JP2006102361A - Intracorporeal medical treatment apparatus - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an intracorporeal medical treatment apparatus for precisely feeding power to an electrode, stably giving an electric stimulation to a viable tissue, and achieving stable propulsion. <P>SOLUTION: A capsule type medical treatment apparatus C1 as the intracorporeal medical treatment apparatus comprises a capsule main body 1 having a biological information acquiring means to acquire biological information in a body cavity; an intracavity insertion part to be inserted to the body cavity, having a balloon 2 which is mounted on at least a part of the capsule main body 1 so as to be elastically expanded and at least one electrode 3 mounted on the balloon 2; a battery 5 for supplying power to the electrode 3; and an electric wire 4 at least a part of which is flexible and which electrically and mechanically connects the battery 5 to the electrode 3. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  The present invention relates to an in-vivo medical device.

  Conventionally, as a method for a subject to check his / her health condition, for example, various inspection methods using a medical checkup are generally known. In addition, an inspection method is known in which an in-vivo medical device such as an endoscope or a capsule-shaped inspection body (capsule type medical device) is introduced into a body cavity of a subject to easily check the health condition. (For example, Patent Document 1).

In recent years, an electro-propelled capsule medical device (in-vivo medical device) that applies local electrical stimulation to a living tissue via an electrode and moves in the living body using the contracting action of the electrically stimulated living tissue. ) Is known (for example, Patent Document 2). Normally, when a capsule medical device is inserted into the body, it naturally moves in the digestive tract by peristaltic movement of a lumen such as the small intestine. By applying electrical stimulation to the body tissue and causing the body tissue to perform peristaltic motion or local contraction motion different from peristaltic motion, it is possible to promote movement in the direction of travel, or to reverse the direction of travel Can move. Accordingly, it is possible to make a detailed observation by quickly arriving at a desired site or staying at the same position, so that an efficient observation can be performed.
JP 2003-135388 A International Publication No. 01/08548 Pamphlet

  In the in-vivo medical device described in Patent Document 2, an electrode is provided on an expandable balloon in order to cope with a change in the diameter of the lumen. However, in this in-vivo medical device, no consideration has been given to the detailed configuration of the balloon and how to supply power to the electrodes, and it was apparent that further improvements are necessary.

  The present invention has been made in view of the above circumstances, and can be used to accurately supply power to an electrode, stably apply electrical stimulation to living tissue, and achieve stable propulsion. The purpose is to provide.

  The invention according to claim 1 is an in-vivo medical device having a biometric information acquisition means for acquiring biometric information in a body cavity, and elastically expandable by being attached to at least a part of the device main body. An extension part, and at least one electrode that is attached to the elastic extension part and applies electrical stimulation to a living tissue in a body cavity are provided, and the body cavity insertion part that is inserted into the body cavity, and the electrode And a power source for supplying power and at least a part of the power source is flexible and electrically and mechanically connects the power source and the electrode.

  Since it is set as such a structure, an electrode can be made to contact | abut exactly with respect to luminal inner walls, such as a digestive tract from which an outer diameter differs, by expanding an elastic expansion part in the desired site | part. And since the electric wire connecting the power source and the electrode has flexibility, it can cope with both expansion and contraction of the elastic expansion portion, and there is almost no problem such as disconnection, Stable electrical stimulation can be given.

  The invention according to claim 2 is the in-vivo medical device according to claim 1, wherein the elastic expansion part is a balloon made of an elastic film.

  As described above, since the elastic expansion portion is a balloon, the elastic expansion portion can be easily expanded and contracted, and at the time of contraction, it is easy to reduce the outer diameter by bringing the elastic expansion portion into close contact with the outer surface of the apparatus main body. Can be.

  A third aspect of the present invention is the in-vivo medical device according to the first or second aspect, wherein the power source is provided integrally with the body cavity insertion portion.

  As described above, since the power source is provided integrally with the body cavity insertion portion, this power source can be shared with other components in the body cavity insertion portion, the number of parts can be reduced, and remote control can be performed. Thus, the body cavity insertion portion can be operated independently.

  Invention of Claim 4 is an in-body medical device of Claim 1 or Claim 2, Comprising: The said power supply is provided in addition to the said body cavity insertion part, These power supply and the body cavity insertion part side are It is characterized by being detachable.

  As described above, since the power source is provided other than the body cavity insertion portion, the configuration of the body cavity insertion portion can be simplified.

  The invention according to claim 5 is the in-vivo medical device according to any one of claims 1 to 4, wherein an expansion means for expanding the elastic expansion portion is provided in the body cavity insertion portion. Features.

  As described above, since the expansion means is provided in the body cavity insertion portion, the elastic expansion portion can be expanded by operating the body cavity insertion portion independently by remote control or the like.

  The invention according to claim 6 is the in-vivo medical device according to any one of claims 1 to 4, wherein an expansion means for expanding the elastic expansion portion is provided in addition to the insertion portion in the body cavity, and the body cavity It is characterized by being able to attach or detach between an internal insertion part and the said expansion means.

  Thus, since the expansion means is provided in addition to the insertion part in the body cavity, the configuration of the insertion part in the body cavity can be simplified.

  The invention according to claim 7 is the in-vivo medical device according to any one of claims 1 to 6, wherein the elastic extension portion is detachable from the device main body. .

  Thus, since the apparatus main body and the elastic expansion part can be attached and detached, it is possible to easily replace the elastic expansion part with an optimal one in accordance with the usage mode of the in-vivo medical device. For example, a relatively expensive apparatus main body can be used repeatedly, and a relatively inexpensive elastic extension can be easily disposed of after each use.

  The invention according to claim 8 is the in-vivo medical device according to any one of claims 1 to 7, wherein the elastic expansion portion is provided with a hard portion that is harder than other portions of the elastic expansion portion. It is characterized by.

  Since such a hard part is provided in the balloon, when the electrode is made of a material that hardly expands and contracts, such as a metal, the difference in expansion ratio between the electrode and the balloon is obtained by mounting the electrode on the hard part. Can be reduced. Therefore, it is possible to more suitably attach and hold the electrode to the balloon.

  In the present invention, the configuration as described above is adopted, so that power can be accurately supplied to the electrodes, and electrical stimulation can be stably applied to the living tissue, and stable propulsion can be realized. A medical device can be provided.

  Embodiments of an in-vivo medical device according to the present invention will be described below with reference to the drawings.

[First Embodiment]
First, a first embodiment will be described with reference to FIGS.
A capsule medical device (internal medical device) C1 shown in FIG. 1 is a basic form of the capsule medical device according to this embodiment. The capsule medical device C1 includes a capsule main body (device main body) 1 having a biological information acquisition means for acquiring biological information in a body cavity, and a balloon (elastic expansion) attached to at least a part of the capsule main body 1 and elastically expandable. Part) 2 and at least a pair of bipolar electrodes 3 that are attached to the balloon 2 and apply electrical stimulation to the contractile tissue (biological tissue) in the body cavity are provided in the body cavity insertion part that is inserted into the body cavity. The electric wire 4, the battery (power source) 5, and the expansion / contraction mechanism part (expansion means) 16 are integrally provided.

  The capsule body (apparatus body) 1 includes an imaging unit (biological information acquisition unit) 12, a control unit (control unit) 13, a wireless transmission / reception unit (communication unit) 14, and a battery (power source) 5. It is configured to be integrally provided inside, and has a function as a capsule endoscope. In the housing 11, an expansion / contraction mechanism 16 for expanding / contracting (expanding and contracting) the balloon 2 is also integrally provided.

  The casing 11 has an oval capsule shape when viewed from the side, and is formed so that the inside is sealed with plastic or the like. An observation window (not shown in FIG. 1) made of a transparent member formed in a dome shape is provided on the front end side (right side in the drawing) of the housing 11. Inside the observation window, that is, on the front side of the capsule main body 1, biometric information acquisition means for acquiring biometric information in the body cavity is housed. In the example of FIG. 1, an imaging element unit 12 a composed of a lens, a CCD (charge coupled device), and the like for imaging each part in the body cavity to obtain a captured image, and an imaging element unit 12 a by irradiating illumination light. An imaging unit (biological information) that is composed of a light emitting element unit 12b composed of an EL (electroluminescence) element, an LED (light emitting diode), or the like for illuminating the visual field range, and acquires biometric information by obtaining a captured image in the body cavity. Acquisition means) 12 is provided inside the observation window. Not only the imaging unit 12 but also various sensors such as a pH sensor, a hemoglobin sensor, and a special light reaction sensor may be provided as appropriate inside the observation window as a biological information acquisition unit.

  The wireless transmission / reception unit 14 is for performing wireless communication with an extracorporeal device 100 described later, and includes a transmission / reception unit body (not shown) and a transmission / reception antenna (not shown) for transmitting and receiving radio waves. . The wireless transmission / reception unit 14 wirelessly transmits biological information, that is, a captured image captured by the imaging unit 12 to the external device 100 and wirelessly receives various control signals (commands) wirelessly transmitted from the external device 100. Then, the data is transmitted to the control unit 13.

The control unit 13 has a function of comprehensively controlling the operation of each component in the capsule medical device C1 based on a control signal (command) from the wireless transmission / reception unit 14. Specifically, wireless transmission / reception control (operation control of the wireless transmission / reception unit 14), imaging / illumination control (operation control of the imaging unit 12), expansion / contraction control of the balloon 2 (operation control of the expansion / contraction mechanism unit 16), and the like are performed. The control unit 13 is provided with a rectangular wave (pulse) generation circuit 13a for flowing the current from the battery 5 to the electrode 3 through the electric wire 4, and the current flowing to the electrode 3 is supplied as described later. It also has a function as a control means for controlling. This rectangular wave generating circuit 13a has a built-in limiter function that prevents current exceeding the set value from flowing to the electrode 3.
In the example of FIG. 1, the rectangular wave generation circuit 13 a is configured to be integrated with the control circuit 13, but may be configured to be integrated with the battery 5.

A balloon 2 is attached to the capsule body 1 so as to cover at least a part of the outer surface side of the housing 11. The balloon 2 is made of an elastic film made of an elastic material having a high elasticity such as a soft rubber, and a fluid such as air or a foaming agent is contained in the balloon 2 by an expansion / contraction mechanism 16 provided in the housing 11. Is supplied and expanded, and fluid can be sucked and contracted from inside the balloon 2. When the balloon 2 is deflated, the balloon 2 is substantially in close contact with the outer surface of the housing 11, and is easily inserted into the body cavity by swallowing or transanally.
In the example shown in FIG. 1, both the front and rear ends of the capsule body 1 are exposed so as to cover the outer periphery of the intermediate part, and the balloon 2 is formed into a substantially annular shape at the two front and rear fixing parts 20. Although it is configured to be fixed, only the front end side where the observation window is provided may be exposed, and the balloon 2 may cover almost the entire rear side. In this case, the balloon 2 is fixed to the capsule main body 1 at one fixing portion 20 on the front side of the capsule main body 1 and on the rear side of the observation window.

At least a pair of bipolar electrodes 3 are attached to the outer surface side of the balloon 2. These electrodes 3 are for contacting with the inner wall of the lumen such as the small intestine and the large intestine, that is, contractile tissue, and for applying electrical stimulation to the contractible tissue, so as not to inhibit the propulsion of the capsule medical device C1. It has a substantially hemispherical shape or a substantially flat plate shape. As described above, since at least the pair of electrodes 3 and 3 are provided integrally with the balloon 2, the distance between the pair of electrodes 3 and 3 is variable as the balloon 2 expands and contracts. Therefore, even if there is a difference in the diameter of the lumen, it is possible to accurately apply electrical stimulation to the contractile tissue in the lumen. These electrodes 3 are preferably made of a metal having high biocompatibility (for example, stainless steel, platinum, titanium, etc.) or a conductive material such as conductive rubber as will be described later.
In the example shown in FIG. 1, a total of two pairs of electrodes 3 are provided, one on each of the front side (right side in the figure) and the rear side (left side in the figure). The number can be changed as appropriate.

  The electric wire 4 is made of at least a part of a conductive material such as a metal having flexibility, and its proximal end is connected to the rectangular wave generating circuit 13a in the housing 11, and the distal end is each electrode. 3 are connected to each other. That is, each electrode 3 is electrically and mechanically connected to the capsule body 1 that integrally incorporates the battery 5. Since the flexible electric wire 4 is used in this way, the balloon 2 can be accommodated in a folded state when the balloon 2 is contracted, and can be expanded along with the expansion of the balloon 2, so that a current generating circuit in the control unit 13 is provided. The electric power from 13a can always be supplied to the electrode 3.

  The outer diameter of the capsule medical device C1 having such a configuration (the outer diameter of the capsule body 1 and the balloon 2 combined) is set to be about 15 mm when the balloon 2 is deflated. This is an outer diameter that can suitably pass through the esophagus and anus. And, when the balloon 2 is fully expanded, it is set to be about φ40 mm. This is an outer diameter that allows the electrode 3 to suitably contact the living tissue even when passing through the large intestine.

  The extracorporeal device 100 controls the capsule medical device C1 from outside the body. As shown in FIG. 2, the extracorporeal device 100 transmits and receives information to and from the capsule medical device C1 in the device main body 100 (transmission). Unit 102, a detection unit) 102, a recording unit 103 such as a memory for storing the biological information, that is, a captured image, a control unit 104 that controls each of these components, and a battery 105 that supplies power to each component. Is provided in the apparatus main body 101.

The apparatus main body 101 is formed in a box shape with a metal such as aluminum, plastic, or the like, and can be attached to the body via the subject's belt or the like, so that it is always arranged outside the subject's body. .
Similar to the wireless transmission / reception unit 4 of the capsule medical device C1, the wireless transmission / reception unit 102 includes a transmission / reception unit body (not shown) and a transmission / reception antenna (transmission antenna, reception antenna) that transmits and receives radio waves. It has a function of receiving a captured image that is biological information wirelessly transmitted from the medical device C <b> 1 and sending it to the control unit 104.

  The control unit 104 has a function of sending a control signal corresponding to a part of a living tissue (for example, stomach, small intestine, or large intestine) where the capsule medical device C1 is located to the capsule medical device C1 via the wireless transmission / reception unit 102. have. Also, the control unit 104 records the sent captured image in the recording unit 103 as needed after performing predetermined processing such as image processing.

A case where the inside of the body cavity of the subject is observed and inspected by the capsule medical device C1 configured as described above will be described.
First, after attaching the extracorporeal device 100 to the abdomen or the like using a belt or the like, the subject introduces the capsule medical device C1 into the body cavity by oral administration (swallowing). At the time of oral injection, the balloon 2 is deflated. The capsule medical device C1 placed in the body cavity images each part in the body cavity by the imaging element unit 12a while moving through the digestive tract, and wirelessly transmits the captured image from the wireless transmission / reception unit 14 to the extracorporeal device 100. On the other hand, the extracorporeal device 100 receives a captured image via the wireless transmission / reception unit 102, performs image processing of the captured image by the control unit 104, and records the image in the recording unit 103 as needed. Then, the control unit 104 transmits a control signal for controlling the capsule medical device C1 to the capsule medical device C1 as needed via the wireless transmission / reception unit 102.

  Further, when the capsule medical device C1 passes through the stomach and duodenum and reaches the small intestine, the balloon 2 is inflated by a control signal from the extracorporeal device 100 and is propelled while appropriately applying electrical stimulation. . In the small intestine, the balloon 2 is expanded by about 5 to 15 mm so that the outer diameter of the capsule medical device C1 (the outer diameter of the capsule main body 1 and the balloon 2) is about φ20 to 30 mm. Make it possible to abut accurately.

  In order to cause contraction by applying electrical stimulation to the contractile tissue of the lumen such as the small intestine and the like and to use the contraction force as the driving force of the capsule medical device C1, in general, electric power of several mW to several tens of mW is required. Has been. Therefore, the rectangular wave generating circuit 13a applies a rectangular wave current of several mA to several tens of mA to the electrode 3 in a pulse manner with a predetermined period. Specifically, the frequency at this time is set to about several Hz to several tens of Hz, and the pulse width is set to about several ms to several tens of ms. Note that such a pulse signal may be a signal modulated by a high frequency signal of about several kHz to several hundred kHz. Such a modulated wave signal is a signal in which a pulse of about several kHz to several hundred kHz is output for about several ms to several tens of ms with a period of about several Hz to several tens of Hz.

  When such electrical stimulation is applied to the inner wall of the small intestine, the small intestine in the vicinity thereof contracts, and the capsule medical device C1 is pushed toward the traveling direction so as to be pushed out by the contracted small intestine. At this time, since the balloon 2 and the electric wire 4 are elastically deformed as the small intestine contracts, changes in the diameter of the small intestine can be accurately absorbed. For this reason, the moving speed by the peristaltic movement of the small intestine can be made faster to move in the small intestine, and the time can be shortened for efficient observation and inspection in the small intestine. When the target site is reached, the capsule medical device C1 can be placed at the site by stopping the electrical stimulation. At this time, in order to place the capsule medical device C1 more accurately, the balloon 2 may be further expanded after the electrical stimulation is stopped to increase the contact pressure with the small intestine.

In this way, the next large intestine passes in the same manner. When passing through the large intestine, the balloon 2 is expanded by about 5 to 25 mm so that the outer diameter of the capsule medical device C1 is about 20 to 40 mm so that the capsule 2 can come into contact with the inner wall of the large intestine accurately. Then, when approaching the anus, the balloon 2 is deflated to reduce the outer diameter in the same manner as in the case of oral injection so that it can be excreted from the anus.
Thereafter, the doctor or the like diagnoses the health condition of the subject based on the captured image that is the biological information recorded in the recording unit 103 of the extracorporeal device 100.

  In this capsule medical device C1, the balloon 2 is expanded at a desired site, so that the electrode 3 can be brought into precise contact with the inner wall of a lumen such as a digestive tract having a different outer diameter. And since the electric wire 4 has flexibility, while being able to respond to both expansion and contraction of the balloon 2, there is almost no problem such as disconnection, and stable electrical stimulation is given. Can do. In addition, by stopping the electrical stimulation at the target site, or further expanding the balloon 2 after stopping the electrical stimulation, the capsule medical device C1 can be placed at the site, and the site can be observed. It can be inspected in detail by sensors. Furthermore, by deflating the balloon 2 to the excretion side after the observation / examination is completed, the balloon 2 can be quickly moved and discharged outside the body in a short time.

Next, modified examples of the capsule medical device C1 are shown in FIGS.
In the following description, components common to the components in the capsule medical device C1 are denoted by the same reference numerals, and detailed description thereof is omitted. Further, in each of the following drawings, the illustration of the electric wire 4 may be omitted as appropriate, but in this case, each electrode 3 is connected to the capsule body via the electric wire 4 as in the capsule medical device C1. 1 is electrically and mechanically connected.

A capsule medical device (in-body medical device) C2 illustrated in FIG. 2 is an example in which a housing and an electric wire are detachable. In this capsule medical device C2, the capsule main body 1A and the balloon 2A are detachably mounted at the mounting portion 20A, the electric wire 4 and the capsule main body 1A are detachable via the connector 4C, and the balloon 2A Is also removable.
The capsule body 1A has the same configuration as the capsule body 1 in the capsule medical device C1 except that the capsule body 1A includes a housing 11A. The housing 11A is different from the housing 11 in that the housing 11A includes a groove 11g that allows the balloon 2A to be easily attached and detached, and a female connector 42 is formed on the outer surface side. In this figure, the observation window is denoted by reference numeral 11d.

  A mounting portion 20A is formed in the groove portion 11g formed in the housing 11A by engaging and disengaging a protruding ridge portion 2t formed in the balloon 2A into the groove portion 11g. The female connector 41 forms a connector 4C with the male connector 41 provided on the proximal end side of the electric wire 4, and the electric wire 4 and the housing 11A are separated by this connector 4C. It is designed to be detachably connected. Further, the electrode 3 is composed of conductive rubber made of conductive silicone rubber, conductive nylon, or the like, which is integrally provided on the outside of the balloon 2.

Thus, since the electrode 3 is made of conductive rubber, when the balloon 2A is expanded, the electrode 3 on the balloon 2A can be expanded in the same manner, and the balloon 2 can be expanded more uniformly. it can.
In addition, since the capsule body 1A, the balloon 2A, the electrode 3 and the electric wire 4 can be attached and detached, the balloon 2A, the electrode 3 and the electric wire 4 can be replaced with optimum ones according to the use mode of the capsule medical device C2. Can be easily done. The relatively expensive capsule body 1A can be used repeatedly, and the relatively inexpensive balloon 2A, the electrode 3 and the electric wire 4 can be easily disposed for each use.

  A capsule medical device (in-vivo medical device) C3a shown in FIG. 3 is an example in which a hard portion is provided on a balloon. This hard part is formed by integrally forming a thick part in a part of the balloon 2 and making it harder than other parts.

In the capsule medical device C3a shown in FIG. 3 (a) and (b), so as to cover the capsule body 1 of the rear side of the observation window 11d, the mounting balloon 2B ₁ is a capsule body 1 at a fixed portion 20 It has been. In this balloon 2B _1, so as to form an annular rearward are rigid portion 21a is formed, and a plurality of electrodes 3 mounted on a circumference on the hard portion 21a.

  As described above, when the balloon 2 is made of a material having high stretchability such as a soft rubber and the electrode 3 is made of a material that hardly stretches such as a metal, the stretch rates of the balloons 2 are greatly different. That is, it becomes difficult to attach and hold the electrode 3 to the balloon, and there is a possibility that it cannot be used for a long time. Therefore, by forming a hard part consisting of a thick part at least in the attachment part of the electrode 3 of the balloon, the difference in expansion / contraction rate can be reduced, and the attachment / holding of the electrode 3 to the balloon can be reduced. More preferably.

Capsule type medical devices (internal medical devices) C3b to C3d shown in FIGS. 4 to 6 are modifications of the capsule type medical device C3a, and the formation positions of the hard portions on the balloon are different.
In the capsule medical device C3b shown in FIG. 4, so as to cover the capsule body 1 of the rear side of the observation window 11d, the balloon 2B ₂ is attached to the capsule main body 1 at a fixed portion 20. The front and rear end side of the balloon 2B _2, is formed with a rigid portion 21b made of thick portion, these rigid portions 21b, a plurality of electrodes 3 on the outer circumferential side of 21b is attached.
In the capsule medical device C3c shown in FIG. 5, so as to cover the capsule body 1 of the rear side of the observation window 11d, the balloon 2B ₃ is attached to the capsule main body 1 at a fixed portion 20. And the peripheral portion near the upper and lower electrodes 3 of the balloon 2B _3, the intermediate portion from the upper and lower electrodes 3 are spaced a predetermined length, the rigid portion 21c made of thick portion is formed.
Further, in the capsule medical device C3d shown in FIG. 6, the balloon 2B ₄ is fixed to the capsule main body 1 at the two fixing parts 20 at the front and rear sides so that the front and rear ends of the capsule main body 1 are exposed to cover the outer periphery of the intermediate part. 1 is attached. _On the outer peripheral side of the balloon 2B4, a hard portion 21d made of a thick portion is formed in a spiral shape, and a plurality of electrodes 3 are attached to the outer peripheral side of the hard portion 21d.
Thus, the formation position of the hard portion can be appropriately changed according to the number of electrodes 3 mounted on the balloon, the arrangement, and the like.

Capsule-type medical devices (in-body medical devices) C3e and C3f shown in FIGS. 7 and 8 are still other modifications of the capsule-type medical device C3a, and by attaching a hard part as a separate member to the balloon 2, An example in which the other parts are hardened is shown.
In the capsule medical device C3e shown in FIG. 7, so as to cover the capsule body 1 of the rear side of the observation window 11d, the balloon 2B ₅ is attached to the capsule main body 1 at a fixed portion 20. In this balloon 2B _5, a plurality of rigid portion 21e is provided on the rear side on the circumference. These hard portions 21e are formed by applying and solidifying an adhesive on the outer surface of the balloon 2. The electrode 3 is attached on each hard part 21e.
In the capsule medical device C3f shown in FIG. 8, so as to cover the capsule body 1 of the rear side of the observation window 11d, the balloon 2B ₆ is attached to the capsule main body 1 at a fixed portion 20. This balloon 2B ₆ is obtained by attaching an electrode 3 integrally provided with a hard portion 21f made of hard rubber made harder than the balloon 2 on the rear side periphery of the balloon 2.

Thus, since to attach by retrofitting the rigid portion of the other member to the balloon 2, as simple a structure of the balloon 2B ₅ and balloon 2B _6, can be a manufacturing easy.

A capsule medical device (in-vivo medical device) C4 shown in FIG. 9 is an example in which the longitudinal cross-sectional shape (cross-sectional shape when viewed from the front) when the balloon is expanded is modified.
The balloon 2C in the capsule medical device C4 shown in FIG. 9 has a longitudinal section that expands in a star shape. Electrodes 3 are respectively provided on the tops of the star-shaped balloons 2C. When such a star-shaped balloon 2C is expanded, only the tops abut against the inner wall of the lumen (here, the small intestine I is illustrated). And the balloon 2C between each top part becomes a recessed part. For this reason, a gap Ih communicating between the inside of the small intestine I is formed between the concave portion and the small intestine I over the capsule medical device C4.

  Since such a gap Ih is formed, the inside of the small intestine I is not blocked even when the balloon 2C is expanded. Therefore, fluids such as digests present in the small intestine I can be suitably distributed over the capsule medical device C4.

Capsule-type medical devices (in-body medical devices) C5 to C7 shown in FIGS. 10 to 12 are modifications of the capsule-type medical device C4, and are examples in which the longitudinal cross-sectional shape is changed. Such a longitudinal cross-sectional shape at the time of expansion of the balloon can be appropriately changed according to the purpose and conditions of the inspection.
The balloon 2D in the capsule medical device C5 shown in FIG. 10 is integrally fixed by fixing portions 20B formed at two positions (upper and lower two positions in the figure) that are symmetrical to each other on the outer periphery of the capsule body 1. When the balloon 2D is expanded, the balloon 2D is expanded substantially symmetrically in the left-right direction. Therefore, a gap Ih is formed between the fixed portion 20B and the small intestine I so as to communicate the inside of the lumen over the front and rear of the capsule medical device C5.

  In addition, the balloon 2E in the capsule medical device C6 shown in FIG. 11 is expanded so that the longitudinal cross section has an oval shape. Therefore, a gap Ih is formed between the long side of the balloon 2E (upper and lower two places in the drawing) and the small intestine I.

The capsule medical device C6 includes a capsule body 1B and a power supply unit (power supply) 5A. The capsule body 1B has a configuration in which the battery for applying electrical stimulation to the electrode 3 and the rectangular wave generating circuit are omitted from the capsule body 1B, and the power supply unit 5A is used for applying electrical stimulation to the electrode 3. The battery and the rectangular wave generating circuit are integrally incorporated. The operation of the power supply unit 5A is controlled by directly receiving a control signal from the extracorporeal device 100 or via the control unit 13 (not shown here) in the capsule body 1B.
Thus, since the power source for electrical stimulation, the rectangular wave generating circuit, and the like are separate members from the capsule body 1B, the configuration of the capsule body 1B can be simplified, and the battery 5 (here, the capsule body 1B) (Not shown) is not used for electrical stimulation, so the battery 5 can be used for a long time.

  Furthermore, the balloon 2F in the capsule medical device C7 shown in FIG. 12 is configured to include a communication hole 22 that communicates across the front and rear of the capsule medical device C7. Therefore, the function similar to that of the gap Ih is secured by the communication hole 22.

  Next, a capsule medical device (in-body medical device) C8 shown in FIG. 13 is an example in which the expansion / contraction mechanism section in the capsule medical device C1 is modified. The capsule main body 1C in the capsule medical device C8 includes the constituent elements of the capsule main body 1 in a housing 11B. A housing chamber 61, guide holes 62a and 62b, and a screw hole 63 are formed in the housing 11B, and a moving member 64 is screwed into the screw hole 63. The function corresponding to the expansion / contraction mechanism section 16 is secured by these components.

  As shown in FIGS. 13A to 13C, in the storage chamber 61 provided in the capsule body 1C, the pressurized gas g is stored from the hole communicating from the outside, and this hole is stored after the storage. The part is closed with a rubber plug 61s. As will be described later, a foaming agent may be used instead of the pressurized gas g. Further, the storage chamber 61 communicates with a screw hole 63 that allows the moving member 64 to freely move through a guide hole 62a, and the screw hole 63 further passes through the guide hole 62b of the capsule medical device C8. It communicates with the outside. The rear end side of the screw hole 63 opens to the outside of the capsule medical device C8.

  Further, the rear end side of the capsule body 1C is covered with a balloon 2, and the front end side of the balloon 2 is airtightly fixed by a belt-like fixing member 20 near the center of the capsule body 1B. An electrode 3 is fixed on the rear end side of the outer surface of the balloon 2 and is electrically and mechanically connected to the capsule body 1C by a flexible electric wire 4.

  As shown in FIG. 13 (d), the moving member 64 is, for example, a rod-shaped permanent magnet 64m magnetized in the N and S poles in a direction perpendicular to the longitudinal direction, and a male screw shape covering the permanent magnet 64m. The elastic rubber 64g.

A case will be described in which the inside of the body cavity of the subject is observed and inspected by the capsule medical device C8 configured as described above.
First, after attaching the extracorporeal device 100 and a rotating magnetic field generator (described later) to the abdomen using a belt or the like, the subject introduces the capsule medical device C8 into the body cavity by oral injection (swallowing). . At the time of oral injection, the balloon 2 is deflated as shown in FIG.

Then, after the capsule-type medical device C8 enters the duodenum, a rotating magnetic field is applied by a rotating magnetic field generator (not shown) arranged outside the body until reaching a site to be examined preferentially by various sensors in the observation window 11d. Thereby, the moving member 64 is rotated along the screw hole 63 and moved to the front end side.
Then, as shown in FIG. 13B, the storage chamber 61 communicates with the balloon 2 through the guide hole 62a and the screw hole 63 portion on the rear end side, and the pressurized gas g (or foaming agent) is supplied. As indicated by the arrow, the balloon 2 flows toward the balloon 2 to expand the balloon 2. In addition, when using a foaming agent instead of the pressurized gas g, it is preferable to apply a trace amount of moisture for reaction in the balloon 2 in advance.

  When the balloon 2 is expanded in this way, the electrode 3 on the balloon 2 is in close contact with the inner wall of the digestive tract (lumen) near the site. And by flowing a square wave current of several mA through the electrode 3 in a constant cycle, the inner wall of the digestive tract is caused to contract by electrical stimulation, and the contraction force is converted into a propulsive force. Promote to the site. Thereafter, when the target site is reached, the flow of current is stopped, the device is placed at that site, and detection by various sensors is performed. Then, after the time when the detection by various sensors is sufficiently performed, the current is passed again to the electrode 3 to propel it up to the anus by contraction force by electrical stimulation.

  Then, by applying a rotating magnetic field in front of the anus to move the moving member 64 to the front end side, the inside of the balloon 2 communicates with the outside of the capsule medical device C8 via the screw hole 63 and the guide hole 62b. It becomes a state to do. That is, the pressurized gas g that has expanded the balloon 2 is released to the outside, and the balloon 2 contracts as shown in FIG. Thereafter, the capsule medical device C8 is easily discharged from the anus to the outside of the body.

  Since the expansion mechanism has such a configuration, the balloon 2 can be expanded and contracted more easily and accurately.

Next, a capsule medical device (in-body medical device) C9 shown in FIG. 14 is an example in which the material of the balloon in the capsule medical device C1 is changed.
Unlike the balloon 2 or the like, the balloon 2H is made of a material that can almost ignore the elastic expansion and contraction. As a specific example of such a material, a thin film Teflon (registered trademark) made of PFA (tetrafluoroethylene / perfluoroalkyl vinyl ether copolymer), PTFE (polytetrafluoroethylene), or the like is preferable. Moreover, the electric wire 4 is integrally printed on the flexible printed circuit board 4F, and this flexible printed circuit board 4F is affixed on the inner surface side of the balloon 2H.

  When the capsule medical device C9 is introduced orally, as shown in FIG. 14 (a), the balloon 2H is wound around the capsule body 1 and is stopped by a band 23 made of starch or wafer. When reaching the stomach in this state, the band 23 dissolves, so that the balloon 2H can be expanded. Thereafter, the balloon 2H is expanded, and the capsule medical device C9 is appropriately propelled while applying electrical stimulation to the inner wall of the lumen by the electrode 3.

  Since this balloon 2H hardly elastically expands and contracts, it does not expand beyond a predetermined maximum outer diameter. Therefore, the length of the electric wire 4 can be set in accordance with the maximum expansion of the balloon 2H, and can be attached to the balloon 2H integrally with the flexible printed board 4F. Therefore, there is almost no possibility that the electric wire 4 is disconnected due to repeated use or the like, and it can withstand longer use.

  Next, a capsule medical device (in-body medical device) C11 shown in FIG. 15 is an example in which the expansion mechanism portion in the capsule medical device C1 is changed. In the capsule medical device C11, the capsule body 1D and the balloon 2I are connected by a shape memory coil (expansion means) 16c.

  The capsule body 1D has a configuration in which the expansion / contraction mechanism 16 is omitted from the capsule body 1. The balloon 2I is made of the same material as the balloon 2, but is shaped so as to protrude further rearward from the rear end side of the capsule body 1D when contracted. A predetermined amount of fluid (water, air, etc.) is sealed in the balloon 2I. In addition, a shape memory coil 16c made of a shape memory alloy is extended from the rear end side of the capsule body 1D, and the front end side is connected to the rear end portion of the balloon 2I by a connecting piece 16d. The shape memory coil 16c has a shape memory so that it extends in a long shape when the ambient temperature is lower than the body temperature, and contracts into a coil shape when the ambient temperature reaches about the body temperature.

  The subject orally injects the capsule medical device C11 in the state shown in FIG. In the body cavity, since the ambient temperature of the capsule medical device C11 is substantially the same as the body temperature, the shape memory coil 16c is contracted. As a result, as shown in FIG. 16B, the balloon 2I is deformed and expanded laterally, and the electrode 3 on the balloon 2I is brought into close contact with the inner wall of the lumen.

Thus, since the balloon is expanded and contracted using the shape memory coil 16c, the expansion / contraction mechanism part can be omitted from the capsule body, and the configuration can be simplified.
The shape memory temperature of the shape memory coil 16c is set higher than the body temperature, and a heater or the like that can be controlled by the control unit 13 (not shown here) is provided so that the balloon 2I can be expanded and contracted at an arbitrary position. Also good.

  Next, a capsule medical device (in-body medical device) C12 shown in FIG. 16 is a modification of the capsule medical device C11. In the capsule medical device C12, instead of the balloon 2, an elastic expansion portion 2J made of a soft rubber (elastomer) having high elasticity is attached to the capsule body 1D. The electric wire 4 (not shown here) is housed in an elastomer in a watertight state.

  When the capsule-type medical device C12 is orally introduced, as shown in FIG. 16A, the elastic expansion portion 2J is folded to reduce the outer diameter, and the reduced diameter state is accommodated in the capsule 24 made of starch, wafer, or the like. Keep it as When reaching the stomach in this state, the capsule 24 is dissolved, so that the elastic expansion portion 2J is elastically expanded to be in a diameter-expanded state. Thereafter, the capsule medical device C12 is appropriately propelled while applying electrical stimulation to the inner wall of the lumen by the electrode 3. In addition, since this elastic expansion part 2J has high elasticity, it is easy to deform | transform. Therefore, it is elastically deformed even when excreted from the anus and can be excreted easily.

  Since such an elastic expansion part 2J is provided, the expansion / contraction mechanism part can be omitted from the capsule body, and the configuration can be simplified.

[Second Embodiment]
Next, a second embodiment of the present invention will be described with reference to FIGS. In the present embodiment, components that are the same as those in the first embodiment are given the same reference numerals, and detailed descriptions thereof are omitted.
FIG. 17A shows the configuration of the distal end side of the endoscope device (in-vivo medical device) according to this embodiment, and FIGS. 17B and 17C show the configuration used in this embodiment. The structure near the insertion port of the capsule medical device is shown. Further, FIGS. 18A and 18B show the state of endoscopy by the capsule medical device after being released into the lumen of the digestive tract such as in the small intestine.

  An endoscopic device (in-body medical device) S1 shown in FIG. 17 includes a capsule medical device C13, a hollow tube body 6 that is detachably attached to the capsule medical device C13, and an inner tube body 6 that can be inserted. And an endoscope 7. The capsule medical device C13 has a configuration in which the expansion / contraction mechanism unit 16 is omitted from the capsule medical device C1 in the first embodiment.

  The capsule-type medical device C13 includes an imaging element unit 12a composed of a solid-state imaging element such as a CCD and a CMOS imager and an optical system such as an objective lens, and a light emitting element part 12b such as a white LED in an observation window 11d at the tip of the capsule body 1E. Further, a balloon 2K made of an elastic material such as silicon rubber or latex rubber, the whole circumference of which easily swells, is attached to the fixing portion 20 by a fixing ring or the like on the rear side surface thereof, and the rear end has an inside of the balloon 2K. An injection port 17a for supplying a fluid to the space (strictly, the space between the balloon 2K and the capsule body 1E) is provided. The injection port 17a communicates with the inside of the balloon 2K through the fluid conduit 17. A tube body 6 for supplying fluid to the balloon 2K is detachably attached to the injection port 17a.

  The distal end of the tube body 6 is a needle-like small diameter portion 6t that can be easily attached to the injection port 17a. Moreover, it has a hand cap part to which a fluid injection tool such as a syringe can be detachably connected on the hand side (not shown). Then, by supplying the fluid from the inlet 17a, the fluid is injected into the balloon 2K through the fluid conduit 17, and the balloon 2K is in close contact with at least the lumen of the small intestine I (20 to 30 mm). To the extent).

  The injection port 17a provided at the rear end of the capsule body 1E has an elastic valve structure such as an intake port of a soft tennis ball that seals the balloon 2K even if the tube body 3 is removed after the balloon 2K is inflated. . In addition, a battery 5 as a power source is disposed inside the capsule body 1E, a pair of bipolar electrodes 3 is fixed to the side end surface of the balloon 2K, and a flexible space is provided between the electrode 3 and the battery 5. It is electrically and mechanically connected with a cord-like electric wire 4.

  The endoscope 7 is provided with a channel 71 along the axial direction of the elongated insertion portion 70. On the other hand, the tube body 6 has a length longer than the length of the channel 71, and has an outer diameter that allows the channel 71 to be smoothly inserted and removed. It can be supplied.

  As shown in FIG. 17 (b), a rubber plug 17v rich in elasticity is attached to the injection port 17a. The thin pipe line 17l formed in advance in the rubber plug 17v is in a closed state when the needle-like small diameter portion 6t on the distal end side of the tube body 6 is not inserted. In this case, at the rear end of the pipe line 17l, a mark or a concave portion 17u for facilitating insertion (insertion) of the needle-like small diameter portion 6t is formed so that the insertion position can be seen.

  When the needle-like small diameter portion 6t is inserted as shown in FIG. 17C, the needle-like small diameter portion 6t can be set in a state of communicating with the pipe line 17u. In this state, by injecting fluid such as liquid or gas from the needle-like small diameter portion 6t side, the outer balloon 2K constituting the fluid storage portion is expanded as shown in FIGS. 18 (a) and 18 (b). It can be made to. When the proximal end portion of the tube body 6 is inserted from the distal end side of the channel 71 with the tube body 6 attached to the inlet 17a of the capsule body 1E, the proximal end portion of the tube body 6 protrudes from the proximal end portion of the channel 71. (Not shown).

FIG. 17A shows the proximal end portion of the protruding tube body 6 by applying a pulling force to the extent that the tube body 6 does not come out, or by sucking the rear end portion of the capsule medical device C13 through the channel 71. In this way, the capsule medical device C13 is detachably fixed to the distal end of the endoscope 7. When the capsule medical device C13 is fixed by suction, an adsorbent 7a made of elastic rubber or the like for enhancing the suction function may be added between the capsule medical device C13 and the distal end portion of the endoscope 7. good.
In addition, in order to assist the release (opening) of the capsule medical device C13, a treatment tool 72F having a gripping function is inserted into the second channel 72 provided in the endoscope 7, and the distal end of the treatment tool 72F is inserted. The balloon 2K may be expanded in a state where the grasping convex portion 1t provided near the rear end of the capsule medical device C13 is grasped by the grasping portion.

  As shown in FIG. 17A, when the endoscope apparatus S1 is orally introduced, the balloon 2K is contracted (the balloon 2K is in close contact with the outer periphery of the capsule body 1E), as shown in FIG. Is fixed to the distal end of the endoscope 7, and the capsule medical device C13 and the endoscope 7 are integrally inserted into the body cavity. Then, the capsule medical device C13 is made to reach a region to be examined, for example, the small intestine I.

  In this way, the fluid is supplied into the balloon 2K through the tube body 6, and the balloon 2K expanded substantially in the whole circumference comes into contact with the inner wall of the small intestine I, so that the capsule medical device C13 is almost in the center of the lumen of the small intestine I The tube body 6 is pulled out and removed from the injection port 17a. By pulling out the tube body 6, the capsule medical device C13 and the tube body 6 are released from fixation, so the tube body 6 and the endoscope 7 are pulled out of the body, and the capsule medical device C13 is placed in the small intestine I. To do.

The resistance created by the expanded balloon 2K and the inner wall of the small intestine I suppresses the rotation and inclination of the capsule medical device C13, and after the capsule medical device C13 is placed in the small intestine I, it is substantially even during movement by peristaltic movement. The position of the imaging element unit 12a placed at the center of the lumen is maintained.
18A and 18B show a state of the capsule medical device C13 after being released. FIG. 18A shows a state in which the axis of the capsule medical device C13 is held along the center of the lumen, and the imaging element unit 12a captures an image with the front side of the lumen in the field of view. It has become. 18B, the rear end side of the capsule medical device C13 is lowered below the lumen with respect to FIG. 18A, and the axis of the capsule medical device C13 is inclined from the central direction of the lumen. Indicates the state. Even in this state, the imaging element unit 12a can take an image with the front side of the lumen in the field of view.

  When the balloon 2K is expanded, the pair of electrodes 3 on the outer surface of the balloon 2K abut against the inner wall of the digestive tract such as the small intestine I. In this state, current is intermittently passed from the battery 5 to the electrode 3 to promote peristaltic movement by electrical stimulation or to cause local contraction of the digestive tract. As a result, the capsule medical device C13 is propelled faster than the normal state due to the active peristaltic movement or local contraction. In addition, since the electric wire 4 in the balloon 2K has flexibility, the electric wire 4 can be freely deformed in the balloon 2K, and the electric wire 4 has problems such as disconnection both at the time of contraction and at the time of expansion. It is prevented.

  The balloon 2K is carried to the large intestine while obtaining a full-circumferential visual field while riding the active peristaltic movement of the small intestine I or the contraction of the small intestine I by electrical stimulation, and reaches the anus after observation of the large intestine. When it is difficult for the balloon 2K to go out of the anus, a needle for puncturing the balloon 2K from outside the anus is inserted.

  The position where the balloon 2K of the capsule medical device C13 is expanded may be in the stomach or duodenum instead of the small intestine I. In this case, a normal endoscope for the upper digestive tract can be used. Further, instead of the endoscope having the observation means, a simple guide tube-shaped endoscope (guide member) having a bending function may be used.

  In this endoscope apparatus S1, the balloon 2K can be expanded in a body cavity by a simple method without increasing the size of the capsule medical device C13 as a simple structure, and the capsule after balloon expansion Only the type medical device C13 can be placed in the body cavity (inside the lumen), and observation and inspection can be performed satisfactorily.

  In the first and second embodiments described above, at least a pair of bipolar electrodes are attached to the elastic extension portion. However, the present invention is not limited to this, and at least one electrode, that is, a pair is used. Only one of the electrodes formed may be attached to the elastic extension portion. In this case, the distance between the electrodes may be made variable by attaching the other of the pair of electrodes directly to the capsule body.

[Third Embodiment]
Next, a third embodiment of the present invention will be described with reference to FIG. In the present embodiment, components that are the same as those in the first or second embodiment are given the same reference numerals, and detailed descriptions thereof are omitted. The endoscope apparatus (in-vivo medical apparatus) S2 in this embodiment has a balloon 2L, an electrode 3, and a flexible electric wire 4 similar to the balloon 2 attached to a flexible endoscope (apparatus body) 7S. It is an example.

  As shown in FIG. 19A, the flexible endoscope 7S includes a hard portion 75 at the distal end of the flexible portion 76 and a connector portion 78 on the proximal end side. As shown in FIG. 19B, the hard portion 75 is provided with an objective lens 75a, an illumination lens 75b, a channel 75c, and the like. The connector part 78 is located outside the body and is detachably connected to a connector part 118 of the extracorporeal device 110 described later.

  A balloon 2L is fixed to the rear side of the hard portion 75 in the endoscope 7S. Reference numeral 20e in the drawing is a fixing portion between the endoscope 7S and the balloon 2L. At least a pair of bipolar electrodes 3 are attached to the rear surface of the balloon 2L. The electrode 3 and the connector portion 78 are connected by a flexible electric wire 4.

  The soft portion 76 located inside the balloon 2L is formed with an injection / discharge port 77 for injecting fluid such as air or water into the balloon 2L and discharging the fluid from the balloon 2L. ing. The injection / discharge port 77 communicates with a connector 78 so that fluid from an extracorporeal device 110 described later can be injected / discharged.

  The extracorporeal device 110 includes a power source 111, a limiter 111L, a light source device 112, a fluid injection / discharge device (expansion means) 113, a video processor 114, a monitor 115, and a connector unit 118. If the connector part 78 is connected to the connector part 118, the illumination light from the light source device 112 can be transmitted to the illumination lens 76b, and the image from the objective lens 75a is transmitted to the video processor 114 for recording or recording. It can be displayed on the monitor 115. In addition, the power source 111 and the electrode 3 are mechanically and electrically connected to each other by the electric wire 4, and a current for electrical stimulation can flow from the power source 111 to the electrode 3 through the electric wire 4. . The fluid injecting / discharging device 113 communicates with the injecting / discharging port 77 so that the fluid can be injected into the balloon 2L or discharged from the balloon 2L.

FIG. 19A shows a case where such an endoscope apparatus S2 is inserted into the large intestine R from the anus. When the endoscope apparatus S2 is inserted, the balloon 2L is in a contracted state (a state in which the balloon 2L is substantially in close contact with the outer peripheral surface of the flexible portion 76). After the insertion, the fluid injection / discharge device 113 is operated to expand the balloon 2L, and the power source 111 is operated to pulse a rectangular current to the power source 3 so that electrical stimulation is applied to the inner wall of the large intestine R. Given this, the endoscope apparatus S2 is promoted. When the target site is reached, the electrical stimulation is stopped or the electrical stimulation is stopped, and the balloon 2L is further expanded to be left in the site, and observation / inspection in the large intestine R is performed. At this time, the limiter 111L prevents the electrode 3 from flowing a current greater than the set value.
When the endoscope apparatus S2 is removed from the large intestine R after the observation / examination is completed, the balloon 2L is deflated in the same manner as the insertion so that it can be easily discharged from the anus.

  In this endoscope apparatus S2, since it is set as the structure which added the balloon, the electrode, and the flexible electric wire to the flexible endoscope, it was stable with respect to the contractile tissue also in the general-purpose flexible endoscope. A function to which electrical stimulation is given can be added. In addition, since the power source for electrical stimulation and the balloon expansion means are provided outside the body, the configuration of the endoscope apparatus as the body cavity insertion portion can be simplified.

[Fourth Embodiment]
Next, a fourth embodiment of the present invention will be described with reference to FIGS. In the present embodiment, components that are the same as those in the first to third embodiments are given the same reference numerals, and detailed descriptions thereof are omitted.
An endoscope apparatus (in-body medical apparatus) S3 shown in FIG. 20 is an example in which a balloon portion 8 is attached to a capsule body (apparatus body) 1G.

  The capsule body 1G is a general-purpose capsule endoscope in which the rectangular wave generation circuit 13a and the expansion / contraction mechanism unit 16 are omitted from the capsule body 1 in the capsule medical device C1. As shown in FIG. 20B, the capsule body 1G can be separated into a front case 11x and a rear case 11y, and a button-type battery 5 can be mounted therein. It has become. A groove portion 11h is formed on the outer peripheral side of the housing (rear housing 11y in the illustrated example).

The balloon portion 8 includes a flexible tube body 81, a mounting portion 82, a balloon (elastic expansion portion) 2M similar to the balloon 2, at least a pair of electrodes 3, and a flexible electric wire 4. It has been configured.
The proximal end side of the tube body 81 is connected to an external device (not shown), and a mounting portion 82 is integrally attached to the distal end side thereof. The mounting portion 82 is detachably integrated with the capsule body 1G, and is provided with a band portion 82b made of an elastic body that engages with the groove portion 11h of the capsule body 1G. A balloon 2M is fixed to the tube body 81 on the rear side of the mounting portion 82. Reference numeral 20g in the figure denotes a fixing portion between the tube body 81 and the balloon 2M. At least a pair of bipolar electrodes 3 are detachably attached to the rear surface of the balloon 2M. A flexible electric wire 4 is attached to the electrode 3 and is inserted into the tube body 81 and connected to the extracorporeal device on the base end side. That is, the electrode 3 and the extracorporeal device are mechanically and electrically connected by the flexible electric wire 4, and the current from the extracorporeal device can flow to the electrode 3 through the electric wire 4. Yes.

  The tube body 81 positioned inside the balloon 2M is formed with an injection / discharge port 81h for injecting fluid into the balloon 2M and discharging the fluid from the balloon 2M. The injection / discharge port 81h communicates with the extracorporeal device, and can inject / exclude fluid from the extracorporeal device.

FIG. 21A shows a case where such an endoscope apparatus S3 is inserted from the anus P into the large intestine R. When the endoscope apparatus S3 is inserted, the balloon 2M is in a contracted state (a state in which the balloon 2M is substantially in close contact with the outer peripheral surface of the tube body 81). After the insertion, the extracorporeal device is operated to expand the balloon 2M and the power supply 111 is operated to pulse the rectangular wave current to the power supply 3 as shown in FIGS. 21 (b) and (c). The endoscope apparatus S3 is promoted by applying electrical stimulation to the inner wall of the large intestine R. When the target site is reached, the electrical stimulation is stopped, or the electrical stimulation is stopped, and the balloon 2M is further expanded to be left in the site, and observation / inspection in the large intestine R is performed.
When the endoscopic device S3 is removed from the large intestine R after the observation / examination is completed, the balloon 2M is deflated in the same manner as at the time of insertion so that it can be easily discharged from the anus P.

As shown in FIG. 22, if the endoscope apparatus S3 is used in combination with the flexible endoscope 7W, the deepest part of the large intestine R, that is, the cecum A and the ileocecal valve V can be easily observed and examined. It can be carried out. Specifically, by inserting the endoscope device S3 first and using the tube body 81 as a guide wire for the flexible endoscope 7W, endoscope insertion into the large intestine R that requires skill in insertion operation is performed. It can be done easily.
The flexible endoscope 7W is preferably a two-channel type as shown in the figure. With such a two-channel system, the tube body 81 of the endoscope apparatus S3 can be inserted into the first channel ch1, and the forceps F or the like can be inserted into the second channel ch2. That is, observation / inspection by the endoscope apparatus S3 and treatment of a lesion site (polyp or the like) by the forceps F can be performed at a time.

An endoscopic device (in-vivo medical device) S4 shown in FIG. 23 is a modification of the endoscopic device S3, and is an example in which a balloon portion 9 is attached to a capsule main body (device main body) 1H.
The capsule body 1H has observation windows 11d1 and 11d2 formed on both front and rear sides of the capsule body 1G, and biological information acquisition means (not shown here) such as the imaging unit 12 and various sensors inside the observation windows 11d1 and 11d2. It is set as the structure provided with each. The operations of the biometric information acquisition means before and after these are appropriately controlled by the control unit 13 (not shown here). Moreover, in this capsule main body 1H, the groove part 11h is formed one each in the front-back side.

As shown in FIGS. 23A, 23B, and 24A, the balloon portion 9 includes a balloon (elastic expansion portion) 2N similar to the balloon 2, a mounting band portion 91b, and at least a pair of electrodes. 3, a flexible electric wire 4, a tube body 92, and an electric wire jacket 93.
On both front and rear ends of the balloon 2N, mounting band portions 91b made of an elastic body that respectively engage with the groove portions 11h of the capsule body 1H are integrally provided. With these attachment band portions 91b, the balloon 2N is detachably attached to the capsule body 1H. A flexible tube body 92 is attached to the rear side of the balloon 2N. A connector 92c connected to an extracorporeal device is formed on the proximal end side of the tube body 92. Here, a syringe (expansion means) 121 and a two-way stopcock (expansion means) 121v are illustrated as extracorporeal devices. By operating the syringe 121 and the two-way cock 121v, fluid can be injected into the balloon 2N and fluid from the balloon 2N can be discharged.

  In addition, at least a pair of bipolar electrodes 3 are attached to the front surface of the balloon 2N. The electrode 3 is attached with a flexible electric wire 4 inserted into a flexible electric wire jacket 93 attached to the rear side of the balloon 2N and connected to a proximal end side connector 93c. Yes. The connector 93c is connected to a connector 122c provided in a power feeding device 122 as an example of an extracorporeal device. That is, if the connector 93c and the connector 122c are connected, the electrode 3 and the power feeding device 122 are mechanically and electrically connected by the flexible electric wire 4, and the electric current from the power feeding device 122 is supplied to the electric wire 4. It is possible to flow to the electrode 3 via

  FIG. 24B shows a case where such an endoscope apparatus S4 is inserted from the anus P into the large intestine R. When the endoscope apparatus S4 is inserted, the balloon 2N is in a deflated state (a state in which the balloon 2N is in close contact with the outer peripheral surface of the capsule body 1H). Then, the capsule body 1H is inserted into the large intestine R so that the rear side faces forward, that is, the observation window 11d2 is located on the front side. When inserted in this manner, the electrode 3 is positioned on the rear side (anus P side), and can be pushed toward the deep part in the large intestine R. After the insertion, the syringe 121 and the two-way cock 121v are operated to expand the balloon 2N, and the power feeding device 122 is operated to cause a rectangular wave current to flow to the power source 3 in a pulsed manner, so that the inner wall of the large intestine R is electrically Stimulation is given and the endoscope apparatus S4 is promoted. When the target part is reached, the electrical stimulation is stopped and left at the part, and observation / inspection of the large intestine R is performed from the front and rear observation windows 11d1 and 11d2.

When the endoscope apparatus S4 is pulled out from the large intestine R after the observation / examination is completed, the tube body 92 and the electric wire jacket 93 are pulled from the outside of the body, and the capsule body 1H is turned in the opposite direction. If it carries out like this, the electrode 3 will be located in the front side (the deep part side of the large intestine R), and can be now driven toward the anus P.
When the capsule body 1H approaches the anus P, the balloon 2N is deflated in the same manner as when inserted, so that it can be easily discharged from the anus P.

  In these endoscope apparatuses S3 and S4, since a balloon, an electrode, and a flexible electric wire are added to a capsule body as a capsule endoscope, a general-purpose capsule endoscope is also used. In addition, it is possible to add a function of giving stable electrical stimulation to the contractile tissue. In addition, since the power source for electrical stimulation and the balloon expansion means are provided outside the body, the configuration of the endoscope apparatus as the body cavity insertion portion can be simplified.

  In the third and fourth embodiments, one or a plurality of pairs of electrodes are attached to the balloon. However, the present invention is not limited to this, and at least one electrode, that is, one pair is formed. Only one of the electrodes need be attached to the balloon. In this case, a monopolar type electrode configuration in which the other of the pair of electrodes is attached to the body surface of the subject and current is allowed to flow from the extracorporeal device to both electrodes may be used.

(Additional item 1)
The in-vivo medical device according to claim 1, wherein the electrode is detachable from the elastic expansion portion.

(Appendix 2)
The in-vivo medical device according to claim 2, wherein the elastic expansion portion is a balloon that expands when a fluid is injected into the elastic expansion portion.

(Additional Item 3)
The in-vivo medical device according to claim 1, wherein the elastic expansion portion is made of a soft rubber that can be reduced in diameter by being folded.

(Appendix 4)
The in-vivo medical device according to claim 1, wherein the electrode is made of conductive rubber.

(Appendix 5)
The in-vivo medical device according to claim 1, wherein the device main body is a capsule endoscope.

(Appendix 6)
The in-vivo medical device according to claim 1, wherein the device main body is a flexible endoscope.

(Appendix 7)
The in-vivo medical device according to claim 1, wherein the elastic expansion portion has a shape capable of forming a gap portion communicating with the inside of the living tissue throughout the front and back thereof.

(Appendix 8)
The in-vivo medical device according to claim 6, wherein the expansion means is a flexible tube body connected to an external fluid injection / discharge means.

(Appendix 9)
9. The in-vivo medical device according to appendix 8, wherein the tube body is removable after expansion of the balloon.

(Appendix 10)
6. The intracorporeal medical device according to claim 5, wherein the expansion means is a fluid discharge mechanism that releases a pressurized gas or a foaming agent in the device main body into the balloon by an operation from outside the body. .

(Appendix 11)
The in-vivo medical device according to claim 1, wherein the elastic expansion portion is set to have an outer diameter of approximately 15 mm when contracted and an outer diameter of approximately 40 mm when fully expanded.

(Appendix 12)
The in-vivo medical device according to claim 1, wherein the electrical stimulation signal applied to the electrode is a signal obtained by modulating a pulse signal of several kHz to several hundred kHz with a pulse signal of several Hz to several tens Hz. .

  The in-vivo medical device according to claim 1, wherein the electrodes are a pair of electrodes.

It is a schematic structure figure showing an example of an in-vivo medical device concerning a 1st embodiment of the present invention. It is a figure which shows the modification of the same-body medical device, Comprising: (a) is a sectional side view, (b) is the elements on larger scale of (a). It is a figure which shows the other modification of the same-body medical device, Comprising: (a) is a side view, (b) is a sectional side view. It is a side view which shows the other modification of the same-body medical device. It is a side view which shows the other modification of the same-body medical device. It is a side view which shows the other modification of the same-body medical device. It is a side view which shows the other modification of the same-body medical device. It is a side view which shows the other modification of the same-body medical device. It is a longitudinal cross-sectional view which shows the other modification of the same-body medical device. It is a longitudinal cross-sectional view which shows the other modification of the same-body medical device. It is a longitudinal cross-sectional view which shows the other modification of the same-body medical device. It is a longitudinal cross-sectional view which shows the other modification of the same-body medical device. It is a figure which shows the other modification of the same-body medical device, Comprising: (a)-(c) is a sectional side view, (d) is a sectional side view which shows the moving member used by (a)-(c). It is. It is a figure which shows the other modification of the same-body medical device, Comprising: (a), (b) is a side view, (c) is a sectional side view. It is an immediate sectional view showing another modification of the same-body medical device. It is a figure which shows the other modification of the same-body medical device, Comprising: (a) is a sectional side view, (b) is a schematic perspective view. It is a figure which shows an example of the internal medical device which concerns on the 2nd Embodiment of this invention, (a) is a side view, (b), (c) is the elements on larger scale of (a). It is a side view which shows after the release of the capsule type medical device in the same medical device. It is a figure which shows an example of the internal medical device which concerns on the 3rd Embodiment of this invention, (a) is a sectional side view, (b) is a front view. It is a fragmentary sectional view showing an example of an in-vivo medical device concerning a 4th embodiment of the present invention. It is a side view of the same-body medical device. It is a side view of the same-body medical device. It is a figure which shows the modification of the same-body medical device, Comprising: (a) is a schematic side view, (b) is a fragmentary sectional view. It is a figure which shows the same-body medical device, Comprising: (a) is a fragmentary sectional view, (b), (c) is a side view.

Explanation of symbols

C1, C2, C3a, C3b, C3c, C3d, C3e, C3f, C4, C5, C6, C7, C8, C9, C11, C12 capsule medical device (in-body medical device)
S1, S2, S3, S4 Endoscopic device (in-body medical device)
1, 1A, 1B, 1C, 1D, 1E, 1G, 1H Capsule body (apparatus body)
_{2A, 2B 1, 2B 2,} 2B 3, 2B 4, 2B 5, 2B 6, 2C, 2D, 2E, 2F, 2H, 2I, 2K, 2L, 2M, 2N balloon (elastic expansion unit)
2J Elastic expansion part 3 Electrode 4 Electric wire 5 Battery (power supply)
5A power supply unit (power supply)
12 Imaging unit (biological information acquisition means)
16 Expansion / contraction mechanism (expansion means)
16c Shape memory coil (expansion means)
111 Power supply 113 Fluid injection / discharge device (expansion means)
121 Syringe (expansion means)
121v Two-way stopcock (expansion means)
122 Power supply device (power supply)

Claims (8)

An apparatus main body having biological information acquisition means for acquiring biological information in the body cavity, an elastic expansion part that is attached to at least a part of the apparatus main body and can be elastically expanded, and an elastic extension part that is attached to the elastic expansion part An intracorporeal cavity insertion portion provided with at least one electrode for applying electrical stimulation to a living tissue and inserted into the body cavity;
A power source for supplying power to the electrodes;
An electric wire at least partially flexible and electrically and mechanically connecting the power source and the electrode;
An in-vivo medical device comprising:   The in-vivo medical device according to claim 1, wherein the elastic expansion portion is a balloon made of an elastic film.   The in-vivo medical device according to claim 1, wherein the power source is provided integrally with the body cavity insertion portion.   The in-vivo medical device according to claim 1 or 2, wherein the power source is provided in addition to the body cavity insertion portion, and the power source and the body cavity insertion portion side are detachable.   The in-vivo medical device according to any one of claims 1 to 4, wherein an expansion means for expanding the elastic expansion portion is provided in the body cavity insertion portion.   The expansion means for expanding the elastic expansion section is provided in addition to the body cavity insertion section, and is detachable between the body cavity insertion section and the expansion means. An in-vivo medical device according to any one of the above.   The in-vivo medical device according to any one of claims 1 to 6, wherein the elastic expansion portion is detachable from the device main body. The in-vivo medical device according to any one of claims 1 to 7, wherein the elastic expansion portion is provided with a hard portion that is harder than other portions of the elastic expansion portion.

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