JP2010179021A - Medical endoscope - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a medical endoscope easily discharging a perfusion liquid toward a target part even in a small organ and discharging the perfusion liquid while using a treatment instrument. <P>SOLUTION: In this medical endoscope 10, a first perfusion passage 26 which is a passage for the perfusion liquid is formed in the interior of an insert part, and an opening end of the first perfusion passage is formed at the end of the insert part. The opening end of the first perfusion passage is formed on the peripheral surface of the end, and the axis of the end of the first perfusion passage connected to the opening end is inclined to the axis of the end. <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

  The present invention relates to a medical endoscope having a perfusion function.

  The endoscope disclosed in Patent Document 1 is a medical endoscope for observing organs such as the urinary tract and the uterus, and has a perfusate flow path inside. When such an endoscope is used, the perfusate is discharged from the perfusate channel and the observation target organ is filled with the perfusate for observation and treatment.

JP 2002-222402 A

If there is a bleeding site in the observation target organ, blood precipitates in the lower part of the organ and the perfusate becomes turbid due to part of the blood, making observation with an endoscope difficult. Therefore, in such a case, the front end opening of the perfusate flow channel is directed to the precipitated blood, and the precipitated blood is washed away by the fluid pressure of the perfusate exiting from the opening. As disclosed in Patent Document 1, since the open end of the conventional perfusate flow path is formed at the distal end surface of the insertion portion of the endoscope, in order to direct the perfusate toward the precipitated blood, insert It is necessary to direct the distal end surface of the insertion portion toward the precipitated blood while making the axis of the distal end portion perpendicular to the bleeding site (inner wall surface of the organ).
However, since organs such as the urinary tract and the uterus are never large, it has never been easy to curve the insertion portion so that the distal end surface of the insertion portion faces the precipitated blood side.
In addition, since the perfusate channel is also used as a treatment instrument insertion path or a suction channel, the perfusate does not flow into the perfusate channel during use of the treatment tool or during suction operation. The blood could not be washed away.
A bifurcated attachment with each end opening is attached to the forceps opening (treatment tool insertion opening) of the endoscope, and the treatment tool is inserted into the perfusate channel from each opening of the attachment. It is possible to flow the perfusate while inserting. However, in this case, blood precipitated by the perfusate cannot be removed efficiently.

  An object of the present invention is to provide a medical endoscope that can easily discharge perfusate toward a target site even in a small organ and that can discharge the perfusate while using a treatment tool.

  In the medical endoscope of the present invention, a first perfusion channel, which is a channel for perfusate, is formed inside an insertion portion, and the first perfusion channel is formed at the distal end of the insertion portion. In the medical endoscope having an open end, the open end of the first perfusion channel is formed on the peripheral surface of the distal end, and the end of the first perfusion channel is connected to the open end. The axis is inclined with respect to the axis of the tip.

  Preferably, a second perfusion channel is formed inside the insertion portion, and an open end of the second perfusion channel is formed on the distal end surface of the insertion portion.

  Further, when the distal end surface of the insertion portion is viewed from the front, the second perfusion channel is located on the outer peripheral side of the distal end surface with respect to the first perfusion channel, and the second perfusion channel It is preferable that the opening end side end and the end of the first perfusion channel communicate with each other.

  According to the present invention, the perfusate passing through the first perfusion channel is discharged to the outside from the peripheral surface of the distal end portion of the insertion portion. Therefore, the purpose of the observation target organ can be achieved without greatly curving the distal end portion of the insertion portion. The perfusate can be drained toward the site. Therefore, it is easy to discharge the perfusate toward the target site as compared with the conventional endoscope.

  According to the second aspect, even when the second perfusion channel is used as the treatment instrument insertion path, it is possible to perform perfusion using the first perfusion channel. Precipitated blood can be removed efficiently.

  According to the third aspect, when the treatment tool is inserted through the second perfusion channel, the treatment is performed while washing the blood adhering to the treatment tool with the perfusate flowing through the first perfusion channel. Can do. In addition, when perfusion is simultaneously performed from the first perfusion channel and the second perfusion channel, strong water can be discharged in a wide range by the two water streams, so that blood precipitated in the organ can be efficiently removed.

It is a top view showing the whole medical endoscope of one embodiment of the present invention. It is a figure which shows the state which inserted the endoscope into the observation object organ. It is an enlarged side view which fractures | ruptures and shows a part of front-end | tip part of the insertion part of an endoscope. It is sectional drawing which follows the IV-IV arrow line of FIG. It is a front view of the front-end | tip part of an insertion part.

Hereinafter, an embodiment of the present invention will be described with reference to the accompanying drawings.
The medical endoscope 10 according to the present embodiment includes an operation unit 11, an insertion unit 12 extending from the operation unit 11, a universal tube 15 extending from the operation unit 11 toward the opposite side of the insertion unit 12, and an end of the universal tube 15. And a connector part 16 provided in the part. The distal end portion 13 of the insertion portion 12 is a hard portion that cannot be deformed, and the peripheral surface on the distal end side of the distal end portion 13 is a tapered surface 13a. The bending portion 14 positioned immediately after the distal end portion 13 is a portion that bends in response to the rotation operation of the bending operation lever 17 provided in the operation portion 11, and the portion of the insertion portion 12 that is closer to the operation portion 11 than the bending portion 14. It has flexibility. The connector portion 16 is a portion connected to a light source device (also an image processing device) not shown. Further, a forceps port 18 communicating with a second perfusion tube C2 described later is provided inside the medical endoscope 10 at a portion located immediately before the operation unit 11, and a medical internal area is provided on the back surface of the operation unit 11. A base 19 and a base 20 that project from the first perfusion tube C <b> 1 and the second perfusion tube C <b> 2, respectively, protrude from the endoscope 10. The operation unit 11 is provided with an operation button B1 and an operation button B2 that can be moved in and out (slidable) with respect to the operation unit 11.
As shown in FIG. 5, an observation lens L <b> 1 and two illumination lenses L <b> 2 are provided on the distal end surface of the distal end portion 13 of the insertion portion 12. As shown in FIG. 3, immediately after the observation lens L <b> 1, an image sensor 22 that captures an image transmitted through the observation lens L <b> 1 is provided, and an image transmission cable 23 extending from the image sensor 22 is provided inside the medical endoscope 10. And extends to the connector portion 16. Further, a light guide fiber 24 having one end connected to the two illumination lenses L2 and the other end extending to the connector portion 16 is provided inside the medical endoscope 10. Accordingly, when the connector unit 16 is connected to the light source device, light generated by the light source is supplied to the two illumination lenses L2 via the light guide fiber 24. Further, the image data captured by the image sensor 22 is sent to the image processing unit in the light source device via the image transmission cable 23, and the image data processed by the image processing unit is displayed on a television monitor (not shown).

As shown in FIGS. 3 to 5, a first perfusion channel 26 and a second perfusion channel 28 that extend in the longitudinal direction of the insertion portion 12 (in the axial direction of the distal end portion 13) are provided inside the distal end portion 13. It is formed. As shown in FIG. 3, the distal end portion of the first perfusion channel 26 is a bent end portion 27 that is substantially orthogonal to the longitudinal direction of the insertion portion 12, and the end portion of the bent end portion 27 is the distal end portion 13 ( An opening is formed on the peripheral surface of the tapered surface 13a). On the other hand, the second perfusion channel 28 is opened at the distal end surface of the distal end portion 13, and part of the opening extends to the tapered surface 13a. As shown in FIGS. 3 and 4, the second perfusion channel 28 is located on the outer peripheral side of the first perfusion channel 26 (and the bent end 27) when the front end portion 13 is viewed from the front. The opening end of the bent end portion 27 intersects (communicates with) the opening end side end portion of the second perfusion channel 28.
One end of the first perfusion tube C1 is connected to the end of the first perfusion channel 26 opposite to the bent end 27, and the other end of the first perfusion tube C1 is connected to the base 19. Yes. Further, the inner end of the operation button B1 is connected to the first perfusion tube C1 inside the operation unit 11. On the other hand, one end of the second perfusion tube C2 is connected to the end opposite to the opening of the second perfusion channel 28, and the other end of the second perfusion tube C2 is connected to the base 20. . A portion branched from the middle portion of the second perfusion tube C2 is connected to the forceps port 18, and an inner end portion of the operation button B2 is connected to the second perfusion tube C2 inside the operation portion 11.

Then, the usage point of the medical endoscope 10 of this embodiment is demonstrated.
First, a case where the other end of a suction tube (not shown) having one end connected to a suction source (not shown) is connected to the base 20 will be described.
One end of a perfusion tube (not shown) is connected to the base 19, and the other end of the perfusion tube is connected to a container (not shown) with a pump function filled with a colorless and transparent perfusate. As shown in FIG. 2, when the insertion portion 12 of the medical endoscope 10 is inserted into a patient's observation target organ (for example, urinary organ or uterus) A and the operation button B1 is pushed into the inside of the operation portion 11, The direction in which the perfusate in the container passes through the first perfusion tube C1 and the first perfusion channel 26 and is substantially orthogonal to the longitudinal direction of the insertion portion 12 (the axis of the distal end portion 13) from the bent end portion 27 (FIG. 2 and in the direction of arrow D1 in FIG. The drainage (perfusion) of the perfusate is performed during the observation and treatment, and the inside of the organ is filled with the perfusate. In this state, the affected part is irradiated with light emitted from the illumination lens L2, and an observation image obtained by using the observation lens L1 and the image sensor 22 is displayed on the television monitor. Then, the treatment tool inserted into the forceps opening 18 is projected from the opening end of the second perfusion channel 28 through the cut of the rubber cap placed on the forceps opening 18, and the affected part is treated with the treatment tool. At this time, the treatment can be performed while washing the blood adhering to the treatment instrument with the perfusate discharged from the bent end portion 27 of the first perfusion channel 26. Further, if necessary, the operation button B2 is pushed into the inside of the operation unit 11, and the perfusate or the like in the observation target organ A is discharged from the opening end of the second perfusion channel 28 using the negative pressure of the suction source. Suction is performed inside the medical endoscope 10.
As shown in FIG. 2, when there is a bleeding portion on the inner surface of the observation target organ A, the bending portion 14 is bent by moving the insertion portion 12 or by bending the bending operation lever 17. The opening end of the portion 27 (tip surface of the tip portion 13) is directed to the bleeding portion side. Then, since the blood X discharged from the bleeding part is washed away by the perfusate discharged from the bent end portion 27, the turbidity of the perfusate due to the blood X is eliminated. As described above, the medical endoscope 10 discharges the perfusate to the outside using the first perfusion tube C1 and the first perfusion channel 26 while the treatment tool is being used or during the suction operation. Therefore, even when blood X is generated from the observation target organ A, the surgeon can accurately observe and treat the affected area.

Subsequently, the other end of a perfusion tube (separate from the perfusion tube) connected to a cap 20 (not shown; the container may be different from the container or the container) having one end on the base 20. The case of connecting will be described.
Also in this case, the perfusion tube is connected to the base 19. Therefore, if the operation button B1 is pressed, the perfusate is discharged from the bent end portion 27 in the direction of the arrow D1 in FIGS. 2 and 3, and if the operation button B2 is pressed, the perfusate is shown from the opening end of the second perfusion channel 28. 2 and the arrow D2 in FIG. 3 (the axial direction of the tip 13).
When the perfusion tube is connected to the base 20 in this way, the perfusate can be discharged in two directions, so that the perfusate can be changed by simply moving the insertion portion 12 or slightly bending the bending portion 14. Can be discharged in the direction. For this reason, even when the internal space of the observation target organ A is small, the blood X in the perfusate can be easily and reliably washed out.
Further, if perfusion is performed simultaneously from the first perfusion channel 26 and the second perfusion channel 28, the strong perfusate can be discharged in a wide range by two water streams, so that the precipitated blood X can be efficiently removed.

As mentioned above, although this invention was demonstrated based on the said embodiment, this invention can be implemented, giving various changes.
For example, the first perfusion channel is such that the second perfusion channel 28 is located on the inner peripheral side of the first perfusion channel 26 (and the bent end portion 27) when the distal end portion 13 is viewed from the front. 26 and the second perfusion channel 28 may be disposed. Alternatively, the first perfusion channel 26 (bent end portion 27) and the second perfusion channel 28 may not be crossed, and both may be disconnected.
Furthermore, the axis of the bent end portion 27 may be inclined (for example, 45 °) with respect to the longitudinal direction of the insertion portion 12 instead of being substantially orthogonal to the longitudinal direction of the insertion portion 12.

DESCRIPTION OF SYMBOLS 10 Medical endoscope 11 Operation part 12 Insertion part 13 Tip part 13a Tapered surface 14 Bending part 15 Universal tube 16 Connector part 17 Bending operation lever 18 Forceps port 19 20 Connection base 22 Imaging element 23 Image transmission cable 24 Light guide fiber 26 First perfusion channel 27 Bent end 28 Second perfusion channel A Organ B1 B2 Operation button L1 Observation lens L2 Illumination lens C1 First perfusion tube C2 Second perfusion tube X Blood

Claims (3)

A medical endoscope in which a first perfusion channel, which is a channel for perfusate, is formed inside the insertion portion, and an open end of the first perfusion channel is formed at the distal end of the insertion portion. In
The opening end of the first perfusion channel is formed on the peripheral surface of the tip, and the axis of the end of the first perfusion channel connected to the opening is inclined with respect to the axis of the tip A medical endoscope characterized by having been made. The medical endoscope according to claim 1, wherein
A medical endoscope in which a second perfusion channel is formed inside the insertion portion, and an opening end of the second perfusion channel is formed on a distal end surface of the insertion portion. The medical endoscope according to claim 2, wherein
When the distal end surface of the insertion portion is viewed from the front, the second perfusion channel is positioned on the outer peripheral side of the distal surface relative to the first perfusion channel, and the open end of the second perfusion channel A medical endoscope in which a side end and the end of the first perfusion channel communicate with each other.

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