JP2005211434A - Endoscope system - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an endoscope system which can detect positions of a first balloon at an endoscope insertion side and a second balloon at a covering tube side in a body cavity using a means other than X rays. <P>SOLUTION: An antenna 152 to radiate a radio wave is attached to the first balloon 30 of the endoscope insertion section 12 and an antenna 154 to radiate a radio wave is attached to the second balloon 60 of the covering tube 50. The radio waves radiated by the antennas 152 and 154 are received by a radio wave receiving antenna 202 and the positions of the antennas 152 and 154 or the positions of the first balloon 30 and the second balloon 60 are displayed on a monitor 218 as point images 222 and 224. <P>COPYRIGHT: (C)2005,JPO&NCIPI

Description

  The present invention relates to an endoscope system, and in particular, an endoscope in which a first balloon is attached to a distal end portion of an insertion portion, and a second balloon is attached to the distal end portion, and the insertion portion of the endoscope is placed in a body cavity. The present invention relates to a double balloon type endoscope system that includes an overtube for guiding and detects positions of a first balloon and a second balloon in a body cavity.

  When inserting the insertion part of the endoscope into the deep digestive tract such as the small intestine, simply inserting the insertion part makes it difficult for force to be transmitted to the distal end of the insertion part due to the complicated bending of the intestinal tract. Have difficulty. Therefore, an insertion aid called an overtube or a sliding tube is attached to the insertion portion of the endoscope and inserted into the body cavity, and the insertion portion is guided by this insertion aid, so that the extra portion of the insertion portion is inserted. An endoscope apparatus that prevents bending and bending has been proposed (for example, Patent Document 1).

  In addition, the conventional endoscope apparatus includes a double balloon type endoscope apparatus in which a first balloon is provided at the distal end portion of the endoscope insertion portion and a second balloon is provided at the distal end portion of the overtube. Known (for example, Patent Document 2 and Patent Document 3).

Even in the double balloon type endoscope apparatus, it is necessary to detect the positions of the first balloon and the second balloon inserted into the body cavity, and this position detection has been performed by X-ray imaging as usual. .
JP-A-10-248794 JP 2001-340462 A JP 2002-301019 A

  However, since the conventional double-balloon type endoscope apparatus uses X-rays for detecting the positions of the first balloon and the second balloon, the cost of equipment for preventing X-ray leakage is high. was there.

  The present invention has been made in view of such circumstances, and provides an endoscope system capable of detecting the positions of the first balloon and the second balloon in the body cavity by using means other than X-rays. The purpose is to do.

  In order to achieve the above object, the first aspect of the present invention provides an endoscope in which a first balloon is attached to a distal end portion of an insertion portion, and a second balloon is attached to the distal end portion and the endoscope. An overtube for inserting the insertion portion of the mirror into the body cavity and assisting insertion of the insertion portion into the body cavity, a first recognition object attached to the first balloon, and an attachment to the second balloon The second recognition object, the recognition means for recognizing the first recognition object and the second recognition object, and the positions of the first recognition object and the second recognition object recognized by the recognition means And a control means having a display means for displaying an image.

  According to the first aspect of the present invention, the recognition unit recognizes the first recognition object attached to the first balloon and the second recognition object attached to the second balloon, and The position of the first balloon and the second balloon in the body cavity is displayed on the display means having a predetermined coordinate screen based on the image display of the position of the first recognized body and the position of the second recognized body. Is detected. Thereby, the position in the body cavity of the 1st balloon and the 2nd balloon can be detected using means other than X-rays.

  According to a second aspect of the present invention, the first recognition object and the second recognition object are a recognition object that emits radio waves, a recognition object that emits ultrasonic waves, or a detection object that generates a magnetic field. It is a recognition body. That is, the first balloon and the second balloon can be distinguished by changing both frequencies in the frequency band of the signal radiated from the first recognition object and the second recognition object. The first balloon can also be provided by providing magnetic field generating means for generating a magnetic field in place of the signal radiating means in the first balloon and the second balloon, and changing the strength of the magnetic field generated by each magnetic field generating means. And the second balloon can be discriminated.

  According to the endoscope system according to the present invention, the first recognition object attached to the first balloon and the second recognition object attached to the second balloon are recognized by the recognition means, Since the display means displays the image of the position of the first recognized object and the position of the second recognized object on the basis of the display means, the means in the body cavity of the first balloon and the second balloon are used using means other than X-rays. The position at can be detected.

  Hereinafter, preferred embodiments of an endoscope system according to the present invention will be described with reference to the accompanying drawings.

  FIG. 1 shows a configuration diagram of an endoscope system according to an embodiment of the present invention. The endoscope system shown in the figure includes an endoscope 10, an overtube 50, a balloon control device 100, a radio wave oscillator 150, and a computer (control means) 200 shown in FIG.

  The endoscope 10 illustrated in FIG. 1 includes a hand operation unit 14 and an insertion unit 12 connected to the hand operation unit 14. A universal cable 15 is connected to the hand operation unit 14, and a connector (not shown) connected to a processor or a light source device (not shown) is provided at the tip of the universal cable 15.

  The hand operation unit 14 is provided with an air / water supply button 16, a suction button 18, and a shutter button 20 that are operated by an operator, and a pair of angle knobs 22, 22 and a forceps insertion unit 24 are respectively provided. It is provided in the position. Further, the hand operating unit 14 is provided with a balloon air supply port 26 for supplying air to the first balloon 30 and sucking air from the balloon 30.

  The insertion portion 12 includes a flexible portion 32, a bending portion 34, and a distal end hard portion 36. The bending portion 34 is configured by connecting a plurality of node rings so as to be able to bend, and is remotely operated by a turning operation of a pair of angle knobs 22, 22 provided on the hand operation portion 14. Thereby, the front end surface 37 of the front end hard portion 36 can be directed in a desired direction.

  As shown in FIG. 3, an objective optical system 38, an illumination lens 40, an air / water supply nozzle 42, a forceps port 44, and the like are provided at predetermined positions on the distal end surface 37 of the distal rigid portion 36. An air supply / suction port 28 is opened on the outer peripheral surface of the distal end hard portion 36, and this air supply / suction port 28 is inserted into the insertion portion 12 and has an inner diameter of about 0.8 mm (not shown). Is communicated with the balloon air inlet 26 of FIG. Accordingly, air is blown from the air supply / suction port 28 of the distal end hard portion 36 by supplying air to the balloon supply port 26, and conversely, by sucking air from the balloon supply port 26, the air supply / suction port 28. Air is sucked from.

  As shown in FIG. 1, a first balloon 30 made of an elastic material such as rubber is detachably attached to the distal end hard portion 36 of the insertion portion 12. As shown in FIG. 4, the first balloon 30 is formed of a central bulging portion 30c and attachment portions 30a and 30b at both ends thereof, and the air supply / suction port 28 is located inside the bulging portion 30c. Thus, it attaches to the front-end | tip hard part 36 side. The attachment portions 30a and 30b are formed to have a diameter smaller than the diameters of the distal end hard portion 36 and the curved portion 34, and after being in close contact with the distal end hard portion 36 with its elastic force, the distal end hard portion 36 is formed by a ring-shaped band member (not shown). It is firmly fitted to the outer peripheral surface.

  In the first balloon 30 attached to the distal end hard portion 36, the bulging portion 30c is inflated into a substantially spherical shape by the air supplied from the air supply / suction port 28 shown in FIG. On the contrary, when air is sucked from the air supply suction port 28, the bulging portion 30 c is contracted and is brought into close contact with the outer peripheral surface of the distal end hard portion 36.

  The overtube 50 shown in FIG. 1 is formed of a tube main body 51 and a grip portion 52. The tube body 51 is formed in a cylindrical shape as shown in FIG. 5 and has an inner diameter slightly larger than the outer diameter of the insertion portion 12. The tube body 51 is a molded product of a flexible urethane resin, and the outer peripheral surface thereof is coated with a lubricant coat, and the inner peripheral surface is also coated with a lubricant coat. The tube main body 51 is fitted with a hard grip 52 in a watertight manner, and the grip 52 is detachably connected to the tube main body 51. The insertion portion 12 is inserted from the proximal end opening 52A of the grip portion 52 toward the tube body 51.

  As shown in FIG. 1, a balloon air supply port 54 is provided on the proximal end side of the tube main body 51. An air supply tube 56 having an inner diameter of about 1 mm is connected to the balloon air supply port 54, and this tube 56 is bonded to the outer peripheral surface of the tube body 51 and extends to the tip of the tube body 51 as shown in FIG. ing.

  The distal end portion 58 of the tube main body 51 is formed in a tapered shape to prevent the intestinal wall from being caught. A second balloon 60 made of an elastic body such as rubber is attached to the proximal end side of the distal end portion 58 of the tube main body 51. The second balloon 60 is mounted in a state where the tube main body 51 penetrates, and includes a central bulging portion 60c and attachment portions 60a and 60b at both ends thereof. The distal end side attachment portion 60a is folded inside the bulging portion 60c, and the folded attachment portion 60a is fixed to the tube main body 51 by winding the X-ray contrast yarn 62. The proximal-side attachment portion 60 b is disposed outside the second balloon 60, and is fixed to the tube body 51 by winding a thread 64.

  The bulging part 60c is formed in a substantially spherical shape in a natural state (a state in which neither is inflated nor contracted), and its size is larger than that in a natural state (a state in which neither is inflated nor contracted) of the first balloon 30. Is also formed large. Therefore, when air is supplied to the first balloon 30 and the second balloon 60 at the same pressure, the outer diameter of the bulging portion 60 c of the second balloon 60 is set to be outside the bulging portion 30 c of the first balloon 30. It becomes larger than the diameter. For example, when the outer diameter of the first balloon 30 is φ25 mm, the outer diameter of the second balloon 60 is configured to be φ50 mm.

  The above-described tube 56 is opened inside the bulging portion 60c, and an air supply / suction port 57 is formed. Therefore, when air is supplied from the balloon air supply port 54, air is blown out from the air supply / suction port 57, and the bulging portion 60c is expanded. When air is sucked from the balloon air supply port 54, air is sucked from the air supply suction port 57, and the second balloon 60 is deflated.

  Incidentally, an antenna (first object to be recognized) 152 that radiates radio waves is attached to the bulging portion 30 c of the first balloon 30, and radio waves are transmitted to the bulging portion 60 c of the second balloon 60. A radiating antenna (second object to be recognized) 154 is attached.

  As shown in FIG. 4, the antenna 152 is connected to one end of a signal line 156 disposed in the first balloon 30, and the other end of the signal line 156 is bonded to the attachment portion 30 b of the first balloon 30. Connected to the connector 158. The connector 158 is mounted so as to contact the connector 160 on the insertion portion 12 side shown in FIG. 1 when the first balloon 30 is mounted. The connector 160 is connected to one end of a signal line 162 disposed in the insertion unit 12, and the signal line 162 extends from the hand operation unit 14 to the outside and is connected to the radio wave oscillator 150.

  The antenna 154 is connected to one end of a signal line 164 wired from the second balloon 60 through the tube main body 51 and the grip portion 52 as shown in FIG. 1, and the other end of the signal line 164 is connected to the overtube 50. It extends to the outside and is connected to the radio wave oscillator 150.

  The radio wave oscillator 150 is a known radio wave generator having a positive feedback circuit using an amplification element such as a transistor or a vacuum tube. The radio wave oscillator 150 is connected to the antenna 152 via the signal lines 162 and 156 and to the antenna 154 via the signal line 164. By supplying high-frequency energy having different frequencies, radio waves having different frequencies in the frequency band of the radio waves are radiated from the antennas 152 and 154.

  The radio waves radiated from the antennas 152 and 154 are received by the radio wave receiving antenna (recognition means) 202 of the computer 200 shown in FIG. The radio wave receiving antenna 202 is installed on an L-shaped arm 206 installed on the treatment table 204 with the receiving unit facing downward. Further, this receiving unit has directivity and can search for a direction in which the radio wave is strong. Thereby, the radio wave receiving antenna 202 can search the direction in which the antennas 152 and 154 that are radio wave oscillation sources are located. In addition, you may make it look for the direction where an electromagnetic wave is strong by moving the electromagnetic wave receiving antenna 202 above the treatment table 204. The radio wave receiving antenna 202 is provided with a detector 208, and radio waves from the antennas 152 and 154 received by the radio wave receiving antenna 202 are amplified and detected by the detector 208.

  A signal indicating the direction in which the antennas 152 and 154 are located is transmitted from the transmission antenna 210 installed on the arm 206 and taken into the computer main body 212 via the reception antenna 214 of the computer main body 212.

  In the computer main body 212, coordinates of the treatment table 204 are stored in advance, and a number of coordinate positions for indicating the position of the sleeping state of the patient 216 laid down on the treatment table 204 by a contour line are stored in advance. This contour line is drawn on the treatment table 204, and the patient 216 is laid along the contour line. The coordinate position is displayed as a contour image 220 on the coordinate screen of the treatment table 204 displayed on the monitor (display means) 218. Further, the computer main body 212 calculates the coordinate position on the treatment table 204 corresponding to the direction indicating the direction in which the antennas 152 and 154 are taken in, and outputs the coordinate position on the monitor 218 to the point images 222 and 224. Display as. Thereby, since the point images 222 and 224 are displayed in the contour image 220 on the monitor 218, the operator views the positions of the first balloon 30 and the second balloon 60 in the body cavity. Can be confirmed. Note that the monitor 218 displays that the point image 222 corresponds to the first balloon 30 and the point image 224 corresponds to the second balloon 60 by characters or figures.

  On the other hand, the balloon control device 100 of FIG. 1 is a device that supplies and sucks fluid such as air to the first balloon 30 and supplies and sucks fluid such as air to the second balloon 60. The balloon control device 100 includes a device main body 102 having a pump, a sequencer, and the like (not shown) and a hand switch 104 for remote control.

  On the front panel of the apparatus main body 102, a power switch SW1, a stop switch SW2, a pressure gauge 106 for the first balloon 30 and a pressure gauge 108 for the second balloon 60 are provided. Further, a tube 110 that supplies and sucks air to the first balloon 30 and a tube 120 that supplies and sucks air to the second balloon 60 are attached to the front panel of the apparatus main body 102. In the middle of each tube 110, 120, a reservoir tank for storing body fluid flowing back from the first balloon 30 and the second balloon 60 when the first balloon 30 and the second balloon 60 are damaged. 130 and 140 are provided.

  On the other hand, the hand switch 104 has the same stop switch SW3 as the stop switch SW2 on the apparatus main body 102 side, the ON / OFF switch SW4 for instructing the pressurization / decompression of the first balloon 30, and the pressure of the first balloon 30. A pause switch SW5 for holding, an ON / OFF switch SW6 for instructing pressurization / depressurization of the second balloon 60, and a pause switch SW7 for holding the pressure of the second balloon 60 are provided. The hand switch 104 is electrically connected to the apparatus main body 102 via a cable 150.

  The balloon control device 100 configured in this way supplies air to the first balloon 30 and the second balloon 60 to inflate them, and controls the air pressure to a constant value to control the first balloon 30 and the second balloon 60. The second balloon 60 is held in an inflated state. In addition, air is sucked and deflated from the first balloon 30 and the second balloon 60, and the air pressure is controlled to a constant value to hold the first balloon 30 and the second balloon 60 in a deflated state. To do.

  Next, an example of an operation method of the endoscope apparatus performed on the patient 216 illustrated in FIG. 2 will be described with reference to FIGS. 2 is assumed to be laid down along a contour line (not shown) drawn on the treatment table 204.

  First, as illustrated in FIG. 6A, the insertion portion 12 is inserted into the intestinal tract (for example, the descending leg of the duodenum) 70 with the overtube 50 placed on the insertion portion 12. At this time, the first balloon 30 and the second balloon 60 are deflated.

  Next, as shown in FIG. 6B, the second balloon 60 is inflated by supplying air to the second balloon 60 with the distal end portion 58 of the overtube 50 inserted into the bent portion of the intestinal tract 70. As a result, the second balloon 60 is locked to the intestinal tract 70, and the distal end portion 58 of the overtube 50 is fixed to the intestinal tract 70.

  Next, as shown in FIG. 6C, only the insertion part 12 of the endoscope 10 is inserted into the deep part of the intestinal tract 70. Then, as shown in FIG. 6D, air is supplied to the first balloon 30 to be inflated. As a result, the first balloon 30 is fixed to the intestinal tract 70. At that time, since the first balloon 30 is smaller in size when expanded than the second balloon 60, the burden on the intestinal tract 70 is small, and damage to the intestinal tract 70 can be prevented.

  Next, after the air is sucked from the second balloon 60 and the second balloon 60 is contracted, the overtube 50 is pushed in and inserted along the insertion portion 12 as shown in FIG. And after pushing the front-end | tip part of the overtube 50 to the vicinity of the 1st balloon 30, as shown in FIG.6 (f), air is supplied to the 2nd balloon 60 and it is made to expand. As a result, the second balloon 60 is fixed to the intestinal tract 70. That is, the intestinal tract 70 is grasped by the second balloon 60.

  Next, as shown in FIG.6 (g), the overtube 50 is drawn around. As a result, the intestinal tract 70 contracts substantially straight, and the excess bending or bending of the overtube 50 is eliminated. It should be noted that when the overtube 50 is pulled together, both the first balloon 30 and the second balloon 60 are locked to the intestinal tract 70, but the frictional resistance of the first balloon 30 is that of the second balloon 60. Since it is smaller than the frictional resistance, even if the first balloon 30 and the second balloon 60 move relative to each other, the first balloon 30 having a small frictional resistance slides with respect to the intestinal tract 70. Therefore, the intestinal tract 70 is not pulled and damaged by both the balloons 30 and 60.

  Next, as shown in FIG. 6 (h), air is sucked from the first balloon 30 to contract the first tube 30. Then, the distal end hard portion 36 of the insertion portion 12 is inserted as deep as possible into the intestinal tract 70. That is, the insertion operation shown in FIG. Thereby, the distal end hard portion 36 of the insertion portion 12 can be inserted into the deep portion of the intestinal tract 70. When inserting the insertion portion 12 into a deeper portion, after performing a fixing operation as shown in FIG. 6D, a pushing operation as shown in FIG. ), A hand dragging operation as shown in FIG. 6G, and an insertion operation as shown in FIG. Thereby, the insertion part 12 can be further inserted into the deep part of the intestinal tract 70.

  During the operation of such an endoscope apparatus, the positions of the first balloon 30 and the second balloon 60 are the radio waves radiated from the antenna 152 of the first balloon 60 and the antenna 154 of the second balloon 60. Based on this, the point images 222 and 224 are displayed on the monitor 218 of the computer 200 shown in FIG. Thus, the operator can confirm the positions of the first balloon 30 and the second balloon 60 in the body cavity, and can perform operations and treatments while viewing the point images 222 and 224.

  Therefore, according to the endoscope system of the embodiment, the positions of the first balloon 30 and the second balloon 60 in the body cavity can be confirmed without using X-rays.

  In the endoscope system according to the embodiment, an example in which radio waves are used as signals has been described, but ultrasonic waves may be used. In this case, the first balloon 30 and the second balloon 60 can be discriminated by attaching ultrasonic transducers to the first balloon 30 and the second balloon 60 and changing the frequency of both. In addition, magnetic field generating means for generating a magnetic field is provided in the first balloon and the second balloon in place of the radio wave and ultrasonic signal radiating means, and a magnetic field detector is provided, and the strength of the magnetic field generated by each magnetic field generating means is increased. The first balloon 30 and the second balloon 60 can also be discriminated by changing the height. Furthermore, by attaching a recognition object such as an iron piece to the first balloon and the second balloon, the first balloon and the second balloon can be easily recognized by the MRI method.

  FIG. 7 is a side view of a main part in which a radio wave oscillation source is attached to the endoscope insertion portion 12 and the overtube 50. As shown in FIG. 7, a plurality of radio wave oscillation sources 230A, 230B, 230C,... Are attached at equal intervals from the distal end hard portion 36 of the endoscope insertion portion 12 to the hand operation portion 14 of FIG. Further, as shown in FIG. 7, a plurality of radio wave oscillation sources 240A, 240B, 240C,... Are attached at equal intervals from the distal end portion 58 of the tube main body 51 of the overtube 50 to the grip portion 52 of FIG. These radio wave oscillation sources 230A, 230B, 230C,..., 240A, 240B, 240C,... Are changed in frequency, and the radio wave oscillation sources 230A, 230B, 230C,. 2 is displayed as a point image on the monitor 218 shown in FIG. 2, so that the positions of the endoscope insertion portion 12 and the overtube 50 in the body cavity and their states (straight or curved) are displayed. It can be confirmed visually.

System configuration diagram of an endoscope system according to an embodiment of the present invention Configuration diagram of the endoscope system in the treatment room The perspective view which shows the front-end | tip part of an endoscope insertion part The perspective view which shows the front-end | tip part of the insertion part equipped with the 1st balloon Side sectional view of the overtube with the insertion section inserted Explanatory drawing which shows the operation method of the endoscope apparatus shown in FIG. Cross-sectional side view of the main part with a radio wave source attached to the endoscope insertion part and overtube

Explanation of symbols

  DESCRIPTION OF SYMBOLS 10 ... Endoscope, 12 ... Insertion part, 14 ... Hand operation part, 26 ... Balloon air supply port, 28 ... Air supply suction port, 30 ... 1st balloon, 36 ... Hard tip part, 50 ... Overtube, 51 DESCRIPTION OF SYMBOLS ... Tube main body, 52 ... Holding part, 58 ... Tip part, 60 ... 2nd balloon, 100 ... Balloon control apparatus, 102 ... Apparatus main body, 104 ... Hand switch, 150 ... Radio wave oscillator, 152, 154 ... Antenna, 200 ... Computer, 202 ... Radio wave receiving antenna, 212 ... Computer main body, 218 ... Monitor, 220 ... Contour image, 222, 224 ... Point image

Claims (2)

An endoscope in which a first balloon is attached to the distal end of the insertion portion;
An overtube attached to the distal end of the second balloon and into which the insertion portion of the endoscope is inserted to assist insertion of the insertion portion into a body cavity;
A first recognition object attached to the first balloon;
A second object to be recognized attached to the second balloon;
Control having recognition means for recognizing the first recognition object and the second recognition object, and display means for displaying images of the positions of the first recognition object and the second recognition object recognized by the recognition means. Means,
An endoscope system comprising:   The first recognition object and the second recognition object are recognition objects that emit radio waves, recognition objects that emit ultrasonic waves, or recognition objects that generate a magnetic field. The endoscope system according to 1.

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