JP2005040184A - Visual field of endoscope securing apparatus - Google Patents

Visual field of endoscope securing apparatus Download PDF

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JP2005040184A
JP2005040184A JP2003200453A JP2003200453A JP2005040184A JP 2005040184 A JP2005040184 A JP 2005040184A JP 2003200453 A JP2003200453 A JP 2003200453A JP 2003200453 A JP2003200453 A JP 2003200453A JP 2005040184 A JP2005040184 A JP 2005040184A
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endoscope
visual field
blade portion
tubular member
distal end
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JP4198005B2 (en
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Tsuruo Hatori
鶴夫 羽鳥
Akihisa Ogawa
晶久 小川
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Olympus Corp
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Olympus Corp
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00064—Constructional details of the endoscope body
    • A61B1/00071—Insertion part of the endoscope body
    • A61B1/0008—Insertion part of the endoscope body characterised by distal tip features
    • A61B1/00087—Tools
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/12—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with cooling or rinsing arrangements
    • A61B1/126—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with cooling or rinsing arrangements provided with means for cleaning in-use
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00131—Accessories for endoscopes
    • A61B1/00135—Oversleeves mounted on the endoscope prior to insertion

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
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  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
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Abstract

<P>PROBLEM TO BE SOLVED: To provide a visual field of an endoscope securing apparatus with which a visual field of an object lens of the endoscope can be sufficiently secured. <P>SOLUTION: The visual field of the endoscope securing apparatus 2 includes an installation unit which is installed in the endoscope. The installation unit includes a tubular member 4 which is installed in an insertion section of the endoscope. A transparent dome member 12 with almost hemispherical shape which is arranged in front of a distal end surface of the endoscope is disposed at a distal end part of the tubular member 4. Also, the visual field of the endoscope securing apparatus 2 includes a wiping unit to wipe an outer surface of the dome member 12. The wiping unit includes an elastic strip blade section 22 which can be arranged to traverse the dome member 12. The blade section 22 is moved along the outer surface in a condition of contacting the outer surface of the dome member 12 by an operation means 14 to wipe the outer surface. <P>COPYRIGHT: (C)2005,JPO&NCIPI

Description

【０００１】
【発明の属する技術分野】
本発明は、内視鏡の対物レンズの視野を確保する内視鏡視野確保装置に関する。
【０００２】
【従来の技術】
従来、医療分野において、内視鏡の細長い挿入部を体腔内に挿入し、体腔内を観察することが行われている。また、内視鏡観察下、高周波／超音波処置具等の様々な処置具により体腔内の患部等を処置することが行われている。
【０００３】
内視鏡の先端部には、術野の観察を行うための対物レンズが設けられており、この対物レンズの先端面は外部に露出している。従って、内視鏡が腹腔鏡下手術等に使用される場合、血液、粘液、高周波／超音波処置具による生体組織のミスト等といった様々な汚物が対物レンズに付着する。対物レンズに汚物が付着すると対物レンズの視野が妨げられ、術野の視覚情報が得にくくなる。この結果、適切な観察、処置を行うことができなくなる。従って、対物レンズに付着した汚物を除去する必要がある。
【０００４】
対物レンズに付着した汚物を除去するための内視鏡視野確保装置が、特許文献１に開示されている。特許文献１の内視鏡視野確保装置は、内視鏡の挿入部に装着される管状部材を有する。管状部材の先端部には、ブレード部としての弾性を有する帯状の拭き取り部材が配設されている。この拭き取り部材は、管状部材の先端部の開口を横切って延びている。
【０００５】
内視鏡による観察を行う際には、内視鏡を管状部材に対して先端側に移動させ、内視鏡の先端部を内視鏡視野確保装置の先端部から突出させる。対物レンズに汚物が付着した場合には、内視鏡を管状部材に対して基端側へと移動させる。この際、拭き取り部材は、自身の弾性の作用により、対物レンズに当接された状態で対物レンズに沿って移動され、対物レンズの拭き取りを行う。係る操作により、対物レンズに付着した汚物が除去され、内視鏡の視野が確保される。
【０００６】
【特許文献１】
特開２００２−２２４０１４号公報
【０００７】
【発明が解決しようとする課題】
特許文献１の内視鏡視野確保装置は、拭き取り部材を対物レンズに直接当接させて汚物を掻き取る構成となっている。しかし、内視鏡の先端面は、凹凸を有する複雑な外形となっており、拭き取り部材を対物レンズに完全に当接させることが難しい。このため、拭き取り操作において拭き残りが生じ、内視鏡の対物レンズの視野を充分に確保することが困難である。
【０００８】
また、拭き取り操作において充分な効果を得るために、拭き取り部材は、圧縮、曲げ、引っ張り力といった様々な力を作用され複雑に変形する。このため、拭き取りが度重なると、拭き取り部材に弾性変形が癖となって残る可能性がある。この場合、拭き取り部材は所定の弾性力を発揮することができず、拭き取り操作において拭きムラが発生する可能性がある。このため、内視鏡の対物レンズの視野を充分に確保することが困難となる。
【０００９】
本発明は、上記課題に着目してなされたもので、その目的とするところは、内視鏡の対物レンズの視野を充分に確保することができる内視鏡視野確保装置を提供することである。
【００１０】
【課題を解決するための手段】
請求項１の発明は、内視鏡の挿入部に装着される管状部材の先端部に前記内視鏡の先端面の前方に配置されるほぼ半球状の透明なドーム部材が設けられている装着ユニットと、
前記ドーム部材を横切る状態で配置可能な弾性を有する帯状のブレード部とこのブレード部を前記ドーム部材の外表面に当接させた状態で外表面に沿って移動させて外表面を拭き取らせる操作手段とを有する拭き取りユニットとを、
具備する内視鏡視野確保装置である。
【００１１】
そして、本請求項１の発明では、内視鏡の挿入部に装着される管状部材の先端部に、内視鏡の先端面の前方に配置されるほぼ半球状の透明なドーム部材を設け、ドーム部材を横切る状態で配置可能な弾性を有する帯状のブレード部を、操作手段によってドーム部材の外表面に当接させた状態で外表面に沿って移動させて外表面を拭き取らせるようにしたものである。
【００１２】
請求項２の発明は、前記操作手段は、前記管状部材に外装され前記管状部材に対して軸方向に移動可能な外装管であり、前記ブレード部は、前記外装管の先端部に設けられ前記外装管の先端部の開口を横切って延びていることを特徴とする請求項１の内視鏡視野確保装置である。
【００１３】
そして、本請求項２の発明では、管状部材と外装管とを軸方向に相対的に移動させることにより、外装管の先端部の開口を横切って延びているブレード部をドーム部材の外表面に当接させて外表面に沿って移動させて外表面を拭き取らせるようにしたものである。
【００１４】
請求項３の発明は、前記操作手段は、先端部が前記ブレード部に固定され基端部が前記管状部材の基端側に延びている牽引可能な牽引部材であることを特徴とする請求項１の内視鏡視野確保装置である。
【００１５】
そして、本請求項３の発明では、先端部がブレード部に固定され基端部が管状部材の基端側に延びている牽引可能な牽引部材を牽引することにより、ブレード部をドーム部材の外表面に当接させて外表面に沿って移動させて外表面を拭き取らせるようにしたものである。
【００１６】
請求項４の発明は、前記操作手段は、前記管状部材の基端部に設けられ前記ブレード部と連動される駆動部材を有し、前記管状部材に対する前記駆動部材の移動位置から前記ドーム部材に対する前記ブレード部の移動位置が認知可能であることを特徴とする請求項１の内視鏡視野確保装置である。
【００１７】
そして、本請求項４の発明では、管状部材の基端部に、ブレード部と連動されている駆動部材を設け、管状部材に対する駆動部材の移動位置からドーム部材に対するブレード部の移動位置を認知可能にしたものである。
【００１８】
【発明の実施の形態】
以下、本発明の第１実施形態を図１乃至３を参照して説明する。
【００１９】
図１（Ａ）は、本発明の第１実施形態の内視鏡視野確保装置２を硬性鏡である内視鏡３０に装着した状態で示す。
【００２０】
この内視鏡視野確保装置２は、内視鏡３０の挿入部３２に装着される管状部材４を有する。この管状部材４の基端部には、内視鏡の基端部３４に装着される装着部６が配設されている。図１（Ｂ）に示されるように、装着部６には、軸方向に沿って切り欠き部８が延設されている。切り欠き部８の幅は、内視鏡３０の基端部３４から径方向に突出しているライトガイドポスト３６の幅よりも小さい。切り欠き部８の末端部には、ライトガイドポスト３６の外形とほぼ等しい形状を有する拡大部１０が形成されている。装着部６の切り欠き部８の周辺は、ライトガイドポスト３６が切り欠き部８の基端部から拡大部１０まで移動可能な程度の可撓性を有する。
【００２１】
再び図１（Ａ）を参照すると、管状部材４の先端部には、ドーム部材１２が配設されている。このドーム部材１２は、ほぼ半球状であり、前方に突出し、ほぼ均一の肉厚を有する。また、ドーム部材１２は、管状部材４の内部の内視鏡３０の対物レンズによって外部が観察可能な程度に透明であり、例えば、ガラス、アクリルからなる。
【００２２】
ドーム部材１２の基端部と管状部材４の先端部とは、ほぼ滑らかな外形をなすように連結されている。本実施形態では、ドーム部材１２の基端側環状面と管状部材４の先端側環状面とが接着固定されている。
【００２３】
あるいは、ドーム部材１２と管状部材４とに互いに重複する肉部を設けて、接着固定又は溶着しても良い。例えば、ドーム部材１２の基端部に管状の肉部を連接し、管状部材４の先端部に細径部を形成し、ドーム部材１２の肉部を管状部材４の細径部に外装して接着固定又は溶着する。
【００２４】
管状部材４には、外装管１４が外装されている。この外装管１４は、管状部材４に対して軸方向に移動自在かつ軸回り方向に回転自在である。
【００２５】
外装管１４の基端部には、操作者に把持される把持部１６が配設されている。この把持部１６はフランジ形状であり、外装管１４の外径よりも太径となっている。
【００２６】
外装管１４の先端部には、ドーム部材１２を拭き取るための拭き取り部材１８が配設されている。ここで、拭き取り部材１８は、弾性を有し、例えばゴムからなる。図１（Ｃ）に示されるように、拭き取り部材１８の基端側には、管部２０が設けられている。この管部２０は、外装管１４の先端部に外装され固定されている。
【００２７】
拭き取り部材１８の先端側には、帯状のブレード部２２が設けられている。このブレード部２２は、外装管１４の先端部の開口２６を横切ってベルト状に延びている。ブレード部２２の中央線は、前方から見て外装管１４の直径方向に延びている。ブレード部２２は、外装管１４の先端面と管状部材４の先端面とをアラインメントした場合に、ドーム部材１２の外表面により僅かに押圧されて、その弾性によりドーム部材１２の外表面にぴったりと当接する形状となっている。
【００２８】
ブレード部２２の両端は、管部２０の先端部の直径方向に対向した位置に夫々接続されている。ブレード部２２の両端部には、後述する視野確保操作時にブレード部２２の回動を円滑にする凹部２４ａ，２４ｂが配設されている。凹部２４ａ，２４ｂは、ブレード部２２の端部の両側方に配設され、ブレード部２２の中央線に対して互いに対称である。
【００２９】
図２（Ａ）に示されるように、ブレード部２２の内周面には、エッジ２８が突設されている。このエッジ２８は、ブレード部２２の中央線に沿って、ブレード部２２の全長に渡って延設されている。
【００３０】
なお、本実施形態では、管状部材４とドーム部材１２とが、内視鏡３０に装着される装着ユニットを構成している。また、外装管１４と拭き取り部材１８とが、ドーム部材１２を拭き取るための拭き取りユニットを構成している。
【００３１】
次に、上記構成の本実施形態の内視鏡視野確保装置２の作用について説明する。まず、内視鏡視野確保装置２を内視鏡３０に装着する。この際、内視鏡３０のライトガイドポスト３６は、切り欠き部８の基端部に嵌入され、切り欠き部８内で軸方向に移動される。そして、ライトガイドポスト３６は、拡大部１０に達して係脱自在に保持される。また、ドーム部材１２は、内視鏡の先端面の前方に配置される。
【００３２】
内視鏡３０による観察を行う際には、内視鏡３０即ち管状部材４を外装管１４に対して先端側へと移動させ、図３（Ａ）に示されるように、外装管１４の先端部の開口２６からドーム部材１２並びに管状部材４の先端部を突出させる。この状態では、ブレード部２２は、管状部材４の先端部の外周面に配置されている。即ち、ブレード部２２は、ドーム部材１２を横切っておらず、内視鏡３０の対物レンズの視野を妨げない。
【００３３】
ドーム部材１２の外表面に汚物が付着した場合には、以下に述べる視野確保操作を行う。ブレード部２２は、その弾性力により自然な状態に復帰しようとする傾向にある。従って、図３（Ａ）に示される観察状態から、内視鏡３０即ち管状部材４を外装管１４に対して基端側へと徐々に移動させていくと、ブレード部２２は、図３（Ｂ）の矢印Ａに示されるように、ドーム部材１２の外表面に当接された状態で外表面に沿って移動する。この際、ブレード部２２のエッジ２８は、ドーム部材１２の外表面に付着した汚物を掻き取る。最終的に、ブレード部２２は、図３（Ｃ）に示される自然な状態に復帰する。このようにして、ドーム部材１２の外表面のほぼ半分が拭き取られる。
【００３４】
ここで、外装管１４の把持部１６を把持して、外装管１４を管状部材４に対して軸回り方向にほぼ１８０°回転させる。
【００３５】
そして、内視鏡３０即ち管状部材４を外装管１４に対して先端側へと移動させる。すると、ブレード部２２は、ドーム部材１２の押圧力によってドーム部材１２の外表面に沿って滑り、ドーム部材１２の基端部に配置される。ブレード部２２は、管状部材４の中心軸に対して、当初に配置されていた位置と逆の位置に配置される。この後、ドーム部材１２の外表面の残りの半分に対して上記した拭き取り操作を行って視野を確保する。
【００３６】
万一、ドーム部材１２の外表面の汚物が充分に除去されない場合には、上記した拭き取り操作を繰り返す。
【００３７】
なお、外装管１４を管状部材４即ち内視鏡３０に対して軸方向に移動してもよい。また、外装管１４の管状部材４に対する回転操作の回転角は、１８０°に限らず、汚物の除去に有効なようにどのような回転角を選択してもよい。
【００３８】
そこで、上記構成のものにあっては次の効果を奏する。即ち、本実施形態では、管状部材４に、外装管１４が管状部材４の軸方向に移動自在に外装されている。この外装管１４の先端部の開口２６を横切って、帯状のブレード部２２がベルト状に延びている。このブレード部２２は、ドーム部材１２の外表面により僅かに押圧されて、その弾性によりドーム部材１２の外表面にぴったりと当接する形状となっている。
【００３９】
従って、内視鏡３０即ち管状部材４を外装管１４に対して軸方向に移動させて、ブレード部２２によってドーム部材１２の外表面に付着した汚物を拭き取る場合には、ドーム部材１２の外表面にはほとんど拭き残り部分が生じない。また、拭き取り操作では、ブレード部２２に作用するのはほぼ引っ張り力のみであり、ブレード部２２は通常操作では複雑に変形することはない。このため、内視鏡視野確保装置２を繰り返し使用した場合であっても、ブレード部２２に弾性変形が癖となって残ることが防止される。従って、拭き取り操作においてドーム部材１２の外表面に拭きムラが生じることが防止される。
【００４０】
図２（Ｂ）は、本発明の第１実施形態の内視鏡視野確保装置２のブレード部２２の第１の変形例を示す。このブレード部３８の内周面には、２つのエッジ４０ａ，４０ｂが、突設されている。これらエッジ４０ａ，４０ｂは、ブレード部３８の中央線と側面との中間位置に、ブレード部３８の全長に渡って延設されている。
【００４１】
図２（Ｃ）は、本発明の第１実施形態の内視鏡視野確保装置２のブレード部２２の第２の変形例を示す。この第２の変形例のブレード部４２の内部には、補強部材４４が埋設されている。この補強部材４４は、板状の部材であり、ブレード部４２の外周面に平行にブレード部４２の全長に渡って延びている。補強部材４４は、ばね性を有し、ブレード部４２の剛性を増大している。補強部材４４は、例えば金属板である。
【００４２】
図４は、本発明の第２実施形態を示す。本実施形態の内視鏡視野確保装置は、第１実施形態の内視鏡視野確保装置２とブレード部の構成のみ異なる。
【００４３】
図４（Ａ）に示されるように、本実施形態の内視鏡視野確保装置のブレード部４６のエッジ４８は、ブレード部４６の中央線から距離ｄだけオフセットされた位置に配設されている。ブレード部４６がほぼ自然な状態でドーム部材１２に当接されているとき、ブレード部４６のエッジ４８は、ドーム部材１２の中心線（ほぼ自然な状態にあるブレード部４６の中央線と前方から見て重なるドーム部材１２の外表面上の線）からほぼｄだけ離間して配置される。
【００４４】
ブレード部４６内には、補強部材５０が埋設されている。この補強部材５０は、ブレード部４６の中心線に対してエッジ４８に対向した側に配置されている。この点を除き、補強部材５０は、第１実施形態の第２の変形例の補強部材４４と同様な構成を有する。従って、ブレード部４６の剛性は、エッジ４８側よりも補強部材５０側のほうが大きくなっている。
【００４５】
本実施形態の内視鏡視野確保装置の作用は、基本的には第１実施形態の内視鏡視野確保装置２と同様である。内視鏡３０による観察を行う際には、内視鏡３０即ち管状部材４を外装管１４に対して先端側へと移動させて、ブレード部４６を管状部材４の先端部の外周面に配置する。この際、ブレード部４６は、ドーム部材１２の外表面上で、エッジ４８側から補強部材５０側へと向かう方向に移動される。
【００４６】
ブレード部４６による拭き取り操作の際、ブレード部４６は、補強部材５０側からエッジ４８側へと向かう方向に移動される。従って、ブレード部４６のエッジ４８は、ドーム部材１２の中心線を越えて移動され、ドーム部材１２の外表面の半分以上を掻き取る。
【００４７】
そこで、上記構成のものにあっては第１実施形態の効果に加えて次の効果を奏する。即ち、本実施形態では、ブレード部４６のエッジ４８は、ブレード部４６の中心線から距離ｄだけオフセットされた位置に配設されている。また、ブレード部４６内には、ブレード部４６の中心線に対してエッジ４８に対向した側に補強部材５０が埋設され、ブレード部４６の一側方の剛性を増大している。このため、拭き取り操作において、ブレード部４６のエッジ４８は、補強部材５０側からエッジ４８側に向かってドーム部材１２の中心線を越えて移動され、ドーム部材１２の外表面の半分以上を掻き取る。従って、ドーム部材１２の中心線の付近に拭き残りが生ずることが防止される。
【００４８】
図４（Ｂ）に本発明の第２実施形態のブレード部４６の変形例を示す。このブレード部５２には、補強部材５０は埋設されていない。代わって、ブレード部５２には、ブレード部５２の中心線に対してエッジ４８に対向した側に、肉厚部５４が配設されている。この肉厚部５４は、ブレード部５２の全長に渡って延設されている。ブレード部５２の剛性は、エッジ４８側よりも肉厚部５４側で大きくなっている。
【００４９】
図５及び図６は、本発明の第３実施形態を示す。図５（Ａ）は、本発明の第３実施形態の内視鏡視野確保装置５８を内視鏡３０に装着した状態で示す。この内視鏡視野確保装置５８は、内視鏡３０の挿入部３２に装着される管状部材６０を有する。この管状部材６０の先端部には、第１実施形態と同様に、ドーム部材１２が配設されている。一方、管状部材６０の基端部には、操作者に把持される把持部６２が設けられている。この把持部６２は、管状部材６０よりも太径のフランジ形状の部分である。
【００５０】
管状部材６０とドーム部材１２との接続部分には、ドーム部材１２を拭き取るための拭き取り部材６４が配設されている。拭き取り部材６４は、弾性を有し、例えばゴムからなる。拭き取り部材６４の基端側には、管部６６が設けられている。この管部６６は、管状部材６０の先端部に外装され固定されている。
【００５１】
拭き取り部材６４の先端側には、帯状のブレード部６８が設けられている。このブレード部６８の両端部は、管部６６の先端部の直径方向に対向した位置に接続されている。ブレード部６８は、ドーム部材１２の基端部の外表面に沿って、管状部材６０の周方向にほぼ半周に渡って延びている。また、ブレード部６８は、その弾性によりドーム部材１２の外表面にぴったりと当接している。ブレード部６８の基端側端面は、管部６６の先端面に隣接している。
【００５２】
ブレード部６８の内周面には、第１実施形態と同様なエッジが配設されている。
【００５３】
ブレード部６８の外周面の長手方向の中央部には、線状部材７０の先端が固定されている。線状部材７０は、ドーム部材１２を横切り、管状部材６０の外周面に沿って基端側へと延びている。
【００５４】
図５（Ｂ）に示されるように、管部６６の後方で、ガイド部７２が管状部材６０の外周面に配設されている。このガイド部７２は、管状部材６０の中心軸に対して、自然な状態にあるブレード部６８の長手方向の中央部に対向した位置に配設されている。線状部材７０は、ガイド部７２に挿通されている。
【００５５】
再び図５（Ａ）を参照すると、把持部６２には、管状部材６０の軸方向に沿ってガイド孔７４が延設されている。このガイド孔７４は、管状部材６０の軸方向に対してガイド部７２とアラインメントされている。線状部材７０は、ガイド孔７４に挿通されている。
【００５６】
線状部材７０の基端部には、操作リング７８が配設されている。線状部材７０は、操作リング７８によって牽引自在に配置されている。
【００５７】
なお、本実施形態では、管状部材６０とドーム部材１２とが、内視鏡３０に装着される装着ユニットを構成している。また、線状部材７０と操作リング７８とが、牽引部材を構成し、この牽引部材と拭き取り部材６４とが、ドーム部材１２を拭き取るための拭き取りユニットを構成している。
【００５８】
次に、上記構成の本実施形態の内視鏡視野確保装置５８の作用について説明する。まず、内視鏡視野確保装置５８を内視鏡３０の挿入部３２に装着する。そして、内視鏡３０を体腔内に挿入し、観察を行う。この際、ブレード部６８は、図６（Ａ）に示されるように、自然な状態にあり、ドーム部材１２の外表面の一方の基端部に配置され内視鏡３０の対物レンズの視野を妨げない。
【００５９】
ドーム部材１２の外表面に汚物が付着した場合には、視野確保操作を行う。即ち、操作リング７８を基端側に引っ張り、線状部材７０を基端側に牽引する。ブレード部２２は、線状部材７０によって、図６（Ｂ）の矢印Ｂに示されるように、ドーム部材１２の外表面に当接された状態で外表面に沿って線状部材７０の牽引方向に移動される。ブレード部６８は、図６（Ｃ）に示されるように、管状部材６０の中心軸に対して、自然な状態とは対称な位置まで移動され、管部６６の先端面に当接されて停止する。この際、ブレード部６８のエッジは、ドーム部材１２の外表面に付着した汚物を掻き取る。このようにして、ドーム部材１２の外表面の全体が拭き取られる。
【００６０】
この後、線状部材７０の牽引を解除すると、ブレード部６８は、ドーム部材１２の外表面上を拭き取り作動時とは逆方向に滑り、自然な状態に復帰する。万一、ドーム部材１２の汚れが充分に除去されていない場合には、上記した拭き取り操作を繰り返す。
【００６１】
そこで、上記構成のものにあっては次の効果を奏する。即ち、本実施形態では、管状部材６０の先端部に、ドーム部材１２が配設されており、弾性を有する帯状のブレード部６８が、ドーム部材１２の基端部の外表面にぴったりと当接し、管状部材６０の周方向にほぼ半周に渡って延びている。このブレード部６８の外周面の長手方向の中央部に、線状部材７０の先端が固定され、線状部材７０の先端側は、ドーム部材１２の外表面を横切って延び、線状部材７０の基端側は、管状部材６０の基端側へと延びている。また、線状部材７０は、牽引可能に配置されている。従って、線状部材７０を牽引することによりブレード部６８によってドーム部材１２の外表面を拭き取る場合には、第１実施形態と同様な効果を奏する。
【００６２】
また、管状部材６０に、ガイド部７２が、管状部材６０の中心軸に対して、自然な状態のブレード部６８の長手方向の中央部に対向した位置に配設されている。このガイド部７２に、線状部材７０が挿通されている。このため、線状部材７０を牽引することにより、ブレード部６８によってドーム部材１２の外表面の全体を一度に拭き取ることができる。従って、視野確保操作を効率的に行うことが可能となっている。
【００６３】
また、内視鏡３０の挿入部３２に装着される内視鏡視野確保装置５８の部分は、管状部材６０と線状部材７０とによって形成されており細径である。このため、内視鏡３０をトロッカーを介して体腔内に挿入する際には、細径のトロッカーを使用することが可能であり、患者に対してより低侵襲になる。従って、患者の負担が減少される。
【００６４】
図７は、本発明の第４実施形態の内視鏡視野確保装置８０の全体の概略構成を示す。内視鏡視野確保装置８０は、内視鏡３０の挿入部３２（図１参照）に装着される管状部材８２を有する。管状部材８２の先端部には、第１実施形態と同様なドーム部材１２が配設されている。
【００６５】
管状部材８２の先端部に、弾性を有する拭き取り部材８４が配設されている。拭き取り部材８４は、帯状であり、両端の接続部８６と内側のブレード部８８とからなる。
【００６６】
ブレード部８８は、ドーム部材１２の基端部の外表面に沿って、管状部材６０の周方向にほぼ半周に渡って延びている。ブレード部８８は、その弾性によりドーム部材１２の外表面にぴったりと当接している。ブレード部８８の基端側端面は、管状部材８２の先端面に沿って配置されている。また、第１実施形態と同様に、ブレード部８８の内周面にはエッジが配設されている。
【００６７】
管状部材８２の先端部に、枢着部９０が管状部材８２の軸方向に突設されている。枢着部９０は、管状部材８２の直径方向に対向した位置に夫々配設されている。各枢着部９０の外表面には、第１のプーリ９２が枢着されている。拭き取り部材８４の両接続部８６は、対応する第１のプーリ９２に固定されている。
【００６８】
管状部材８２の基端部に、第２のプーリ９６が枢支されている。この第２のプーリ９６は、管状部材８２の軸方向に対して一方の第１のプーリ９２とアラインメントされている。
【００６９】
管状部材８２の基端部に、レバー（駆動部材）９４が配設されている。このレバー９４の基端部９５は、第２のプーリ９６に固定されている。レバー９４は、拭き取り部材８４が第１のプーリ９２から突出する方向と同じ方向に第２のプーリ９６から突出し、管状部材８２の接線方向に延びている。
【００７０】
第１のプーリ９２と第２のプーリ９６とには、線状部材９８が巻き付けられている。この線状部材９８は、第２のプーリ９６によって駆動されて、第１のプーリ９２を駆動する構成となっている。また、第１のプーリ９２と第２のプーリ９６とは、同様な形状であり、線状部材９８によって互いに連動されてほぼ同じ角度だけ回転する構成となっている。
【００７１】
なお、本実施形態では、管状部材８２とドーム部材１２とが、内視鏡３０に装着される装着ユニットを構成している。また、第１のプーリ９２と線状部材９８と第２のプーリ９６とレバー９４とは、操作手段を構成し、この操作手段と拭き取り部材８４とが、ドーム部材１２を拭き取るための拭き取りユニットを構成している。
【００７２】
次に、上記構成の本実施形態の内視鏡視野確保装置８０の作用について説明する。まず、内視鏡視野確保装置８０を内視鏡３０の挿入部３２に装着する。そして、内視鏡３０を体腔内に挿入して観察を行う。この際、ブレード部８８は、ドーム部材１２の外表面の一方の基端部に配置されており、内視鏡３０の対物レンズの視野を妨げない。
【００７３】
ドーム部材１２の外表面に汚物が付着した場合には視野確保操作を行う。即ち、レバー９４を前方に向かって回動する。すると、第２のプーリ９６が回転され、第２のプーリ９６は線状部材９８を駆動する。駆動された線状部材９８は第１のプーリ９２を駆動し、駆動された第１のプーリ９２は、拭き取り部材８４を回動させる。この際、レバー９４の回動角と拭き取り部材８４の回動角とは、互いにほぼ等しくなっている。
【００７４】
レバー９４を回動していくと、ブレード部８８は、ドーム部材１２の外表面に当接された状態で外表面に沿って移動される。この際、ブレード部８８のエッジは、ドーム部材１２の外表面に付着した汚物を掻き取る。レバー９４がほぼ１８０°回動されると、ブレード部８８は管状部材６０の中心軸に対して初期状態とは対称な位置まで移動される。このようにして、ドーム部材１２の外表面の全体が拭き取られる。
【００７５】
万一、ドーム部材１２の汚れが充分に除去されていない場合には、レバー９４を逆方向に回動して、上記した拭き取り操作と同様な拭き取り操作を行う。さらに必要ならば、上記した拭き取り操作を繰り返す。
【００７６】
そこで、上記構成のものにあっては次の効果を奏する。即ち、本実施形態では、管状部材８２の先端部にドーム部材１２が配設されており、弾性を有する帯状のブレード部８８が、ドーム部材１２の基端部の外表面にぴったりと当接し、管状部材６０の周方向にほぼ半周に渡って延びている。このブレード部８８の両端の接続部８６は、管状部材８２の先端部の直径方向に対向した位置に枢着されている第１のプーリ９２に夫々固定されている。従って、第１のプーリ９２を駆動することによりブレード部８８を回動しドーム部材１２を拭き取る場合には、第１実施形態と同様な効果を奏する。
【００７７】
また、管状部材８２の基端部に、第２のプーリ９６が配設されており、第１のプーリ９２と第２のプーリ９６とは、線状部材９８によって互いに連動されてほぼ同じ角度だけ回転する構成となっている。また、第２のプーリ９６に、レバー９４が固定されている。このため、管状部材８２に対するレバー９４の移動位置から、ドーム部材１２に対するブレード部８８の移動位置を認知することが可能となっている。従って、適切な拭き取り操作を行うことが可能となっている。
【００７８】
次に、本出願の他の特徴的な技術事項を下記の通り付記する。
記
（付記項１） 内視鏡の挿入部に鞘状の内視鏡の視野確保装置を挿着する内視鏡の視野確保装置において、略半球状の透明ドーム部を、内視鏡を挿通させる管状部材の先端に配設し、その透明ドームの表面の曲面を押圧しながら移動する帯状の弾性を有するブレード部と、そのブレード部の移動制御手段を設けたことを特徴とする内視鏡の視野確保装置。
【００７９】
（付記項２） 第一の付記項において、管状部材が内筒部材と外筒部材よりなり、内筒部材先端に該ドーム部材を、基端には内視鏡に対する長手方向の相対的な固定手段を設け、外筒部材の先端には、外筒部材を直径方向に横断する帯状の弾性ブレード部を設けたことを特徴とする内視鏡の視野確保装置。
【００８０】
（付記項３） 第一の付記項において、管状部材の先端にドーム部材が設けられ、ブレード部がドーム部材基端において長手方向を軸に半円筒状に設けられるともに、牽引用線部材が、ブレード部の半円筒の円弧頂点の側面と、管状部材の直径方向反対側側面に設けられたガイド部を挿通しながら、管状部材の基端側に延設されていることを特徴とする内視鏡の視野確保装置。
【００８１】
（付記項４） 第一の請求項において、ブレード部の回転軸中心にプーリーを設け、そのプーリーに巻回された線状部材は管状部材基端側に延設され、基端側制御手段に接続されていることを特徴とする内視鏡の視野確保装置。
【００８２】
【発明の効果】
本発明によれば、内視鏡の対物レンズの視野を充分に確保することが可能となっている。
【図面の簡単な説明】
【図１】（Ａ）は、本発明の第１実施形態の内視鏡視野確保装置を内視鏡に装着した状態で示す説明図、（Ｂ）は、本発明の第１実施形態の内視鏡視野確保装置の後端部を内視鏡に装着した状態で示す斜視図、（Ｃ）は、本発明の第１実施形態の内視鏡視野確保装置の先端部を示す斜視図。
【図２】（Ａ）は、本発明の第１実施形態の内視鏡視野確保装置のドーム部材並びにブレード部を示す断面図、（Ｂ）は、本発明の第１実施形態の内視鏡視野確保装置のドーム部材並びにブレード部の第１の変形例を示す断面図、（Ｃ）は、本発明の第１実施形態の内視鏡視野確保装置のドーム部材並びにブレード部の第２の変形例を示す断面図。
【図３】（Ａ）乃至（Ｃ）は、本発明の第１実施形態の内視鏡視野確保装置の作用を示す説明図。
【図４】（Ａ）は、本発明の第２実施形態の内視鏡視野確保装置のドーム部材並びにブレード部を示す断面図、（Ｂ）は、本発明の第２実施形態の内視鏡視野確保装置のドーム部材並びにブレード部の変形例を示す断面図。
【図５】（Ａ）は、本発明の第３実施形態の内視鏡視野確保装置を内視鏡に装着した状態で示す側面図、（Ｂ）は、本発明の第３実施形態の内視鏡視野確保装置の先端部を示す斜視図。
【図６】（Ａ）乃至（Ｃ）は、本発明の第３実施形態の内視鏡視野確保装置の作用を示す説明図。
【図７】本発明の第４実施形態の内視鏡視野確保装置を示す側面図。
【符号の説明】
２，５８，８０…内視鏡視野確保装置、４，６０，８２…管状部材、１２…ドーム部材、１４（７０，７８）（９２，９４，９６，９８）…操作手段、２２，３８，４２，４６，５２，６８，８８…ブレード部、３０…内視鏡、３２…挿入部。[0001]
BACKGROUND OF THE INVENTION
The present invention relates to an endoscope visual field securing device that secures a visual field of an objective lens of an endoscope.
[0002]
[Prior art]
Conventionally, in the medical field, an elongated insertion portion of an endoscope is inserted into a body cavity and the inside of the body cavity is observed. In addition, treatment of an affected area in a body cavity with various treatment tools such as a high-frequency / ultrasonic treatment tool is performed under endoscopic observation.
[0003]
An objective lens for observing the surgical field is provided at the distal end portion of the endoscope, and the distal end surface of the objective lens is exposed to the outside. Therefore, when the endoscope is used for laparoscopic surgery or the like, various filths such as blood, mucus, and mist of biological tissue by a high frequency / ultrasonic treatment tool adhere to the objective lens. If dirt adheres to the objective lens, the visual field of the objective lens is hindered, making it difficult to obtain visual information on the surgical field. As a result, appropriate observation and treatment cannot be performed. Therefore, it is necessary to remove the dirt adhering to the objective lens.
[0004]
An endoscope visual field securing device for removing dirt attached to an objective lens is disclosed in Patent Document 1. The endoscope visual field securing device of Patent Literature 1 includes a tubular member that is attached to an insertion portion of an endoscope. A strip-shaped wiping member having elasticity as a blade portion is disposed at the distal end portion of the tubular member. The wiping member extends across the opening at the distal end of the tubular member.
[0005]
When performing observation with an endoscope, the endoscope is moved to the distal end side with respect to the tubular member, and the distal end portion of the endoscope is protruded from the distal end portion of the endoscope visual field securing device. When dirt is attached to the objective lens, the endoscope is moved to the proximal end side with respect to the tubular member. At this time, the wiping member is moved along the objective lens while being in contact with the objective lens by its own elastic action to wipe the objective lens. By such an operation, the dirt attached to the objective lens is removed, and the field of view of the endoscope is secured.
[0006]
[Patent Document 1]
JP 2002-224014 A
[0007]
[Problems to be solved by the invention]
The endoscope visual field securing device of Patent Document 1 is configured to scrape dirt by bringing a wiping member into direct contact with an objective lens. However, the distal end surface of the endoscope has a complicated outer shape having irregularities, and it is difficult to completely bring the wiping member into contact with the objective lens. For this reason, wiping residue is generated in the wiping operation, and it is difficult to sufficiently secure the field of view of the objective lens of the endoscope.
[0008]
Further, in order to obtain a sufficient effect in the wiping operation, the wiping member is deformed in a complicated manner by being subjected to various forces such as compression, bending, and pulling force. For this reason, if wiping is repeated, elastic deformation may remain as wrinkles on the wiping member. In this case, the wiping member cannot exhibit a predetermined elastic force, and wiping unevenness may occur in the wiping operation. For this reason, it becomes difficult to ensure a sufficient field of view of the objective lens of the endoscope.
[0009]
The present invention has been made paying attention to the above problems, and an object of the present invention is to provide an endoscope visual field securing device capable of sufficiently securing the visual field of an objective lens of an endoscope. .
[0010]
[Means for Solving the Problems]
According to the first aspect of the present invention, a substantially hemispherical transparent dome member disposed in front of the distal end surface of the endoscope is provided at the distal end portion of the tubular member mounted on the insertion portion of the endoscope. Unit,
An elastic band-shaped blade portion that can be arranged in a state of crossing the dome member, and an operation of wiping the outer surface by moving the blade portion along the outer surface in contact with the outer surface of the dome member A wiping unit having means,
It is an endoscope visual field securing device provided.
[0011]
In the invention of claim 1, a substantially hemispherical transparent dome member disposed in front of the distal end surface of the endoscope is provided at the distal end portion of the tubular member attached to the insertion portion of the endoscope, The belt-shaped blade portion having elasticity that can be arranged in a state of crossing the dome member is moved along the outer surface while being in contact with the outer surface of the dome member by the operating means so that the outer surface is wiped off. Is.
[0012]
According to a second aspect of the present invention, the operation means is an outer tube that is externally mounted on the tubular member and is movable in the axial direction with respect to the tubular member, and the blade portion is provided at a distal end portion of the outer tube. 2. The endoscope visual field securing device according to claim 1, wherein the endoscope visual field securing device extends across an opening at a distal end portion of the outer tube.
[0013]
In the second aspect of the invention, the blade member extending across the opening at the tip of the outer tube is moved to the outer surface of the dome member by relatively moving the tubular member and the outer tube in the axial direction. The outer surface is wiped off by abutting and moving along the outer surface.
[0014]
According to a third aspect of the present invention, the operating means is a pullable pulling member having a distal end portion fixed to the blade portion and a proximal end portion extending to the proximal end side of the tubular member. 1 is an endoscope visual field securing device.
[0015]
According to the third aspect of the present invention, by pulling a pullable pulling member having a distal end portion fixed to the blade portion and a proximal end portion extending to the proximal end side of the tubular member, the blade portion is removed from the dome member. The outer surface is wiped off by being brought into contact with the surface and moved along the outer surface.
[0016]
According to a fourth aspect of the present invention, the operating means includes a driving member provided at a proximal end portion of the tubular member and interlocked with the blade portion, and the moving member moves relative to the tubular member from the moving position of the driving member. 2. The endoscope visual field securing device according to claim 1, wherein the moving position of the blade portion can be recognized.
[0017]
In the fourth aspect of the present invention, a drive member linked to the blade portion is provided at the base end portion of the tubular member, and the movement position of the blade portion relative to the dome member can be recognized from the movement position of the drive member relative to the tubular member. It is a thing.
[0018]
DETAILED DESCRIPTION OF THE INVENTION
Hereinafter, a first embodiment of the present invention will be described with reference to FIGS.
[0019]
FIG. 1A shows the endoscope visual field securing device 2 according to the first embodiment of the present invention mounted on an endoscope 30 that is a rigid endoscope.
[0020]
The endoscope visual field securing device 2 includes a tubular member 4 attached to the insertion portion 32 of the endoscope 30. At the base end portion of the tubular member 4, a mounting portion 6 to be mounted on the base end portion 34 of the endoscope is disposed. As shown in FIG. 1B, the mounting portion 6 has a notch 8 extending along the axial direction. The width of the cutout portion 8 is smaller than the width of the light guide post 36 protruding in the radial direction from the proximal end portion 34 of the endoscope 30. An enlarged portion 10 having a shape substantially equal to the outer shape of the light guide post 36 is formed at the end portion of the cutout portion 8. The periphery of the notch portion 8 of the mounting portion 6 has such flexibility that the light guide post 36 can move from the base end portion of the notch portion 8 to the enlarged portion 10.
[0021]
Referring to FIG. 1A again, a dome member 12 is disposed at the distal end portion of the tubular member 4. The dome member 12 is substantially hemispherical, protrudes forward, and has a substantially uniform thickness. The dome member 12 is transparent to the extent that the outside can be observed by the objective lens of the endoscope 30 inside the tubular member 4, and is made of, for example, glass or acrylic.
[0022]
The proximal end portion of the dome member 12 and the distal end portion of the tubular member 4 are connected so as to form a substantially smooth outer shape. In this embodiment, the proximal end side annular surface of the dome member 12 and the distal end side annular surface of the tubular member 4 are bonded and fixed.
[0023]
Alternatively, the dome member 12 and the tubular member 4 may be provided with a flesh portion that overlaps with each other, and may be adhesively fixed or welded. For example, a tubular meat portion is connected to the base end portion of the dome member 12, a thin diameter portion is formed at the distal end portion of the tubular member 4, and the meat portion of the dome member 12 is externally attached to the thin diameter portion of the tubular member 4. Adhesive fixing or welding.
[0024]
The tubular member 4 is covered with an outer tube 14. The outer tube 14 is movable in the axial direction with respect to the tubular member 4 and is rotatable in the direction around the axis.
[0025]
A gripping portion 16 that is gripped by the operator is disposed at the base end portion of the outer tube 14. The gripping portion 16 has a flange shape and is thicker than the outer diameter of the outer tube 14.
[0026]
A wiping member 18 for wiping the dome member 12 is disposed at the distal end portion of the outer tube 14. Here, the wiping member 18 has elasticity and is made of, for example, rubber. As shown in FIG. 1C, a tube portion 20 is provided on the proximal end side of the wiping member 18. The tube portion 20 is sheathed and fixed to the distal end portion of the sheath tube 14.
[0027]
A belt-like blade portion 22 is provided on the distal end side of the wiping member 18. The blade portion 22 extends in a belt shape across the opening 26 at the distal end portion of the outer tube 14. The center line of the blade portion 22 extends in the diameter direction of the outer tube 14 when viewed from the front. When the distal end surface of the outer tube 14 and the distal end surface of the tubular member 4 are aligned, the blade portion 22 is slightly pressed by the outer surface of the dome member 12, and the elasticity of the blade portion 22 fits closely to the outer surface of the dome member 12. It has a shape to abut.
[0028]
Both ends of the blade portion 22 are connected to positions opposed to each other in the diameter direction of the distal end portion of the tube portion 20. At both ends of the blade portion 22, recesses 24 a and 24 b are provided for smooth rotation of the blade portion 22 during a visual field securing operation to be described later. The concave portions 24 a and 24 b are disposed on both sides of the end portion of the blade portion 22, and are symmetric with respect to the center line of the blade portion 22.
[0029]
As shown in FIG. 2A, an edge 28 protrudes from the inner peripheral surface of the blade portion 22. The edge 28 extends along the center line of the blade part 22 over the entire length of the blade part 22.
[0030]
In the present embodiment, the tubular member 4 and the dome member 12 constitute a mounting unit that is mounted on the endoscope 30. Further, the outer tube 14 and the wiping member 18 constitute a wiping unit for wiping the dome member 12.
[0031]
Next, the operation of the endoscope visual field securing device 2 of the present embodiment having the above-described configuration will be described. First, the endoscope visual field securing device 2 is attached to the endoscope 30. At this time, the light guide post 36 of the endoscope 30 is inserted into the proximal end portion of the notch portion 8 and is moved in the axial direction within the notch portion 8. The light guide post 36 reaches the enlarged portion 10 and is detachably held. The dome member 12 is disposed in front of the distal end surface of the endoscope.
[0032]
When performing observation with the endoscope 30, the endoscope 30, that is, the tubular member 4, is moved toward the distal end side with respect to the outer tube 14, and the distal end of the outer tube 14 is moved as shown in FIG. The dome member 12 and the distal end portion of the tubular member 4 are projected from the opening 26 of the portion. In this state, the blade portion 22 is disposed on the outer peripheral surface of the distal end portion of the tubular member 4. That is, the blade portion 22 does not cross the dome member 12 and does not obstruct the field of view of the objective lens of the endoscope 30.
[0033]
When filth adheres to the outer surface of the dome member 12, the visual field securing operation described below is performed. The blade portion 22 tends to return to a natural state due to its elastic force. Therefore, when the endoscope 30, that is, the tubular member 4 is gradually moved toward the base end side with respect to the outer tube 14 from the observation state shown in FIG. As indicated by arrow A in B), the dome member 12 moves along the outer surface while being in contact with the outer surface. At this time, the edge 28 of the blade portion 22 scrapes off dirt attached to the outer surface of the dome member 12. Finally, the blade part 22 returns to the natural state shown in FIG. In this way, almost half of the outer surface of the dome member 12 is wiped off.
[0034]
Here, the gripping portion 16 of the outer tube 14 is gripped, and the outer tube 14 is rotated about the axis by 180 ° with respect to the tubular member 4.
[0035]
Then, the endoscope 30, that is, the tubular member 4 is moved toward the distal end side with respect to the outer tube 14. Then, the blade portion 22 slides along the outer surface of the dome member 12 by the pressing force of the dome member 12 and is disposed at the proximal end portion of the dome member 12. The blade portion 22 is arranged at a position opposite to the position where it was originally arranged with respect to the central axis of the tubular member 4. Thereafter, the above-described wiping operation is performed on the remaining half of the outer surface of the dome member 12 to secure the visual field.
[0036]
If the dirt on the outer surface of the dome member 12 is not sufficiently removed, the wiping operation described above is repeated.
[0037]
The outer tube 14 may be moved in the axial direction with respect to the tubular member 4, that is, the endoscope 30. Moreover, the rotation angle of the rotation operation with respect to the tubular member 4 of the outer tube 14 is not limited to 180 °, and any rotation angle may be selected so as to be effective for removing dirt.
[0038]
Therefore, the above configuration has the following effects. That is, in the present embodiment, the outer tube 14 is externally mounted on the tubular member 4 so as to be movable in the axial direction of the tubular member 4. A belt-like blade portion 22 extends in a belt shape across the opening 26 at the distal end portion of the outer tube 14. The blade portion 22 is slightly pressed by the outer surface of the dome member 12 and has a shape that abuts the outer surface of the dome member 12 exactly due to its elasticity.
[0039]
Therefore, when the endoscope 30, that is, the tubular member 4 is moved in the axial direction with respect to the outer tube 14, and the dirt attached to the outer surface of the dome member 12 is wiped off by the blade portion 22, the outer surface of the dome member 12 is removed. There is almost no wiping remaining. Further, in the wiping operation, only the pulling force acts on the blade portion 22 only, and the blade portion 22 does not deform in a complicated manner in the normal operation. For this reason, even when the endoscope visual field securing device 2 is repeatedly used, elastic deformation of the blade portion 22 is prevented from remaining as a wrinkle. Accordingly, it is possible to prevent wiping unevenness from occurring on the outer surface of the dome member 12 in the wiping operation.
[0040]
FIG. 2B shows a first modification of the blade portion 22 of the endoscope visual field securing device 2 according to the first embodiment of the present invention. Two edges 40 a and 40 b are projected from the inner peripheral surface of the blade portion 38. These edges 40 a and 40 b extend over the entire length of the blade portion 38 at an intermediate position between the center line and the side surface of the blade portion 38.
[0041]
FIG. 2C shows a second modification of the blade portion 22 of the endoscope visual field securing device 2 according to the first embodiment of the present invention. A reinforcing member 44 is embedded in the blade portion 42 of the second modification. The reinforcing member 44 is a plate-like member and extends over the entire length of the blade portion 42 in parallel with the outer peripheral surface of the blade portion 42. The reinforcing member 44 has a spring property and increases the rigidity of the blade portion 42. The reinforcing member 44 is, for example, a metal plate.
[0042]
FIG. 4 shows a second embodiment of the present invention. The endoscope visual field securing device of the present embodiment is different from the endoscope visual field securing device 2 of the first embodiment only in the configuration of the blade portion.
[0043]
As shown in FIG. 4A, the edge 48 of the blade portion 46 of the endoscope visual field securing device of the present embodiment is disposed at a position offset from the center line of the blade portion 46 by a distance d. . When the blade portion 46 is in contact with the dome member 12 in a substantially natural state, the edge 48 of the blade portion 46 is aligned with the center line of the dome member 12 (from the front side of the center line of the blade portion 46 in the substantially natural state). It is arranged at a distance of approximately d from the line on the outer surface of the overlapping dome member 12 as viewed.
[0044]
A reinforcing member 50 is embedded in the blade portion 46. The reinforcing member 50 is disposed on the side facing the edge 48 with respect to the center line of the blade portion 46. Except for this point, the reinforcing member 50 has the same configuration as the reinforcing member 44 of the second modified example of the first embodiment. Therefore, the rigidity of the blade portion 46 is greater on the reinforcing member 50 side than on the edge 48 side.
[0045]
The operation of the endoscope visual field securing device of the present embodiment is basically the same as that of the endoscope visual field securing device 2 of the first embodiment. When performing observation with the endoscope 30, the endoscope 30, that is, the tubular member 4 is moved to the distal end side with respect to the outer tube 14, and the blade portion 46 is disposed on the outer peripheral surface of the distal end portion of the tubular member 4. To do. At this time, the blade portion 46 is moved on the outer surface of the dome member 12 in a direction from the edge 48 side toward the reinforcing member 50 side.
[0046]
During the wiping operation by the blade portion 46, the blade portion 46 is moved in a direction from the reinforcing member 50 side toward the edge 48 side. Accordingly, the edge 48 of the blade portion 46 is moved beyond the center line of the dome member 12 and scrapes more than half of the outer surface of the dome member 12.
[0047]
Thus, the above configuration has the following effects in addition to the effects of the first embodiment. That is, in the present embodiment, the edge 48 of the blade portion 46 is disposed at a position offset from the center line of the blade portion 46 by the distance d. Further, a reinforcing member 50 is embedded in the blade portion 46 on the side facing the edge 48 with respect to the center line of the blade portion 46 to increase the rigidity of one side of the blade portion 46. For this reason, in the wiping operation, the edge 48 of the blade portion 46 is moved from the reinforcing member 50 side toward the edge 48 side beyond the center line of the dome member 12, and more than half of the outer surface of the dome member 12 is scraped off. . Therefore, it is possible to prevent wiping residue from occurring near the center line of the dome member 12.
[0048]
FIG. 4B shows a modification of the blade portion 46 according to the second embodiment of the present invention. The reinforcing member 50 is not embedded in the blade portion 52. Instead, the blade portion 52 is provided with a thick portion 54 on the side facing the edge 48 with respect to the center line of the blade portion 52. The thick portion 54 extends over the entire length of the blade portion 52. The rigidity of the blade portion 52 is larger on the thick portion 54 side than on the edge 48 side.
[0049]
5 and 6 show a third embodiment of the present invention. FIG. 5A shows the endoscope visual field securing device 58 according to the third embodiment of the present invention attached to the endoscope 30. The endoscope visual field securing device 58 includes a tubular member 60 that is attached to the insertion portion 32 of the endoscope 30. The dome member 12 is disposed at the distal end of the tubular member 60 as in the first embodiment. On the other hand, a grip portion 62 that is gripped by an operator is provided at the proximal end portion of the tubular member 60. The grip portion 62 is a flange-shaped portion having a diameter larger than that of the tubular member 60.
[0050]
A wiping member 64 for wiping the dome member 12 is disposed at a connection portion between the tubular member 60 and the dome member 12. The wiping member 64 has elasticity and is made of, for example, rubber. A tube portion 66 is provided on the proximal end side of the wiping member 64. The tube portion 66 is sheathed and fixed to the distal end portion of the tubular member 60.
[0051]
A belt-like blade portion 68 is provided on the distal end side of the wiping member 64. Both end portions of the blade portion 68 are connected to positions opposed to each other in the diameter direction of the distal end portion of the tube portion 66. The blade portion 68 extends along the outer surface of the proximal end portion of the dome member 12 over almost a half circumference in the circumferential direction of the tubular member 60. The blade portion 68 is in close contact with the outer surface of the dome member 12 due to its elasticity. The proximal end side end surface of the blade portion 68 is adjacent to the distal end surface of the tube portion 66.
[0052]
An edge similar to that of the first embodiment is disposed on the inner peripheral surface of the blade portion 68.
[0053]
The tip of the linear member 70 is fixed to the central portion in the longitudinal direction of the outer peripheral surface of the blade portion 68. The linear member 70 extends across the dome member 12 and extends toward the proximal end along the outer peripheral surface of the tubular member 60.
[0054]
As shown in FIG. 5B, the guide portion 72 is disposed on the outer peripheral surface of the tubular member 60 behind the tube portion 66. The guide portion 72 is disposed at a position facing the central portion in the longitudinal direction of the blade portion 68 in a natural state with respect to the central axis of the tubular member 60. The linear member 70 is inserted through the guide portion 72.
[0055]
Referring to FIG. 5A again, a guide hole 74 is extended in the grip portion 62 along the axial direction of the tubular member 60. The guide hole 74 is aligned with the guide portion 72 with respect to the axial direction of the tubular member 60. The linear member 70 is inserted through the guide hole 74.
[0056]
An operation ring 78 is disposed at the base end portion of the linear member 70. The linear member 70 is disposed so as to be freely pulled by the operation ring 78.
[0057]
In the present embodiment, the tubular member 60 and the dome member 12 constitute a mounting unit that is mounted on the endoscope 30. Further, the linear member 70 and the operation ring 78 constitute a traction member, and the traction member and the wiping member 64 constitute a wiping unit for wiping the dome member 12.
[0058]
Next, the operation of the endoscope visual field securing device 58 of the present embodiment having the above-described configuration will be described. First, the endoscope visual field securing device 58 is attached to the insertion portion 32 of the endoscope 30. Then, the endoscope 30 is inserted into the body cavity and observed. At this time, as shown in FIG. 6A, the blade portion 68 is in a natural state, and is disposed at one base end portion of the outer surface of the dome member 12 to view the field of the objective lens of the endoscope 30. I do not disturb.
[0059]
When filth adheres to the outer surface of the dome member 12, a visual field securing operation is performed. That is, the operation ring 78 is pulled toward the base end side, and the linear member 70 is pulled toward the base end side. The blade portion 22 is pulled by the linear member 70 along the outer surface in a state in which the blade portion 22 is in contact with the outer surface of the dome member 12 as shown by an arrow B in FIG. Moved to. As shown in FIG. 6C, the blade portion 68 is moved to a position symmetrical to the natural state with respect to the central axis of the tubular member 60, and comes into contact with the distal end surface of the tube portion 66 and stops. To do. At this time, the edge of the blade portion 68 scrapes off dirt attached to the outer surface of the dome member 12. In this way, the entire outer surface of the dome member 12 is wiped off.
[0060]
Thereafter, when the pulling of the linear member 70 is released, the blade portion 68 slides on the outer surface of the dome member 12 in the direction opposite to that during the wiping operation, and returns to a natural state. If the dirt on the dome member 12 is not sufficiently removed, the wiping operation described above is repeated.
[0061]
Therefore, the above configuration has the following effects. That is, in this embodiment, the dome member 12 is disposed at the distal end portion of the tubular member 60, and the elastic band-shaped blade portion 68 abuts on the outer surface of the proximal end portion of the dome member 12. The tubular member 60 extends almost half a circumference in the circumferential direction. The distal end of the linear member 70 is fixed to the central portion in the longitudinal direction of the outer peripheral surface of the blade portion 68, and the distal end side of the linear member 70 extends across the outer surface of the dome member 12. The proximal end side extends to the proximal end side of the tubular member 60. Moreover, the linear member 70 is arrange | positioned so that pulling is possible. Accordingly, when the outer surface of the dome member 12 is wiped by the blade portion 68 by pulling the linear member 70, the same effect as that of the first embodiment is obtained.
[0062]
Further, a guide portion 72 is disposed on the tubular member 60 at a position facing the central portion in the longitudinal direction of the blade portion 68 in a natural state with respect to the central axis of the tubular member 60. The linear member 70 is inserted through the guide portion 72. For this reason, by pulling the linear member 70, the entire outer surface of the dome member 12 can be wiped at once by the blade portion 68. Therefore, the visual field securing operation can be performed efficiently.
[0063]
The portion of the endoscope visual field securing device 58 attached to the insertion portion 32 of the endoscope 30 is formed by the tubular member 60 and the linear member 70 and has a small diameter. For this reason, when inserting the endoscope 30 into the body cavity via the trocar, it is possible to use a trocar with a small diameter, which is less invasive to the patient. Therefore, the burden on the patient is reduced.
[0064]
FIG. 7 shows an overall schematic configuration of an endoscope visual field securing device 80 according to the fourth embodiment of the present invention. The endoscope visual field securing device 80 includes a tubular member 82 that is attached to the insertion portion 32 (see FIG. 1) of the endoscope 30. A dome member 12 similar to that of the first embodiment is disposed at the distal end portion of the tubular member 82.
[0065]
A wiping member 84 having elasticity is disposed at the distal end portion of the tubular member 82. The wiping member 84 has a strip shape and includes a connecting portion 86 at both ends and an inner blade portion 88.
[0066]
The blade portion 88 extends along the outer surface of the proximal end portion of the dome member 12 over almost a half circumference in the circumferential direction of the tubular member 60. The blade portion 88 is in close contact with the outer surface of the dome member 12 due to its elasticity. The proximal end side end surface of the blade portion 88 is disposed along the distal end surface of the tubular member 82. Similarly to the first embodiment, an edge is provided on the inner peripheral surface of the blade portion 88.
[0067]
A pivoting portion 90 projects from the distal end portion of the tubular member 82 in the axial direction of the tubular member 82. The pivot attachment portions 90 are respectively disposed at positions opposed to the diameter direction of the tubular member 82. A first pulley 92 is pivotally attached to the outer surface of each pivot attachment portion 90. Both connection portions 86 of the wiping member 84 are fixed to corresponding first pulleys 92.
[0068]
A second pulley 96 is pivotally supported at the proximal end portion of the tubular member 82. The second pulley 96 is aligned with one first pulley 92 with respect to the axial direction of the tubular member 82.
[0069]
A lever (driving member) 94 is disposed at the proximal end portion of the tubular member 82. A base end portion 95 of the lever 94 is fixed to the second pulley 96. The lever 94 projects from the second pulley 96 in the same direction as the direction in which the wiping member 84 projects from the first pulley 92, and extends in the tangential direction of the tubular member 82.
[0070]
A linear member 98 is wound around the first pulley 92 and the second pulley 96. The linear member 98 is driven by the second pulley 96 to drive the first pulley 92. Further, the first pulley 92 and the second pulley 96 have the same shape, and are configured to rotate by substantially the same angle in conjunction with each other by the linear member 98.
[0071]
In the present embodiment, the tubular member 82 and the dome member 12 constitute a mounting unit that is mounted on the endoscope 30. Further, the first pulley 92, the linear member 98, the second pulley 96, and the lever 94 constitute an operation means, and the operation means and the wiping member 84 constitute a wiping unit for wiping the dome member 12. It is composed.
[0072]
Next, the operation of the endoscope visual field securing device 80 of the present embodiment having the above-described configuration will be described. First, the endoscope visual field securing device 80 is attached to the insertion portion 32 of the endoscope 30. Then, the endoscope 30 is inserted into the body cavity for observation. At this time, the blade portion 88 is disposed at one base end portion of the outer surface of the dome member 12 and does not interfere with the field of view of the objective lens of the endoscope 30.
[0073]
When filth adheres to the outer surface of the dome member 12, a visual field securing operation is performed. That is, the lever 94 is rotated forward. Then, the second pulley 96 is rotated, and the second pulley 96 drives the linear member 98. The driven linear member 98 drives the first pulley 92, and the driven first pulley 92 rotates the wiping member 84. At this time, the rotation angle of the lever 94 and the rotation angle of the wiping member 84 are substantially equal to each other.
[0074]
As the lever 94 is rotated, the blade portion 88 is moved along the outer surface while being in contact with the outer surface of the dome member 12. At this time, the edge of the blade portion 88 scrapes off dirt attached to the outer surface of the dome member 12. When the lever 94 is rotated by approximately 180 °, the blade portion 88 is moved to a position symmetrical to the initial state with respect to the central axis of the tubular member 60. In this way, the entire outer surface of the dome member 12 is wiped off.
[0075]
If the dirt on the dome member 12 is not sufficiently removed, the lever 94 is rotated in the reverse direction to perform a wiping operation similar to the wiping operation described above. If necessary, the wiping operation described above is repeated.
[0076]
Therefore, the above configuration has the following effects. That is, in this embodiment, the dome member 12 is disposed at the distal end portion of the tubular member 82, and the elastic band-like blade portion 88 abuts on the outer surface of the proximal end portion of the dome member 12, The tubular member 60 extends substantially half a circumference in the circumferential direction. The connecting portions 86 at both ends of the blade portion 88 are respectively fixed to first pulleys 92 that are pivotally attached to the diametrically opposed positions of the distal end portion of the tubular member 82. Therefore, when the blade portion 88 is rotated by driving the first pulley 92 and the dome member 12 is wiped off, the same effect as that of the first embodiment is obtained.
[0077]
Further, a second pulley 96 is disposed at the base end portion of the tubular member 82, and the first pulley 92 and the second pulley 96 are interlocked with each other by the linear member 98 only at substantially the same angle. It is configured to rotate. A lever 94 is fixed to the second pulley 96. For this reason, it is possible to recognize the movement position of the blade portion 88 relative to the dome member 12 from the movement position of the lever 94 relative to the tubular member 82. Therefore, it is possible to perform an appropriate wiping operation.
[0078]
Next, other characteristic technical matters of the present application are appended as follows.
Record
(Additional Item 1) In an endoscope visual field securing device in which a sheath-like endoscope visual field securing device is inserted into an insertion portion of an endoscope, an approximately hemispherical transparent dome is inserted through the endoscope. An endoscope having a belt-like elastic blade portion that is disposed at the distal end of a tubular member and moves while pressing the curved surface of the surface of the transparent dome, and movement control means for the blade portion. Visual field securing device.
[0079]
(Additional Item 2) In the first additional item, the tubular member is composed of an inner cylinder member and an outer cylinder member, the dome member is fixed to the distal end of the inner cylinder member, and the longitudinal direction is fixed to the endoscope at the proximal end. An endoscope visual field securing device, characterized in that a means is provided, and a belt-like elastic blade portion that crosses the outer cylinder member in the diametrical direction is provided at the tip of the outer cylinder member.
[0080]
(Additional Item 3) In the first additional item, a dome member is provided at the distal end of the tubular member, and the blade portion is provided in a semi-cylindrical shape with the longitudinal direction as an axis at the proximal end of the dome member. An internal view characterized by being extended to the base end side of the tubular member while being inserted through the side surface of the arcuate vertex of the semi-cylindrical blade of the blade portion and the guide portion provided on the side surface opposite to the diameter direction of the tubular member Mirror visual field securing device.
[0081]
(Additional Item 4) In the first claim, a pulley is provided at the center of the rotation axis of the blade portion, and the linear member wound around the pulley is extended to the proximal end side of the tubular member, and is connected to the proximal end side control means. An endoscope visual field securing device characterized by being connected.
[0082]
【The invention's effect】
According to the present invention, it is possible to secure a sufficient field of view of the objective lens of the endoscope.
[Brief description of the drawings]
FIGS. 1A and 1B are explanatory views showing the endoscope visual field securing device according to the first embodiment of the present invention mounted on an endoscope, and FIG. 1B shows the inside of the first embodiment of the present invention; The perspective view which shows the state which mounted | wore the endoscope with the rear-end part of the endoscope visual field securing apparatus, (C) is a perspective view which shows the front-end | tip part of the endoscope visual field securing apparatus of 1st Embodiment of this invention.
2A is a cross-sectional view showing a dome member and a blade portion of an endoscope visual field securing device according to a first embodiment of the present invention, and FIG. 2B is an endoscope according to the first embodiment of the present invention. Sectional drawing which shows the 1st modification of the dome member and blade part of a visual field ensuring apparatus, (C) is the 2nd modification of the dome member and blade part of the endoscope visual field ensuring apparatus of 1st Embodiment of this invention. Sectional drawing which shows an example.
FIGS. 3A to 3C are explanatory views showing the operation of the endoscope visual field securing device according to the first embodiment of the present invention. FIGS.
4A is a cross-sectional view showing a dome member and a blade portion of an endoscope visual field securing device according to a second embodiment of the present invention, and FIG. 4B is an endoscope according to the second embodiment of the present invention. Sectional drawing which shows the modification of the dome member and blade part of a visual field ensuring apparatus.
FIG. 5A is a side view showing the endoscope visual field securing device according to the third embodiment of the present invention mounted on the endoscope, and FIG. 5B is the inside view of the third embodiment of the present invention. The perspective view which shows the front-end | tip part of an endoscope visual field ensuring apparatus.
FIGS. 6A to 6C are explanatory views showing the operation of the endoscope visual field securing apparatus according to the third embodiment of the present invention. FIGS.
FIG. 7 is a side view showing an endoscope visual field securing device according to a fourth embodiment of the present invention.
[Explanation of symbols]
2, 58, 80 ... endoscope visual field securing device, 4, 60, 82 ... tubular member, 12 ... dome member, 14 (70, 78) (92, 94, 96, 98) ... operating means, 22, 38, 42, 46, 52, 68, 88 ... blade part, 30 ... endoscope, 32 ... insertion part.

Claims (4)

内視鏡の挿入部に装着される管状部材の先端部に前記内視鏡の先端面の前方に配置されるほぼ半球状の透明なドーム部材が設けられている装着ユニットと、
前記ドーム部材を横切る状態で配置可能な弾性を有する帯状のブレード部とこのブレード部を前記ドーム部材の外表面に当接させた状態で外表面に沿って移動させて外表面を拭き取らせる操作手段とを有する拭き取りユニットとを、
具備する内視鏡視野確保装置。An attachment unit in which a substantially hemispherical transparent dome member disposed in front of the distal end surface of the endoscope is provided at a distal end portion of a tubular member attached to an insertion portion of the endoscope;
An elastic band-shaped blade portion that can be arranged in a state of crossing the dome member, and an operation of wiping the outer surface by moving the blade portion along the outer surface in contact with the outer surface of the dome member A wiping unit having means,
Endoscope visual field securing device provided. 前記操作手段は、前記管状部材に外装され前記管状部材に対して軸方向に移動可能な外装管であり、前記ブレード部は、前記外装管の先端部に設けられ前記外装管の先端部の開口を横切って延びていることを特徴とする請求項１の内視鏡視野確保装置。The operating means is an outer tube that is externally mounted on the tubular member and is movable in an axial direction with respect to the tubular member, and the blade portion is provided at a distal end portion of the outer tube and is opened at a distal end portion of the outer tube. The endoscope visual field securing device according to claim 1, wherein the endoscope visual field securing device extends across. 前記操作手段は、先端部が前記ブレード部に固定され基端部が前記管状部材の基端側に延びている牽引可能な牽引部材であることを特徴とする請求項１の内視鏡視野確保装置。2. The endoscope visual field securing according to claim 1, wherein the operating means is a pullable pulling member having a distal end portion fixed to the blade portion and a proximal end portion extending to the proximal end side of the tubular member. apparatus. 前記操作手段は、前記管状部材の基端部に設けられ前記ブレード部と連動される駆動部材を有し、前記管状部材に対する前記駆動部材の移動位置から前記ドーム部材に対する前記ブレード部の移動位置が認知可能であることを特徴とする請求項１の内視鏡視野確保装置。The operation means includes a drive member provided at a proximal end portion of the tubular member and interlocked with the blade portion, and a movement position of the blade portion with respect to the dome member from a movement position of the drive member with respect to the tubular member. The endoscope visual field securing device according to claim 1, wherein the endoscope visual field securing device is recognizable.
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