JP2011104333A - Endoscope apparatus and distal end hood used for endoscope used therefor - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To enable a user to quickly switch procedures such as PDD (Photodynamic Diagnosis) and PDT (Photodynamic Therapy) etc. as using a same endoscope without re-inserting a once-inserted and pulled out endoscope, and further, irradiation with light can be performed at respectively suitable irradiation angle according to contents of procedures. <P>SOLUTION: In the apparatus, a slide member 73 including condenser lenses 81A, 81B, a light cut filter 83 with a specific absorption wave length band, and transparent parts 85A, 85B, 85C is movably supported on a hood body part. The apparatus is structured so that a first position wherein the condenser lenses 81A, 81B of the slide member 73 face irradiation windows 37A, 37B and the light cut filter 83 of the slide member 73 faces an observation window 38 or a second position wherein the transparent parts 85A, 85B, 85C of the slide member 73 face the irradiation windows 37A, 37B and the observation window 38 can be switched by moving the slide member 73 toward an endoscope distal end part 35. <P>COPYRIGHT: (C)2011,JPO&INPIT

Description

  The present invention relates to an endoscope apparatus and an endoscope distal end hood used therefor.

  2. Description of the Related Art Some endoscope apparatuses that perform observations and examinations in a body cavity perform photodynamic diagnosis (PDD) for diagnosing a tumor. This is because a photosensitive substance that has a tumor affinity and is sensitive to specific excitation light is administered to a living body, and then the surface of the living tissue is irradiated with a laser beam that becomes excitation light with a relatively weak output. This is a diagnostic method for observing fluorescence from a site where the concentration of the photosensitive substance is high in the lesion of the tumor. In addition, an endoscope apparatus that performs photodynamic therapy (PDT) for treating a tumor such as cancer by irradiating the surface of a living tissue with a laser beam with a relatively strong output has been proposed (Patent Documents 1 to 3). 3).

  In general, in order to perform PDT, first, an affected part that emits fluorescence is identified by PDD, and the identified affected part is irradiated with laser light for PDT. However, since the intensity difference between the irradiated PDT laser beam and the PDD laser beam is large, the observed image is saturated at the PDT even if the affected part can be observed at the PDD by the image sensor. Therefore, in the configuration of Patent Document 1, an image sensor for PDT and an image sensor for PDD to which a light cut filter for cutting the laser light for PDT is attached are used by switching between them. In Patent Document 2, an endoscope is inserted into a body cavity and observed with a laser beam for PDD to identify an affected part. Thereafter, the endoscope is extracted from the body cavity, and the endoscope front hood is endoscopeed. It attaches to a mirror front-end | tip part, and covers the observation window of an endoscope front-end | tip part with a light cut filter. Then, the endoscope with the endoscope tip hood attached is inserted again into the body cavity, and observation is performed by irradiating the affected part with the laser light for PDT. In Patent Document 3, as in Patent Document 2, an endoscope sheath having an optical cut filter that cuts the laser light for PDT is attached to and detached from the endoscope insertion portion, thereby observing both PDD and PDT. It is possible.

  However, in Patent Document 1, after identifying a diseased part by irradiating a laser beam for PDD from an irradiation window at the distal end portion of an endoscope, a PDT probe that emits a laser beam for PDT is inserted into a forceps hole. It is configured to project the laser beam for PDT toward the identified affected part by projecting from the distal end part of the endoscope. Therefore, a PDT probe is separately prepared and handled, and the procedure becomes complicated. In Patent Documents 2 and 3, the PDD and PDT procedures cannot be performed continuously, and it is necessary to remove the endoscope from the body cavity and insert it again. The PDD and the PDT are quickly switched. I can't.

  In addition, the white illumination light and the PDD laser light emitted from the irradiation window at the distal end of the endoscope preferably have a wide irradiation angle in order to widely illuminate the inside of the body cavity, and the PDT laser light is directed toward the affected area. In order to irradiate locally, it is preferable to narrow the irradiation angle. However, when light is emitted from the same irradiation window, it is difficult to set favorable irradiation conditions for both PDD and PDT.

JP 2008-86680 A JP 2007-20759 A JP 2007-50072 A

  The present invention can quickly switch between techniques such as PDD and PDT while using the same endoscope without removing and reinserting the endoscope once inserted, and according to the contents of each technique. An object of the present invention is to provide an endoscope apparatus that can perform light irradiation at an appropriate irradiation angle and an endoscope tip hood used therefor.

The present invention has the following configuration.
(1) An illumination window that emits a plurality of types of light having different center wavelengths and an observation window for imaging the subject are arranged at the distal end of an endoscope insertion portion that is inserted into the subject, A hooded endoscope apparatus provided with an endoscope distal end hood that covers the distal end of the endoscope insertion portion on the front side of the illumination window and the observation window,
The endoscope front end hood is supported movably with respect to the hood main body and the hood main body, facing the front end of the endoscope insertion portion, and a condensing lens, a specific absorption wavelength band A light cut filter, and a slide member on which the translucent part is disposed,
The slide member has a first position where a light condensing lens of the slide member faces the irradiation window, a light cut filter of the slide member faces the observation window, and a light transmitting portion of the slide member emits the irradiation. A hooded endoscope apparatus at least movable between a window and a second position facing the observation window.
(2) Endoscope hood for endoscope used for the above endoscope apparatus with a hood.

  According to the endoscope apparatus of the present invention and the endoscope distal end hood used therefor, it is possible to remove the endoscope that has been inserted once and re-insert it without using the same endoscope. Procedures can be switched quickly, and light irradiation can be performed at an appropriate irradiation angle according to the contents of each procedure.

It is a figure for demonstrating embodiment of this invention, and is a notional block block diagram of an endoscope apparatus. It is an external view as an example of the endoscope apparatus shown in FIG. It is a rough section perspective view of the tip hood for endoscopes. It is a top view of a slide member. (A) is explanatory drawing which shows the state by which the opening hole is arrange | positioned in the irradiation window of an endoscope front-end | tip part, and the front of an observation window, (B) is a condensing lens in front of the irradiation window of an endoscope front-end | tip part. It is explanatory drawing which shows the state by which the light cut filter is arrange | positioned and is arrange | positioned in front of the observation window. It is a schematic sectional view of a state where an endoscope tip hood is attached to the endoscope tip. It is a flowchart which shows an example of the procedure procedure of PDD and PDT. (A) is a timing chart showing the irradiation timing of imaging by irradiating the odd-numbered frames of the imaging frame with the laser light for PDD and white light and irradiating the even-numbered frame with the laser light for PDT, and (B) is ( It is a timing chart which shows the irradiation timing which irradiates even light in the case of A) with white light together with the laser light for PDT. It is a block diagram which shows the other structural example of the front-end | tip hood for endoscopes. It is a notional block block diagram of another endoscope apparatus. FIG. 5 is a schematic plan view illustrating a configuration example of a rotating color filter.

Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.
FIG. 1 is a diagram for explaining an embodiment of the present invention, and is a conceptual block diagram of an endoscope apparatus. FIG. 2 is an external view as an example of the endoscope apparatus shown in FIG.
As shown in FIGS. 1 and 2, the endoscope apparatus 100 includes an endoscope 11 and a control device 13 to which the endoscope 11 is connected. The control device 13 is connected to a display unit 15 that displays image information and an input unit 17 that receives an input operation. The endoscope 11 includes an imaging optical that includes an illumination optical system that emits illumination light from the distal end of an endoscope insertion portion 19 that is inserted into a subject, and an imaging element 21 (see FIG. 1) that captures an observation region. An electronic endoscope having a system.

  The endoscope 11 includes an endoscope insertion unit 19, an operation unit 23 (see FIG. 2) for performing an operation for bending and observing the distal end of the endoscope insertion unit 19, and the endoscope 11. Connector portions 25A and 25B that are detachably connected to the control device 13 are provided. Although not shown, various channels such as a forceps channel for inserting a tissue collection treatment instrument and the like, a channel for air supply / water supply, and the like are provided inside the operation unit 23 and the endoscope insertion unit 19. .

  The endoscope insertion portion 19 includes a flexible soft portion 31, a bending portion 33, and a tip portion (hereinafter also referred to as an endoscope tip portion) 35. As shown in FIG. 1, the endoscope distal portion 35 has irradiation windows 37 </ b> A and 37 </ b> B that irradiate light to the observation region, and a CCD (Charge Coupled Device) that acquires image information of the observation region through the observation window 38. An image sensor 21 such as an image sensor or a CMOS (Complementary Metal-Oxide Semiconductor) image sensor is disposed. An objective lens unit 39 is disposed between the observation window 38 and the image sensor 21.

  An endoscope front end hood 71 is attached to the endoscope front end 35, and a slide member 73 having a disk portion facing the endoscope front end 35 is rotated on the endoscope front end hood 71. It is supported freely. The slide member 73 is rotationally driven in the endoscope front end hood 71 by a drive gear 77 rotated by a transmission wire 75. The transmission wire 75 is connected to the slide member drive unit 79 of the control device 13 via the connector unit 25B of the endoscope 11, and is rotated and driven linearly. Details of the configuration of the endoscope front hood 71, the irradiation windows 37A and 37B, the observation window 38, and the like will be described later.

  The bending portion 33 of the endoscope insertion portion 19 is provided between the flexible portion 31 and the distal end portion 35, and can be freely bent by a turning operation of the angle knob 22 disposed in the operation portion 23 shown in FIG. Yes. The bending portion 33 can be bent in an arbitrary direction and an arbitrary angle according to a part of the subject in which the endoscope 11 is used, and the light irradiation direction of the irradiation windows 37A and 37B of the endoscope distal end portion 35. , And the observation direction of the image sensor 21 through the observation window 38 can be directed to a desired observation site.

  The control device 13 includes a light source device 41 that supplies light to the irradiation windows 37A and 37B of the endoscope distal end portion 35, and a processor 43 that performs image processing on an image signal from the imaging device 21, and includes connector portions 25A and 25B. Via the endoscope 11. Further, the display unit 15 and the input unit 17 are connected to the processor 43. The processor 43 performs image processing on the imaging signal transmitted from the endoscope 11 based on an instruction from the operation unit 23 or the input unit 17 of the endoscope 11, generates a display image, and outputs the display image to the display unit 15. Supply.

  The light source device 41 has a plurality of laser light sources having different center emission wavelengths. In this configuration example, as shown in FIG. 1, the laser light sources LD1, 405nm and 665nm have a center emission wavelength of 445nm. A laser light source LD3 is provided. LD1 is a light source that emits blue laser light and generates white illumination light by a wavelength conversion member to be described later, and LD2 is a special light observation light source that emits violet laser light to perform photodynamic diagnosis (PDD). Also used as illumination light. The LD 3 is a light source for performing photodynamic therapy (PDT) for irradiating the surface of a living tissue with a laser beam with a relatively strong output to treat a tumor such as cancer. In PDD, a photosensitive substance that is administered to a living body and has affinity for a tumor and is sensitive to the wavelength of the laser beam of LD2 excites and emits light at a site where the concentration is high in a tumor lesion such as cancer. By detecting the excitation light, the position of the lesion is specified. The lesion part identified by the PDD is irradiated with the laser light for PDT by the LD 3.

  The light sources of these LD1 to LD3 are individually dimmed and controlled by the light source control unit 49, and the emission timing and emission light quantity ratio of each laser beam can be changed.

  As the laser light sources LD1 to LD3, broad area type InGaN-based laser diodes can be used, and InGaNAs-based laser diodes, GaNAs-based laser diodes, and the like can also be used. In addition, a light-emitting body such as a light-emitting diode may be used as the light source. For the white illumination light, a xenon lamp, a halogen lamp, or the like can be used instead of the laser light source LD1 and the wavelength conversion member. The center emission wavelength of LD3 may be in the range of 620 to 680 nm.

  Laser beams emitted from the LD1 to LD3 are respectively input to optical fibers by a condenser lens (not shown) and transmitted to the connector portion 25A. The laser beams from LD2 and LD3 are combined by a combiner 51, which is a multiplexer, and then transmitted to the connector portion 25A.

  Optical fibers 55A and 55B extend from the connector portion 25A to the endoscope distal end portion 35, the laser light from the LD1 is introduced into the optical fiber 55A, and the laser light from the LD2 and LD3 is transmitted to the optical fiber 55B. To be introduced. The laser light from the LD 1 is applied to the phosphor 57 that is a wavelength conversion member disposed at the endoscope distal end portion 35, and white light is emitted from the irradiation window 37A. The laser beams from LD2 and LD3 are emitted from the irradiation window 37B through the light deflection / diffusion member 58.

  The optical fibers 55A and 55B are multimode fibers. For example, a thin fiber cable having a core diameter of 105 μm, a cladding diameter of 125 μm, and a diameter including a protective layer that is an outer shell of φ0.3 to 0.5 mm can be used.

  If a plurality of light sources LD1 to LD3 are arranged to multiplex laser beams of the same type of light sources, individual differences in characteristics for each light source are absorbed and uniform light is obtained. Can be obtained. Alternatively, the phosphor 57 may be irradiated with laser light from the LD1 and LD2 introduced into the optical fiber 55A. In that case, the phosphor 57 having a small absorption with respect to the wavelength of the laser beam from the LD 2 is selected. Thus, the arrangement and combination of the laser light sources LD1 to LD3 can be appropriately changed according to the purpose.

The phosphor 57 absorbs a part of the blue laser light from the LD 1 and emits green to yellow excitation light, for example, a phosphor such as a YAG phosphor or a BAM (BaMgAl ₁₀ O ₁₇ ). ). Thereby, the green to yellow excitation light emitted from the blue laser light as the excitation light and the blue laser light transmitted without being absorbed by the phosphor 57 are combined to generate white (pseudo white) illumination light.

  Here, the white light referred to in the present specification is not limited to the one that strictly includes all wavelength components of visible light, and examples thereof include R (red), G (green), and B (blue) that are reference colors. As long as it includes light in a specific wavelength band, for example, light including a wavelength component from green to red, light including a wavelength component from blue to green, and the like are broadly included.

  In addition, the phosphor 57 can prevent noise superposition and flickering when performing moving image display due to speckle caused by coherence of laser light. In consideration of the refractive index difference between the phosphor constituting the phosphor and the fixing / solidifying resin serving as the filler, the phosphor 57 has a particle size with respect to the phosphor itself and the filler in the infrared region. It is preferable to use a material that absorbs light little and scatters a lot. This enhances the scattering effect without reducing the light intensity for red or infrared light, and reduces the optical loss.

  The light deflection / diffusion member 58 may be any material that transmits the laser light from the LD2 and LD3. For example, a light-transmitting resin material or glass is used. Furthermore, the light deflection / diffusion member 58 has a structure in which a light diffusion layer in which fine irregularities or particles (fillers, etc.) having different refractive indexes are mixed on the surface of a resin material or glass, or a translucent material. It is good also as a structure using. Thereby, the transmitted light emitted from the light deflection / diffusion member 58 becomes illumination light with a narrow band wavelength in which the amount of light is made uniform within a predetermined irradiation region.

  As described above, the illumination light composed of the blue laser light and the white light generated by the excitation light emitted from the phosphor 57 and the narrow-band light generated by each laser light is transmitted from the irradiation windows 37A and 37B of the endoscope distal end portion 35 to the endoscope. Irradiation toward the observation region of the subject through the distal tip hood 71 is performed. The state of the observation region irradiated with the illumination light is imaged on the light receiving surface of the image sensor 21 through the observation window 38 by the objective lens unit 39, and a captured image is generated.

  The image signal of the captured image output from the image sensor 21 is transmitted to the A / D converter 61 through the scope cable 59, converted into a digital signal, and input to the image processing unit 63 of the processor 43 via the connector unit 25B. Is done. The image processing unit 63 performs various processes such as white balance correction, gamma correction, contour enhancement, and color correction on the captured image signal from the image sensor 21 converted into a digital signal. The picked-up image signal processed by the image processing unit 63 is sent to the control unit 65, converted into an endoscopic observation image together with various information by the control unit 65, and displayed on the display unit 15. It is stored in the storage unit 67 comprising a storage device.

Next, a configuration example of the endoscope tip hood 71 will be described in detail.
FIG. 3 is a schematic cross-sectional perspective view of the endoscope front end hood. The endoscope distal end hood 71 is detachably attached to the distal end portion 35 of the endoscope insertion portion 19, and the slide member 73 is rotatable with respect to the endoscope distal end hood 71 in the direction A in the figure. And is supported so as to be movable in the direction B in the figure. As shown in the plan view of the slide member in FIG. 4, the slide member 73 has condensing lenses 81 </ b> A and 81 </ b> B, a light cut filter 83, and aperture holes 85 </ b> A, 85 </ b> B, and 85 </ b> C serving as light transmitting portions arranged in the same plane. It has a disk part 87. The disc portion 87 has a forceps hole opening 89 corresponding to the forceps hole opening at the distal end portion of the endoscope.

  The condensing lenses 81A and 81B have a function of condensing light emitted from the irradiation windows 37A and 37B of the endoscope distal end portion 35 shown in FIG. 1 toward the subject (affected part). The light cut filter 83 has a function of limiting the amount of transmitted light by absorbing the wavelength component of the PDT laser light from the LD 3.

  The opening holes 85A, 85B, and 85C maintain the same circumferential angles θ1 and θ2 with respect to the arrangement positions of the condenser lenses 81A and 81B and the light cut filter 83, with the rotation center C of the slide member 73 as the center. It is arranged at a position rotationally displaced by a predetermined angle α. As a result, as shown in FIG. 5A, the opening hole 85A is disposed in front of the irradiation window 37A of the endoscope distal end portion 35, the opening hole 85B is disposed in front of the irradiation window 37B, and the observation window 38 As shown in FIG. 5B, the condensing lens 81A is disposed on the front surface of the irradiation window 37A of the endoscope distal end portion 35 and is collected on the front surface of the irradiation window 37B. The optical lens 81B is disposed, and the light cut filter 83 is disposed in front of the observation window 38. In addition, you may comprise opening hole 85A, 85B, 85C which is a translucent part with the member which has translucency, such as glass.

  As described above, the slide member 73 has a rotation position in which light is diffusely irradiated from the irradiation windows 37A and 37B of the endoscope distal end portion 35 shown in FIG. The light from the irradiation windows 37A and 37B of the endoscope distal end portion 35 shown in FIG. 5B is condensed and irradiated by the condensing lenses 81A and 81B, and the laser light component from the LD 3 is irradiated by the light cut filter 83. It can be selectively placed at the rotational position where it is removed and imaged.

Next, an example of the rotation support structure of the slide member 73 and a structure for advancing / retreating will be described.
FIG. 6 shows a schematic cross-sectional view of a state where an endoscope tip hood is attached to the endoscope tip. The endoscope distal end hood 71 is elastically fixed by inserting the proximal end side 91 a of the hood main body 91 made of an elastic member into the outer periphery of the endoscope distal end portion 35. An annular groove 93 is formed on the inner peripheral surface of the hood main body 91, and an annular outer ring 95 is accommodated in the annular groove 93 so as to be slidable in the direction B in the figure. An accommodation groove 97 is formed inside the outer ring 95, and the above-mentioned slide member 73 is rotatably accommodated in the accommodation groove 97.

  The slide member 73 has an outer peripheral edge of the disk portion 87 connected to the side wall portion 88, and driving teeth are formed on at least a part of the inner peripheral surface of the side wall portion 88, and screwed with the drive gear 77. Yes. Further, the transmission wire 75 connected to the drive gear 77 is supported by the outer ring 95 and the hood main body 91, and rotates the drive gear 77 to rotate the slide member 73 in the direction A shown in FIG. Let

  The transmission wire 75 can be moved forward and backward in the axial direction by the slide member driving portion 79 shown in FIG. 1, thereby moving the outer ring 95 in the annular groove 93 in the B direction shown in FIG. 6. Thereby, the slide member 73 can be moved in the B direction. When the slide member 73 is moved in the B direction, the condensing lenses 81A and 81B approach or separate from the irradiation windows 37A and 37B, and the condensing characteristics from the irradiation windows 37A and 37B change.

  The optimum position of the condenser lens is the distance between the irradiation windows 37A and 37B and the observation window 38 in the endoscope distal end portion 35, the type and amount of light emitted from the irradiation windows 37A and 37B, and the observation window 38. Is set in accordance with at least one of the imaging angle of view of the subject to be imaged.

  Thus, the slide member drive unit 79 can drive the slide member 73 to rotate and move the condenser lens. The above configuration is an example, and other configurations may be used as long as the slide member 73 can be rotated and moved in the axial direction.

Next, a procedure for performing PDD and PDT procedures using the endoscope apparatus configured as described above will be described.
FIG. 7 is a flowchart showing an example of procedures for PDD and PDT. Based on this flowchart, first, blue laser light is emitted from the LD 1 shown in FIG. 1, and white light is emitted from the irradiation window 37 </ b> A having the phosphor 57. In addition, irradiation with violet laser light (narrow band light), which is a laser light for PDD, from LD2 to produce illumination light enhances the capillary blood vessels in the tissue surface layer and facilitates observation of the blood vessel structure. At this time, the slide member 73 of the endoscope front end hood 71 is set to the rotation position shown in FIG. 5A, and the irradiation windows 37A and 37B and the observation window 38 are exposed.

  As described above, normal observation using white light or special light observation using illumination light obtained by adding blue laser light or violet laser light to white light is performed (S1), and the endoscope distal end is advanced to the affected area. Then, when the distal end of the endoscope reaches the vicinity of the affected part, the light output from the LD 1 is stopped and the laser light for PDD from the LD 2 is irradiated (S 2). Then, since the concentration of the photosensitive substance administered to the patient is increased in the lesion area and excited light is emitted by the laser light for PDD, the presence or absence of the lesion area is confirmed by fluorescence detection by PDD (S3).

  This is repeated until the lesion is found. When the lesion is found, the endoscope tip is brought close to the lesion and the aim of the PDT laser light irradiation is adjusted to the lesion (S4). At this time, the slide wire 73 is rotated by the slide member drive unit 79 shown in FIG. 1 to change the slide member 73 from the rotation position shown in FIG. 5A to the rotation position shown in FIG. To do. Next, the axial position of the slide member 73 shown in FIG. 6 is adjusted in the arrow B direction by moving the transmission wire 75 forward and backward by the slide member drive unit 79, and the degree of light collected from the irradiation windows 37 </ b> A and 37 </ b> B. Adjust. Specifically, the irradiation area of the PDT laser light is adjusted to be in a range of φ20 mm or less on the irradiation surface. The driving of the transmission wire 75 by the slide member driving unit 79 can be controlled by an instruction from the control unit 65 in addition to the operation of the switch 80 provided in the endoscope 11.

  After aiming at the lesion, the LD 3 is driven to irradiate the PDT laser light from the irradiation windows 37A, 37B toward the lesion with a relatively high intensity (S5). At this time, as shown in FIG. 5B, the observation window 38 is covered with the light cut filter 83, and the component of the laser light for PDT is shielded and the introduction to the image sensor is restricted. Image information can be acquired with appropriate exposure without saturating the observation image.

  Further, even during the irradiation of the PDT laser light, the observation image is displayed on the display unit 15 shown in FIG. 1, thereby confirming the presence or absence of the irradiation position shift of the PDT laser light (S6). When a deviation occurs in the irradiation position, the endoscope 11 is operated each time and adjustment is performed so that the laser beam for PDT is correctly irradiated to the lesion.

  After a predetermined time has elapsed after irradiating the lesion with the PDT laser light (S7), the irradiation of the PDT light by the LD 3 is stopped (S8), and the PDT is terminated. Then, by rotating the transmission wire 75 by the slide member driving unit 79, the slide member 73 is changed from the rotation position shown in FIG. 5B to the rotation position shown in FIG. 5A. And the laser beam for PDD by LD2 is irradiated to the position where the lesion part existed (S9), and the presence or absence of fluorescence is confirmed. When fluorescence is generated from the position of the lesion, treatment such as irradiating the PDT light again to the lesion is performed, and when fluorescence is not observed, the treatment is terminated assuming that the lesion has been completely cured ( S10).

  As described above, each treatment of normal observation (special light observation), PDD, and PDT can be continuously performed with the endoscope inserted into the body cavity of the patient. In addition, when the PDD is performed and when the PDT is performed by the rotation operation (A direction rotation) of the slide member 73, the slide member 73 can be quickly switched by operating the switch 80 or the like. By the operation (movement in the B direction), the laser light for PDT can be properly aimed at a desired region. As a result, the procedure can be performed efficiently and accurately, and the burden on the patient can be reduced.

  Here, it is preferable to switch the irradiation timing of the laser light for PDD, the irradiation of white light, and the irradiation of the laser light for PDT in synchronization with the imaging frame by the imaging device. FIGS. 8A and 8B show examples of irradiation timing, respectively. In the pattern shown in FIG. 8A, imaging is performed by irradiating PDD laser light and white light with odd-numbered frames of the imaging frame, and irradiating with PDT laser light with even-numbered frames. In this case, it is possible to obtain an image in which the image during normal observation and the fluorescence of the PDD are superimposed in an odd number of frames, thereby making it easy to confirm the observation location with white light and grasping the position of the lesion that emits fluorescence. Easy to do. Then, it is possible to obtain an image in which the state of irradiation with the laser light for PDT is projected in even frames. By displaying these odd frames and even frames as a single piece of image information, images with PDD and PDT can be displayed simultaneously on the observation image during normal observation, and the visibility of PDD and PDT is improved. Can be done smoothly.

  In the pattern shown in FIG. 8B, white light is irradiated together with the laser light for PDT in the even-numbered frame in the case of FIG. According to this, the color reproducibility of the observation image at the time of PDT in the even-numbered frame is enhanced by the white light, and it can be acquired as a more natural image.

  In addition, the above even-numbered frame image and odd-numbered frame image may be displayed in different positions in the display area of the display unit 15 without overlapping each other, so that they can be observed while comparing the two. .

  The present invention is not limited to the above-described embodiments, and those skilled in the art can change or apply the present invention based on the description in the specification and well-known techniques. included.

  For example, the condensing lenses 81A and 81B arranged on the slide member 73 shown in FIG. 6 change the illumination angle by deforming the lens by applying a voltage in addition to adjusting the illumination angle by moving the slide member 73 in the B direction. It can also be set as the structure to do.

  In addition to the drive by the rack and pinion mechanism with the drive gear 77, the slide member 73 may be driven by using an ultrasonic motor, magnetism or the like as a drive source, and is prepared separately for other purposes. A drive system connected to a rotary drive shaft may be used. Moreover, it is good also as slide operations, such as not only a rotation operation but a horizontal rectilinear movement.

  Further, as shown in FIG. 9, an endoscope tip hood 71 is provided with an illumination optical axis La from the irradiation windows 37 </ b> A and 37 </ b> B and an imaging optical axis of an observation window (not shown). A configuration may also be adopted in which a reflecting member 99 that deflects sideward from the axial direction of the portion 35 is disposed. In other words, a support part 99a having a spring property is fixed to the distal end part on the subject side of the endoscope front end hood 71, and the reflection member 99 having the reflection surface 99b continuously provided on the support part 99a A configuration is adopted in which the wire 101 that is led out from the endoscope distal end 35 is displaced in the direction D in the drawing by pulling and feeding. According to this configuration, the illumination optical axis La and the imaging optical axis can be freely deflected.

  That is, according to the endoscope front end hood 71 shown in FIG. 9, the wire 101 is unwound from the housed state where the wire 101 is pulled at an arbitrary timing, and the reflecting member 99 is moved inside the hood by the elastic force of the support portion 99a. The illumination optical axis La and the imaging optical axis can be deflected laterally. Therefore, observation from the side of the endoscope distal end portion 35 is possible, and a wider range of observation can be performed by switching the optical axis from the axial direction of the endoscope distal end portion 35.

  Thus, according to the endoscope apparatus of this configuration, it is possible to switch between the PDD and PDT procedures while using the same endoscope without removing the endoscope inserted into the body cavity and inserting it again. Moreover, light irradiation can be performed at an appropriate irradiation angle with PDD and PDT. This facilitates endoscopic procedures and reduces the burden on the patient.

  Further, as shown in FIG. 10, the light source for generating white illumination light of the light source device 41 of the endoscope apparatus 200 selectively transmits a plurality of types of wavelength bands and sequentially generates a plurality of types of light. The rotating color filter 111 having a disk shape to be output and the white light source 113 for irradiating the rotating color filter 111 with white light may be used. Specifically, the light source device 41 in this case includes a white light source 113 that uses a xenon lamp that emits white light as a light source, a diaphragm device 115 that controls the amount of light emitted from the xenon lamp, and a plurality of types of transmission filters. And the above-described rotating color filter 111 that converts white light into surface sequential light, and a light collecting device that condenses the surface sequential light via the rotating color filter 111 on the incident surface of the light guide 117 connected to the endoscope apparatus. An optical lens 119, a rotary filter motor 121 that rotationally drives the rotary color filter 111, and a filter moving stage 123 that moves the rotary color filter 111 perpendicular to the optical path.

  Further, the LD 3 that generates the PDT laser light irradiates the light deflection / diffusion member 58 of the endoscope distal end portion 35 through the optical fibers 125 and 127 with the laser light.

  As an example, as shown in FIG. 11, the rotating color filter 111 has a G filter 131 that transmits green component light, an R filter 133 that transmits red component, and B1 that transmits first blue component light. A filter 135 and a B2 filter 137 that transmits light of the second blue component are provided. The transmission filters including the R filter 131, the G filter 133, the B1, and the B2 filters 135 and 137 are arranged side by side in the circumferential direction around the rotation center of the rotating color filter 111, and the B1 and B2 filters 135 and 137 are arranged. In the same circumferential position, it is divided and arranged radially inside and outside. Further, a light shielding portion 139 is formed between different colors of each transmission filter.

  The light transmitted through each transmission filter of the rotary color filter 111 having the above configuration is irradiated to the subject, and the light returning from the subject is detected by the image sensor 21A.

  Here, the B1 filter 135 is for generating B light used during normal observation (when observing white light), and the B2 filter 137 is for generating narrow band light for capturing a narrow band image. That is, the B2 filter 137 is a filter that transmits only a light component in a narrower band than the B1 filter 135, and narrow band light (for example, having a half-value width of 20 to 40 nm) corresponding to the above-described 405 nm laser light (PDD laser light). Band-pass characteristic light) is generated from white light. Further, as the transmitted light center wavelength of the B2 filter 137, a bandpass characteristic having a half-value width of 20 to 40 nm including 500 nm which is an absorption peak of hemoglobin or 430 nm may be used.

Next, the operation of the endoscope apparatus 200 configured as described above will be described.
First, after the endoscope insertion portion 19 is inserted into the body cavity, the processor 43 is driven, and white light is emitted from the xenon lamp of the white light source 113. Then, at the same time as the white light is emitted from the xenon lamp, the rotary color filter 111 is driven to rotate by the rotary filter motor 121.

  Further, after rotating the rotary color filter 111 as described above, the rotary color filter 111 is moved in the radial direction by driving the filter moving stage 123 at every predetermined rotation or at an arbitrary timing. For example, each time the rotating color filter 111 makes one rotation, the rotating color filter 111 is moved radially outward or inward so that the B1 filter 135 is irradiated with white light and B2 for each rotation of the rotating color filter 111. The filter 137 can be switched to white light irradiation. This switching may be performed at an arbitrary timing.

  By such operations of the white light source 113 and the rotating color filter 111, a specific pattern (an emission pattern in which R light, G light, B1 light, and B2 light are emitted in an arbitrary order according to the arrangement position of the rotating color filter) Are sequentially emitted from the rotating color filter 111 and incident on one end of the light guide 117 via the condenser lens 119.

  Then, the surface sequential light guided by the light guide 117 is emitted from the other end of the light guide 117, and is irradiated to the observation target via the light deflection / diffusion member 58. The light returning from the observation target by the irradiation of the surface sequential light is imaged on the image pickup surface of the image pickup device 21A by the objective lens unit 39. Then, the image sensor 21A outputs an image signal with the image to be observed as an R component, a G component, a B1 component, and a B2 component. Each of these image signals can be subjected to appropriate image processing or displayed on the display unit 15 for each frame described above.

  In this case, the image sensor 21A may be a monochrome image sensor, but a color image sensor can also be used. In that case, the rotating color filter is rotated at least once in one frame, and the image information of each color is accumulated within the charge accumulation period of the image sensor. That is, the time for one rotation of the rotating color filter is controlled so as to correspond to the frame rate of the image sensor 21A. That is, when the frame rate is 60 fps, the rotation speed of the rotation color filter 111 is controlled so that the time for one rotation of the rotation color filter 111 is 1/60 second. The color image sensor may be a primary color image sensor having R, G, B sensitivity, or a C, M, Y, or complementary color image sensor having C, M, Y, G sensitivity.

As another configuration example, a configuration of an endoscope apparatus as described below may be used.
In the above example, the PDT laser is emitted from the distal end portion of the endoscope. However, the present invention is not limited to this, and an optical fiber member that guides the PDT laser is inserted from the forceps hole of the endoscope to insert the PDT into the affected area. The structure which irradiates the laser beam for operation may be sufficient.

  In addition, the above-described endoscope front hood has been described as an example of a configuration in which it is detachably attached to the distal end of the endoscope insertion portion. However, the observation shown in FIGS. Endoscope so that the relationship between the arrangement of the window 38 and the illumination windows 37A and 37B and the arrangement of the apertures 85A, 85B and 85C and the arrangement of the light cut filter 83 and the condensing lenses 81A and 81B can be realized. The distal end hood may be integrated with the distal end of the endoscope insertion portion so as to be rotatable. According to this configuration, it is possible to save the trouble of attaching the endoscope distal end hood to the endoscope distal end portion 35 and to perform the endoscope procedure more quickly.

As described above, the following items are disclosed in this specification.
(1) An illumination window that emits a plurality of types of light having different center wavelengths and an observation window for imaging the subject are arranged at the distal end of an endoscope insertion portion that is inserted into the subject, A hooded endoscope apparatus provided with an endoscope distal end hood that covers the distal end of the endoscope insertion portion on the front side of the illumination window and the observation window,
The endoscope front end hood is supported movably with respect to the hood main body and the hood main body, facing the front end of the endoscope insertion portion, and a condensing lens, a specific absorption wavelength band A light cut filter, and a slide member on which the translucent part is disposed,
The slide member has a first position where a light condensing lens of the slide member faces the irradiation window, a light cut filter of the slide member faces the observation window, and a light transmitting portion of the slide member emits the irradiation. A hooded endoscope apparatus at least movable between a window and a second position facing the observation window.
According to this endoscope apparatus with a hood, by switching the slide member between the first position and the second position, it is possible to perform imaging in which the light irradiation angle is changed and unnecessary light components are removed from the normal observation state. You can easily and quickly change to a state where you can do it.

(2) The endoscope apparatus with a hood according to (1),
The slide member has a disk portion in which the condensing lens, the light cut filter, and the light transmitting portion are integrally arranged in the same plane, and the hooded internal view in which the disk portion is rotatably supported Mirror device.
According to this hooded endoscope apparatus, each of the distal end portions of the endoscope is moved by a simple operation of rotating the disk portion of the slide member and sliding the condenser lens, the light cut filter, and the light transmitting portion integrally. It can be adjusted to the position of the irradiation window and the observation window.

(3) The hooded endoscope apparatus according to (1) or (2),
A hooded endoscope apparatus in which the slide member is supported movably in the axial direction of the endoscope insertion portion.
According to the hooded endoscope apparatus, the light emission direction from the irradiation window can be changed by moving the condenser lens in the axial direction, and the irradiation range of the emitted light can be adjusted.

(4) The hooded endoscope apparatus according to any one of (1) to (3),
A reflection that is disposed on the hood tip side with respect to the slide member of the hood main body, and deflects the illumination optical axis from the irradiation window and the imaging optical axis of the observation window laterally from the axial direction of the endoscope tip. A hooded endoscope apparatus having a member.
According to this hooded endoscope apparatus, it is possible to observe also the side of the endoscope tip, and a wider range of observation is possible by switching the illumination optical axis and the observation optical axis from the axial direction of the endoscope tip. Become.

(5) The hooded endoscope apparatus according to any one of (1) to (4),
A hooded endoscope apparatus in which the light source unit emits white light and special light having a narrower wavelength band than the white light.
According to this endoscope apparatus with a hood, white light for normal observation and special light for special light observation can be selectively and simultaneously emitted from the light source unit.

(6) The endoscope apparatus with a hood according to (5),
The light source unit includes a laser light source and a wavelength conversion member disposed inside the irradiation window, and the light emitted from the laser light source and the light whose wavelength is converted by the wavelength conversion member. A hooded endoscope that produces white light.
According to this hooded endoscope apparatus, white light is generated based on the light emitted from the laser light source, so that white light with high efficiency and high luminance can be obtained. In addition, the wavelength conversion member can prevent the occurrence of noise superimposition or flickering when displaying moving images due to speckles caused by the coherence of laser light.

(7) The endoscope apparatus with a hood according to (5),
The light source unit includes a color filter in which a plurality of transmission filters that selectively transmit light in a specific wavelength band are arranged with different transmission wavelength bands,
A hooded endoscope apparatus that selectively emits white light to each transmission filter of the color filter to generate light components of a plurality of types of wavelength bands.
According to this endoscope apparatus with a hood, by irradiating each transmission filter of the color filter with white light, light of a plurality of types of wavelength bands can be extracted as the transmitted light.

(8) The hooded endoscope apparatus according to (7),
A hooded endoscope apparatus that moves the slide member in synchronization with a switching timing of a transmission filter that emits the white light.
According to this hooded endoscope apparatus, since the transmission filter switching timing becomes the irradiation light switching timing, the slide member can always be changed to a position corresponding to the irradiation light.

(9) The endoscope apparatus with a hood according to (7) or (8),
A hooded endoscope apparatus, wherein the color filter is a disk-shaped rotating color filter in which the plurality of transmission filters are arranged in a circumferential direction around a rotation center.
According to this endoscope apparatus with a hood, a plurality of types of light can be continuously generated by rotating a rotating color filter and sequentially irradiating each transmission filter arranged in the circumferential direction with white light. it can.

(10) The hooded endoscope apparatus according to any one of (1) to (9),
A hooded endoscope apparatus in which the special light generated by the light source unit is a photodynamic therapeutic light including a wavelength range for treating the affected part by photochemical reaction of a photosensitive substance administered to a patient and staying in the affected part.
According to this hooded endoscope apparatus, light for photodynamic therapy used for photodynamic therapy can be selectively irradiated.

(11) The hooded endoscope apparatus according to (10), wherein a specific absorption wavelength band of the light cut filter includes a center wavelength of the photodynamic therapeutic light.
According to this hooded endoscope apparatus, it is possible to prevent the captured image from being saturated by the photodynamic therapeutic light emitted at a relatively high intensity, and to observe the affected part even when the photodynamic therapeutic light is irradiated. Is possible.

(12) The hooded endoscope apparatus according to any one of (1) to (11),
A hooded endoscope apparatus in which the special light generated by the light source unit is a photodynamic diagnostic light including a wavelength range that excites a photosensitive substance that is administered to a patient and stays in the affected part.
According to this hooded endoscope apparatus, images can be acquired under imaging conditions suitable for observation of a photosensitive substance.

(13) The hooded endoscope apparatus according to (12),
When the photodynamic therapeutic light is emitted from the irradiation window, the slide member is switched to the first position;
A hooded endoscope apparatus comprising a slide member movement control unit that switches the slide member to the second position when the light dynamic diagnostic light or white light is emitted from the irradiation window.
According to this hooded endoscope apparatus, when irradiating light for photodynamic therapy, light for photodynamic therapy is irradiated to a narrow irradiation range by a condensing lens, and photodynamic therapy is performed by a light cut filter. Since the image is picked up after removing the reflection component of the light for use, the lesion can be irradiated with light with an increased energy density, and the captured image is not saturated. Moreover, when irradiating light for photodynamic diagnosis or white light, it is possible to irradiate a wide range and image even weak fluorescence.

(14) The hooded endoscope apparatus according to any one of (1) to (13),
A hood in which a switching instruction section for instructing to switch the slide member to the first position or the second position is disposed in an endoscope operation section that extends to a proximal end side of the endoscope insertion section. Endoscope device.
According to this endoscope apparatus with a hood, the slide member can be switched between the first position and the second position at an arbitrary timing by the operation of the switching instruction section disposed in the endoscope operation section. The operability of the endoscope can be improved.

(15) The hooded endoscope apparatus according to any one of (1) to (14),
A hooded endoscope apparatus that moves the slide member in synchronization with a frame of an imaging signal output by an imaging device that images through the imaging window.
According to this endoscope apparatus with a hood, by moving the slide member in synchronization with the frame, it is possible to display an image with different irradiation light for each frame.

(16) The hooded endoscope apparatus according to any one of (1) to (15),
An endoscope apparatus with a hood, wherein the hood is detachably attached to a distal end of the endoscope insertion portion.
According to this endoscope apparatus with a hood, the hood can be detached and configured separately from the endoscope so that the hood can be attached only when necessary. Does not interfere with operability during use.

(17) An endoscope tip hood used in the hooded endoscope device according to any one of (1) to (16).
According to this endoscope tip hood, by attaching the endoscope tip hood to the endoscope apparatus, it is possible to set appropriate illumination conditions and observation conditions according to the contents of the procedure.

DESCRIPTION OF SYMBOLS 11 Endoscope 13 Control apparatus 15 Display part 19 Endoscope insertion part 21 Image pick-up element 35 End-of-endoscope part 37A, 37B Irradiation window 38 Observation window 39 Objective lens unit 41 Light source device 43 Processor 49 Light source control part 55A, 55B Light Fiber 57 phosphor (wavelength conversion member)
63 Image processing unit 65 Control unit 71 Endoscope hood for endoscope 73 Slide member 75 Transmission wire 77 Drive gear 79 Slide member drive unit
80 switch 81A, 81B condensing lens 83 light cut filter 85A, 85B, 85C opening hole (translucent part)
87 Disk part 88 Side wall part 91 Hood body part 93 Annular groove 95 Outer ring 97 Housing groove 99 Reflective member 100, 200 Endoscope device 111 Rotating color filter 113 White light source 131 G filter (transmission filter)
133 R filter (transmission filter)
135 B1 filter (transmission filter)
137 B2 filter (transmission filter)

Claims (17)

An illumination window that emits a plurality of types of light having different center wavelengths and an observation window for imaging the subject are arranged at the tip of an endoscope insertion portion that is inserted into the subject, and the illumination window A hooded endoscope apparatus provided with an endoscope tip hood that covers the tip of the endoscope insertion portion on the front side of the observation window,
The endoscope front end hood is supported movably with respect to the hood main body and the hood main body, facing the front end of the endoscope insertion portion, and a condensing lens, a specific absorption wavelength band A light cut filter, and a slide member on which the translucent part is disposed,
The slide member has a first position where a light condensing lens of the slide member faces the irradiation window, a light cut filter of the slide member faces the observation window, and a light transmitting portion of the slide member emits the irradiation. A hooded endoscope apparatus at least movable between a window and a second position facing the observation window. The endoscope apparatus with a hood according to claim 1,
The slide member has a disk portion in which the condensing lens, the light cut filter, and the light transmitting portion are integrally arranged in the same plane, and the hooded internal view in which the disk portion is rotatably supported Mirror device. A hooded endoscope device according to claim 1 or 2,
A hooded endoscope apparatus in which the slide member is supported movably in the axial direction of the endoscope insertion portion. It is an endoscope apparatus with a hood of any one of Claims 1-3,
A reflection that is disposed on the hood tip side with respect to the slide member of the hood main body, and deflects the illumination optical axis from the irradiation window and the imaging optical axis of the observation window laterally from the axial direction of the endoscope tip. A hooded endoscope apparatus having a member. The endoscope apparatus with a hood according to any one of claims 1 to 4,
A hooded endoscope apparatus in which the light source unit emits white light and special light having a narrower wavelength band than the white light. The hooded endoscope apparatus according to claim 5,
The light source unit includes a laser light source and a wavelength conversion member disposed inside the irradiation window, and the light emitted from the laser light source and the light whose wavelength is converted by the wavelength conversion member. A hooded endoscope that produces white light. The hooded endoscope apparatus according to claim 5,
The light source unit includes a color filter in which a plurality of transmission filters that selectively transmit light in a specific wavelength band are arranged with different transmission wavelength bands,
A hooded endoscope apparatus that selectively emits white light to each transmission filter of the color filter to generate light components of a plurality of types of wavelength bands. The hooded endoscope apparatus according to claim 7,
A hooded endoscope apparatus that moves the slide member in synchronization with a switching timing of a transmission filter that emits the white light. A hooded endoscope apparatus according to claim 7 or claim 8,
A hooded endoscope apparatus, wherein the color filter is a disk-shaped rotating color filter in which the plurality of transmission filters are arranged in a circumferential direction around a rotation center. A hooded endoscope apparatus according to any one of claims 1 to 9,
A hooded endoscope apparatus in which the special light generated by the light source unit is a photodynamic therapeutic light including a wavelength range for treating the affected part by photochemical reaction of a photosensitive substance administered to a patient and staying in the affected part. The hooded endoscope apparatus according to claim 10, wherein a specific absorption wavelength band of the light cut filter includes a center wavelength of the photodynamic therapeutic light. It is an endoscope apparatus with a hood of any one of Claims 1-11,
A hooded endoscope apparatus in which the special light generated by the light source unit is a photodynamic diagnostic light including a wavelength range that excites a photosensitive substance that is administered to a patient and stays in the affected part. A hooded endoscope device according to claim 12,
When the photodynamic therapeutic light is emitted from the irradiation window, the slide member is switched to the first position;
A hooded endoscope apparatus comprising a slide member movement control unit that switches the slide member to the second position when the light dynamic diagnostic light or white light is emitted from the irradiation window. It is an endoscope apparatus with a hood of any one of Claims 1-13,
A hood in which a switching instruction section for instructing to switch the slide member to the first position or the second position is disposed in an endoscope operation section that extends to a proximal end side of the endoscope insertion section. Endoscope device. A hooded endoscope apparatus according to any one of claims 1 to 14,
A hooded endoscope apparatus that moves the slide member in synchronization with a frame of an imaging signal output by an imaging device that images through the imaging window. A hooded endoscope apparatus according to any one of claims 1 to 15,
An endoscope apparatus with a hood, wherein the hood is detachably attached to a distal end of the endoscope insertion portion.   An endoscope front end hood used in the endoscope apparatus with a hood according to any one of claims 1 to 16.

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