JP2008272388A - Endoscope apparatus - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To simultaneously solve problems that a liquid to be injected from the distal end of an endoscope has to be transparent as much as possible (1) and has biocompatibility (2), in order to attain non-invasiveness, since the excessive injection of saline is highly invasive in conventional research development for attaining the endoscope apparatus, which injects the liquid from the distal end in order to secure a visual field in a wide region such as a cardiac inner cavity or in a blood vessel while keeping non-invasiveness, and for adopting a method to temporarily secure the visual field by injecting the saline from a gap, which is generated at the distal end of the endoscope as an in-blood observation means. <P>SOLUTION: A plasma component extracted from autologous blood or an equivalent component is used as a flash liquid in order to obtain the visual field of the endoscope which is used in a state with the existence of a body fluid such as the blood. The usage of the autologous blood is extremely high in biocompatibility. When the remained blood cell component is returned to the inner part of a body, a load on a patient is reduced. <P>COPYRIGHT: (C)2009,JPO&INPIT

Description

  The present invention relates to an endoscope in medical engineering for realizing a minimally invasive treatment.

  Vascular endoscopes have come to be used not only for diagnosis of vascular stenosis and sclerosis but also for treatment by insertion of a catheter. However, it is difficult to observe the image inside the blood vessel with blood flow due to the light scattering characteristics of red blood cells. Especially in cardiovascular surgery, the blood around the observation object is evacuated and treated by extracorporeal circulation, and the risk and invasiveness are high. Therefore, as a means of observing an image in a blood vessel, an endoscope that secures a visual field space by creating a laser-induced bubble from the distal end of the endoscope has been developed (for example, see Non-Patent Document 1). However, this method is not suitable for securing a visual field in a wide area such as the heart lumen. In addition, in the presence of blood flow, an instantaneous visual field is ensured by ejecting physiological saline from the tip of the vascular endoscope to the front of the visual field. A system has been proposed that always obtains clear images of blood vessels during surgery (see Non-Patent Document 2, for example).

However, this conventional method increases the amount of saline solution for image observation. Therefore, excessive injection of water into the blood vessels may affect the circulatory system, and is considered to be invasive for patients.
Yamashita et al .: Ho: YAG laser-induced water vapor removal by water vapor bubbles: A method for securing a visual field for a new blood vessel endoscope, medical electronics and biotechnology, Vol. 42, Suppl. 1, p. 279, 2004 Rishi, et al .: Development of a blood vessel wall visualization system to support intravascular surgery, medical electronics and biotechnology, Vol. 42, Suppl. 1, p. 278, 2004

The present invention relates to an endoscope apparatus that ejects liquid from the distal end portion of an endoscope in order to ensure a wide area such as a heart lumen and a visual field in a blood vessel while maintaining a low invasiveness with less burden on a living body. Is realized.

In the previous research, a method of temporarily securing the visual field by ejecting physiological saline from the gap created at the distal end of the endoscope as an observation means in blood. However, excessive saline ejection is highly invasive. To achieve minimal invasiveness, the liquid ejected from the tip should be as transparent as possible (1). (2) It must be biocompatible. Is required.

Therefore, in the present invention, in order to obtain a field of view of an endoscope used in the presence of a body fluid such as blood, the solution is achieved by using a plasma component extracted from autologous blood or an equivalent component as a flush solution.

Plasma components are obtained by blood centrifugation or plasma membrane exchange, and the method of preparation is generally established. Plasma permeability is high when blood hematocrit is very small. The greatest advantage of the present invention is that the use of plasma components makes it possible to use the patient's autologous blood, so that it can be used as a highly permeable liquid with good biocompatibility.

Fig. 1 shows an example of an endoscope apparatus. In this example, it is assumed that an endoscopic device is inserted and observed from the left atrium in order to treat the left atrium of the heart. In the embodiment, an endoscope device (including a rigid endoscope having a diameter of 4 mm and a length of 200 mm, an endoscope light source, a CCD camera, a perfusion outer tube from which a liquid is ejected from the distal end of the rigid endoscope), liquid injection It consists of a pump, an infusion tube, a plasma separation system, a controller that performs image capture, processing, pump control, and biological information processing, and a monitor that displays endoscopic images.

  First, blood is drawn from the target patient, and plasma components are extracted from the blood using a centrifuge or plasma separator (hollow fiber filter). Basically, the concentration of red blood cells in the blood is low, and it may be a liquid that is biocompatible with the patient. Store the extracted fluid and return other components directly or diluted to the body. When using patient's autologous blood, the treatment is extremely biocompatible.

  An endoscopic device is a rigid endoscope including a light source, and an outer tube having an inner diameter thicker than that of the endoscope is coaxially attached, and a stopcock for perfusion is used at a joint with the endoscope camera. Put on. The position of the outer tube and endoscope is fixed by protrusions, and the liquid is not leaked by rubber packing. Adjust the position of the outer tube tip so that the endoscope field of view is not narrowed. As a result, when the infusion solution is injected from the tube attached to the stopcock, the infusion solution is released from the tip through the gap between the outer tube and the endoscope. In this example, a rigid endoscope was used. However, the type can be selected if it is configured to have the same functions as a general endoscope, such as the presence of a light source and the ability to obtain an image in the endoscope field of view. Absent.

  The plasma components that have already been stored or extracted as needed are sent to the endoscopic device via an infusion pump or the like and a tube. At this time, the timing for driving the pump can be set to automatic operation by a controller or a signal for manually driving can be sent. The drive timing measures the electrocardiogram etc. emitted from the heart as needed, and the time interval at which the infusion is discharged from the distal end of the endoscope is controlled by driving the pump at the appropriate timing.

  Furthermore, the controller records an endoscopic image and displays it on the monitor screen at the time when the infusion is released. Physicians using this endoscopic device will only observe the images while releasing the infusion. For this reason, it is possible to switch from conventional treatments that observe coarse images such as ultrasound images to treatments that are clearer and observe the treatment target. Improvement is expected.

  Although minimally invasive treatment is mainly a keyword in the medical industry, the present invention can realize a new advanced endovascular treatment with a material having extremely high biocompatibility. This leads to the spread of

Shows the block diagram of the example. The symbols in the figure are as follows.

Explanation of symbols

a. Plasma separator b. Storage tank c. Infusion pump d. Mantle tube e. Biological signals such as ECG f. Endoscopic image display monitor g. Controller (image input, image processing, biological signal processing, pump drive function)
h. Plasma flow i. Image signal j. Packing of outer tube and endoscope joint k. Rigid endoscope l. Mainly blood cell components from which plasma was extracted m. Blood (autologous blood) n. Plasma component o. Pump drive signal p. The blood vessel wall or heart chamber wall of the subject patient q. Plasma discharge part at the tip of the endoscope device r. A connecting portion of the endoscopic device and the infusion tube s. Video signal

Claims (1)

An endoscopic device that uses plasma components extracted from autologous blood or equivalent compatible blood to obtain the field of view of the endoscope used in the presence of body fluid such as blood

Images