripping member 11 base 12 of drawn into the forceps channel C, and the operating device 30 a magnetic anchor apparatus 10 are integrated.

このように、内視鏡20に磁気アンカー装置10と操作装置30をセットしたら、図8に示すように、挿入コイル32の基端部を掴みながら挿入コイル32を挿入部21の先端側に移動させて、磁性把持部材11を病変部Xに近接させる。 Thus movement, after loading the magnetic anchor apparatus 10 and the operating device 30 to the endoscope 20, as shown in FIG. 8, the inserted coils 32 on the distal end side of the insertion portion 21 while grasping the proximal end of the insertion the coil 32 by causes a magnetic gripping member 11 close to the lesion X. この状態で操作ワイヤ35を内視鏡20に対して相対的に後方に引くと、磁性把持部材11の基部12が筒状締付部材15内に引き込まれ、磁性把持部材11は図8に示す開状態となる。 Pull relatively rearward with respect to the endoscope 20 the operation wire 35 in this state, the base portion 12 of the magnetic gripping member 11 is drawn into the tubular clamping member 15, the magnetic gripping member 11 is shown in FIG. 8 the open state.

さらに操作ワイヤ35を後方に引くと、磁性把持部材11の基部12が筒状締付部材15内部の後方にさらに引き込まれ、かつ、傾斜片13aが筒状締付部材15の先端開口部に当接するので、磁性把持部材11の中間片13bが閉じて、両爪部13cにより病変部Xが確実に把持される(図9参照)。 Further pulling the operating wire 35 to the rear, the base 12 of the magnetic gripping member 11 is further pulled to the rear of member 15 inside with a tubular fastening, and inclined piece 13a abuts on the tip opening of the cylindrical clamping member 15 since contact to close an intermediate piece 13b of the magnetic gripping member 11, the lesion portion X is reliably gripped by Ryotsume portion 13c (see FIG. 9).

この状態で、操作ワイヤ35を上記切断力以上の強い力で後方に引くと、フック部34と係合している牽引分離部材14が、その中間部で切断され、その結果、磁気アンカー装置10が操作ワイヤ35から分離する(図10参照)。 In this state, when the operation wire 35 pulled backwards by a strong force over the cutting force, pulling the separation member 14 which is engaged with the hook portion 34 is cut at an intermediate portion thereof, as a result, the magnetic anchor apparatus 10 There separated from the operation wire 35 (see FIG. 10).

続いて、図11に示すように、患者Aの体外に配置されている磁気誘導部材46の発生磁界を強める。 Subsequently, as shown in FIG. 11, strengthen the magnetic field generated by the magnetic induction member 46 disposed outside the patient's body A. 磁性把持部材11に生じる吸引力は磁性把持部材11の体積と密接な関係があり、磁性把持部材11の体積が大きいほど吸引力も大きくなる。 Suction force generated in the magnetic gripping member 11 is closely related to the volume of the magnetic gripping member 11, the attraction force becomes larger the larger the volume of the magnetic gripping member 11. 例えば、磁性把持部材(材質は磁性SUS)11の寸法を、外形10mm、長さ17mm、体積754mm 3とすると、磁気誘導部材46が発生する磁界の強さが0.604kOe(キロエルステッド)で、かつ、磁気誘導部材46から磁性把持部材11までの距離が10.5cmの場合、磁性把持部材11には12.1gの吸引力が生じる。 For example, the dimensions of the magnetic gripping member (made of magnetic SUS) 11, outer 10 mm, length 17 mm, when the volume 754Mm 3, the strength of the magnetic field magnetic induction member 46 is generated at 0.604KOe (kilo-oersted), and, when the distance from the magnetic induction member 46 until the magnetic gripping member 11 is 10.5cm, the suction force of 12.1g is generated in the magnetic gripping member 11.
このように、磁性把持部材11の体積を所定の大きさ以上にすれば、磁性把持部材11には図11の上側を向く十分な大きさの吸引力が掛かり、磁性把持部材11に掴まれている病変部Xも同方向に十分な距離だけ持ち上げられる。 Thus, if the volume of the magnetic gripping member 11 above a predetermined size, the magnetic gripping member 11 takes suction force of sufficient magnitude facing upper side of FIG. 11, it is gripped magnetic gripping member 11 lesion X who is also lifted a sufficient distance in the same direction.

このように、病変部Xを所望方向に所望距離だけ移動させると、病変部Xと正常組織との境界部に、十分な大きさの切除部分が形成されるので、挿入管31、挿入コイル32、及び操作ワイヤ35を内視鏡20から取り出し、図11に示すように、内視鏡20(図11では図示略)の鉗子チャネルCを利用して高周波メス50などの切開具を臓器B内に挿入し、病変部Xを粘膜とともに一方の端部側から切除する。 Thus, when the pathological lesion portion X is moved by a desired distance in the desired direction, the boundary between the pathological lesion portion X and normal tissue, the cutting portion of sufficient size is formed, the insertion tube 31, inserted coils 32 and operating the wire 35 is taken out from the endoscope 20, as shown in FIG. 11, the endoscope 20 (FIG. in 11 not shown) of the forceps channel by using the C cutting instrument inside an organ B, such as high-frequency scalpel 50 It is inserted into and excision from one end side lesions X with mucosa.
そして、病変部Xを一方の端部側から反対の端部側に切除すると、やがて、病変部X全体が完全に切除される(図12参照)。 Then, when the cut on the end side opposite the lesion portion X from one end side, eventually, the entire lesion X is completely excised (see Figure 12).
なお、高周波メス50による切除作業時においては、切除領域が拡がるにつれて、高周波メス50の先端50aの位置の確認は、より容易となる。 Incidentally, at the time of resection operation by the high-frequency knife 50, as the resection area expands, confirmation of the position of the tip 50a of the high frequency knife 50 is made easier.

以上のように切除作業を終えると、正常組織から切り離された病変部Xは磁性把持部材11(磁気アンカー装置10)に把持されたままの状態となるので、病変部Xの紛失が防止される。 Upon completion of the ablation working as described above, since the lesion portion X, separated from normal tissue becomes a state of being gripped by the magnetic gripper member 11 (magnetic anchor apparatus 10), loss of the lesion portion X is prevented .
切除した病変部Xを回収するには、図12に示すように、内視鏡20(図12では図示略)の鉗子チャンネルCに、その先端部に開閉可能な一対の把持片61を具備し、さらに、その基端部に操作部(図示略)を具備する把持鉗子60を挿入する。 To recover the excised diseased tissue X as shown in FIG. 12, the forceps channel C of the endoscope 20 (FIG. 12, not shown), comprises a pair of gripping pieces 61 which can be opened and closed at its distal end further inserting the grasping forceps 60 that includes an operation unit (not shown) at its proximal end. そして、この操作部を操作して、把持片61を開放状態にした状態で牽引分離部材14に近接させ、その後に両把持片61を閉じて、両把持片61により牽引分離部材14を確実に把持する。 Then, by operating the operation unit, the gripping piece 61 is brought close to the towing separating member 14 in a state of being open, then close the two holding pieces 61, ensures the traction separating member 14 by both gripping pieces 61 to grip. そして、そのままの状態で内視鏡20を体内から抜き去り、病変部Xを磁気アンカー装置10とともに体外に取り出し、その後に、そして、切除した部分の縫合、消毒などの処置を行う。 Then, drained off the endoscope 20 from the body as it is, the pathological lesion portion X is taken out from the body with magnetic anchor apparatus 10, then, and suturing the cut portion, a treatment such as disinfection performed.

以上のように、本実施形態の磁気アンカー遠隔誘導システムを用いれば、磁性把持部材11が、従来の磁気アンカー遠隔誘導システムの磁気アンカーと把持部材の両方の機能を兼ねるので、従来の磁気アンカー遠隔誘導システムに比べて、部品点数の減少を図ることができ、磁気アンカー装置10の組み立て作業を容易に行うことができる。 As described above, by using a magnetic anchor remote guide system of the present embodiment, the magnetic gripping member 11, also serves as both the magnetic anchor and the gripping member of the conventional magnetic anchoring remote guide system functions, conventional magnetic anchor remote compared to the induction system, it is possible to decrease the number of parts, it is possible to easily assembling work of the magnetic anchoring device 10.

さらに、従来の磁気アンカー遠隔誘導システムでは連結ひも(連結部材)を必要としており、磁気誘導部材46から磁界を発生させると、磁気アンカーが臓器の内壁に接触するものの、連結ひもが緊張せず、その結果、把持部材に牽引力が掛からないということがあったが、本実施形態では連結ひも(連結部材)が不要となので、磁気誘導部材46から磁界を発生させれば、病変部Xを所望の方向に所望の距離だけ確実に移動させることができる。 Furthermore, in the conventional magnetic anchoring remote guide systems have required coupling cord (connecting member), when a magnetic field is generated from the magnetic induction member 46, although the magnetic anchor is in contact with the inner wall of the organ, coupling cord is not tensioned, as a result, the traction force to the gripping member there is that not applied, because in this embodiment, such coupling cord (connecting member) unnecessary, the magnetic induction member 46 are caused to generate a magnetic field with the pathological lesion portion X desired it can be moved by surely desired distance in the direction.

さらに、病変部Xを所望方向に十分な距離だけ移動させることができるため、病変部Xと正常組織との境界の切除部分を、容易かつ確実に十分な大きさで確保することができる。 Furthermore, since it is possible to move the lesion X sufficient distance desired direction, the cutting portion of the boundary between the pathological lesion portion X and normal tissue, can be secured easily and reliably enough. また、病変部Xが扁平な形状であっても、十分な大きさの切除部分を作りだすことができるので、このような場合であっても、病変部Xを容易に切除することが可能となる。 Further, even in the lesion X is flat shape, it is possible to create a cutting portion of sufficient size, even in such a case, it is possible to easily cut the lesion X .

さらに、病変部Xは磁性把持部材11により持ち上げられるため、切除部分を十分確保することができ、すでに切除した病変部Xが固有筋層B2上に落ち込むことを防止できる。 Furthermore, the lesion X since lifted by magnetic gripping member 11, the cutting portion can be sufficiently secured, the lesion portion X is an already cut can be prevented from falling on the proper muscular layer B2.
また、任意の位置に磁性把持部材11を配置できるため、切除した病変部Xにより内視鏡20の視界が妨げられることがない。 Further, since it arranged magnetic gripping member 11 at an arbitrary position, it is not hindered view of the endoscope 20 by excised lesion X.

本発明について上記実施形態を参照しつつ説明したが、本発明は上記実施形態に限定されるものではなく、改良の目的または本発明の思想の範囲内において改良または変更が可能である。 Although the invention has been described with reference to the above embodiments, the present invention is not limited to the above embodiments and can be modified or changed within the object or range of spirit of the present invention improved. 例えば、基部12の形状を変更した上で、傾斜片13aと中間片13bと爪部13cの一体物を3個以上としてもよい。 For example, in terms of changing the shape of the base 12, the integral of the inclined piece 13a and intermediate piece 13b and the claw portion 13c may be three or more. このようにすれば、磁性把持部材11の体積が大きくなるので、磁性把持部材11に掛かる吸引力が大きくなる。 Thus, the volume of the magnetic gripping member 11 is increased, the suction force increases applied to the magnetic gripping member 11.

本発明の一実施形態の磁気アンカー装置の全体図である。 It is an overall view of a magnetic anchoring device according to an embodiment of the present invention. 磁性把持部材が開いた状態の磁気アンカー装置の全体図である。 It is an overall view of a magnetic anchoring device in a state where the magnetic gripping member is opened. 磁性把持部材が閉じた状態の磁気アンカー装置の全体図である。 It is an overall view of a magnetic anchoring device in a state where the magnetic gripping member is closed. 内視鏡の全体図である。 It is an overall view of an endoscope. 病変部の切除が行われる患者を載せたベッドと、磁気アンカー誘導装置を、患者の頭部側から見た図である。 A bed excision of lesion bearing the patient to be performed, the magnetic anchor guide device, which is seen from the head side of the patient. 患者を載せたベッドと、磁気アンカー誘導装置の側面図である。 A bed carrying the patient is a side view of a magnetic anchor induction device. 鉗子チャンネル内に、磁気アンカー装置と連係した状態で操作装置を挿入した状態を示す、内視鏡先端部の拡大縦断側面図である。 In the forceps channel, showing a state of inserting the operating device in a state in conjunction with a magnetic anchor device is an enlarged vertical sectional side view of the distal end of the endoscope. 開いた状態で、内視鏡の先端から突出した磁性把持部材が、病変部を掴む直前の状態を示す拡大縦断側面図である。 In the opened state, the magnetic gripping member projecting from the distal end of the endoscope is an enlarged vertical sectional side view showing a state immediately before grasping the lesion. 内視鏡の先端から突出した磁性把持部材が閉じて、病変部を掴んだ状態を示す拡大縦断側面図である。 Close endoscope magnetic gripping members projecting from the tip of an enlarged vertical sectional side view showing a state in which grabbed lesion. 内視鏡の内部において、磁気アンカー装置と操作装置が分離した状態を示す拡大縦断側面図である。 In the interior of the endoscope is an enlarged vertical sectional side view showing a state in which the magnetic anchoring device and the operating device are separated. 磁性把持部材が病変部を把持した後に、磁気アンカー誘導装置を用いて、病変部を持ち上げている状態を示す拡大縦断側面図である。 After magnetic gripping member grips the lesion, using a magnetic anchor induction device is an enlarged vertical sectional side view showing a state of lifting the lesion. 臓器から切り離された病変部を磁性把持部材で把持し、板状連結部材を把持鉗子により把持する状態を示す図である。 The lesions that were disconnected from the organ held by magnetic gripping member, showing a state of gripping a plate-like connecting member by the grasping forceps.

符号の説明 DESCRIPTION OF SYMBOLS

10 磁気アンカー装置11 磁性把持部材12 基部12a 挿入孔13a 傾斜片13b 中間片13c 爪部14 牽引分離部材(開閉手段) 10 magnetic anchoring device 11 the magnetic gripping member 12 the base 12a insertion holes 13a inclined piece 13b intermediate piece 13c claw portion 14 pulling separating member (switching means)
14a 挿入片14b 抜け止め部14c 鈎部15 筒状締付部材20 内視鏡21 挿入部22 先端面23 鉗子チャンネルの出口24 鉗子口24a 入口30 操作装置31 挿入管32 挿入コイル(押出部材)(開閉手段) 14a insertion piece 14b retaining portion 14c hook portion 15 cylindrical clamping member 20 the endoscope 21 insertion portion 22 front end surface 23 of the forceps channel outlet 24 forceps opening 24a inlet 30 the operating device 31 insertion tube 32 inserted coil (pushing member) ( opening and closing means)
33 規制管(押出部材)(開閉手段) 33 regulating tube (pushing member) (switching means)
33a 大径部33a1 環状段部33b 小径部34 フック部35 操作ワイヤ(開閉手段) 33a large diameter portion 33a1 annular step 33b small-diameter portion 34 hook portion 35 operating wire (switching means)
40 磁気アンカー誘導装置41 ベッド41a 床板42 XYステージ(一方向移動機構) 40 magnetic anchor guiding device 41 beds 41a floorboard 42 XY stage (one-way moving mechanism)
43 フレーム/レール(一平面内移動機構) 43 frames / rails (one plane moving mechanism)
44 45 レール46 磁気誘導部材47 電磁石48 基体49 カウンターウェイト50 高周波メス50a 先端部60 把持鉗子61 把持片A 患者A1 頭部B 臓器(対象物) 44 45 rail 46 magnetic induction member 47 electromagnet 48 base 49 counter weight 50 high-frequency knife 50a tip 60 the grasping forceps 61 gripping piece A patient A1 head B organ (target object)
B1 粘膜下層B2 固有筋層C 鉗子チャンネルP 重力X 病変部(対象部位) B1 submucosa B2 muscularis propria C forceps channel P of gravity X lesion (target site)

Claims (7)

  1. 対象物内部の対象部位を把持可能な磁性体からなる磁性把持部材と、 A magnetic gripping member comprising an object inside the target part from the graspable magnetic,
    上記対象物外部に配置され、磁界を発生する磁気アンカー誘導装置と、を具備し、 Disposed above the object outside, equipped with magnetic anchor guidance device for generating a magnetic field, and
    該磁気アンカー誘導装置が発生する磁界からの磁力により、上記対象部位を把持している上記磁性把持部材を移動させて、上記対象部位を所定方向に移動させることを特徴とする内視鏡用磁気アンカー遠隔誘導システム。 By the magnetic force from the magnetic field by the magnetic anchor induction device generates, by moving the magnetic gripping member that grips the target site, the magnetic endoscopic, characterized in that moving the target region in a predetermined direction anchor remote guidance system.
  2. 請求項1記載の内視鏡用磁気アンカー遠隔誘導システムにおいて、 In the magnetic anchoring remote guide system for an endoscope according to claim 1,
    上記磁性把持部材が開閉自在な複数の爪部を有しており、さらに、 The magnetic gripping member has a plurality of claw portions that openably and further,
    両端が開口する筒状をなし、上記磁性把持部材が挿脱可能な筒状締付部材と、 A cylindrical shape with both ends open, the magnetic gripping members and detachably a with tubular clamping member,
    該筒状締付部材と上記磁性把持部材の相対位置を変化させることにより、上記爪部を開閉させる開閉手段と、 By changing the relative position of the cylindrical fastening member and the magnetic gripping member opening and closing means for opening and closing the claw portion,
    を具備する内視鏡用磁気アンカー遠隔誘導システム。 Magnetic anchoring remote guide system for an endoscope having a.
  3. 請求項2記載の内視鏡用磁気アンカー遠隔誘導システムにおいて、 In the magnetic anchoring remote guide system for an endoscope according to claim 2,
    上記開閉手段は、 It said opening and closing means,
    内視鏡の鉗子チャンネル内に挿通され操作部側から牽引操作可能な操作ワイヤと、 Traction operable operation wire from the insertion to the operation unit side in the endoscope forceps in the channel,
    この操作ワイヤと、上記鉗子チャンネル内に挿入されている上記磁性把持部材とを接続する、操作ワイヤに加える操作力で切断可能な牽引分離部材と、 And the operation wire, for connecting the magnetic gripping member which is inserted into the forceps channel, and the traction separation member cleavable by an operating force applied to the operation wire,
    上記鉗子チャンネル内にあって、上記操作ワイヤの牽引力に抗して磁性把持部材を保持する、該磁性把持部材を押し出し可能な押出部材と、 Be within the forceps channel, for holding the magnetic gripping member against the pulling force of the operation wire, and the pushing member that can push out the magnetic gripping member,
    を備えている内視鏡用磁気アンカー遠隔誘導システム。 Magnetic anchoring remote guide system for an endoscope which comprises a.
  4. 請求項1から3のいずれか1項記載の内視鏡用磁気アンカー遠隔誘導システムにおいて、 In the endoscope magnetic anchoring remote guide system for according to any one of claims 1 to 3,
    上記磁気アンカー誘導装置は、 The magnetic anchor induction apparatus,
    発生する磁界によって磁力を生じさせて、該磁力によって、上記磁気アンカーを所定方向に移動させる磁気誘導部材と、 And causing a magnetic force by the magnetic field generated by the magnetic force, the magnetic induction member for moving the magnetic anchor in a predetermined direction,
    該磁気誘導部材を特定の一平面内に配置したU字状のフレーム部材に沿って移動させる一平面内移動機構と、 And a plane in the moving mechanism for moving along the frame members of the U-shaped placing the magnetic induction member within one particular plane,
    上記U字状のフレーム部材を上記一平面と直交する方向に相対移動させる一方向移動機構と、 A one-way moving mechanism that relatively moves the U-shaped frame member in a direction perpendicular to the one plane,
    を有する内視鏡用磁気アンカー遠隔誘導システム。 Magnetic anchoring remote guide system for an endoscope having a.
  5. 対象物内部の対象部位を把持可能な磁性体からなる磁性把持部材を上記対象物内部に配設するステップ、 The step of disposing a magnetic gripping member comprising an object inside the target part from the graspable magnetic material inside the object,
    該磁性把持部材により、上記対象物内部の対象部位を把持する把持ステップ、及び 上記対象物外部に配置された磁気アンカー誘導装置から磁界を発生させ、該磁界から生じる磁力により上記磁性把持部材を移動させて、上記磁性把持部材に把持された対象部位を所定方向に移動させる移動ステップ、 The magnetic gripping member movement, the gripping step of gripping the target site within the object, and to generate a magnetic field from the magnetic anchor guiding device which is arranged on the object outside the magnetic gripping member by magnetic force generated from the magnetic field is allowed, the moving step of moving the target part which is gripped by the magnetic gripper member in a predetermined direction,
    を有することを特徴とする磁気アンカー遠隔誘導システムを用いた内視鏡による処置方法。 How treatment with an endoscope using a magnetic anchor remote guidance system characterized in that it comprises a.
  6. 請求項5記載の磁気アンカー遠隔誘導システムを用いた内視鏡による処置方法において、 In the treatment method with the endoscope using the magnetic anchoring remote guide system according to claim 5,
    上記磁性把持部材が開閉自在な複数の爪部を有しており、さらに、 The magnetic gripping member has a plurality of claw portions that openably and further,
    両端が開口する筒状をなし、上記磁性把持部材が挿脱可能な筒状締付部材と、該筒状締付部材に接続された開閉手段、とを具備しており、 A cylindrical shape with both ends open, the magnetic gripping members removably inserted a tubular with shaped clamping member, the opening and closing means connected to the member with the cylindrical clamping, which comprises a capital,
    上記把持ステップが、 The grip step,
    上記開閉手段を操作して、上記磁性把持部材の上記筒状締付部材に対する相対位置を変化させることにより、上記爪部を閉じるステップである、磁気アンカー遠隔誘導システムを用いた内視鏡による処置方法。 And operating the switching means, by changing the relative position with respect to the tubular clamping member of the magnetic gripping member, a step of closing the claw portion, treatment with an endoscope using the magnetic anchoring remote guide system Method.
  7. 請求項6記載の磁気アンカー遠隔誘導システムを用いた内視鏡による処置方法において、 In the treatment method with the endoscope using the magnetic anchoring remote guide system according to claim 6,
    上記開閉手段は、 It said opening and closing means,
    内視鏡の鉗子チャンネル内に挿通され操作部側から牽引操作可能な操作ワイヤと、 Traction operable operation wire from the insertion to the operation unit side in the endoscope forceps in the channel,
    この操作ワイヤと、上記鉗子チャンネル内に挿入されている上記磁性把持部材とを接続する、操作ワイヤに加える操作力で切断可能な牽引分離部材と、 And the operation wire, for connecting the magnetic gripping member which is inserted into the forceps channel, and the traction separation member cleavable by an operating force applied to the operation wire,
    上記鉗子チャンネル内にあって、上記操作ワイヤの牽引力に抗して磁性把持部材を保持する、該磁性把持部材を押し出し可能な押出部材と、 Be within the forceps channel, for holding the magnetic gripping member against the pulling force of the operation wire, and the pushing member that can push out the magnetic gripping member,
    を備えている磁気アンカー遠隔誘導システムを用いた内視鏡による処置方法。 How treatment with an endoscope using a magnetic anchor remote guide system comprising a.

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Cited By (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2007097663A (en) * 2005-09-30 2007-04-19 Sumitomo Bakelite Co Ltd Clip for endoscope
JP2007130408A (en) * 2005-11-07 2007-05-31 River Seiko:Kk Clip apparatus for endoscope
JP2009504250A (en) * 2005-08-10 2009-02-05 ガイディッド デリバリー システムズ インコーポレイテッド Method and apparatus for deploying tissue anchors
JP2011524793A (en) * 2008-06-19 2011-09-08 ボストン サイエンティフィック サイムド, インコーポレイテッド Hemostatic clipping device and method
JP4814874B2 (en) * 2004-05-05 2011-11-16 ボストン サイエンティフィック リミテッド Instruments and methods for manipulating intravascular instrument in force
JP2012517258A (en) * 2009-02-06 2012-08-02 バイオテク イノヴェイションズ リミターダ Guide / remote traction system for minimally invasive surgery
US9616197B2 (en) 2009-01-20 2017-04-11 Ancora Heart, Inc. Anchor deployment devices and related methods
US9636107B2 (en) 2002-06-13 2017-05-02 Ancora Heart, Inc. Devices and methods for heart valve repair
JP2017169676A (en) * 2016-03-22 2017-09-28 株式会社日進製作所 Medical clip and position specification tool thereof
US10010370B2 (en) 2013-03-14 2018-07-03 Levita Magnetics International Corp. Magnetic control assemblies and systems therefor
US10058321B2 (en) 2015-03-05 2018-08-28 Ancora Heart, Inc. Devices and methods of visualizing and determining depth of penetration in cardiac tissue

Cited By (13)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9636107B2 (en) 2002-06-13 2017-05-02 Ancora Heart, Inc. Devices and methods for heart valve repair
JP4814874B2 (en) * 2004-05-05 2011-11-16 ボストン サイエンティフィック リミテッド Instruments and methods for manipulating intravascular instrument in force
JP2009504250A (en) * 2005-08-10 2009-02-05 ガイディッド デリバリー システムズ インコーポレイテッド Method and apparatus for deploying tissue anchors
JP2007097663A (en) * 2005-09-30 2007-04-19 Sumitomo Bakelite Co Ltd Clip for endoscope
JP2007130408A (en) * 2005-11-07 2007-05-31 River Seiko:Kk Clip apparatus for endoscope
JP2011524793A (en) * 2008-06-19 2011-09-08 ボストン サイエンティフィック サイムド, インコーポレイテッド Hemostatic clipping device and method
US9616197B2 (en) 2009-01-20 2017-04-11 Ancora Heart, Inc. Anchor deployment devices and related methods
JP2012517258A (en) * 2009-02-06 2012-08-02 バイオテク イノヴェイションズ リミターダ Guide / remote traction system for minimally invasive surgery
US9844391B2 (en) 2009-02-06 2017-12-19 Levita Magnetics International Corp. Remote traction and guidance system for mini-invasive surgery
US9974546B2 (en) 2009-02-06 2018-05-22 Levita Magnetics International Corp. Remote traction and guidance system for mini-invasive surgery
US10010370B2 (en) 2013-03-14 2018-07-03 Levita Magnetics International Corp. Magnetic control assemblies and systems therefor
US10058321B2 (en) 2015-03-05 2018-08-28 Ancora Heart, Inc. Devices and methods of visualizing and determining depth of penetration in cardiac tissue
JP2017169676A (en) * 2016-03-22 2017-09-28 株式会社日進製作所 Medical clip and position specification tool thereof

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