JP2005095590A - 処置用内視鏡 - Google Patents
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Abstract
【解決手段】先端硬性部13の先端面には先端観察カバー41、先端照明カバー42、第1処置具導入口39aから挿通される把持鉗子51等が導出される先端開口43が設けられている。可撓管先端部16の先端面には第2湾曲部15の基端部が固定されるとともに、中途部観察カバー44、中途部照明カバー45、第2処置具導入口39bから挿通される高周波スネア52等が導出される可撓管開口46が設けられている。第1湾曲部14は、湾曲ノブ35UD、35LRの回動操作によって上下方向、左右方向に湾曲動作する。第2湾曲部15は、湾曲ノブ36の回動操作によって上下方向に湾曲動作する。可撓管湾曲部17は、湾曲ノブ37の回動操作によって左右方向に湾曲動作する。
【選択図】図5
Description
前記ユニット挿入具のユニット挿通チャンネルは第1挿通路及び第2挿通路に分岐する分岐部を有し、第1挿通路の端部開口に配設される観察窓が先端部の一面に設けられ、第2通路の端部開口に配設される観察窓が中途部の一面に設けられる構成において、
前記ユニット挿入具は、手元側の基端部に、前記観察光学ユニットを導入するための光学ユニット導入口と、処置具が挿通される少なくとも1つの処置具導入口を有し、前記先端部の一面又は前記中途部の一面の少なくとも一方に、前記処置具導入口から延出される前記処置具挿通チャンネルに連通する処置具導出口を備えている。
図1ないし図6は本発明の第1実施形態にかかり、図1は観察ユニットとユニット挿入具とを有する処置用内視鏡の構成及びこの処置用内視鏡を備えた処置用内視鏡装置を説明する図、図2は観察ユニットの挿入部先端側の構成を説明する図、図3は観察ユニットの挿入部基端側の構成を説明する図、図4はユニット挿入具の操作部の構成を説明する図、図5は内視鏡の先端側の構成及び作用を説明する斜視図、図6は内視鏡の先端側の構成及び作用を説明する一部断面を含む説明図である。
前記内視鏡80においては、挿入部81を構成する可撓管湾曲部17を湾曲させることにより、胃のように内腔の大きな臓器内の被検部位に対してであっても可撓管先端部16の中途部観察系カバー85等を対向させられる。また、前記挿入部81は、第1湾曲部14と第2湾曲部15を独立して湾曲動作させられるので、先端硬性部13の先端面を可撓管先端部16の挿入軸方向に対して垂直に向けることも容易である。
まず、内視鏡ユニット101の先端面とユニット挿入具110の先端面とを面一致させた状態の内視鏡100を目的部位に向けて挿入していく。そして、観察系カバー103を通して撮像された観察画像をモニタの画面上で確認しながら、内視鏡ユニット101をユニット挿入具110の先端面から突出させていく。
まず、内視鏡を胃等の体腔内の目的部位まで挿入するとき、先端フード130を最も手前に引きよせた状態にして爪状フック133をフック収納溝135内に格納しておく。このことによって、挿入時に、爪状フック133が体壁に引っかかることが防止される。
まず、図38(a)に示すように先端フード170のフード凹部171を開状態位置から手元側に移動させる操作を行って、体壁をフード凹部171内に引き込む。次に、図38(b)に示すように先端フード170の先端側内壁面と先端硬性部172の先端面173との間で体組織を挟み込むように先端フード170を後退させる。このとき、同時に穿刺針174にて穿刺が行われる。そして、前記フード凹部131が閉状態になることによって、前記穿刺針174の先端が針受け部177に突き刺さり、この穿刺針174が針受け部177に固定された状態になる。
内視鏡挿入部180の湾曲部192を操作して先端硬性部181を目的部位に近づける。ここで、可動部183を開き、先端開口189より、例えば把持鉗子193を突出させて目的部位の体組織を把持する。そして、体組織を前記可動部183と前記固定部182との間に配置する。この体組織を前記可動部183と前記固定部182の間に引き込んだ状態でステープラー191を射出する。すると、前記可動部183が閉状態になるように移動して、ステープラー191の針が組織に刺されるとともに、その後、針が押し畳まれる。このことによって、体組織がステープラー191によって針止めすることができる。
以上詳述したような本発明の上記実施形態によれば、以下の如き構成を得ることができる。
照明光学系及び撮像装置を備えた観察光学系を一面に設けた挿入部の先端部と、
照明光学系及び撮像装置を備えた観察光学系を一面に設けた挿入部の中途部と、
前記先端部の一面又は前記中途部の一面の少なくとも一方に設けられ、前記処置具挿通チャンネルに連通する処置具導出口と、
前記挿入部の基端部に配設された操作部に設けられ、前記処置具挿通チャンネルに連通する処置具導入口と、
を具備する処置用内視鏡。
前記先端部及び前記中途部に設けた撮像装置で光電変換した電気信号を映像信号に信号処理するビデオプロセッサと、
このビデオプロセッサで処理された映像信号を受けて、観察画像を表示するモニタと、
前記先端部及び前記中途部に設けた撮像装置で光電変換した電気信号を前記ビデオプロセッサに伝送して、前記モニタの画面上に観察画像を表示させる切換装置と、
を具備する処置用内視鏡装置。
前記先端部に設けた撮像装置で光電変換した電気信号を映像信号に信号処理する第1のビデオプロセッサと、
前記中途部に設けた撮像装置で光電変換した電気信号を映像信号に信号処理する第2のビデオプロセッサと、
前記第1のビデオプロセッサで処理された映像信号を受けて、観察画像を表示する第1のモニタと、
前記第2のビデオプロセッサで処理された映像信号を受けて、観察画像を表示する第2のモニタと、
を具備する処置用内視鏡装置。
照明光学系及び撮像装置を備えた観察光学系を一面に設けた挿入部の先端部と、
超音波観測部設けた挿入部の中途部と、
前記先端部の一面又は前記中途部の一面の少なくとも一方に設けられ、前記処置具挿通チャンネルに連通する処置具導出口と、
前記挿入部の基端部に配設された操作部に設けられ、前記処置具挿通チャンネルに連通する処置具導入口と、
を具備する処置用内視鏡。
長手方向中途部に形成され、配置孔に連通する長手軸方向に対して直交する方向の切り欠き部と、
前記挿入部の側周面に配置したワイヤ案内チューブと、
このワイヤ案内チューブ内に挿通配置され、一端部が前記先端フードに固定されるフード牽引ワイヤと、
を具備する先端フード。
このフードベースの前記シリンダ部内に摺動自在に配置されるシリンダヘッドを有する、
長手方向中途部に切り欠き部が形成されたフード部と、
前記挿入部の側周面に配置され、先端部が前記シリンダ部に連通し、基端部が内圧操作手段に連結される送気チューブと、
を具備する先端フード。
前記送気チューブの中途部に電磁弁を設ける一方、この電磁弁の開閉操作を指示する操作レバーを前記内視鏡の操作部に設けた付記13記載の先端フード。
10…ユニット挿入部 13…先端硬性部 14…第1湾曲部
15…第2湾曲部 16…可撓管先端部 17…可撓管湾曲部
18…可撓管部 38…長孔 39…処置具導入部
39a、39b…処置具導入口 41…観察用レンズカバー 43…先端開口
44…観察用レンズカバー 46…可撓管開口 47…ユニット挿通路
48a、48b…挿通路 49…分岐部 50a、50b…処置具挿通チャンネル
代理人 弁理士 伊藤 進
Claims (8)
- 少なくとも観察光学系を有する細長で柔軟な観察光学ユニットと、前記観察光学ユニットが挿通されるユニット挿通チャンネル及び処置具が挿通される処置具挿通チャンネルを有するユニット挿入具とを備えた処置用内視鏡であって、
前記ユニット挿入具のユニット挿通チャンネルは第1挿通路及び第2挿通路に分岐する分岐部を有し、第1挿通路の端部開口に配設される観察窓が先端部の一面に設けられ、第2通路の端部開口に配設される観察窓が中途部の一面に設けられる構成において、
前記ユニット挿入具は、
手元側の基端部に、前記観察光学ユニットを導入するための光学ユニット導入口と、処置具が挿通される少なくとも1つの処置具導入口を有し、
前記先端部の一面又は前記中途部の一面の少なくとも一方に、前記処置具導入口から延出される前記処置具挿通チャンネルに連通する処置具導出口を備えることを特徴とする処置用内視鏡。 - 前記観察光学ユニットは、手元側の操作で挿入形状が直線状態又は湾曲状態に変化する湾曲機構部を有することを特徴とする請求項1に記載の処置用内視鏡。
- 前記観察光学ユニットは、先端部近傍に曲がり癖部を有することを特徴とする請求項1に記載の処置用内視鏡。
- 前記観察光学ユニットが挿通される前記ユニット挿通チャンネルが前記第1挿通路と前記第2挿通路とに分岐する分岐部に、
前記ユニット挿通チャンネル内を挿通する前記観察光学ユニットの挿通方向を、前記第1挿通路方向又は前記第2挿通路方向に選択的に切り替えるチャンネル切替機構を設けたことを特徴とする請求項1に記載の処置用内視鏡。 - 前記チャンネル切替機構は、
回動自在に配置される回動板と、
この回動板を第1挿通路に向かう開口を塞ぐように付勢する付勢部材と、
牽引操作によって前記回動板を前記付勢部材の付勢力に抗して移動させる牽引操作ワイヤと、
を具備することを特徴とする請求項5に記載の処置用内視鏡。 - 前記ユニット挿入具は、前記先端部と前記中途部との間、又は前記中途部の後方側の少なくとも一方に、手元側操作によって湾曲動作する湾曲部を有することを特徴とする請求項1に記載の処置用内視鏡。
- 前記ユニット挿入具が直線状態において、前記先端部の一面に設けられた観察窓の光軸又は前記中途部の一面に設けられた観察窓の光軸の少なくとも一方は、前記ユニット挿入具の長手軸方向に平行であることを特徴とする請求項1に記載の処置用内視鏡。
- 可撓性の挿入部に処置具が挿通される処置具挿通チャンネルを有する処置用内視鏡において、
照明光学系及び撮像装置を備えた観察光学系を一面に設けた挿入部の先端部と、
照明光学系及び撮像装置を備えた観察光学系を一面に設けた挿入部の中途部と、
前記先端部の一面又は前記中途部の一面の少なくとも一方に設けられ、前記処置具挿通チャンネルに連通する処置具導出口と、
前記挿入部の基端部に配設された操作部に設けられ、前記処置具挿通チャンネルに連通する処置具導入口と、
を具備することを特徴とする処置用内視鏡。
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