JP2010220763A - Actuator for intraductal moving body and control method therefor, endoscope - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an actuator for any intraductal moving body and its control method in an endoscope, where the actuator insertion head can easily go ahead even into a complicatedly curved duct like the sigmoid colon, etc, and to provide an endoscope. <P>SOLUTION: The actuator can go in and out to/from an opening at the end of an insertion part where the actuator head is inserted, and includes an auxiliary tool movable between a first position where the head can contact or near the duct wall located ahead the opening and a second position located after the opening, an extendable part provided at the actuator head end, and a control part to control the movements of the auxiliary tool and the extendable part. The control part controls the inner pressure of the extendable part so that a duct wall section on the side of the opening hauled by the auxiliary tool near it can move to a place behind the opening. <P>COPYRIGHT: (C)2011,JPO&INPIT

Description

  The present invention relates to an actuator for a moving body in a tube, a control method therefor, and an endoscope, and more particularly to a technique for moving the inside of a tube by moving a tube wall.

  In Patent Document 1, four variable tubes that can expand and contract spirally are wound around the outer peripheral surface of the flexible tube portion, and the four variable tubes are changed by varying the pressure in each variable tube. In this technique, the outer peripheral surface of the outer skin is sequentially expanded and contracted to move the inflatable portion from the distal end side to the proximal side, and the intestinal tract is drawn up to insert it into the large intestine. .

Japanese Patent Laid-Open No. 11-009545

  However, in the technique of Patent Document 1, there is almost no effect of moving the contact surface of the tube only by the vertical movement of the plurality of variable tubes. The folds of the intestinal tract are effective only when they enter the groove between the expanded tubes, but there are almost no folds in the sigmoid colon. Since the amount is small, the effect of dragging is remarkably reduced and the insertion into the large intestine may not be possible.

  In addition, if the intestinal tract that has been handed over is not sent backward in the traveling direction, the intestinal tract that has been handed over may accumulate, and the visibility of the distal end portion may not be secured. Therefore, it is necessary for the doctor to perform the work of feeding the intestinal tract that has been pulled back to the back in the traveling direction as well as the work of inserting into the large intestine, which increases the work load.

  The present invention has been made in view of such circumstances, and for an in-pipe moving body that can easily advance the insertion portion even in a complicatedly bent tube such as the sigmoid colon while reducing the work load of an operator such as a doctor. An object is to provide an actuator, a control method thereof, and an endoscope.

  In order to achieve the above object, an actuator for a moving body in a tube of the present invention can be freely inserted and removed from an opening provided at a distal end of an insertion portion inserted into the tube, and the distal end portion is located in front of the opening. An auxiliary tool that is freely displaceable between a first position that is in contact with or close to the wall and a second position that is located in front of the opening; an expansion / contraction member provided at a distal end of the insertion part; A control unit that controls the operation of the expansion / contraction member, and the control unit feeds a lateral tube wall located on the side of the opening that has been pulled by the auxiliary tool to the rear of the opening. The internal pressure of the expansion / contraction member is controlled as described above.

  According to the present invention, control is performed so that the hand-drawn tube is fed backward in the traveling direction, so that the insertion portion can be easily advanced even in a complicatedly bent tube while reducing the work load on the operator.

  As one aspect of the present invention, the control unit starts feeding the side tube wall to the rear of the opening when a signal indicating that the side tool wall has been moved by the auxiliary tool is output. The internal pressure of the expansion / contraction member is controlled as described above.

  According to this aspect, since the internal pressure of the expansion / contraction member is controlled so that the backward feeding is started when the hand-drawing by the auxiliary tool is finished, the side that has been hand-drawn reliably while reducing the work burden on the operator. The tube wall can be fed backwards.

  As one aspect of the present invention, the control unit controls the expansion / contraction member to regulate an amount of feeding the side tube wall to the rear of the opening based on a displacement amount of the tip portion of the auxiliary tool. It is characterized by doing.

  According to this aspect, since the amount fed backward is controlled based on the amount of displacement of the distal end portion of the assisting tool, there is no possibility that hand drag will accumulate near the opening.

  As one aspect of the present invention, the control unit inflates and contracts the expansion / contraction member and engages the side tube wall with the distal end portion of the auxiliary tool in contact with or close to the front tube wall. It is characterized by controlling to make it happen.

  According to this aspect, the distal end portion of the auxiliary tool is controlled so as to abut or approach the front tube wall in a state where the expansion / contraction member is locked to the side tube wall. While ensuring, the front-end | tip part of an auxiliary tool can be contact | abutted or adjoined to the front tube wall.

  As one aspect of the present invention, two pairs of the expansion / contraction members are arranged symmetrically with respect to the axial direction of the insertion portion, and are arranged with a phase shifted at substantially the same position in the axial direction of the insertion portion, It is characterized by.

  One aspect of the present invention is characterized in that the expansion / contraction member is formed over the circumference around the axis of the insertion portion, and is disposed at least two in the axial direction of the insertion portion.

  As one aspect of the present invention, at least one of the expansion / contraction members has directivity in a direction of deformation when expanded.

  As one aspect of the present invention, three of the expansion / contraction members are sequentially arranged in the axial direction of the insertion portion.

  As one aspect of the present invention, the insertion portion is configured from the distal end side in the order of a distal end portion including the opening, a bending portion that freely changes the orientation of the distal end portion, and a flexible portion connected to the bending portion. And the said expansion / contraction member is arrange | positioned at the said front-end | tip part, It is characterized by the above-mentioned.

  As one aspect of the present invention, the insertion portion is configured from the distal end side in the order of a distal end portion including the opening, a bending portion that freely changes the orientation of the distal end portion, and a flexible portion connected to the bending portion. And the said expansion / contraction member is arrange | positioned at the said soft part, It is characterized by the above-mentioned.

  As one aspect of the present invention, there is provided auxiliary tool fixing means that is provided at the distal end portion of the auxiliary tool and fixes the distal end portion to the front tube wall when the distal end portion is displaced to the first position. Features.

  As an aspect of the present invention, the auxiliary tool fixing means is a suction port that is attracted to the front tube wall by a negative pressure suction force.

  As one aspect of the present invention, the auxiliary tool fixing means is a hook.

  In order to achieve the above object, an endoscope according to the present invention includes any one of the actuators for moving in a tube.

  In order to achieve the above object, the method for controlling an actuator for a moving body in a pipe according to the present invention can be freely inserted and removed from an opening provided at a distal end of an insertion part inserted into the pipe, and the distal end is positioned in front of the opening. An auxiliary tool that is displaceable to a first position that is in contact with or close to the front tube wall and a second position that is located in front of the opening, and an expansion / contraction member provided at the distal end of the insertion portion. A method for controlling an actuator for a moving body in a tube, wherein the internal pressure of the expansion / contraction member is controlled so as to feed a side tube wall located on the side of the opening that has been pulled by the auxiliary tool to the rear of the opening. It is characterized by doing.

  According to the present invention, it is possible to easily advance the insertion portion even in a complicatedly bent tube such as the sigmoid colon while reducing the work load of an operator such as a doctor.

It is the whole endoscope apparatus schematic of a 1st embodiment. It is an external view of the front surface of the insertion part front-end | tip part of 1st Embodiment. It is a figure which shows the state in which an insertion part is inserted in a sigmoid colon through a rectum. It is a figure which shows the state which has an auxiliary tool front-end | tip part in a 1st position. It is a figure which shows the state which has an auxiliary tool front-end | tip part in a 2nd position. It is a block diagram which shows the electrical structure of an endoscope, an auxiliary tool, and an auxiliary tool controller. It is an enlarged view of an insertion part front-end | tip part. It is a figure which shows an example of a balloon structure. It is AA sectional drawing in FIG. It is a block block diagram of a balloon control apparatus. It is a figure which shows the mode of expansion | swelling of a balloon. It is a figure which shows the example which has arrange | positioned and arranged three balloons formed over the circumferential direction centering on the axis | shaft of an insertion part along the axial direction of an insertion part. It is a figure which shows the modification of a balloon. It is a timing chart figure of automatic control. It is a flowchart figure of automatic control. It is a timing chart figure of sending operation by a balloon. It is a figure which shows the outline | summary of the expansion / contraction of the balloon in the feeding operation | movement by a balloon. It is a figure which shows the state in which the lateral intestinal wall was sent in by the balloon. It is a timing chart figure of the modification of automatic control. It is a block block diagram of the balloon control apparatus which controls the pressure of a 1st balloon, a 2nd balloon, and a 3rd balloon. It is a timing chart figure of the propulsion operation of the in-pipe moving body actuator of the present invention. It is the schematic sectional drawing which showed the mode of expansion | swelling of each balloon, and shrinkage | contraction corresponding to the timing chart figure of the propulsion operation | movement shown in FIG. It is the schematic sectional drawing which showed the mode of expansion | swelling of each balloon, and shrinkage | contraction corresponding to the timing chart figure of the propulsion operation | movement shown in FIG. It is the schematic sectional drawing which showed the mode of expansion | swelling of each balloon, and shrinkage | contraction corresponding to the timing chart figure of the propulsion operation | movement shown in FIG. It is the schematic sectional drawing which showed the mode of expansion | swelling of each balloon, and shrinkage | contraction corresponding to the timing chart figure of the propulsion operation | movement shown in FIG. It is the schematic sectional drawing which showed the mode of expansion | swelling of each balloon, and shrinkage | contraction corresponding to the timing chart figure of the propulsion operation | movement shown in FIG. It is the schematic sectional drawing which showed the mode of expansion | swelling of each balloon, and shrinkage | contraction corresponding to the timing chart figure of the propulsion operation | movement shown in FIG. It is the schematic sectional drawing which showed the mode of expansion | swelling of each balloon, and shrinkage | contraction corresponding to the timing chart figure of the propulsion operation | movement shown in FIG. It is the schematic sectional drawing which showed the mode of expansion | swelling of each balloon, and shrinkage | contraction corresponding to the timing chart figure of the propulsion operation | movement shown in FIG. It is the schematic sectional drawing which showed the mode of expansion | swelling of each balloon, and shrinkage | contraction corresponding to the timing chart figure of the propulsion operation | movement shown in FIG. It is the schematic sectional drawing which showed the mode of expansion | swelling of each balloon, and shrinkage | contraction corresponding to the timing chart figure of the propulsion operation | movement shown in FIG. It is a principal part schematic of the endoscope apparatus of 2nd Embodiment. It is an external view of the front surface of the insertion part front-end | tip part of 2nd Embodiment. It is an external view of the front surface of the insertion part front-end | tip part of 3rd Embodiment. It is sectional drawing of an insertion part suction port. It is a block diagram which shows the electrical structure of an endoscope, an auxiliary tool, an auxiliary tool controller, and an insertion part suction device. It is a timing chart figure about automatic control of a 3rd embodiment. It is a figure which shows the state which the insertion part suction port contacted the lateral intestinal wall. It is an external view of the front surface of the insertion part front-end | tip part of 4th Embodiment. It is a figure which shows the state which made the suction port of 4th Embodiment adsorb | suck to the intestinal wall of a sigmoid colon. It is a figure which shows the example whose closed shape of a suction opening is a substantially cylindrical shape. It is a figure which shows the example whose closed shape of a suction opening is a taper shape (bud shape of a morning glory). It is a figure which shows the example which provided a pair of hook in the auxiliary tool front-end | tip part.

  Hereinafter, preferred embodiments of the present invention will be described in detail with reference to the accompanying drawings.

[Overall description of the endoscope apparatus]
As shown in FIG. 1, an endoscope apparatus 10 includes an endoscope 12, an elongated tubular auxiliary tool (hereinafter simply referred to as an auxiliary tool) 14 formed of various elastic bodies, and an auxiliary tool controller. 16, a processor device 18, a light source device 20, and the like.

  The endoscope 12 includes an insertion portion 22 that is inserted into a lumen such as a small intestine and a large intestine, an operation portion 24 that is used to hold the endoscope 12 and operate the insertion portion 22, and a first balloon 26-1. The second balloon 26-2 and the balloon control device 28 are provided.

  The insertion portion 22 is a flexible rod-like body, and includes an insertion portion distal end portion 22a provided with a known imaging portion and illumination portion (not shown) from the distal end side, a bending portion 22b, and a flexible portion 22c. ing. The flexible portion 22 c has a length that occupies most of the insertion portion 22. The direction of the distal end side can be freely changed by operating the bending portion 22b with the operation unit 24.

  Inside the insertion portion 22, there are a forceps channel 30, an air / water supply channel (not shown) through which air and water flow, and an air supply / exhaust passage for supplying and discharging gas to the first balloon 26-1, as will be described later. 84 (see FIG. 9) and the like are provided. The forceps channel 30 is a tube having flexibility and waterproofness, and a treatment tool (not shown) such as a forceps and an injection needle used for treatment of a patient, the auxiliary tool 14 and the like are inserted therethrough.

  The operation unit 24 includes an angle knob 32 and a forceps inlet 34. The angle knob 32 is rotated when adjusting the bending direction and the bending amount of the bending portion 22b. The forceps inlet 34 is an inlet side opening of the forceps channel 30. The auxiliary tool 14 and the like are inserted into the forceps channel 30 from the forceps inlet 34. The operation unit 24 is provided with operation buttons 36 used for various operations such as air supply and water supply.

  In addition to the air / water supply channel, the universal cord 38 connected to the operation unit 24 incorporates a wiring to the imaging unit at the distal end 22a of the insertion unit, a light guide to the illumination unit, and the like. A connector portion 40 a is provided at the distal end portion of the universal cord 38. This connector part 40 a is connected to the light source device 20. Further, a connector portion 40b connected to the processor device 18 and a connector portion 40c connected to the balloon control device 28 are branched from the connector portion 40a.

  The processor device 18 displays an endoscopic image based on image data or the like input from the imaging unit on a monitor (not shown). The light source device 20 emits illumination light from the light source unit and guides it to the light guide.

  As shown in FIGS. 2A and 2B, an observation window 42, an illumination window 44, an air / water supply nozzle 46, and a forceps outlet 48 are provided on the front surface of the insertion portion distal end portion 22a. The imaging unit and the illumination unit are arranged behind the observation window 42 and the illumination window 44, respectively. The air / water supply nozzle 46 is an opening on the outlet side of the air / water supply channel, and injects air and water into the lumen and the observation window 42. The forceps outlet 48 is an outlet side opening of the forceps channel 30. The treatment tool or the auxiliary tool 14 inserted into the forceps channel 30 from the forceps inlet 34 protrudes forward from the forceps outlet 48.

<First Embodiment>
[Configuration related to assistive devices]
The auxiliary tool 14 has a diameter smaller than that of the forceps outlet 48, the forceps channel 30, and the forceps inlet 34, and is slidably inserted into the forceps channel 30. The assisting tool 14 is an adsorption assisting tool in which the assisting tool tip 14a is detachably adsorbed to the inner wall of the lumen located in front of the forceps outlet 48 (hereinafter referred to as the front lumen inner wall). In the present invention, by inserting the auxiliary tool 14 from the forceps outlet 48 and adsorbing it to the inner wall of the front lumen, the insertion portion distal end portion 22a is in a complicatedly bent lumen such as the sigmoid colon 50 (see FIG. 3). Move forward relatively.

  The auxiliary tool 14 can be freely inserted and removed from the forceps outlet 48 by a delivery operation (operation for sending the auxiliary tool 14 from the forceps outlet 48) and a pulling operation (operation for pulling the auxiliary tool 14 into the forceps outlet 48) at the doctor's hand. It is. Thereby, the auxiliary tool distal end portion 14a is freely displaceable between a first position (see FIG. 4) that abuts against the inner wall of the front lumen and a second position (see FIG. 5) located in front of the forceps outlet 48.

  The auxiliary tool distal end portion 14a is provided with a suction port 52 that is attracted to the inner wall of the front lumen by a negative pressure suction force. The suction port 52 has a trumpet shape (see FIG. 2 (B)) that expands in a substantially trumpet shape (suction cup shape), and is smaller than the trumpet shape. The elastic body has the same outer diameter as 14a and can be deformed into a closed shape (see FIG. 2A) that can be stored in the forceps outlet 48 (forceps channel 30).

  The suction port 52 is deformed by using a wire 54 (not shown in FIG. 2B) provided in the suction port 52. Each wire 54 is a shape memory alloy that bends in a bow shape by energization heating and deforms the suction port 52 into a trumpet shape. When the energization of each wire 54 is stopped, the temperature of each wire 54 is lowered and the wire 54 can be deformed into an arbitrary shape. Therefore, the suction port 52 is restored to the original closed shape by its own elastic restoring force. At this time, if it takes time to lower the temperature of each wire 54 and the recovery of the suction port 52 is slow, the temperature of the wire 54 may be forcibly lowered by various cooling means such as a Peltier element.

  Returning to FIG. 1, the auxiliary tool rear end portion 14 b of the auxiliary tool 14 is connected to the auxiliary tool controller 16. The rear end portion of each wire 54 is connected to the auxiliary device controller 16 through the auxiliary device 14. The auxiliary instrument controller 16 includes an energization device 56 that controls energization of the wire 54 (deformation of the suction port 52), and a suction device 58 that controls suction of air from the suction port 52 (generation of negative pressure suction force). The auxiliary device displacement device 60, the control device 62, the operation panel 64, and the like.

  The auxiliary tool controller 16 automatically controls processing (hereinafter simply referred to as adsorption / traction processing of the auxiliary tool 14) including sending / pulling of the auxiliary tool 14, opening / closing of the suction port 52, and suction / suction stop.

  In addition, as shown in FIG. 6, a contact sensor 66 and a suction pressure detection sensor 68 are provided in the suction port 52 of the auxiliary tool 14, and an auxiliary tool detection sensor 70 is provided in the forceps outlet 48 of the endoscope 12. It has been.

  As the energization device 56, various power supply devices capable of energizing each wire 54 are used. The energization device 56 changes the suction port 52 into a trumpet shape and a closed shape by switching between energization and deenergization of each wire 54.

  A known vacuum pump is used for the suction device 58. The suction device 58 generates a negative pressure suction force at the suction port 52 by sucking air in the assisting tool 14 from the assisting tool rear end 14b. The suction device 58 can adjust the negative pressure suction force of the suction port 52 in two stages, “strong” and “weak”. The negative pressure suction force “strong” is suppressed to a force that does not damage the inner wall of the front lumen.

  Returning to FIG. 1, the auxiliary tool displacement device 60 is a device for automatically sending and pulling the auxiliary tool 14, and drives the transport roller pair 72 that transports the auxiliary tool 14 and the transport roller pair 72. The conveyance motor 74, a pair of pass rollers 76 provided upstream of the conveyance roller pair 72 in the auxiliary tool conveyance direction, and a dancer roller 78 provided between the two pass rollers 76.

  The dancer roller 78 is held movably in the vertical direction in the figure by a dancer mechanism (not shown). The dancer roller 78 rises when the conveyance motor 74 rotates forward and the auxiliary tool 14 is sent out by the conveyance roller pair 72, and descends when the conveyance motor 74 reverses and the conveyance roller pair 72 pulls in the auxiliary tool 14. To do. The maximum delivery amount of the auxiliary tool 14 by the auxiliary tool displacement device 60 is twice as long as the maximum stroke amount of the dancer roller 78 in the vertical direction.

  As described above, the auxiliary tool displacement device 60 can cause the auxiliary tool distal end portion 14 a to protrude from the forceps outlet 48 or to be stored in the forceps outlet 48 by rotating the transport motor 74 forward and backward. Even when the distal end portion 22a of the insertion portion and the inner wall of the front lumen are separated, the maximum stroke amount of the dancer roller 78 is sufficiently ensured so that the assisting device distal end portion 14a can reach the first position. ing.

  Further, the auxiliary tool 14 delivered from the auxiliary tool displacement device 60 is inserted into the forceps channel 30 from the forceps inlet 34.

  As shown in FIG. 6, the contact sensor 66, the suction pressure detection sensor 68, and the auxiliary tool detection sensor 70 are connected to the control device 62. Further, the control device 62 is provided with a traction end determination circuit (hereinafter referred to as a determination circuit) 80.

  The contact sensor 66 outputs an ON signal to the control device 62 when the suction port 52 contacts the front lumen inner wall. The detection result of the contact sensor 66 is used to determine whether or not the auxiliary tool distal end portion 14a has reached the aforementioned first position.

  The suction pressure detection sensor 68 detects the magnitude of the negative pressure suction force of the suction port 52, and outputs an ON signal to the control device 62 when the negative pressure suction force becomes “strong”. The detection result of the suction pressure detection sensor 68 determines whether or not the negative pressure suction force of the suction port 52 has reached “strong”, that is, whether or not the suction port 52 is completely adsorbed on the inner wall of the front lumen. Used for.

  The auxiliary tool detection sensor 70 is a pair of optical sensors including, for example, a light emitting sensor and a light receiving sensor. When the light emitted from the light emitting sensor toward the light receiving sensor is blocked by the auxiliary tool 14, an ON signal is controlled by the control device. To 62. The detection result of the auxiliary tool detection sensor 70 is used to determine whether or not the auxiliary tool distal end portion 14a inserted into the forceps channel 30 has reached the forceps outlet 48 (in order to obtain a protruding amount of an auxiliary tool distal end portion 14a described later). ).

  The determination circuit 80 determines whether or not the auxiliary tool distal end portion 14a has reached the second position when the auxiliary instrument distal end portion 14a is pulled to the second position as described above. This determination is made based on the result of obtaining the amount of protrusion of the auxiliary tool tip 14a from the forceps outlet 48 (hereinafter simply referred to as the amount of protrusion).

  When the passage of the auxiliary tool tip 14a is first detected by the auxiliary tool detection sensor 70, the determination circuit 80 resets the protrusion amount to 0 and then starts calculating the protrusion amount. Specifically, the number of rotations of the transport motor 74 is counted, and the amount of protrusion is calculated based on the count result and the amount of movement D of the auxiliary tool 14 per one rotation of the motor. The determination circuit 80 adds the moving amount D to the protruding amount every time the carry motor 74 rotates forward once, and subtracts the moving amount D from the protruding amount every time the carry motor 74 reverses once.

  The amount of protrusion when the auxiliary tool tip 14a is in the second position (hereinafter referred to as target protrusion amount) is known. For this reason, the determination circuit 80 determines that the auxiliary tool distal end portion 14a is pulled to the second position when the calculated protrusion amount reaches the target protrusion amount after the auxiliary tool distal end portion 14a starts to be pulled. Outputs a towing end determination signal. In addition, although the assist tool front-end | tip part 14a passes the 2nd position on the way to the 1st position after passing the assist tool detection sensor 70, the output of the traction completion | finish determination signal is not performed at that time.

  The control device 62 comprehensively controls the energization device 56, the suction device 58, and the auxiliary tool displacement device 60 based on signals input from the operation panel 64 and the sensors 66, 68, and 70, and Automatic control of suction and traction processing.

[Configuration related to balloons]
FIG. 7 is an enlarged view of the insertion portion distal end portion 22a. 7A is a view of the insertion portion distal end portion 22a as viewed from the side surface, and FIG. 7B is a view of the insertion portion distal end portion 22a as viewed from the distal end side. As shown in FIG. 7, a pair of first balloons 26-1 and a pair of second balloons 26-2 are arranged at substantially the same position in the axial direction of the insertion portion 22 (advancing direction of the moving body in the tube). The phase is shifted in the outer circumferential direction (planar arrangement).

  FIG. 8 is a diagram illustrating an example of a balloon configuration. In the embodiment shown in FIG. 8, forward balloons are used as the first balloon 26-1 and the second balloon 26-2. Here, the forward balloon is a deformation directional balloon having directivity in the direction of deformation when inflated, and is directed in the direction opposite to the insertion portion distal end portion 22a side, that is, in the direction of the bending portion 22b side. A balloon that expands while deforming.

  9 is a cross-sectional view taken along line AA in FIG. As shown in FIG. 9, an air supply / exhaust path 84 is communicated with the lumen of the first balloon 26-1 via an air supply / exhaust port 82 opened on the outer peripheral surface of the insertion portion distal end 22a. The air supply / exhaust path 84 is provided in the axial direction of the insertion portion 22 and is connected to the balloon control device 28 through the operation portion 24 and the universal cord 38 shown in FIG.

  FIG. 10 is a block configuration diagram of the balloon control device 28. As shown in FIG. 10, the balloon control device 28 includes an air supply pump 86 that supplies air to the first balloon 26-1 via the air supply / exhaust passage 84 (see FIG. 9), Two suction pumps 88 for sucking the air are provided. The operation of the air supply pump 86 and the suction pump 88 is controlled by the controller 90, whereby the pair of first balloons 26-1 are individually inflated and contracted.

  Further, although not shown, the air supply / exhaust is provided in the lumen of the second balloon 26-2 through the air supply / exhaust port opened in the outer peripheral surface of the insertion portion 22 in the same manner as the lumen of the first balloon 26-1. The passage is communicated, and the air supply / exhaust passage is provided in the axial direction of the insertion portion 22 and is connected to the balloon control device 28 through the operation portion 24 and the universal cord 38 shown in FIG.

  As shown in FIG. 10, the balloon control device 28 includes an air supply pump 92 that supplies air to the second balloon 26-2 through an air supply / exhaust passage (not shown), and an inside of the second balloon 26-2. Two suction pumps 94 for sucking the air are provided. Then, by controlling the operations of the air supply pump 92 and the suction pump 94 with the controller 90, the pair of second balloons 26-2 are individually inflated and contracted.

  Further, as shown in FIG. 9, in this embodiment, the first balloon 26-1 is a forward balloon, and the traveling direction of the insertion portion 22 (from the curved portion 22 b of the insertion portion 22 to the distal end portion 22 a of the insertion portion). The rear portion 26a (indicated by the oblique lines, hereinafter simply referred to as the rear portion) and the circumferential portion 26b (indicated by the oblique lines, hereinafter simply referred to as the circumferential portion) in the direction of the head are more than the other portions. The wall thickness is thick.

  Therefore, when air is supplied from the air supply pump 86 via the air supply / exhaust path 84, the first balloon 26-1 expands as shown in FIG. That is, since the rear portion 26a and the circumferential portion 26b are formed thicker than the other portions, the rear portion 26a and the circumferential portion 26b have a lower expansion rate than the other portions, and the rear portion 26a and the circumferential portion 26b A portion other than the circumferential portion 26b extends and expands in a substantially fan shape toward the rear in the traveling direction of the insertion portion 22 as indicated by a dotted line.

  In addition, the 1st balloon 26-1 equips the back part 26a and the circumferential part 26b with the low expansion | swelling material whose expansion rate is lower than another part, and the back part 26a and the circumferential part 26b are other parts. The expansion coefficient may be lower than that. Specifically, as the low expansion material, for example, PET fiber or aramid fiber is bonded to the surface, embedded or integrally formed in the rear portion 26a and the circumferential portion 26b, and the expansion rate is partially changed. Also good.

  The specification of the balloon is not limited to this, and various specifications can be considered.

  For example, the first balloon 26-1 may be a forward balloon and the second balloon 26-2 may be a locking balloon. Here, the locking balloon is a balloon that does not have deformation directivity when inflated and deforms almost uniformly as a whole.

  In the present embodiment, the second balloon 26-2 is also a forward balloon having the same configuration as the first balloon 26-1.

  Further, as a combination of the first balloon 26-1 and the second balloon 26-2, it is conceivable that either one is a forward balloon and the other is a backward balloon. Here, the backward balloon is a deformation-directing balloon that deforms in the direction opposite to the forward balloon when inflated, and is inflated while being deformed toward the distal end side of the insertion portion distal end portion 22a. is there. Specifically, the reverse balloon has a lower expansion rate in the forward portion of the insertion portion 22 in the traveling direction and in the circumferential portion than in other portions.

  In addition, as shown in FIG. 12, three balloons (indicated by reference numerals 108, 110, and 112) formed over the circumference in the circumferential direction centering on the axis of the insertion portion 22 are arranged in the axial direction of the insertion portion 22. You may arrange.

  Further, a balloon having a cross-sectional shape as shown in FIG. 13 may be arranged. The balloon shown in FIG. 13A is made of a shape memory material, artificial muscle, or the like at the end of latex rubber that can be expanded and contracted. The balloon shown in FIG. 13 (B) is made of latex rubber which can be expanded and contracted as a whole, and has three pressure chambers. Then, the balloon is rotated by expanding and contracting the shape memory material or artificial muscle or by expanding and contracting the pressure chambers at both ends.

[Description of suction / traction processing and feeding operation]
Next, with reference to FIG. 14 (timing chart) and FIG. 15 (flowchart), the suction / traction processing of the auxiliary tool 14 by the auxiliary tool controller 16 and the automatic control of the balloon feeding operation by the balloon control device 28 will be described in detail. .

  As shown in FIG. 3, the doctor inserts the insertion portion 22 of the endoscope 12 from the patient's anus (not shown), and then pushes out the insertion portion 22. Thereby, the insertion part 22 is inserted into the sigmoid colon 50 through the rectum (not shown).

  When the doctor performs the push-out operation, the insertion portion distal end portion 22a moves along the intestinal wall of the sigmoid colon 50, for example, the ascending portion 50b of the sigmoid colon 50 (a portion extending substantially upward from the bent portion 50a). The desired position or the bent portion 50a on the descending colon 51 side (the transition between the sigmoid colon 50 and the descending colon 51) is advanced to the desired position.

  Here, a case where the ascending portion 50b of the sigmoid colon 50 is advanced to a desired position will be described as an example.

  After the doctor advances the insertion portion distal end portion 22a to a position where the ascending portion 50b is desired, the doctor connects the assisting device displacement device 60 and the forceps inlet 34 with the guide tube T, and sets the assisting device 14 on the endoscope 12 ( Step S1).

  Next, a start instruction (operation) for suction / traction processing of the auxiliary tool 14 is performed on the operation panel 64 (step S2).

  When this start instruction is given, the control device 62 rotates the transport motor 74 of the auxiliary tool displacement device 60 in the normal direction and starts sending the auxiliary tool 14 (step S3, “t1” in FIG. 14). Thereby, the auxiliary tool distal end portion 14 a is inserted into the forceps channel 30 through the guide tube T and the forceps inlet 34.

  When the auxiliary tool distal end portion 14a reaches the forceps outlet 48, an ON signal is output from the auxiliary tool detection sensor 70 to the control device 62 ("t2" in FIG. 14). When the ON signal is input to the control device 62, the determination circuit 80 resets the protruding amount of the auxiliary tool tip 14a to 0 and then starts calculating the protruding amount.

  Based on the calculation result of the determination circuit 80, the control device 62 determines that the auxiliary tool distal end portion 14a has protruded from the forceps outlet 48 (step S4), and then operates the energization device 56 to make the suction port 52 into a trumpet shape. Deformation (step S5, “t3” in FIG. 14). At the same time, the control device 62 operates the suction device 58 to generate a “weak” negative pressure suction force at the suction port 52 (step S6).

  When the assisting tool displacement device 60 continues to send out the assisting tool 14 and the assisting tool tip 14a comes into contact with the ascending part 50b as shown in FIG. 4, the contact sensor 66 sends an ON signal to the control device 62. (Step S7, “t4” in FIG. 14). When the ON signal from the contact sensor 66 is input, the control device 62 stops the sending process of the auxiliary tool 14 by the auxiliary tool displacement device 60 (step S8). Thereby, since the further delivery of the auxiliary tool 14 is prevented, the intestinal wall is prevented from being perforated by the auxiliary tool tip 14a.

  Next, the control device 62 controls the suction device 58 to change the negative pressure suction force of the suction port 52 to “strong” (step S9). As a result, the negative pressure suction force detected by the suction pressure detection sensor 68 gradually increases from “weak”. Then, the suction pressure detection sensor 68 outputs an ON signal to the control device 62 when the detection result of the negative pressure suction force reaches “strong” (step S10, “t5” in FIG. 14).

  After the ON signal from the suction pressure detection sensor 68 is input, that is, after the suction port 52 is completely adsorbed to the ascending portion 50b, the control device 62 is fixed to the ascending portion 50b. Then, the transport motor 74 is reversed. Thereby, the auxiliary tool front-end | tip part 14a and the ascending part 50b are pulled integrally (step S11).

  When pulling of the auxiliary tool 14 is started, the protrusion amount of the auxiliary tool 14 calculated by the determination circuit 80 decreases. Then, when the calculated protrusion amount reaches the target protrusion amount, the determination circuit 80 determines that the auxiliary tool distal end portion 14a has been pulled to the second position as shown in FIG. ON signal) (step S12, “t6” in FIG. 14).

  When the traction end determination signal is output from the determination circuit 80, the control device 62 stops the reverse rotation (traction process) of the transport motor 74 (step S13). Thereby, after moving the insertion part 22 to the vicinity of the ascending part 50b, the auxiliary tool front-end | tip part 14a can be pulled to the vicinity of the insertion part front-end | tip part 22a integrally with the ascending part 50b (refer FIG. 5).

  In this way, by pulling the auxiliary tool distal end portion 14a integrally with the ascending portion 50b to the vicinity of the insertion portion distal end portion 22a, the lateral intestinal wall 50c positioned on the side can be drawn.

  Note that the control device 62 may display on the monitor (not shown) of the auxiliary tool controller 16 that the suction / traction process of the auxiliary tool 14 has ended after the above-described pulling process is stopped.

  Further, when the traction end determination signal is output from the determination circuit 80, the traction end determination signal is input to the balloon control device 28. Then, the feeding operation for feeding the lateral intestinal wall 50c backward by the balloon is started (step S14).

  Here, the feeding operation by the balloon will be described. FIG. 16 is a timing chart of the balloon feeding operation, and FIG. 17 is a diagram showing an outline of balloon expansion and contraction in the balloon feeding operation. 17 is a cross-sectional view taken along the line AA in FIG. 8, and the right view of FIG. 17 is a cross-sectional view taken along the line BB in FIG.

  First, as shown in FIG. 17A, air is supplied to the first balloon 26-1 from the state in which the first balloon 26-1 and the second balloon 26-2 are contracted (see FIGS. 16 and 17). Step A) shown. As a result, as shown in FIG. 11, the first balloon 26-1 expands in a substantially fan shape toward the rear in the traveling direction. And as shown in the left figure of FIG.17 (b), the side intestinal wall 50c is sent back in the advancing direction.

  Next, air is supplied to the second balloon 26-2 (step B shown in FIGS. 16 and 17). Accordingly, as in the first balloon 26-1, the lateral intestinal wall 50c is fed backward in the traveling direction as shown in the right diagram of FIG. 17 (c).

  Next, the air in the first balloon 26-1 is sucked and the first balloon 26-1 is deflated as shown in the left diagram of FIG. 17D (step C shown in FIGS. 16 and 17). .

  Here, when the first balloon 26-1 is deflated, the first balloon 26-1 is deflated toward the front in the advancing direction, so the side intestinal wall 50c is about to be sent forward in the advancing direction. However, since the second balloon 26-2 is inflated and locked, the lateral intestinal wall 50c is not sent forward in the traveling direction.

  Next, air is again supplied to the first balloon 26-1 (step D shown in FIGS. 16 and 17). Thereby, as shown in the left figure of FIG.17 (e), the side intestinal wall 50c is further sent in the back of the advancing direction.

  Next, the air in the second balloon 26-2 is sucked to deflate the second balloon 26-2 (step E shown in FIGS. 16 and 17).

  Thereby, it will be in the state shown similarly to said FIG.17 (b).

  Thereafter, by repeating Step B to Step E, the expansion and contraction of the first balloon 26-1 and the second balloon 26-2 are repeated, whereby the lateral intestinal wall 50c is inserted into the distal end of the insertion portion as shown in FIG. It is fed from the portion 22a toward the soft portion 22c (backward in the traveling direction).

Here, it is conceivable that the time for feeding the side intestinal wall 50c by the first balloon 26-1 and the second balloon 26-2 is determined based on the protruding amount of the auxiliary tool 14. Specifically, the time of the feeding operation by the first balloon 26-1 and the second balloon 26-2 is T, and the unit length of the lateral intestinal wall 50c by the first balloon 26-1 and the second balloon 26-2. the feed time per a k, the amount of projection of the auxiliary tool 14 is L, the first balloon 26-1 activation time of the second balloon 26-2 and t _0, is considered a formula as follows.

[Equation 1]
T = k × L + t ₀
In this way, by determining the time for the feeding operation of the side intestinal wall 50c by the first balloon 26-1 and the second balloon 26-2 based on the protruding amount of the auxiliary tool 14, the intestinal wall due to the unnecessary operation of the balloon. Can be avoided.

  Next, returning to FIGS. 14 and 15, when the feeding of the side intestinal wall 50c is finished and the balloon feeding operation is stopped (steps S15 and S16, “t7” in FIG. 14), the gas from the suction port 52 is discharged. Is stopped (step S17). Then, while viewing the monitor image, the operation of the angle knob 32 is conveniently performed, and the front surface of the auxiliary tool distal end portion 14a is directed to the new target intestinal wall.

  Next, when the doctor gives an instruction to start the suction / traction process of the auxiliary tool 14 on the operation panel 64 (step S18), the process returns to step S3, and the delivery of the auxiliary tool 14 and the suction of the suction port 52 are performed again. Is called.

On the other hand, the doctor does not give an instruction to start the suction / traction process of the auxiliary tool 14 on the operation panel 64,
When the auxiliary tool 14 is not used (for example, when the insertion portion distal end portion 22a is inserted into the fixed intestine such as the descending colon 51), the operation panel 64 instructs the storage start of the auxiliary tool distal end portion 14a (step S19). ).

  When this instruction is given, the control device 62 stops the operation of the energization device 56 and deforms the suction port 52 into a closed shape (step S20). Next, the control device 62 reversely rotates the transport motor 74 until the protrusion amount of the auxiliary tool 14 calculated by the determination circuit 80 becomes “0” (the auxiliary tool detection sensor 70 is OFF), and the auxiliary tool tip end portion 14a. Then, the suction port 52 is stored in the forceps outlet 48 (step S21).

  When the insertion portion 22 is inserted into a complicatedly bent lumen, the insertion portion distal end portion 22a can reach the target point in the lumen by repeatedly executing the above-described processes and operations. Then, the doctor manually removes the auxiliary tool 14 and the guide tube from the endoscope 12 after reaching the insertion portion distal end portion 22a to the target point.

  Further, according to the timing chart as shown in FIG. 19, the front surface of the assisting device distal end portion 14a can be directed to the new target intestinal wall while ensuring the field of view of the insertion portion distal end portion 22a with a balloon.

  As shown in FIG. 19, when the delivery of the auxiliary tool 14 is started (“t1” in FIG. 19), both the first balloon 26-1 and the second balloon 26-2, or the first balloon 26 -1 and the second balloon 26-2 are inflated and locked to the lateral intestinal wall 50c.

  Thereby, the field of view of the front surface of the auxiliary tool distal end portion 14a can be secured, and it becomes easy to find a new target intestinal wall.

  As described above, according to the present embodiment, the lateral intestinal wall 50c that has been brought close by the auxiliary tool 14 is further fed backward by the first balloon 26-1 and the second balloon 26-2. Therefore, the doctor can concentrate on intestinal wall suction by the assisting tool 14 and can improve the insertion efficiency of the insertion portion 22. Thus, for example, the doctor can concentrate on the angle operation of the bending portion 22b and the insertion and removal of the auxiliary tool 14.

  In addition, since the feeding operation by the first balloon 26-1 and the second balloon 26-2 is automatically started from the point where the traction operation is finished and the traction end determination signal falls, the doctor makes the first balloon 26- There is no need to issue an activation instruction for the first and second balloons 26-2.

  Instead of the first balloon 26-1 and the second balloon 26-2, as shown in FIG. 12, a balloon that forms a balloon over the entire circumference in the circumferential direction centering on the axis of the insertion portion 22 is provided. Also, the feeding operation by the balloon when three are arranged in the axial direction of the insertion portion 22 will be described.

  As shown in FIG. 12, the first balloon 108, the second balloon 110, and the third balloon 112 are arranged in this order from the rear in the traveling direction at the insertion portion distal end portion 22a. The first balloon 108, the second balloon 110, and the third balloon 112 are all made of latex rubber that is freely expandable and contractible.

  As will be described later, the first balloon 108 and the second balloon 110 are both inflated and arranged so as to contact each other in a state of being locked to the lateral intestinal wall 50c. Further, both the second balloon 110 and the third balloon 112 are arranged so as to contact each other in a state where they are inflated and locked to the lateral intestinal wall 50c. On the other hand, the first balloon 108 and the third balloon 112 are both arranged so as not to contact each other in a state where they are inflated and locked to the lateral intestinal wall 50c.

  FIG. 20 is a block diagram of a balloon control device 114 that controls the pressures of the first balloon 108, the second balloon 110, and the third balloon 112. As shown in FIG. 20, the balloon control device 114 mainly includes a CPU 116, a pump 118, a three-way valve 120, electromagnetic valves 122a, 122b, and 122c. The first balloon 108, the second balloon 110, and the third balloon 112 can be independently adjusted for internal pressure.

  As shown in FIG. 20, an air supply pipe 124 (first supply / exhaust port) through which gas is communicated with the first balloon 108 via the communication port 124 a and the second balloon 110 are inserted into the insertion portion distal end portion 22 a. An air supply pipe 126 (second supply / exhaust port) through which gas is communicated via the communication port 126a, and an air supply pipe 128 (third supply / exhaust gas) through which the gas is communicated to the third balloon 112 via the communication port 128a. Port). The air supply pipe 124, the air supply pipe 126, and the air supply pipe 128 are connected to the balloon control device 114 through the inside of the bending portion 22b, the flexible portion 22c, and the universal cord 38 (see FIG. 1).

  The propulsion operation flow to be described later is executed by the CPU 116 performing control such as ON / OFF of the operation of the pump 118, switching of the three-way valve 120, and opening / closing of the electromagnetic valves 122a, 122b, 122c. .

  FIG. 21 is a timing chart of the propulsion operation of the in-pipe moving body actuator of the present invention. FIG. 22 is a schematic cross-sectional view showing the state of inflation and deflation of each balloon in correspondence with the timing chart of the propulsion operation shown in FIG. In FIG. 22, the air supply pipe 124, the air supply pipe 126, and the air supply pipe 128 are omitted.

  First, as shown in FIG. 22 (a), the first balloon 108, the second balloon 110, and the third balloon 112 are all deflated, and then the first balloon 108 is filled with gas and inflated to obtain the first balloon. 108 is locked to the lateral intestinal wall 50c (step A in FIG. 21). The state of expansion and contraction of the balloon at this time can be expressed as shown in FIG.

  Next, the second balloon 110 is filled with gas and inflated (step B in FIG. 21). The state of inflation and deflation of the balloon at this time can be expressed as shown in FIGS. 22 (c) and 22 (d).

  As shown in FIG. 22C, by inflating the second balloon 110 in a state where the first balloon 108 is inflated and locked to the lateral intestinal wall 50c, the second balloon 110 is in the first state. The balloon 108 is gradually pressed.

  Then, the first balloon 108 falls down so as to incline toward the rear in the traveling direction of the insertion portion distal end portion 22a while the side intestinal wall 50c is locked. Alternatively, the first balloon 108 rotates so that the surface of the first balloon 108 is drawn out rearward in the traveling direction of the insertion portion distal end portion 22a while the side intestinal wall 50c is locked.

  As a result, the first balloon 108 applies a pressing force (propulsive force) to the lateral intestinal wall 50c toward the rear in the traveling direction of the insertion portion distal end portion 22a (black arrow in FIG. 22C).

  Therefore, the lateral intestinal wall 50c is fed to the rear of the insertion portion distal end portion 22a in the traveling direction.

  When the second balloon 110 is further filled with gas and inflated, the second balloon 110 is locked to the lateral intestinal wall 50c as shown in FIG. 22 (d). At this time, as shown in FIG. 22 (d), since the first balloon 108 is in an inflated state, the second balloon 110 is inclined to the side of the intestinal wall 50c while being tilted forward in the direction of travel of the insertion portion distal end portion 22a. Locked.

  Next, gas is sucked from the first balloon 108 and contracted to separate the first balloon 108 from the lateral intestinal wall 50c (step C in FIG. 21). The state of inflation and deflation of the balloon at this time can be expressed as shown in FIGS. 22 (e) and 22 (f).

  Here, in step B of FIG. 21 (FIG. 22D), the second balloon 110 is locked to the lateral intestinal wall 50c in a state where the second balloon 110 is inclined forward in the traveling direction of the insertion portion distal end portion 22a. It was. Therefore, as shown in FIG. 22 (e), when the first balloon 108 is deflated and the locking to the lateral intestinal wall 50c is released, the second balloon 110 remains locked to the lateral intestinal wall 50c. The insertion portion tip 22a falls down so as to incline backward in the traveling direction. Or the 2nd balloon 110 rotates so that the surface may be drawn out toward the back of the advancing direction of the insertion part front-end | tip part 22a, locking the side intestinal wall 50c.

  As a result, the second balloon 110 applies a pressing force to the lateral intestinal wall 50c toward the rear in the traveling direction of the insertion portion distal end portion 22a (black arrow in FIG. 22E).

  Therefore, the lateral intestinal wall 50c is fed to the rear of the insertion portion distal end portion 22a in the traveling direction.

  When the gas is further sucked and contracted from the first balloon 108, the second balloon 110 is moved to the side while the first balloon 108 and the third balloon 112 are contracted as shown in FIG. It will be in the state latched by the enema wall 50c.

  Next, the third balloon 112 is filled with gas and inflated (step D in FIG. 21). The state of expansion and contraction of the balloon at this time can be expressed as shown in FIGS. 22 (g) and 22 (h).

  As shown in FIG. 22 (g), by inflating the third balloon 112 in a state where the second balloon 110 is locked to the lateral intestinal wall 50c, the third balloon 112 causes the second balloon 110 to be inflated. Press gradually. Then, the 2nd balloon 110 falls down so that it may incline toward the back of the advancing direction of the insertion part front-end | tip part 22a, retaining the side intestinal wall 50c. Or the 2nd balloon 110 rotates so that the surface may be drawn out toward the back of the advancing direction of the insertion part front-end | tip part 22a, locking the side intestinal wall 50c.

  Accordingly, a pressing force is applied to the second balloon 110 and the lateral intestinal wall 50c toward the rear in the traveling direction of the insertion portion distal end portion 22a (black arrow in FIG. 22G).

  Therefore, the lateral intestinal wall 50c is fed to the rear of the insertion portion distal end portion 22a in the traveling direction.

  When the third balloon 112 is further filled with gas and inflated, the third balloon 112 is locked to the lateral intestinal wall 50c as shown in FIG. 22 (h). At this time, as shown in FIG. 22 (h), since the second balloon 110 is in an inflated state, the third balloon 112 is inclined to the side of the intestinal wall 50c while being inclined forward in the direction of travel of the insertion portion distal end portion 22a. Locked.

  Next, gas is sucked from the second balloon 110 and contracted to separate the second balloon 110 from the lateral intestinal wall 50c (step E in FIG. 21). The state of inflation and deflation of the balloon at this time can be expressed as shown in FIGS. 22 (i) and 22 (j).

  Here, in the step D of FIG. 21 (FIG. 22H), the third balloon 112 is locked to the lateral intestinal wall 50c in a state of being tilted forward in the traveling direction of the insertion portion distal end portion 22a. It was. Therefore, as shown in FIG. 22 (i), when the second balloon 110 is deflated and the locking to the lateral intestinal wall 50c is released, the third balloon 112 remains locked to the lateral intestinal wall 50c. The insertion portion tip 22a falls down so as to incline backward in the traveling direction. Or the 3rd balloon 112 rotates so that it may be drawn out toward the back of the advancing direction of the insertion part front-end | tip part 22a, with the surface locking the side intestinal wall 50c.

  Thereby, the third balloon 112 applies a pressing force to the lateral intestinal wall 50c toward the rear in the traveling direction of the insertion portion distal end portion 22a (black arrow in FIG. 22 (i)).

  Therefore, the lateral intestinal wall 50c is fed to the rear of the insertion portion distal end portion 22a in the traveling direction.

  Then, when the gas is further sucked and contracted from the second balloon 110, the third balloon 112 is moved to the side while the first balloon 108 and the second balloon 110 are contracted as shown in FIG. It will be in the state latched by the enema wall 50c.

  Next, the first balloon 108 is filled with gas and inflated (step F in FIG. 21). Next, gas is sucked from the third balloon 112 and contracted to separate the third balloon 112 from the lateral intestinal wall 50c (step G in FIG. 21).

  Thereby, the state of expansion and contraction of the first balloon 108, the second balloon 110, and the third balloon 112 returns to the state shown in FIG. And when continuing forward movement, the above process B-process G (FIG. 22 (b)-(l)) of FIG. 21 are repeated.

  Thus, since the first balloon 108, the second balloon 110, and the third balloon 112 are used as the inflating bodies, the expansion rate of each balloon can be easily adjusted. Therefore, by increasing the expansion rate of each balloon, the propulsion mechanism can be reliably brought into contact with the lateral intestinal wall 50c. Therefore, the propulsive force can be reliably transmitted to the intestinal wall in the tortuous intestinal tract.

<Second Embodiment>
Next, an endoscope apparatus 130 according to the second embodiment of the present invention will be described with reference to FIG. The endoscope apparatus 130 automatically controls the suction / traction process of the auxiliary tool 14 and the balloon feeding operation, as in the first embodiment.

  However, in the second embodiment, an auxiliary instrument channel 132 for inserting an auxiliary instrument is provided in addition to the forceps channel 30 inside the endoscope 12 of the endoscope apparatus 130. The auxiliary tool 14 is slidably inserted into the auxiliary tool channel 132 at all times, and is integrated with the endoscope 12. The auxiliary tool 14 can be removed from the endoscope 12 when, for example, the endoscope 12 is cleaned, disinfected, sterilized (reprocessed), or the like.

  Automatic control of the suction / traction processing of the auxiliary tool 14 is performed by the auxiliary tool controller 16 as described in the first embodiment. The auxiliary tool controller 16 is connected to the operation unit 24 of the endoscope 12 via the guide tube T for preventing slack. The auxiliary tool 14 is inserted through the guide tube T and the auxiliary tool channel 132.

  As shown in FIG. 24 (A), the auxiliary tool controller 16 closes the suction port 52 when the auxiliary tool 14 is not attracted or pulled, or when the auxiliary tool 14 is retracted. At the same time, the auxiliary tool tip 14a and the suction port 52 are stored in the auxiliary tool outlet 132 (auxiliary tool dedicated port) 132a of the auxiliary tool channel 132.

  The assisting instrument outlet 132a is provided with the assisting instrument detection sensor 70 described in the first embodiment, and the determination circuit 80 of the assisting instrument controller 16 is the same as in the first embodiment described above. The amount of protrusion of the auxiliary tool tip 14a from 132a is obtained. When the auxiliary tool controller 16 stores the auxiliary tool tip 14a in the auxiliary tool outlet 132a, the amount of protrusion of the auxiliary tool tip 14a calculated by the determination circuit 80 is “0” (an auxiliary tool detection sensor). The auxiliary tool 14 is pulled until 70 becomes OFF.

  As shown in FIG. 24B, when the auxiliary tool controller 16 starts the suction / traction process of the auxiliary tool 14, the auxiliary tool controller 16 starts sending the auxiliary tool 14, and the auxiliary tool tip 14a After protruding from the auxiliary tool outlet 132a, the suction port 52 is deformed into a trumpet shape. The subsequent processing is the same as in the first embodiment.

  As described above, according to the second embodiment of the present invention, since the forceps channel 30 is not blocked by the auxiliary tool 14, it is possible to save the trouble of inserting the treatment tool into the forceps channel 30 after removing the auxiliary tool 14.

<Third Embodiment>
As shown in FIG. 25, a plurality of insertion portion suction ports 134 may be provided along the circumferential direction on the side surface (circumferential surface) of the insertion portion distal end portion 22a. The insertion portion suction port 134 is adsorbed by a negative pressure suction force to a lateral lumen inner wall that is an inner wall of a lumen located on the side of the insertion portion distal end portion 22a. In addition, the number, arrangement position, and shape of the insertion portion suction port 134 are not particularly limited and can be arbitrarily changed.

  As shown in FIG. 26, a substantially cylindrical suction tool 134a having one end closed and the other end closed is provided inside the insertion portion suction port 134. An air tube 134b is connected to the side surface of each suction tool 134a. Each air tube 134b is connected to a suction channel (not shown) provided over the insertion portion 22, the operation portion 24, and the universal cord 38 via a branch connector (not shown).

  Accordingly, each suction tool 134a is connected to the insertion portion suction device 144 (see FIG. 27) via the air tube 134b and the suction channel, and sucks air when the insertion portion suction device 144 is activated. A negative pressure suction force is generated at each insertion portion suction port 134. This negative pressure suction force is suppressed to a force that does not damage the inner wall of the side lumen. In addition, the structure which attracts | sucks air from the insertion part suction port 134 is not limited to the structure shown in FIG.

  FIG. 27 is a block diagram of an endoscope apparatus according to the third embodiment. As shown in FIG. 27, the difference from the first embodiment (see FIG. 6) is that an insertion portion suction port 134 is provided in the endoscope 12, and an insertion portion is provided at the opening peripheral portion of the insertion portion suction port 134. A contact sensor 136 is provided. The control device 140 of the auxiliary instrument controller 138 is provided with a LAN I / F 142.

  Further, an insertion portion suction device 144 that automatically controls the suction / suction stop processing of the insertion portion suction port 134 is provided, and the insertion portion contact sensor 136 is connected to the insertion portion suction device 144. The insertion portion suction device 144 is provided with a CPU 145 and a LAN I / F 148, which is connected to the LAN I / F 142 of the control device 140 of the assisting instrument controller 138 via a LAN cable (not shown). .

  Other configurations are common to the first embodiment (see FIG. 6).

  FIG. 28 is a timing chart for automatic control of suction / traction processing of the auxiliary tool 14 by the auxiliary tool controller 138 and balloon delivery processing by the balloon control device 28.

  As shown in FIG. 28, in the example in which the insertion portion suction port 134 is provided, when the feeding operation of the side intestinal wall 50c by the balloon is finished as described above ("t7" in FIG. 28), the insertion portion suction is performed. A “weak” negative pressure suction force is generated at the mouth 134.

  Next, when the insertion portion suction port 134 contacts the lateral intestinal wall 50c (see FIG. 29), the insertion portion contact sensor 136 outputs an ON signal to the insertion portion suction device 144 (“t8” in FIG. 28).

  When the on signal from the insertion portion contact sensor 136 is input, the CPU 140 a controls the insertion portion suction device 144 to generate a “strong” negative pressure suction force at the insertion portion suction port 134. As a result, as shown in FIG. 29, the insertion portion suction port 134 is adsorbed to the lateral intestinal wall 50c, and the insertion portion distal end portion 22a is fixed to the lateral intestinal wall 50c. The relative position of the insertion portion distal end portion 22a is fixed.

  When the control device 140 determines that the negative pressure suction force of the insertion portion suction port 134 has been changed to “strong” based on the negative pressure suction information input from the insertion portion suction device 144, the insertion portion suction device 144. Is stopped, and the suction of air from the suction port 52 is stopped. Thereby, since the suction of the suction port 52 is released, the insertion portion suction port 134 is attracted to the lateral intestinal wall 50c, and the relative position of the insertion portion distal end portion 22a in the sigmoid colon 50 is fixed. Then, the suction / traction process of the auxiliary tool 14 can be performed again.

<Fourth embodiment>
Further, as shown in FIG. 30, an auxiliary tool channel 150 is provided in the insertion portion 22, and an insertion portion fixing auxiliary tool 152 is slidably inserted into the auxiliary tool channel 150. It may be used to fix the insertion portion distal end portion 22a. The auxiliary tool channel 150 is the same as the auxiliary tool channel 132 described above.

  The insertion portion fixing auxiliary tool 152 can be inserted and removed from an auxiliary device outlet 150a of an auxiliary device channel 150 provided on the front surface of the insertion portion distal end portion 22a, and basically has the same configuration as the auxiliary device 14 described above. However, the auxiliary tool distal end portion 152a of the insertion portion fixing auxiliary tool 152 is bent substantially 90 degrees and is perpendicular to the front surface of the insertion portion distal end portion 22a, and can be stored in the auxiliary device outlet 150a. It can be transformed into a retracted shape. This deformation is performed using a wire (not shown) made of a shape memory alloy, like the suction port 52 described above.

  A suction port 154 is provided at the distal end portion 152a of the assisting tool. The suction port 154 is the same as the suction port 52 described above, and is deformed into a trumpet shape and a closed shape by switching between energization and deenergization of the wire 54 (see FIG. 2). The suction port 154 is adsorbed to the inner wall of the second front lumen, which is the inner wall of the lumen located approximately in front of the auxiliary tool outlet 150a, by the negative pressure suction force. A fixing device (not shown) for fixing the insertion portion fixing auxiliary tool 152 to the insertion portion 22 when the suction port 154 is adsorbed to the inner wall of the second front lumen in the auxiliary device channel 150. ) Is provided.

  The protrusion / storage / bending of the auxiliary tool tip 152a and the opening / closing / suction / suction stop processing of the suction port 154 are controlled by a fixing auxiliary controller (not shown) having substantially the same configuration as the auxiliary tool controller 16 described above. The

  The assisting tool controller for fixing causes the assisting tool distal end part 152a to protrude from the assisting instrument outlet 150a when the assisting tool distal end part 14a is pulled to the second position and the feeding operation by the balloon is finished. Then, the auxiliary assisting tool controller deforms the assisting tool tip 152a from the retracted shape to the bent shape, and deforms the suction port 154 to the trumpet shape. In addition, in order to prevent perforation from occurring in the intestinal wall when the assisting device distal end portion 152a protrudes from the assisting device outlet 150a, a contact sensor is provided in the suction port 154 similarly to the suction port 52.

  Next, the auxiliary assisting controller for controller generates a negative pressure suction force at the suction port 154, and this suction port 154 is the intestinal wall 50d of the sigmoid colon 50 corresponding to the inner wall of the second front lumen (see FIG. 31). Adsorb to. At this time, the negative pressure suction force of the suction port 154 may be adjusted in two stages. Further, after the suction port 154 is adsorbed, the fixing device is operated to fix the insertion portion fixing auxiliary tool 152 to the insertion portion 22. Thereby, the relative position of the insertion portion distal end portion 22a in the sigmoid colon 50 can be fixed.

  As shown in FIG. 31, after the suction port 154 is adsorbed to the intestinal wall 50d, the auxiliary instrument controller 16 releases the suction of the suction port 52. Since the insertion portion distal end portion 22a is fixed by the insertion portion fixing auxiliary tool 152, the sigmoid colon 50 is restored to its original shape and position after the suction port 52 is released, and the position of the insertion portion distal end portion 22a is restored. It is prevented from moving backward relatively.

  In the embodiment shown in FIGS. 30 and 31, the auxiliary tool outlet 150a is provided on the front surface of the insertion portion distal end portion 22a. However, the present invention is not limited to this, and the insertion portion distal end portion 22a has a It may be provided on the side surface. In this case, for example, the distal end portion of the assisting device channel 150 may be bent or bent in the insertion portion 22, and in particular, it is not necessary to deform the assisting device distal end portion 152 a into a bent shape.

<Other embodiments>
In each of the above embodiments, the balloon is provided at the insertion portion distal end portion 22a, but the present invention is not limited to this. For example, a balloon may be provided on the soft part 22c. Thereby, since a balloon is not provided in the insertion part front-end | tip part 22a or the curved part 22b, the auxiliary tool 14 can be inserted to the detail of a large intestine, and the freedom degree made to adsorb | suck to an intestinal wall becomes large.

  In each of the above embodiments, the case where the suction port 52 is folded into a closed shape when the suction port 52 is partially folded is described as an example, but the present invention is not limited to this. For example, as shown in FIGS. 32A and 32B, the closed shape of the suction port 52 may be a substantially cylindrical shape. In this case, the suction port 52 is formed of an easily deformable material (for example, rubber) so that the suction port 52 is easily elastically deformed into a trumpet shape.

  Further, as shown in FIGS. 33A and 33B, the suction port 52 may be twisted and folded so that the closed shape of the suction port 52 becomes a tapered shape (a morning glory bud shape). .

  In each of the above embodiments, an example is provided in which the suction port 52 is provided in the auxiliary tool distal end portion 14a, and the suction tool 52 is adsorbed to the inner wall of the lumen to fix the auxiliary tool distal end portion 14a to the inner wall of the lumen. Although described, the present invention is not limited to this. For example, as shown in FIG. 34, a pair of hooks 156 may be provided on the assisting tool tip 14a, and the assisting tool tip 14a may be fixed to the lumen inner wall with the hooks 156.

  The pair of hooks 156 can be opened and closed like a hook by a link mechanism (not shown), and is deformed into an open shape that hooks on the inner wall of the lumen and a closed shape (dotted line) that can be stored in the forceps outlet 48 (forceps channel 30). It is free. For example, an operation wire and a spring that biases the link mechanism so that the hook 156 is always closed are connected to the link mechanism. By pulling the operation wire, the link mechanism is activated and the hook 156 is deformed into an open shape, and when the operation wire is retracted, the hook 156 is deformed into a closed shape by the biasing force of the spring.

  As described above, the actuator for a moving body in a tube of the present invention controls the internal pressures of the first balloon 26-1 and the second balloon so as to feed the lateral intestinal wall 50c that has been hand-drawn by the auxiliary tool 14 backward. The insertion portion 22 can be easily advanced even in the sigmoid colon 50 bent in a complicated manner while reducing the work load on the doctor.

  Moreover, compared with the case where only a balloon is used, the stroke of hand drag can be enlarged by using the auxiliary tool 14, and the insertion efficiency of the insertion part 22 can be enlarged.

  As described above, the actuator for a moving body in a tube, the control method therefor, and the endoscope of the present invention have been described in detail. However, the present invention is not limited to the above examples, and various types can be used without departing from the gist of the present invention. Of course, improvements and modifications may be made.

  For example, in each of the above-described embodiments, the suction port 52 is deformed into a trumpet shape, but the present invention is not limited to this, and has a shape that is easily adsorbed on the inner wall of the front lumen (for example, a shape with an expanded opening area). If there is no particular limitation.

  Further, the auxiliary tool displacement device, the energization device, the hook differential device, and the like may be reduced in size and incorporated in the endoscope 12. Thereby, it is not necessary to provide the auxiliary tool controller 16 separately from the endoscope 12.

  Further, in each of the above embodiments, the suction force of the suction port 52 can be adjusted in two stages of “strong” and “weak”, but the present invention is not limited to this and can be adjusted in three or more stages. Or only one step.

  Further, a proximity switch may be provided instead of the contact sensor 66 and the insertion portion contact sensor 136.

  Further, the auxiliary tool controller 16 may be integrated with the processor device 18. Further, the assisting device controller 16 may be operated by a button of the endoscope 12 or the like.

  Further, the assisting tool 14 may be provided with a bending portion or the like that can freely change the orientation of the assisting tool tip 14a. As a result, the auxiliary tool distal end portion 14a can be curved in a state where the suction port 52 is adsorbed to the inner wall of the front lumen.

  Further, for example, the operation of sending the auxiliary tool 14 may be performed manually while the doctor watches the monitor image. Further, the suction port 52 may be deformed into a trumpet shape and a closed shape by a doctor turning on / off an energization switch (not shown). Alternatively, a negative pressure suction force may be generated / stopped at the suction port 52 by a doctor turning ON / OFF a suction switch (not shown).

  Moreover, in the said embodiment, although gas was supplied as a fluid in a balloon, supply of a liquid is also considered.

  DESCRIPTION OF SYMBOLS 10 ... Endoscope apparatus, 12 ... Endoscope, 14 ... Auxiliary tool, 14a ... Auxiliary tool front-end | tip part, 16 ... Auxiliary-tool controller, 22 ... Insertion part, 22a ... Insert part front-end | tip part, 26-1 ... 1st balloon , 26-2 ... second balloon, 28 ... balloon control device, 30 ... forceps channel, 50 ... sigmoid colon, 50b ... ascending part, 50c ... lateral intestinal wall, 52 ... suction port, 54 ... wire, 60 ... auxiliary Displacement device 62 ... Control device 66 ... Contact sensor 68 ... Suction pressure detection sensor 70 ... Auxiliary device detection sensor

Claims (15)

A first position where the tip is in contact with or close to the front tube wall located in front of the opening and in front of the opening can be inserted and removed from the opening provided at the tip of the insertion portion inserted into the tube. An auxiliary tool that is displaceable to a second position,
An expansion / contraction member provided at a distal end of the insertion portion;
A controller for controlling the operation of the auxiliary tool and the expansion / contraction member,
The control unit controls the internal pressure of the expansion / contraction member so as to feed a side tube wall located on a side of the opening portion that is handed by the auxiliary tool to the rear of the opening portion;
An actuator for an in-pipe moving body. The control unit is configured to start the feeding of the side tube wall to the rear of the opening when a signal indicating that the side tube wall has been pulled by the auxiliary tool is output. Controlling the internal pressure,
The actuator for a moving body in a pipe according to claim 1. The control unit controls the amount of the side tube wall to be fed rearward of the opening by the expansion / contraction member based on a displacement amount of the tip of the auxiliary tool;
The actuator for a moving body in a pipe according to claim 1 or 2. The control unit is configured to control the distal end portion of the auxiliary tool to contact or approach the front tube wall in a state where the expansion / contraction member is inflated and locked to the side tube wall;
The actuator for a moving body in a pipe according to any one of claims 1 to 3. The expansion / contraction members are arranged in two pairs in an axially symmetrical manner with respect to the insertion portion, and are arranged with a phase shifted at substantially the same position in the axial direction of the insertion portion,
The actuator for a moving body in a pipe according to any one of claims 1 to 4. The expansion / contraction member is formed over the circumference around the axis of the insertion portion, and is disposed at least two in the axial direction of the insertion portion;
The actuator for a moving body in a pipe according to any one of claims 1 to 4. At least one of the expansion and contraction members has directivity in a direction of deformation when expanded.
The actuator for a moving body in a pipe according to claim 6. The three expansion / contraction members are arranged in order in the axial direction of the insertion portion,
The actuator for a moving body in a pipe according to claim 6. The insertion portion is configured from the distal end side in the order of a distal end portion provided with the opening, a bending portion that freely changes the direction of the distal end portion, and a flexible portion connected to the bending portion,
The expansion / contraction member is disposed at the tip;
The actuator for a moving body in a pipe according to any one of claims 1 to 8. The insertion portion is configured from the distal end side in the order of a distal end portion provided with the opening, a bending portion that freely changes the direction of the distal end portion, and a flexible portion connected to the bending portion,
The expansion / contraction member is disposed in the soft part;
The actuator for a moving body in a pipe according to any one of claims 1 to 8. Provided at the distal end portion of the auxiliary tool, and having an auxiliary tool fixing means for fixing the distal end portion to the front tube wall when the distal end portion is displaced to the first position;
The actuator for a moving body in a pipe according to any one of claims 1 to 10. The auxiliary tool fixing means is a suction port that is attracted to the front tube wall by a negative pressure suction force;
The actuator for a moving body in a pipe according to claim 11. The auxiliary device fixing means is a hook;
The actuator for a moving body in a pipe according to claim 11. Comprising an actuator for a moving body in a pipe according to any one of claims 1 to 13,
Endoscope characterized by. A first position where the tip is in contact with or close to a front tube wall located in front of the opening and in front of the opening can be inserted and removed from the opening provided at the tip of the insertion portion to be inserted into the tube. A control method for an in-pipe moving body actuator comprising an auxiliary tool that is displaceable to a second position, and an expansion / contraction member provided at a tip of the insertion portion,
Controlling the internal pressure of the expansion / contraction member so as to feed a side tube wall located on the side of the opening that has been handed by the auxiliary tool to the rear of the opening;
A method for controlling an actuator for a moving body in a pipe, characterized in that

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