JP2011152305A - Endoscope system - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an endoscope system, capable of simultaneously performing endoscopic observation and treatment with other treatment devices by operation by one hand, and coping with multiple treatment modes. <P>SOLUTION: The endoscope system 1 includes a grip part 2 which can be held and operated by one hand, a pipe part 3 connected to a distal end part of the grip part 2, and an image guide 5 provided from a distal end 3a of the pipe part 3 through the inside of the pipe part 3 and the inside of the grip part 2 to connect to an imaging device 4. On the grip part 2, an installation part 7 for a treatment device is formed, on which the treatment device 6 can be detachably installed, and a holding means 8 is provided to hold the treatment device 6 where it can be grasped and operated with the grip part 2 by one hand. On the pipe part 3, a channel 3d for a treatment means is formed inside, so that the treatment means 61 of the treatment device 6 installed on the installation part 7 is extended to the distal end of the pipe part 3 to operate to an affected part. <P>COPYRIGHT: (C)2011,JPO&INPIT

Description

  The present invention relates to an endoscope system that can improve an endoscope system, in particular, an observation of an affected area with an endoscope and a treatment of the affected area with a treatment instrument in parallel.

  Recently, in various clinical medicines, treatment of an affected area while observing the affected area with an endoscope has been widely performed. In addition, laser treatment instruments for irradiating the affected area with laser light to treat the affected area have been widely used. Patent Document 1 discloses a first fiber bundle that transmits light from a light source to irradiate an affected area, and a dental endoscope that captures and transmits an image of the affected area and can be reproduced by a camera or a monitor. Has been. Patent Document 2 discloses a therapeutic laser device used when performing treatments such as excision of living tissue, hemostasis, coagulation, and healing of wounds. Patent Document 1 is a dental endoscope apparatus for observing an affected area, and Patent Document 2 is a therapeutic instrument for performing treatment by irradiating a laser to the affected area. Shows an example of an endoscope system configured such that an endoscope and a treatment instrument can be combined to perform observation of the affected area with the endoscope and treatment of the affected area with the treatment instrument in parallel. Yes. That is, Patent Document 3 incorporates endoscope fibers (illumination light transmission fiber and optical image transmission fiber), and treats the affected area with a curettage blade (therapeutic instrument) while performing endoscopic observation of the affected area. An endoscopic system for subgingival dental treatment that can be shown is shown. Patent Document 3 also shows an endoscope system that includes a fiber for transmitting laser light instead of a curettage blade and is configured to perform laser treatment of an affected area while performing endoscopic observation of the affected area. . On the other hand, in Patent Document 4, an illumination light fiber, an image transmission fiber, and a treatment instrument (blade, tweezers, drill bite, etc.) are bundled with a single polymer jacket, and the affected part is treated with the treatment instrument while performing endoscopic observation of the affected part. An endoscopic system configured to be able to perform the treatment of is shown.

JP-A-2-279129 JP 2003-126114 A JP 7-502441 A Japanese National Patent Publication No. 10-504472

  Since the endoscope shown in Patent Document 1 performs only observation of an affected part, when an attempt is made to treat the affected part in parallel, a separately prepared treatment instrument is brought close to the affected part to be observed, and the endoscope It is necessary to perform treatment work by operating differently. Conversely, when performing treatment in vivo using the therapeutic laser device disclosed in Patent Document 2, an endoscope prepared separately is brought close to the treatment target and operated separately from the treatment device (instrument). It is necessary to perform treatment work. In such a treatment form, a large number of operator's hands are required, and the treatment work becomes complicated. On the other hand, in the endoscope system as shown in Patent Documents 3 and 4, since the endoscope and the treatment instrument are combined, the observation of the affected part with the endoscope and the treatment of the affected part with the treatment instrument are performed. Can be performed in parallel, which is extremely convenient and improves the treatment efficiency. However, in the case of the endoscope system disclosed in Patent Document 3, there is an endoscope system having an endoscope observation function and a curettage treatment function, or an endoscope system having an endoscope observation function and a laser treatment function. There is no idea of individually replacing different types of treatment instruments and adapting to other surgical methods in each endoscope system. Therefore, the adaptability to various treatment modes does not fully meet the needs of users. In the case of the endoscope system shown in Patent Document 4, in the example shown in FIG. 9, the function of observing the affected part with an endoscope, the function of incising the affected part with a knife blade, and the suture function with a suture thread or wire It is considered that it is possible to cope with a plurality of surgical procedures. However, the mechanism of the operation unit for expressing each of these functions is not clearly shown, and even from the other disclosed technology of Patent Document 4, a plurality of hands are required to operate these operation units. However, it is reasonable to operate with one hand. Therefore, it is not considered to be excellent in operability, and especially in the case of treatment in a narrow oral cavity such as dental treatment, the hands of a plurality of surgeons are located near the oral cavity of the patient, and this facilitates the dental treatment. It was undeniable that it was a factor that lacked gender.

  The present invention has been made in view of the above, and an endoscope system capable of performing endoscopic observation and treatment with another treatment instrument in parallel by one-hand operation and capable of dealing with multifaceted treatment modes. The purpose is to provide.

  An endoscope system according to the present invention includes a grip part that can be gripped and operated with one hand, a pipe part that is connected to a tip part of the grip part, and images from the tip of the pipe part through the pipe part and the grip part. An endoscope system including an image guide provided so as to be connected to the apparatus, wherein the grip portion is provided with a treatment instrument attachment portion to which the treatment instrument is detachably attached, and the treatment instrument is mounted on the grip portion. A holding means for holding the grip portion together with the grip portion at a position where the gripping operation can be performed is provided, and the treatment portion of the treatment instrument attached to the attachment portion is extended to the distal end of the pipe portion on the pipe portion. It is characterized in that a channel for treatment means for acting on the body is installed.

  The endoscope system of the present invention may further include a light guide provided so as to be connected to the light source device from the distal end of the pipe portion through the pipe portion and the grip portion. Moreover, you may comprise so that the water supply conduit provided so that it might continue from the front-end | tip of the said pipe part through this pipe part and the said grip part to a water supply source may be included.

  In the endoscope system of the present invention, the holding means may be slidable along the longitudinal axis direction of the grip portion.

  In the endoscope system of the present invention, the treatment instrument is a treatment laser irradiation handpiece provided with a laser light guide chip as a treatment means at a tip, and the treatment laser irradiation handpiece is attached to the attachment portion. Then, the laser light guide chip may be configured to be inserted into the treatment means channel and protrude from the tip of the pipe portion. Further, the therapeutic instrument is a chemical injection device that can be filled with a chemical solution as the treatment means, and when the chemical injection device is attached to the attachment portion, the chemical solution passes through the treatment means channel and the pipe portion You may comprise so that it can pour out from a front-end | tip. Furthermore, the treatment instrument is a root canal cutting instrument including a needle-like cutting tool as the treatment means, and the needle-like cutting tool is in the treatment means channel in a state where the root canal cutting instrument is attached to the attachment portion. You may comprise so that it may penetrate and may protrude from the front-end | tip of the said pipe part.

  According to the endoscope system of the present invention, the grip part is gripped with one hand, the tip of the pipe part is positioned near the affected part to be observed, and an image of the affected part is imaged from the tip of the pipe part through the image guide. Thus, an endoscopic observation of the affected area can be performed by appropriately reproducing an image acquired by the imaging apparatus and reproducing the image by a reproducing means (for example, a monitor apparatus). The therapeutic device is attached to the grip portion via the attachment portion, and in this attached state, the treatment means of the treatment device reaches the tip of the pipe portion via the treatment means channel built in the pipe portion. The endoscopic observation of the affected area and the treatment of the affected area by the treatment means can be performed in parallel. Moreover, since the treatment instrument is held by the holding means at a position where it can be grasped and operated with one hand, the operator can simultaneously operate the endoscope and the treatment instrument with one hand, and the other hand. Becomes free and can carry out treatment work with a margin. In addition, the assistant is free to use both hands, and can perform other auxiliary work in parallel, so that a fine and efficient treatment work can be performed throughout. In addition, since the treatment instrument is detachably attached to the attachment portion, the treatment according to the treatment mode can be performed by appropriately replacing the treatment instrument. Even if it is necessary to change the surgical procedure during the treatment work, it is possible to accurately carry out a flexible treatment by immediately changing to a treatment device suitable for it.

  In the endoscope system of the present invention, when it is configured to further include a light guide provided so as to be connected to the light source device from the tip of the pipe portion, through the pipe portion and the grip portion, the light from the light source device Since the affected part is irradiated from the tip of the pipe part through the guide, the image of the affected part is clearly received at the tip of the image guide, and the image guide is transmitted and accurately acquired by the imaging device. Therefore, the surgeon can perform a highly accurate treatment by operating the treatment instrument while viewing a clear image by the reproducing means.

  Further, in the case where it is configured to further include a water supply conduit provided so as to be connected to the water supply source from the tip of the pipe portion through the pipe portion and the grip portion, the water supply from the water supply source as necessary during the treatment work By irrigating water from the tip of the pipe part to the affected part through the pipe line, cleaning of the affected part, cooling of the treatment means, and the like can be easily performed.

  When the holding means is slidable along the longitudinal axis direction of the grip part, for example, while observing the affected part with an endoscope, the distal end of the therapeutic means in the treatment instrument is positioned at an appropriate position with respect to the affected part. An operation of positioning or expanding the field of view of the endoscope by retracting the distal end of the treatment means can be easily performed. Moreover, this can be done by a one-handed operation while holding the grip portion, which is extremely rational.

  In the endoscope system of the present invention, examples of the therapeutic instrument include a therapeutic laser irradiation handpiece, a chemical solution injection instrument, or a tooth root canal cutting instrument. When the treatment instrument is a therapeutic laser irradiation handpiece, a laser light guide chip as the treatment means is provided at the tip, and the laser light guide chip is inserted into the treatment means channel when attached to the attachment portion. It is comprised so that it may protrude from the front-end | tip of the said pipe part. Therefore, by irradiating the affected part with laser light from the tip of the laser light guide chip protruding from the tip of the pipe part, laser treatment of the affected part can be performed while performing endoscopic observation. Further, in the case where the therapeutic instrument is a chemical injection device that can be filled with a chemical as a therapeutic means, the chemical liquid can be poured out from the tip of the pipe portion through the therapeutic means channel when attached to the attachment portion. Is done. Therefore, by operating the drug solution injector, the drug solution can be poured from the tip of the pipe portion toward the affected part, and the drug solution can be applied and washed with treatment while observing the endoscope. . Further, when the treatment instrument is a root canal cutting instrument, the treatment tool is provided with a needle-like cutting tool as the treatment means, and when attached to the attachment portion, the needle-like cutting tool is inserted into the treatment means channel and the pipe. It is comprised so that it may protrude from the front-end | tip of a part. Therefore, by causing the needle-like cutting tool protruding from the tip of the pipe part to directly act on the root canal of the tooth as the affected part, the tooth root canal treatment for the affected part can be performed while observing the endoscope.

It is a partial expansion whole lineblock diagram showing typically an example of the endoscope system of the present invention. It is a partially broken front view of the principal part of the endoscope system. It is a top view of the principal part of the endoscope system. FIG. 3 is an enlarged sectional view taken along line XX in FIG. 2. (A) is a YY arrow directional cross-sectional view in FIG. 2, (b) is the same figure of the modification. It is a control block diagram of the whole endoscope system. It is a figure similar to FIG. 2 of another embodiment. It is the same figure as FIG. 2 of another embodiment.

  Hereinafter, embodiments of an endoscope system of the present invention will be described with reference to the drawings. As shown in FIGS. 1 to 6, an endoscope system 1 according to the present invention includes a grip portion 2 that can be gripped and operated with one hand, a pipe portion 3 that is connected to a tip portion of the grip portion 2, and the pipe. And an image guide 5 provided so as to continue to the imaging device 4 from the tip 3a of the portion 3 through the pipe portion 3 and the grip portion 2. The grip portion 2 is formed with an attachment portion 7 for detachably attaching a treatment instrument (in the example of FIGS. 1 to 6, a treatment laser irradiation handpiece) 6, and the laser irradiation handpiece 6 is attached to the grip portion 2. A holding means 8 is provided for holding the grip portion 2 at a position where it can be gripped with one hand. Further, in the illustrated embodiment, a light guide 10 provided to continue to the light source device 9 from the tip 3a of the pipe portion 3 through the pipe portion 3 and the grip portion 2, and the tip 3a of the pipe portion 3. To the water supply source 11 through the pipe portion 3 and the grip portion 2. Both the image guide 5 and the light guide 10 are made of a light guide fiber, are bundled by a guide relay member 13, are inserted into the guide tube 14, and are introduced into the grip portion 2.

  The grip portion 2 is made of a synthetic resin molding, and includes a straight barrel portion 2a and a hollow housing portion 2b integrally formed on the front side thereof, and the holding means 8 is provided on the barrel portion 2a. It is slidably and detachably attached along the longitudinal axis direction. The guide tube 14 is joined to the base portion of the body portion 2a, and the image guide 5 and the light guide 10 inserted into the body portion 2a together with the guide tube 14 reach the hollow housing portion 2b, and the pipe portion 3 which will be described later. It is introduced into the pipe part 3 from the connecting base part 3 b and is arranged so as to reach the tip 3 a of the pipe part 3. The housing portion 2b is formed with a mounting socket portion 12a for the water supply conduit 12, and the water supply conduit 12 passes from the water supply source 11 through the mounting socket portion 12a to the hollow housing portion 2b. A pipe base is configured to connect to a water supply channel 3 c in the pipe portion 3 at a connection base portion 3 b of the pipe portion 3 to be described later and extend to the tip 3 a of the pipe portion 3. Furthermore, the distal end of the attachment portion 7 faces the hollow housing portion 2b, and a guide tube 7a for treatment means is connected between the distal end of the attachment portion 7 and the connection base portion 3b of the pipe portion 3. In the illustrated example, the light guide 10 is configured by bundling a large number of ultrafine (outside diameter of about 30 μm) light guiding fibers, and in the pipe portion 3, a treatment means channel 3 d, the water supply channel 3 c, and the image guide 5 described later. However, a single light guide fiber may be provided so as to reach the tip 3 a of the pipe portion 3.

  The pipe portion 3 is connected to the distal end portion of the grip portion 2 via a connecting base portion 3b. The pipe portion 3 is of a straight shape as shown by a two-dot chain line in FIG. 2, a curved shape as shown by a solid line, or a material that can be arbitrarily deformed by fingers. The treatment means channel 3d and the water supply channel 3c are formed in the pipe portion 3, and the front side portions of the image guide 5 and the light guide 10 are introduced into the remaining space in the pipe portion 3 by these. Is retained. In the treatment means channel 3d, a laser light guide chip 61 (light guide fiber 61a) of a laser irradiation handpiece 6 to be described later attached to the attachment portion 7 is passed through the guide tube 7a from the tip 3a of the pipe portion 3. It is inserted so that it can protrude. The water supply channel 3c is supplied with water from the water supply conduit 12, and can be ejected from the tip 3a of the pipe portion 3 toward the affected part. Further, as shown in the enlarged view of FIG. 1, a light receiving lens (convex lens) 5 a is mounted so as to be positioned at the tip 3 a portion of the pipe portion 3 in close contact with the tip surface of the image guide 5. An image of the affected area is condensed through the light receiving lens 5 a and transmitted to the imaging device 4 from the distal end surface of the image guide 5. The image guide 5 is inserted into an image guide channel 3e formed in the pipe portion 5, and the light receiving lens 5a is integrally held at the tip of the image guide channel 3e. The pipe part 3, the treatment means channel 3d and the image guide channel 3e are made of, for example, a stainless steel thin tube, and the water supply channel 3c is made of a polyimide resin thin tube. The pipe portion 3 configured as described above is inserted into a narrow medical treatment site so that the tip 3a faces the vicinity of the affected part, so that endoscopic observation and treatment with a treatment instrument can be performed directly. Has been made. Therefore, for example, in an endoscope system for a root canal, the outer diameter of the pipe portion 3 is about 0.8 mm to 1.3 mm. In an endoscope system for a periodontal pocket, the pipe portion 3 By setting the outer diameter to about 2.0 mm to 2.5 mm, effective and efficient medical care can be performed. In addition, although the cross-sectional shape of the pipe part 3 may be circular as shown in FIG. 4, it may be a cross-sectional shape in which a plurality of circles are joined as shown in FIG.

  1 to 6 show an example in which the therapeutic instrument used in parallel with the endoscopic observation is a therapeutic laser irradiation handpiece 6. A laser light guide chip 61 as a treatment means is attached to the tip of the laser irradiation handpiece 6. The laser light guide chip 61 includes a light guide fiber 61a as a substantial laser light guide chip, and a socket portion 61b for holding the light guide fiber 61a integrally and detachably attaching to the tip of the laser irradiation handpiece 6. A rubber (for example, silicon rubber) tube 61c that is in close contact with the socket portion 61b and is sheathed on the base side of the light guide fiber 61a is configured as a chip unit. When the laser light guide chip 61 is attached to the tip of the laser irradiation handpiece 6 through the socket portion 61b, the laser treatment device 60 described later through the light guide 62 connected to the base of the laser irradiation handpiece 6 is used. A laser light transmission system from the laser oscillator 63 (see FIG. 6) to the light guide fiber 61a is established.

  The laser irradiation handpiece 6 has a cylindrical pen grip portion 6a that can be grasped and operated by an operator with one hand, and is attached to the attachment portion 7 with the laser light guide chip 61. The part 6a is held, and in this mounted / held state, the central axis of the laser irradiation handpiece 6 and the laser light guide chip 61 and the longitudinal axis of the body 2a of the grip part 2 are parallel to each other. The attachment portion 7 has a tapered hollow cylindrical receiving portion 7b that is formed in substantially the same shape as the needle base of an injection needle in a general-purpose medical syringe and gradually decreases in diameter toward the front side. When the laser irradiation handpiece 6 is attached to the mounting portion 7 by using the laser light guide chip 61, the light guide fiber 61a is held from the support portion 7b with the laser irradiation handpiece 6 held by the holding means 8. The tube 61c is press-fitted into the support portion 7b while being inserted through the tube 7a and the treatment means channel 3d.

  As shown in FIG. 5A, the holding means 8 is made of a synthetic resin molded body and has a fitting hole 8 a that is fitted into the body portion 2 a of the grip portion 2. The holding means 8 has a fitting hole 8a with respect to the body portion 2a of the grip portion 2 and is fitted from the base side (the right side in FIGS. 1 and 2) so as to extend in the longitudinal axis direction of the body portion 2a. It can be slid along and can be removed from the body 2a. The fitting hole 8a and the body 2a are in a fitting relationship with friction, and the sliding operation of the holding means 8 can be performed by a finger operation against the friction. A slit 8b for opening the fitting hole 8a is provided at the lower portion of the holding means 8, and the opening width d of the slit 8b is slightly larger than the outer diameter of the guide tube 14. Therefore, the holding means 8 can be removed from the grip portion 2 by sliding the holding means 8 along the body portion 2a to the position of the guide tube 14 and passing the guide tube 14 through the slit 8b. Further, the holding means 8 is formed with a circular holding hole 8c of a treatment instrument (laser irradiation handpiece 6) whose axis is parallel to the fitting hole 8a. The inner diameter of the holding hole 8c is slightly smaller than the outer diameter of the pen grip portion 6a, and when the pen grip portion 6a is fitted and held, friction acts between the pen grip portion 6a. . This friction is set to such an extent that the pen grip portion 6a can be inserted into and removed from the holding hole 8c by the operator's finger operation.

  As described above, in the endoscope system 1 in which the laser irradiation handpiece 6 is attached to the attachment portion 7 and is held by the holding means 8, as shown in FIG. While grasping the grip part 2 and the laser irradiation handpiece 6, the distal end 3a of the pipe part 3 is brought close to the affected part (not shown), and laser treatment is performed by irradiating the affected part with laser light from the distal end of the light guide fiber 61a. The affected area can be illuminated through the light guide 10 and further, endoscopic observation can be performed by a display unit (monitor) 153 to be described later with images of the affected area obtained by the image guide 5 and the imaging device 4. If necessary, water injection is performed from the water supply pipe 12 toward the affected area. When performing the laser treatment, the surgeon D slides the holding means 8 toward the front side of the grip portion 2 and compresses the tube 61c in the axial direction so that the distal end portion of the light guide fiber 61a is piped. The laser beam is irradiated by projecting from the tip 3a of the part 3 closer to the affected part. Thereby, the energy of the laser beam can be used efficiently. When the laser irradiation is stopped and the state of the affected part is observed, when the finger is released from the holding means 8, the holding means 8 is moved toward the base side of the grip part 2 by the elastic restoring force of the compressed tube 61c. With this, the distal end portion of the light guiding fiber 61a that protrudes from the distal end 3a of the pipe portion 3 is retracted, and the field of view to be observed is not obstructed by the light guiding fiber 61a, and the endoscopic observation of the affected part is made more accurately. The A plurality of rack gear-like protrusions 2c are formed on the side of the body part 2a of the grip part 2, and the protrusions 2c function as anti-slips for fingers.

FIG. 5B shows a modification of the holding means 8. That is, in the holding means 8 of this example, a pinion gear (helical gear) 8d that meshes with the rack gear-shaped protrusion 2c is rotatable about an axis parallel to the longitudinal axis of the body 2a, and is partially Is provided so as to protrude from the side of the holding means 8. The surgeon D rotates the pinion gear 8d with the projecting portion, and causes the holding means 8 to move along the longitudinal axis of the trunk portion 2a by screwing and unscrewing relative to the projecting portion 2c. The laser irradiation handpiece 6 held by the holding means 8 can be positioned. Such a holding means 8 is suitably employed in an embodiment as shown in FIG. Also in this example, the holding means 8 can be detached from the grip portion 2, and in the removed state, the protrusion 2c functions as a finger slip stopper as described above. The other configuration is the same as that of the example shown in FIG. 5A, so the same reference numerals are given to the common parts and the description thereof is omitted.
Note that the configuration for sliding the holding means 8 along the longitudinal axis of the body 2a is not limited to the above-described form. For example, a claw that engages with the protrusion 2c of the body 2a so as to advance and retreat stepwise by finger operation. Various configurations are adopted in which such a member is provided on the inner surface of the fitting hole 8a, or an electric motor is driven by a foot switch (not shown) provided separately, and the holding means 8 is moved by using the driving force. Can do.

  FIG. 6 shows a control block diagram of the endoscope system 1 configured as described above. The endoscope system 1 shown in the figure is generally composed of an endoscope observation apparatus 15 and a laser treatment apparatus 60. The endoscope observation apparatus 15 includes an illumination system that irradiates the affected area with light and an imaging system that captures the state of the affected area. These include a common power supply unit 150, a central control unit 151, and an operation unit 152. And the drive control is performed. The light source device 9 includes an illumination light source 9a and an excitation light source 9b, and each includes an LED, a halogen lamp, or the like. The illumination light source 9a emits white light, irradiates the affected part from the tip 3a of the pipe part 3 through the light guide 10, and functions to illuminate the affected part literally. The excitation light source 9b emits light having a wavelength of 410 ± 10 nm, for example, and is used for fluorescence observation by irradiating the teeth. In particular, when such excitation light is applied to a tooth having dental caries or dental plaque, fluorescence with intensity different from that of the healthy part is emitted from the dental caries or dental plaque, which is effective for confirmation diagnosis. The surgeon switches the light emission by operating the operation unit 152 according to the medical treatment mode. The operation switch of the operation unit 152 is provided, for example, in a foot controller (not shown), and the surgeon steps on the foot controller to turn on and off the light source device 9. The imaging device 4 constituting the imaging system is composed of an imaging element such as a CCD (charge coupled device), for example, and image information of an affected part transmitted through the image guide 5 is converted into an electrical signal by the imaging device 4 and is transmitted to the center. The image is processed by the control unit 151 and reproduced and displayed on the display unit (monitor) 153. While seeing the image displayed on the display unit 153, the surgeon can diagnose the affected part and perform laser treatment by irradiating the affected part with laser light using the laser irradiation handpiece 6. The number of pixels of the imaging device 4 used here is, for example, 6000 pixels for a root canal, 15000 pixels for a periodontal pocket, The pipe portion 3 and the image guide 5 can be appropriately selected and set in consideration of the sizes that can be designed in terms of physical strength.

  The laser treatment apparatus 60 includes the laser irradiation handpiece 6, a laser oscillator 63, an oscillation control unit 64 that controls oscillation of the laser oscillator 63, a power supply unit 65, and an operation unit 66. The therapeutic laser light oscillated by the laser oscillator 63 is transmitted to the laser irradiation handpiece 6 and further to the light guide fiber 61a through a laser transmission path 62 such as a hollow waveguide whose inner surface is coated with a dielectric thin film, It is used to treat the affected area. This laser treatment device 60 removes caries, removes the surface layer of the wedge-shaped defect in the hard tissue of the tooth, forms transpiration of the root canal, sterilizes the root canal, irradiates the periodontal pocket, removes the tartar, curettage of the periodontal pocket, It is used for dental treatments such as periodontal flap operation, gingival incision and excision, and formation of a coagulation layer in stomatitis. Various lasers such as Nd: YAG laser, CO2 laser, Er: YSGG laser, etc. can be used, but Er: YAG laser is highly absorbable by water and can evaporate hard tissues. It is desirably employed because it can enhance the effect. The operation switch of the operation unit 66 is provided on a laser treatment apparatus main body (not shown) that can be moved by a caster, a foot controller, or a pen grip unit 6 a of the laser irradiation handpiece 6. When endoscopic observation by the endoscope device 15 and laser treatment by the laser treatment device 60 are performed in parallel, a medical table (not suitable) on which the patient sits or lies on the endoscope device 15 and the laser treatment device 60. The laser irradiation handpiece 6 is attached to and held by the grip portion 2 as shown in FIG. 1, and the grip portion 2 and the laser irradiation handpiece 6 are held with one hand as shown in FIG. Are operated for endoscopic observation and treatment.

FIG. 7 shows another embodiment of the endoscope system of the present invention. In the endoscope system 1A shown in FIG. 7, a drug solution injector 16 is used as a therapeutic instrument. The liquid medicine injection device 16 shown in the figure is an application of a syringe barrel (cylinder 16a and piston 16b) that is not equipped with a general-purpose medical syringe, and the liquid medicine 161 as a treatment means is filled in the cylinder 16a. Is done. The chemical injection device 16 is attached so that the tip nozzle portion 16c of the cylinder 16a is press-fitted into the attachment portion 7, and the cylinder 16a is fitted into the circular holding hole 8c of the holding means 8 similar to the example shown in FIG. Hold. The attachment / holding position is adjusted by rotating a pinion gear 8d provided on the holding means 8 so that the holding means 8 is screwed / retracted along the longitudinal direction of the body 2a of the grip portion 2. Is made by As shown in FIG. 1, the surgeon holds the medicinal solution injection device 16 with the grip portion 2 with one hand and holds the piston 16b with his / her finger while the medicinal solution injection device 16 is attached / held to the grip portion 2 in this manner. When the push-in operation is performed, the drug solution 161 filled in the cylinder 16a passes from the attachment portion 7 through the guide tube 7a and the treatment means channel 3d in the pipe portion 3 (see FIG. 4) from the tip 3a of the pipe portion 3. It is poured into the affected area. Accordingly, by driving the endoscope device 15 (see FIG. 6) in parallel, appropriate drug solution treatment is performed while confirming the dripping position of the drug solution with respect to the affected area, excess or deficiency of the drug solution, etc. by endoscopic observation. Can be implemented.
In the present embodiment, a general-purpose syringe barrel is applied as the chemical solution injector 16. Thus, the versatility is enhanced and practical, but it is not excluded to prepare a dedicated chemical injection device and make the mounting portion 7 in a shape suitable for this. Since other configurations are the same as those of the above-described embodiment, common portions are denoted by the same reference numerals, and description thereof is omitted.

FIG. 8 shows another embodiment of the endoscope system of the present invention. In the endoscope system 1B shown in FIG. 8, a root canal cutting instrument 17 is used as a therapeutic instrument. The root canal cutting instrument 17 includes a needle-like cutting tool 171 made of a reamer or file as a treatment means, and a hand-held handle portion 172 fixed to the base of the needle-like cutting tool 171, and is used as a dental root canal treatment instrument. It is a general purpose one. In this root canal cutting instrument 17, a needle-like cutting tool 171 is inserted from the attachment portion 7 into the guide tube 7 a and the treatment means channel 3 d (see FIG. 4) in the pipe portion 3, and protrudes from the tip 3 a of the pipe portion 3. In this state, it is attached and held to the grip part 2. With such a root canal cutting instrument 17 attached and held, the surgeon holds the root canal cutting instrument 17 together with the grip part 2 with one hand and inserts and removes the handle part 172 with fingers as shown in FIG. Thus, the tip of the needle-like cutting tool 171 can act on the affected part in the root canal. Therefore, by driving the endoscope apparatus 15 (see FIG. 6) in parallel, root canal cutting treatment can be performed while observing the endoscope in the root canal. Since the root canal cutting instrument 17 in the illustrated example is for hand-held operation, it is not necessary to hold the holding means 8. Accordingly, in FIG. 8, the holding means 8 is attached to the body 2 a of the grip portion 2. Although shown, it may be removed.
In addition, an electrically driven root canal cutting instrument has been put into practical use, and when such an electric root canal cutting instrument is used, it is desirable to hold it by the holding means 8. Since other configurations are the same as those of the above-described embodiment, common portions are denoted by the same reference numerals, and description thereof is omitted here.

  In the above embodiment, an example in which the endoscope system of the present invention is applied for dentistry has been described. However, other medical applications such as otolaryngology, obstetrics and gynecology, internal medicine, and surgery are also possible. Moreover, although laser irradiation handpiece, chemical | medical solution injection | pouring instrument, and root canal cutting instrument were illustrated as a therapeutic instrument, other therapeutic instruments, for example, a suction instrument etc., can also be mentioned as the object. In the case of applying a suction device, the therapeutic treatment channel 3d may be a suction path, but a suction channel may be provided separately. Furthermore, although the example endoscope systems 1, 1A and 1B may be positioned as individual units, the grip unit 2 is used in common, and therapeutic instruments (laser irradiation handpiece 6, chemical injection device 16, root canal cutting) are used. You may make it use properly according to each treatment aspect of dental treatment by replacing | exchanging the instrument 17) suitably.

1, 1A, 1B Endoscope system 2 Grip part 3 Pipe part 3a Tip 3d Treatment channel 4 Imaging device 5 Image guide 6 Laser irradiation handpiece (treatment instrument)
61 Laser light guide chip (therapy)
Reference Signs List 7 Mounting portion 8 Holding means 9 Light source device 10 Light guide 11 Water supply source 12 Water supply pipe 16 Chemical solution injection device (treatment device)
161 Drug solution (therapeutic means)
17 Root canal cutting device (treatment device)
171 Needle-shaped cutting tool (treatment method)

Claims (7)

A grip that can be gripped with one hand,
A pipe portion connected to the tip of the grip portion;
An endoscope system including an image guide provided to be connected to the imaging device from the tip of the pipe part through the pipe part and the grip part,
The grip portion is formed with a treatment instrument mounting portion to which the treatment instrument is detachably attached, and is provided with a holding means for holding the treatment instrument in a position where it can be gripped with one hand. ,
An endoscope characterized in that a treatment means channel for allowing a treatment means of a treatment instrument attached to the attachment part to reach the distal end of the pipe part and acting on the affected part is incorporated in the pipe part. system. The endoscope system according to claim 1, wherein
An endoscope system further comprising: a light guide provided so as to be connected to the light source device from the tip of the pipe portion through the pipe portion and the grip portion. The endoscope system according to claim 1 or 2,
An endoscope system, further comprising a water supply conduit provided so as to be connected to a water supply source from the tip of the pipe portion through the pipe portion and the grip portion. The endoscope system according to any one of claims 1 to 3,
The endoscope system according to claim 1, wherein the holding means is slidable along a longitudinal axis direction of the grip portion. The endoscope system according to any one of claims 1 to 4,
When the therapeutic instrument is a therapeutic laser irradiation handpiece having a laser light guide chip as a treatment means at its tip, and the therapeutic laser irradiation handpiece is attached to the attachment portion, the laser light guide An endoscope system, characterized in that a tip can be inserted through the treatment means channel and protrude from the tip of the pipe portion. The endoscope system according to any one of claims 1 to 4,
When the therapeutic instrument is a chemical injection device that can be filled with a chemical solution as the treatment means, and the chemical injection device is attached to the attachment portion, the chemical solution passes through the treatment means channel and the pipe portion. An endoscope system characterized in that it can be poured out from the tip of the endoscope. The endoscope system according to any one of claims 1 to 4,
The treatment instrument is a root canal cutting instrument provided with a needle-like cutting tool as the treatment means, and the needle-like cutting tool is used for the treatment means when the root canal cutting instrument is attached to the attachment portion. An endoscope system configured to be inserted through a channel and protrude from a tip of the pipe portion.

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