JP2011087859A - Endoscope and blood vessel endoscope system using the same - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an endoscope for allowing an inner wall surface to be visually observed even in a suspended fluid and a system for effectively using the endoscope. <P>SOLUTION: A hood 2 is provided in such a way as being extended forward further from an outer peripheral part of a tip end of an endoscope body 1. The endoscope body 1 has at least a fluid sending channel 11 and an image pickup channel 12 and has a bending mechanism. The hood 2 is in a cylindrical shape, has an internal diameter for encircling the fluid emitting channel 11 and the image pickup channel 12, and its tip end has an opening which has a shape of a section that diagonally cuts the cylindrical shape as a basic shape. The system uses the endoscope to be synchronized with pulse of the heart, injects a fixed quantity of transparent fluid into the hood at the moment when bloodstream stops, and effectively discharges blood. <P>COPYRIGHT: (C)2011,JPO&INPIT

Description

  The present invention relates to an endoscope and an endoscope system using the endoscope.

Among the various endoscopes inserted into the living body, the endoscope inserted into the blood vessel has a balloon at the distal end portion so that the observation target part (such as the inner wall surface of the blood vessel) can be seen. There may be a case where a device for blocking blood flow is provided (for example, Patent Documents 1 and 2).
Balloons are typically used with a channel for injecting saline into the blood vessel.
As schematically shown in FIG. 9, the balloon 210 is inflated in the vicinity of the observation site in the blood vessel 100 as shown in FIG. 9 to block the blood 400, and the physiological saline 300 is passed through the channel in the endoscope 200. By feeding in, the vicinity of the observation site in the blood vessel is filled with physiological saline, and visual observation is possible through the imaging channel in the endoscope 200.

  On the other hand, in recent years, the number of patients with heart disease has increased due to changes in lifestyle habits and aging, and accordingly, there has been a demand for treatment (endovascular surgery) performed by inserting a medical instrument such as a catheter into the blood vessel. It has increased. Intravascular surgery is advantageous in that it can be performed while visually observing the lumen of the blood vessel while observing the detailed shape and color of the lesion with the naked eye, and is minimally invasive.

However, when the inventors of the present application examined in detail intravascular surgery with blood flow interruption by a balloon, it was found that the following problems existed.
First, in intravascular surgery involving blood flow blockage with a balloon, blood is replaced with physiological saline in order to make the blood vessel wall visible. Since it is necessary to expand the installed balloon to prevent blood from flowing into the observation section, it is a problem that observation for a long time is impossible. Also, in large blood vessels such as the aorta, applying a balloon blocks blood flow from the heart (left ventricle) and stops blood circulation throughout the body, making it difficult to apply the balloon, and is therefore accompanied by visual inspection. There is also a problem that treatment is difficult.

JP 2002-121954 A JP 2007-289231 A Japanese Patent Laid-Open No. 10-514603

  An object of the present invention is to provide an endoscope that solves the above-mentioned problems and enables visual observation of an inner wall surface with a novel configuration even in a suspended fluid such as a blood vessel, and An object of the present invention is to provide a system for effectively using the endoscope.

The present invention has the following features.
(1) having an endoscope main body and a hood provided to extend further forward from the outer peripheral edge of the tip of the main body;
The endoscope body has at least a fluid delivery channel for ejecting fluid from the tip of the body, and an imaging channel for observing the outside from the tip of the body, and from the tip of the body Having a bending mechanism capable of bending a section of a predetermined length to at least one side;
The basic shape of the hood is a cylindrical shape, and has at least an inner diameter capable of enclosing the ejection port of the fluid ejection channel and the end of the imaging channel on the distal end surface of the endoscope body, and the distal end of the hood It is an opening having the shape of a cut obtained by obliquely cutting a cylindrical shape as a basic shape,
Endoscope.
(2) An elliptical cut surface obtained by cutting the cylindrical shape at a plane in which the opening at the tip of the hood forms an angle of 30 degrees to 60 degrees with respect to the cylindrical central axis of the basic shape of the hood The endoscope according to the above (1), which has the shape of
(3) The endoscope according to (1) or (2), wherein the outer diameter of the hood is substantially the same outer diameter as that of the endoscope body.
(4) Since the outer diameter of the cylindrical portion which is the basic shape of the hood is 4 mm to 6 mm, and the outermost peripheral edge of the opening at the front end of the hood, The endoscope according to any one of (1) to (3), wherein the distance to the distal end surface of the endoscope body is 0.5 mm to 1.5 mm.
(5) Of the outer peripheral edge of the opening at the front end of the hood, A is the point closest to the front end, and B is the point closest to the rear end.
Bending so that the end of the endoscope body bends in a direction in which the line connecting A and B approaches the direction parallel to the central axis of the endoscope or vice versa The endoscope according to any one of (1) to (4), wherein a bending direction by the mechanism and a direction of inclination of the opening of the hood are related to each other.
(6) the endoscope according to any one of (1) to (5) above,
A fluid delivery device for sending the transparent fluid to the fluid delivery channel in order to eject the transparent fluid from the tip of the fluid delivery channel of the endoscope body included in the endoscope;
A control device for controlling the drive of the fluid delivery device;
A vascular endoscope system configured to have at least
The fluid delivery device is configured to be controlled by a control device to deliver and stop fluid to the fluid delivery channel;
The control device receives a signal indicating an operation of the heart of a patient into which the endoscope is to be inserted as an input signal, and based on the input signal, when the blood flow stops at the distal end of the endoscope, The fluid delivery device is configured to be controlled such that a predetermined amount of transparent fluid is ejected from the tip of the fluid delivery channel of the endoscope.
The blood vessel endoscope system.
(7) The imaging channel of the endoscope main body included in the endoscope starts imaging of the object in synchronization with the timing at which the transparent fluid is ejected from the fluid delivery channel, and performs imaging for a predetermined time. Configured to do or
The imaging channel of the endoscope body included in the endoscope always captures an object, but in synchronization with the timing at which the transparent fluid is ejected from the fluid delivery channel, the control device It is configured to start recording and record imaging for a predetermined time.
The blood vessel endoscope system according to (6) above.

  Since the endoscope according to the present invention has a unique hood at the tip, as shown in FIG. 1B, the tip of the endoscope body 1 is bent and the opening of the hood is applied to the observation target portion. If a transparent fluid (for example, physiological saline) 30 is ejected from the fluid ejection channel 11, the periphery of the observation target portion can be effectively transparentized even with a small injection amount. Can be observed visually.

In addition, when the endoscope according to the present invention is applied as a vascular endoscope, in the present invention, the blood flow fluctuates due to the motion of the heart (particularly, the blood flow is almost stationary due to the diastole). The point where there is a moment when the blood flow is present), and by injecting a predetermined amount of the transparent fluid at the moment when the blood flow is almost stationary, the periphery of the observation target portion is effectively transparent with the injection of a small amount of the transparent fluid. It is proposed to make it.
The vascular endoscope system according to the present invention has a control system configured to achieve the above-described [injection of a transparent fluid synchronized with the moment when the blood flow is almost stationary]. An appropriate amount of a transparent fluid is ejected into the hood at an appropriate timing when the flow is almost stationary, and the periphery of the observation target portion is effectively transparentized to enable imaging.

  Further, in a preferable control configuration of the present invention, it is possible to perform imaging or recording of imaging in synchronization with the above-described ejection of the transparent fluid, that is, at the timing when the inside of the hood becomes transparent.

FIG. 1 is a diagram showing a configuration of an endoscope according to the present invention. FIG. 1A is a perspective view showing the appearance of the distal end portion of the endoscope, and FIG. 1B is a cross-sectional view of the distal end portion cut along the central axis of the endoscope. . The detailed structure of each channel and mechanism such as an imaging channel and a bending mechanism in the endoscope body is not shown. FIG. 2 is a cross-sectional view of the distal end portion of the endoscope of the present invention, in particular, a view for explaining the inclination of the distal end of the hood and the shape and dimensions of each portion. FIG. 3 is a cross-sectional view of the distal end portion of the endoscope of the present invention, and more particularly, is a view illustrating an embodiment of the distal end of the hood. FIG. 4 is a diagram showing an example of the relationship between the channel arrangement in the endoscope main body and the inclination of the hood in the endoscope of the present invention. FIG. 4A is a view of the inside of the hood as viewed from the distal end side of the endoscope, and FIG. 4B is a side view in which the distal end portion of the endoscope is partially enlarged. 4A and 4B are in a relationship between a front view and a side view. FIG. 5 is a diagram showing an example of the configuration of the vascular endoscope system of the present invention. FIG. 5A is a block diagram showing a connection relation of each device constituting the system, and FIG. 5B is an input signal and an operation of each unit for illustrating an operation method of the system. It is a time chart. FIG. 6 is a schematic diagram illustrating the configuration of an experimental facility in which the operational effects of the endoscope and the vascular endoscope system of the present invention have been confirmed. FIG. 7 is a diagram showing the dimensional specifications of the target pattern arranged as a target to be observed in the pipe in the experimental facility of FIG. FIG. 8 is a photograph showing a target imaged in an experiment in which the effects of the endoscope and the vascular endoscope system of the present invention were confirmed. FIG. 9 is a diagram schematically showing a use state of a conventional endoscope with a balloon.

As shown in FIG. 1A, an endoscope according to the present invention includes an endoscope main body 1 and a hood 2 provided so as to extend further forward from the distal end thereof.
As shown in FIGS. 1A and 1B, the endoscope body 1 is provided with at least a fluid delivery channel 11 and an imaging channel 12 therein. The fluid delivery channel 11 is configured so that a transparent fluid can be sent from the hand side (not shown), which is an operation unit, and emitted from the distal end surface, and the imaging channel 12 sends the image of the observation target part to the hand. It is configured. The “imaging channel” as used in the present invention means a device that captures a front image on the front end side and sends it to the hand side. Moreover, the endoscope main body 1 has a bending mechanism that can be bent at least one side thereof as shown in FIG. 1B.
As shown in FIG. 1A, the hood 2 has a cylindrical basic shape and extends further forward from the distal end of the endoscope body 1. The inner diameter of the hood (the inner diameter of the cylindrical portion which is the basic shape) can surround at least the ejection port of the fluid ejection channel 11 and the objective port of the imaging channel 12 on the distal end surface of the endoscope body. Dimensions. Therefore, the fluid ejection channel 11 sends the fluid into the hood, and the imaging channel 12 images the outside from the hood. And the front-end | tip of this food | hood becomes an opening which has the shape of the cut end obtained by cut | disconnecting the cylindrical part which is the said basic shape diagonally as a basic shape.

  With the above configuration, as shown in FIG. 1B, the endoscope bends the distal end portion of the endoscope main body 1 by an angle corresponding to an oblique opening at a predetermined hood distal end, and If the transparent fluid (saline solution) 30 is injected from the fluid injection channel 11 into the hood and filled in the hood, the observation target portion can be surrounded even if the injection amount is small. The surrounding opaque fluid (blood, etc.) 40 can be effectively eliminated, and imaging can be performed.

  The endoscope can be used not only for medical purposes but also for all purposes for visually observing an object in an opaque fluid from the outside. In particular, the endoscope is suitable for observing various parts in a living body, and in a large blood vessel such as an ascending aorta, an aortic arch, a descending aorta, etc., in which use of a balloon is not preferable. Useful for use.

The basic internal structure of each part from the distal end of the endoscope body to the operation unit on the hand side, a mechanism for transmitting various information on the tip to the hand side, a mechanism for transmitting the operation on the hand side to the tip side, etc. are conventionally known May be referred to (for example, Patent Document 3).
Since an object of the present invention is to improve visual observation of a target portion, the endoscope main body is provided with at least a fluid ejection channel and an imaging channel. It is preferable that an illumination channel for imaging is added to the endoscope body.
In addition to simply acquiring an image of the target part, the target part can be subjected to various treatments on the spot (mechanical treatment such as cutting of the target part or part of the target part, heating of the target part, current・ When performing voltage application, laser light irradiation, medication, fluorescence observation, tomographic image acquisition, etc., depending on the application, forceps channel, special light irradiation fiber, optical coherence tomography ( Various optical fibers and channels such as OCT (Optical Coherence Tomography) probe channels may be added.

The outer diameter of the body of the endoscope main body is not particularly limited, but the maximum diameter is about 15 mm for industrial use such as observation in a pipe, and the maximum diameter is about 10 mm for medical use. In particular, in an intravascular observation application, the maximum diameter of the body of the endoscope body is about 6 mm, and 5 mm is a more preferable maximum diameter.
On the other hand, the minimum diameter of the body of the endoscope body may be any dimension as long as the endoscope manufacturing technology is possible, regardless of the application, and has a bending mechanism, an imaging channel, and a fluid delivery channel. The minimum diameter is about 2 mm.
For intravascular observation, considering the mechanical strength of the hood, the structure of the connection between the endoscope body and the hood, the fluid resistance of the fluid delivery channel, etc., the preferred minimum diameter of the body of the endoscope body Is about 3 mm, and about 4 mm is a practical and more preferable minimum diameter.

The inner diameter of the fluid delivery channel may be appropriately determined according to the outer diameter of the body of the endoscope body and the presence of other channels. For example, in an intravascular observation application, the outer diameter of the body of the endoscope body is 4 mm to 6 mm as described above, and the preferable inner diameter of the fluid delivery channel in this case is about 1 mm to 2 mm.
The ejection port at the tip of the fluid delivery channel may be a simple opening, or may be a nozzle or an orifice designed to eject a transparent fluid with an intended angular spread.

The transparent fluid to be ejected from the fluid delivery channel may be a gas or a liquid depending on the situation and environment to be observed and the combination with the obstacle.
For example, when applied to a suspended sewage pipe, the transparent fluid may be water, and when applied to a blood vessel, the transparent fluid may be physiological saline or a predetermined amount of plasma or serum from the patient. A preferred embodiment is to use this.
The injection flow rate of the transparent fluid may be appropriately determined according to the outer diameter of the endoscope, the inner diameter of the hood, the viscosity of the opaque fluid to be excluded, etc.
When injecting the endoscope into a blood vessel and injecting physiological saline as a transparent fluid into a hood having an inner diameter of about 3 mm to 5 mm, the physiological saline is used as long as the blood flow is stopped. The flow rate is preferably about 2 [mL / second] to about 5 [mL / second], and the injection time is preferably about 0.1 [second] to about 0.2 [second].

  The imaging channel has an image guide that transmits an image obtained at the tip to the hand through an optical fiber bundle, a configuration in which a CCD camera is disposed at the tip and the image data is sent to the hand through a signal line, or the like. The data may be transmitted wirelessly and received by a receiver installed outside the body.

  In order to perform imaging at the distal end more preferably, the endoscope is preferably provided with an illumination channel. Examples of the illumination channel include a light guide mode that transmits light from the hand to the tip through an optical fiber, and a mode in which a light emitting element such as an LED is arranged at the tip and the light is operated at the hand through an electric wire. However, the type of light source is not limited.

As shown in FIG. 1B, the endoscope body is provided with a bending mechanism that bends the distal end portion from the straight state to at least one side so as to press the opening of the hood against the observation target portion.
The bending mechanism is preferably a mechanism that can bend the endoscope body in one side from a straight state and return it to the original straight state. In addition, depending on the application, a mechanism capable of returning to the original linear state from the one side and performing a bending / extending operation in the same way on the opposite side is also preferable. By the bending to the opposite side as described above, the observation target portion can be covered with a hood corresponding to the bending of the blood vessel.

  The bending mechanism is, for example, a mechanism in which a wire is arranged from the proximal portion to the distal end portion along the longitudinal direction in the body surface layer of the endoscope body (by pulling the wire at the proximal portion, A structure that bends the endoscope body), a mechanism that combines a bending / returning action of a shape memory alloy with a heater (a return spring is also used if necessary), and an ultra-small air cylinder that uses compressed air. And a mechanism using a polymer actuator called “artificial muscle”. The bi-directional bending and stretching operations described above can be achieved, for example, by arranging wires at positions 180 degrees opposite to each other on the outer periphery of the endoscope body. For these bending mechanisms, various known techniques in catheters and endoscopes may be referred to.

The basic shape of the hood is cylindrical, and as shown in FIG. 1, the tip of the cylindrical body is cut obliquely, and the cut end is an opening at the tip of the hood.
The shape of the hood may be a cylindrical shape as long as the basic shape is not only a literal cylindrical shape whose outer diameter and inner diameter are constant in the central axis direction, but within a range where the object of the present invention is achieved. A portion where the outer diameter and the inner diameter are changed may be added. Therefore, the basic shape of the opening at the tip of the hood is a simple oval when the cylindrical shape is cut obliquely, but it may be a cross-sectional shape corresponding to the deformation applied to the shape of the hood.
The inner diameter of the hood (dimension d shown in FIG. 2 (a)) is sufficient if it can surround at least the outlet of the fluid ejection channel and the end of the imaging channel on the distal end surface of the endoscope body. Well, the object of the present invention is thereby achieved, but as shown in FIG. 4 (a), it is a preferred embodiment that the inner diameter surrounds the ends of all other channels.
On the other hand, the outer diameter of the hood (dimension D shown in FIG. 2A) is not particularly limited in general applications. However, in an endoscope for use in a living body, the outer diameter of the hood and the endoscope The difference from the outer diameter of the main body is preferably smaller and most preferably the same outer diameter. However, in the actual design and manufacture of the endoscope, there may be a minute step caused by the joint structure in the joint portion between the hood and the endoscope body. In addition, there may be fluctuations in the outer diameter due to the internal structure on the surface of the endoscope main body, so that the outer diameter of the hood and the outer diameter of the endoscope main body may not exactly match. .

As shown in FIGS. 1 and 2, the opening at the tip of the hood has a basic shape that is obtained by cutting a cylindrical shape obliquely, and is more preferable for the roundness of the tip and the inner wall surface of the blood vessel. Various shapes such as a convex curve along the concave curve of the inner wall surface of the blood vessel, a shape in which the opening is flared to widen the observation range (a shape that spreads like a morning glory flower), etc. You may add the deformation | transformation.
FIG.3 (c) is sectional drawing which shows an example at the time of expanding the opening part of a hood in flare shape. When such deformation is applied to the hood, for example, it is preferable to give the hood material such elasticity that it shrinks when puncturing a blood vessel or the like and spreads when entering the blood vessel.
The basic shape of the hood opening may be a shape obtained by obliquely cutting a cylindrical shape, but the oblique angle, that is, the angle θ formed by the central axis Y of the cylindrical shape shown in FIG. 0 <θ <90 may be satisfied, and 30 ° ≦ θ ≦ 60 ° is a preferable range. This angle θ does not necessarily have one most preferable angle, and each angle has its advantages. For example, FIG. 2A shows the case of θ = 30 degrees, and there is an advantage that the hood covers the side observation target part widely only by bending the endoscope main body by 30 degrees. On the other hand, FIG. 2 (b) shows the case of θ = 60 degrees, and it is necessary to bend the endoscope body up to 60 degrees in order for the hood to cover the side observation object section. There is an advantage that the part can be observed in a state closer to direct view.
An appropriate angle may be selected for these according to the observation environment.
Although not included in the present invention, an aspect in which the angle θ formed by the cylindrical central axis Y and the opening surface 21 is 90 degrees (that is, an aspect of a cut surface obtained by cutting the cylindrical shape at right angles to the axis). Then, it is possible to cover the observation target portion of the wall surface facing directly forward in the traveling direction of the endoscope without bending the endoscope body.

As shown in FIG. 2 (a), the distance from the point B on the most rear end side to the distal end surface of the endoscope main body (the central axis of the endoscope main body) of the outer peripheral edge of the opening at the distal end of the hood It is desirable to determine the dimension L1 in the direction along the range according to the focus distance of the imaging lens within a range that does not affect the bonding between the hood and the endoscope body.
The actual value of the dimension L1 varies depending on the focus distance of the imaging lens. For example, when the most preferable focus distance is 3 mm from the front end of the imaging lens, the dimension L1 is 0.5 mm to 1 mm. .5 mm is a preferred dimension.

  In order to prevent the hood from puncturing or damaging the observation target part, it is preferable to provide an appropriate roundness at the tip of the hood as shown in FIG. FIG. 3 (a) is a mode in which the surface is simply rounded, and FIG. 3 (b) is a mode in which the tip is overfilled and rounded.

The materials of the hood include inorganic materials such as metals and ceramics, organic polymer materials such as plastics and silicone rubber, etc., mechanical strength, chemical resistance, environmental resistance, corrosion resistance, biocompatibility, flexibility, Any material having elasticity or the like may be used.
A metal such as titanium is excellent in mechanical strength. For example, when the outer diameter D of the hood is 4 mm to 6 mm, the thickness can be set to 0.3 mm to 0.5 mm.
Further, organic polymer materials such as silicone rubber are soft and rarely damage the observation target part. However, when the outer diameter D of the hood is 4 mm to 6 mm, the thickness is 0.5 mm to 0 mm. About 8 mm is preferable.

The relationship between the bending direction by the bending mechanism of the endoscope body and the opening of the hood is as follows.
As shown in FIG. 1 (a), among the outer peripheral edges (edges including the meat of the hood) of the opening at the front end of the hood, the point on the most front end side is A, and the point on the most rear end side is As B, the line segment AB is bent in a direction approaching parallel to the central axis of the endoscope (that is, in the bending direction shown in FIG. 1A), and The bending direction and the inclination of the opening of the hood are related so that the endoscope body bends in the opposite direction.
In actual assembly of the endoscope, the hood may be joined to the endoscope body by matching the direction of the opening of the hood with the bending direction of the bending mechanism of the endoscope body.

The relationship between the arrangement of each channel in the endoscope body and the inclination of the hood should be determined appropriately in consideration of the following actions when the endoscope body is bent and the observation target part is surrounded by the hood. Is preferred.
(I) Providing a fluid delivery channel at a position where opaque fluid (such as blood) can be more effectively excluded when a transparent fluid is ejected from the fluid delivery channel.
(Ii) An imaging channel is provided at a position advantageous for imaging such that the observation target portion can be imaged more accurately.
(Iii) When an illumination channel is provided, the illumination channel should be provided at a position advantageous for illumination, such as being able to irradiate light with the observation target portion.
(Iv) As another example, when a forceps channel is provided, for example, the forceps channel should be provided at a position where a space for sufficient forceps operation can be secured according to the shape of the forceps used.
FIG. 4A is a view of the inside of the hood (the distal end surface 1e of the endoscope body) viewed from the distal end side in the embodiment of the endoscope. In the example of FIG. 4A, the fluid delivery channel 11 is provided outside the bend (upper side in the figure). This is intended to obtain an action of more effectively removing blood entering the hood from the upstream side of the blood flow (upper side in the figure).
In the example of FIG. 4A, the illumination channel 13 is provided outside the bend, and the imaging channel 12 is provided inside the bend (the lower side in the figure). This is intended to obtain an effect that the distance to the blood vessel wall to be visualized matches the most preferable focus position of the lens when the focus distance of the imaging lens is relatively short (about 3 mm). is there.
In the example of FIG. 4A, the forceps channel 14 is provided at the remaining position (inside of the bend). This is intended for the use of a puncture needle with a very small operation space.
Points 15 and 16 shown in FIG. 4A are positions of two wires used in the bending mechanism, respectively. These wires do not appear on the end face 1e of the endoscope body, but the positions of the wires should be taken into consideration when determining the arrangement of each channel. Further, a bending mechanism may be employed so that the wire does not occupy an important position so that the arrangement of each channel can be freely determined.

Next, the configuration of a blood vessel endoscope system using the endoscope according to the present invention will be described.
The system includes at least an endoscope C according to the present invention, a fluid delivery device 32, and a control device 30, as schematically shown in FIG. The fluid delivery device 32 is a pump device for sending a transparent fluid to the fluid delivery channel of the endoscope body 1 included in the endoscope C, and responds to a command (output signal or the like) from the control device 30. Thus, the fluid can be delivered to and stopped from the fluid delivery channel.
The control device 30 is configured to receive a signal indicating an operation of the heart of the patient into which the endoscope is to be inserted as an input signal. In the example of FIG. 5A, the endoscope C is inserted into the blood vessel 100 of the patient, and the output signal of the electrocardiogram device (ECG) 33 </ b> A is input to the control device 30. The electrocardiogram device 33A may be regarded as a sensor device included in the system of the present invention, or may be regarded as an external signal source that emits a signal indicating the operation of the patient's heart.

The control device 30 may be composed mainly of a sequence circuit, but it is a complicated signal control that monitors and analyzes a signal indicating the operation of the patient's heart and injects a transparent fluid while appropriately synchronizing with the signal. From the viewpoint of performing the above, it is preferable that the computer is mainly configured so that the operator can finely adjust the parameters of each timing on the screen or with an external control panel.
An interface, an image display device, a printer, and the like necessary for connecting an external device such as a pump and a solenoid valve to the control device may be provided as appropriate.

An important feature of the system is that the control device 30 accepts a signal indicating the operation of the patient's heart (in the example of FIG. 5A, the output signal of the electrocardiogram device 33A) as an input signal, and based on the input signal. The fluid delivery device 32 is operated so that a predetermined amount of transparent fluid is ejected from the distal end of the fluid delivery channel 11 into the hood 2 at an appropriate time when blood flow is stopped at the distal end of the endoscope C. It is in the point comprised so that it may control.
As a result, when the operator of the endoscope of the present invention feeds the endoscope to the observation target part, operates the bending mechanism and surrounds the observation target part with the hood, the physiological saline at an appropriate time when the blood flow stops. An appropriate amount of water can be injected into the hood, and the observation target portion can be seen.

  The fluid delivery device 32 may be a simple pump or cylinder that starts the operation of sending the transparent fluid according to the command of the control device 30. In order to inject the transparent fluid with a steep rise at the timing when the blood flow stops, the transparent fluid is accommodated in a pressure vessel, the inside of the vessel is always pressurized with compressed air, and the injection of the vessel is performed. A mode in which the transparent fluid is injected and stopped by opening and closing a solenoid valve provided at the outlet is preferable.

In the example of FIG. 5A, as a preferred mode, a photographing device 31 is provided, and an image sent from the imaging channel of the endoscope body 1 is converted into an electric signal (digital image data or analog video). Signal) and the like and sent to the control device 30.
Such a photographing apparatus may be appropriately provided with a camera (camera), a video camera, or the like according to the imaging channel or according to the purpose of use. When a photographing device such as a CCD camera is included at the tip of the imaging channel, the signal output may be directly input to the control device 30.

FIG. 5B shows a signal (ECG output) from the electrocardiogram device indicating the operation of the patient's heart and the operation of the electromagnetic valve based on the signal when the transparent valve is controlled to discharge the transparent fluid. 5 is a time chart showing the relationship between the timing and the appropriate timing for capturing video.
As shown in FIG. 5B, an initial time T ₀ is created by setting an appropriate threshold value from the peak portion indicating the systole in the ECG output waveform, and blood flow into the blood vessel from the initial time. The delay time until the stasis of the blood flow was experimentally obtained, and a delay time t1 was delayed from the initial time so that the transparent fluid was ejected from the distal end of the endoscope at the moment of the blood flow stasis. to start the operation of the solenoid valve from the time T _1. At this time, it is preferable to consider the delay time from the start of operation of the solenoid valve to the injection of the transparent fluid. t2 is the opening period of the solenoid valve based on the end of the quiescence of the blood flow or considering the patient's blood dilution by the administration of the transparent fluid.
Furthermore, the delay time t3 from the operation start time T ₁ of the solenoid valve to the hood is clear advance obtained experimentally, to initiate a video capture at the time when the delay time t3 has elapsed. t4 is an imaging period based on the time when transparency in the hood is lost.

As shown in FIG. 5 (b), the operation of the imaging channel starts imaging of the object in synchronization with the ejection timing of the transparent fluid from the fluid delivery channel (after an appropriate delay time t3). You may comprise so that it may image only for predetermined time t4.
In addition, when the imaging channel always captures an object and continuously outputs a video signal, the control device starts recording the imaging in synchronization with the ejection timing of the transparent fluid, and only for a predetermined time. It may be one that records imaging.

Example 1
A circulatory device that simulates the pulsation of the heart in the circulatory system of the human body and the fluctuations in blood flow associated therewith was constructed, and the usefulness of the endoscope and system according to the present invention was confirmed using this device.
FIG. 6 is a block diagram showing the configuration of the circulation device. As shown in the figure, the circulator has a sealed chamber 41 for arterial pressure load, a resistor 42, a venous system reservoir 43, and a compressed air type pulsatile flow pump 44 simulating the contraction and expansion of the heart. In order, a circulator that circulates the liquid in the direction of the arrow while being circulated and connected in a ring shape by a piping pipe P1 simulating a blood vessel is reproduced.
The action of the sealed chamber 41 for loading the arterial pressure simulates the compliance (elasticity) of the aorta that temporarily stores blood ejected from the ventricle (pulsatile pump) during systole.
The action of the venous reservoir 43 simulates the role of the atrium for storing blood in order to pump blood into the ventricle at a stroke during diastole.
The action of the resistance 42 simulates the resistance of blood vessels (total peripheral circulation resistance).
The fluid circulating in the pipe was a cloudy liquid in which tap water was mixed with a commercial cloudy bathing agent (main component: sodium bicarbonate) at a rate of 10 [g / L].

The operating characteristics of the circulating device are as follows.
Frequency: 1 [Hz]
Amplitude: 5 [Vp-p]
Duty ratio: 30 [%]
Average internal pressure of the sealed chamber: 13.3 [kPa]
Pulse pressure: 8.0 [kPa]
Average flow rate: 6 [L / min]

Further, immediately after the pump 44 which is the heart, a flow meter 33B is connected to record a signal indicating the fluctuation of the fluid flow in the pipe, and the drive signal of the pump 44 is used as a control of the system according to the present invention instead of the electrocardiogram. It was set as the structure input into the apparatus 30.
Moreover, the concentric mark shown in FIG. 7 was arrange | positioned as the target of observation in the observation site | part 45 in a pipe | tube. As shown in the figure, the marks are all drawn with the same thickness of 1 mm, and the pattern is a combination of a concentric circle composed of a circle with an outer diameter of 10 mm, a circle with an outer diameter of 6 mm and a circle with an outer diameter of 2 mm, and a cross pattern It is a pattern that connected four.
This mark was photographed to compare how much cloudy liquid was removed and how clear it looked.

The endoscope system of the present invention applied to the above-mentioned circulation device is the same as that shown in FIG. 5 (a). In this embodiment, the endoscope is inserted into a piping pipe, and the tip portion thereof. Has reached the observation site 45.
The inner diameter of the hood was 5 mm, and the angle θ formed by the cylindrical central axis and the opening surface was 50 degrees. By setting the angle θ to 50 degrees, when the bending angle of the endoscope tip is set to 50 degrees, the opening surface of the hood is parallel to the inner wall surface of the observation site.
The structure of the fluid delivery device is that water is stored in a pressure vessel by keeping transparent water constantly pressurized to 0.2 MPa and opening an electromagnetic valve provided at the injection port of the vessel for 200 msec. Was configured to stop the injection.
In addition, each delay time is appropriately set based on the fluctuation of the fluid flow in the pipe by the flow meter 33B, and the injection is performed at the moment when the water flow stops at the observation site.

[Performance confirmation experiment]
When the target mark in the observation site in the piping pipe was observed with the endoscope of the present invention having a hood at the tip, the tip bending angle was set to 30 degrees (in this state, the opening surface of the hood In the injection of transparent water at 20 degrees from the wall surface, a thin mark was confirmed as shown in FIG.
In addition, the transparent water is ejected in a state where the tip bending angle is 50 degrees (in this state, as described above, the opening surface of the hood is parallel to the inner wall surface of the tube and surrounds the observation target portion with almost no gap). Then, as shown in FIG.8 (b), the mark was able to be confirmed clearly.
On the other hand, for comparison, an experiment similar to the above was performed with the distal end of the conventional endoscope with the distal end hood removed, and the target mark was observed. As shown in FIG. 8C, the cloudy water could not be eliminated and almost no mark could be confirmed. Further, in the injection of the transparent water with the tip bending angle set to 50 degrees, as shown in FIG. 8 (d), the mark was slightly confirmed although it was thinner and less blurred than in FIG. 8 (a).
From the above experiment, it was found that the visualization performance of the observation target part in a suspension such as blood was remarkably improved by wearing the hood.

  The endoscope and system according to the present invention effectively removes the opaque fluid around the observation target portion and visually observes it even in a suspended opaque fluid such as in a blood vessel by a transparent fluid. It became possible.

1 Endoscope body 2 Hood 11 Fluid delivery channel 12 Imaging channel

Claims (7)

An endoscope main body, and a hood provided to extend further forward from the outer peripheral edge of the tip of the main body;
The endoscope body has at least a fluid delivery channel for ejecting fluid from the tip of the body, and an imaging channel for observing the outside from the tip of the body, and from the tip of the body Having a bending mechanism capable of bending a section of a predetermined length to at least one side;
The basic shape of the hood is a cylindrical shape, and has at least an inner diameter capable of enclosing the ejection port of the fluid ejection channel and the end of the imaging channel on the distal end surface of the endoscope body, and the distal end of the hood It is an opening having the shape of a cut obtained by obliquely cutting a cylindrical shape as a basic shape,
Endoscope.   The shape of an elliptical cut obtained by cutting the cylindrical shape on a plane in which the opening at the tip of the hood forms an angle of 30 degrees to 60 degrees with respect to the cylindrical central axis of the basic shape of the hood The endoscope according to claim 1, which is provided.   The endoscope according to claim 1 or 2, wherein the outer diameter of the hood is substantially the same outer diameter as the endoscope main body. The outer diameter of the cylindrical portion that is the basic shape of the hood is 4 mm to 6 mm,
The distance from the point which is the rearmost end side among the outer peripheral edge portions of the opening at the front end of the hood to the front end surface of the endoscope body is 0.5 mm to 1.5 mm. The endoscope according to claim 1. Of the outer peripheral edge of the opening at the front end of the hood, the point closest to the front end is A, and the point closest to the rear end is B.
Bending so that the end of the endoscope body bends in a direction in which the line connecting A and B approaches a direction parallel to the central axis of the endoscope or vice versa The endoscope according to any one of claims 1 to 4, wherein a bending direction by the mechanism and a direction of inclination of the opening of the hood are related to each other. The endoscope according to any one of claims 1 to 5,
A fluid delivery device for sending the transparent fluid to the fluid delivery channel in order to eject the transparent fluid from the tip of the fluid delivery channel of the endoscope body included in the endoscope;
A control device for controlling the drive of the fluid delivery device;
A vascular endoscope system configured to have at least
The fluid delivery device is configured to be controlled by a control device to deliver and stop fluid to the fluid delivery channel;
The control device receives a signal indicating an operation of the heart of a patient into which the endoscope is to be inserted as an input signal, and based on the input signal, when the blood flow stops at the distal end of the endoscope, The fluid delivery device is configured to be controlled such that a predetermined amount of transparent fluid is ejected from the tip of the fluid delivery channel of the endoscope.
The blood vessel endoscope system. The imaging channel of the endoscope body included in the endoscope starts imaging of the object in synchronization with the timing when the transparent fluid is ejected from the fluid delivery channel, and performs imaging only for a predetermined time. Configured or
The imaging channel of the endoscope body included in the endoscope always captures an object, but in synchronization with the timing at which the transparent fluid is ejected from the fluid delivery channel, the control device It is configured to start recording and record imaging for a predetermined time.
The vascular endoscope system according to claim 6.