JP2011183000A - Endoscope apparatus - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an endoscope apparatus having a simple structure capable of measuring or recognizing a size of an object by an operator without complicated operation. <P>SOLUTION: An endoscope 1 has a pump 62 for supplying a liquid, a channel 27 for sending water forward, connected to the pump 62 with the one end, an object optical system 44 mounted on the tip of an endoscope inserting part 21 for observing the observation site, and two openings 30 which are connected with the other end of the channel 27 for sending water forward and formed on the tip based on the predetermined treatment standard value corresponding to the observation site. <P>COPYRIGHT: (C)2011,JPO&INPIT

Description

  The present invention relates to an endoscope apparatus, and more particularly, to an endoscope apparatus that can measure or confirm the size of an object.

  Conventionally, endoscope apparatuses have been widely used in the medical and industrial fields for observing the inside of a subject. An endoscope apparatus has an insertion part, and a user approaches a part which wants to observe a tip part of an insertion part. The image obtained through the optical system provided at the tip is photoelectrically converted by the imaging device, and the user can observe the inside of the subject by looking at the image displayed on the monitor and inspecting it.

  In the medical field, the endoscope apparatus is used for an inspection of a body cavity, for example, an inspection of a colon polyp. The surgeon examines the image of the examination site imaged by the imaging device at the distal end of the insertion portion inserted into the large intestine, confirms the presence or absence of the polyp, and inspects the colon polyp. The surgeon may not only confirm the presence or absence of such a lesion, but may need to measure or confirm its size.

  Conventionally, there have been various methods for measuring the size of an object at an observation site. One method is a method using measure forceps. Marks indicating scales of various dimensions such as a ruler are engraved or printed on the tip of the measure forceps. Measuring forceps are inserted through the treatment instrument insertion channel of the endoscope, and the operator can measure the size of the object by pressing the tip of the measuring tool against the site to be measured and reading the dimensions from the scale.

The second method is a method using laser light (see, for example, Patent Document 1). Laser light is emitted in a predetermined direction from the distal end portion of the insertion portion, and the size of the target is calculated from position information on which the laser light hits.
The third method is a method using a stereoscope (see, for example, Patent Document 2). The target size is calculated from the principle of triangulation by two imaging systems provided at the distal end of the insertion portion.

Japanese Patent No. 3863657 JP 2003-93339 A

  However, in the method using the measuring forceps, for example, only for measuring the diameter of the polyp, the operator inserts the measuring forceps into the treatment instrument insertion channel and gently applies the measuring forceps to the target site. It has to be done and has the disadvantages of being time consuming and cumbersome.

  In the method using laser light, a structure in which the laser light is guided to the distal end portion of the insertion portion and the laser light is emitted from the distal end portion must be provided in the insertion portion, and the structure of the insertion portion becomes complicated. There is also a problem that a light source is necessary and the apparatus becomes relatively large.

In addition, in the method using the stereoscope, two imaging elements must be provided at the distal end portion of the insertion portion for stereo imaging, and further, the signal processing circuit also processes two images to calculate the size. There is a problem that the processing section is required, the configuration of the distal end portion of the insertion section is complicated and large in size, and the signal processing section requires many processing circuits.
Therefore, the present invention has been made in view of the above-described problems, and an endoscope apparatus that does not require a complicated operation and that allows an operator to measure or confirm the size of an object with a simple configuration. The purpose is to provide.

  According to one aspect of the present invention, a liquid supply source that supplies a liquid, a pipe line having one end connected to the liquid supply source, and a distal end portion of an endoscope insertion portion are provided to observe an observation site. An endoscope apparatus comprising: an objective optical system; and an opening including one or more openings formed at the distal end portion based on a predetermined treatment reference value related to the observation site, to which the other end of the duct is connected Can be provided.

  According to the endoscope apparatus of the present invention, an operator can measure or confirm the size of an object with a simple configuration without requiring a complicated operation.

1 is a configuration diagram showing a configuration of an endoscope apparatus according to a first embodiment of the present invention. It is sectional drawing which shows the structural example of the front-end | tip part of the insertion part 21 concerning the 1st Embodiment of this invention. It is a front view of the front-end | tip part of the insertion part 21 concerning the 1st Embodiment of this invention. It is a block diagram of the main body apparatus 12 concerning the 1st Embodiment of this invention. 4 is a flowchart for explaining operations of the camera control unit 41 and the endoscope 11 according to the first embodiment of the present invention. It is a flowchart for demonstrating operation | movement of the control part 61 of the main body apparatus 12 concerning the 1st Embodiment of this invention. It is a figure for demonstrating the state of the water flow radiate | emitted from the front-end | tip part of the endoscope 11 concerning the 1st Embodiment of this invention. It is a figure which shows the endoscopic image projected on the monitor 42 concerning the 1st Embodiment of this invention. It is a block diagram of the endoscope apparatus concerning the 2nd Embodiment of this invention. It is a front view of the front-end | tip part of the insertion part 21 concerning the 2nd Embodiment of this invention. It is a figure for demonstrating the state of the water radiate | emitted from the front-end | tip part of 11 A of endoscopes concerning the 2nd Embodiment of this invention. It is a block diagram of the endoscope apparatus concerning the 3rd Embodiment of this invention. It is a front view of the front-end | tip part of the insertion part 21 concerning the 3rd Embodiment of this invention. It is a figure for demonstrating the state of the water radiate | emitted from the front-end | tip part of the endoscope 11B concerning the 3rd Embodiment of this invention. It is a figure which shows the endoscopic image projected on the monitor 42 concerning the 3rd Embodiment of this invention. It is a figure for demonstrating the structural example of 12 A of main body apparatuses which have the structure for introduce | transducing visible light which concerns on the modification 2. FIG. It is a front view of the front-end | tip part of the insertion part 21 which concerns on the modification 4. FIG. It is a figure for demonstrating the state of two water flow WJ when water is supplied also from the nozzle 33 for air / water supply, when the two water flows WJ are radiate | emitted from the two openings 30 based on the modification 4. FIG. .

Embodiments of the present invention will be described below with reference to the drawings.
(First embodiment)
(overall structure)
First, based on FIG. 1, the structure of the endoscope apparatus concerning this Embodiment is demonstrated. FIG. 1 is a configuration diagram showing a configuration of an endoscope apparatus according to the present embodiment.

  The endoscope apparatus 1 includes an endoscope 11, a main body device 12, and a foot switch 13. The endoscope 11 includes an elongated insertion portion 21, an operation portion 22, and a connection cable 23. A proximal end portion of the insertion portion 21 is connected to the operation portion 22. The distal end portion of the insertion portion 21 is provided with a distal end hard portion 24, and a bending portion 25 is provided on the proximal end side of the distal end hard portion 24. Inside the insertion portion 21, a treatment instrument insertion channel 26 and a front water supply channel 27, each of which constitutes a pipe portion, are arranged.

The distal end surface 21a of the distal end portion of the insertion portion 21 has two openings 30 as openings for forward water feeding, an observation window 31 for an image sensor such as a CCD, an illumination window 32 for illumination, and an observation window An air supply / water supply nozzle 33 for 31 and an opening 34 of the treatment instrument insertion channel 26 are provided.
The air supply / water supply nozzle 33 is a nozzle that is provided at the distal end of the insertion portion 21 and supplies air or water toward the observation window 31 corresponding to the objective optical system 44.

  An opening for feeding a liquid such as water into the forward water supply channel 27, that is, a water supply port 35 is provided in the operation unit 22. An opening for inserting a treatment instrument into the treatment instrument insertion channel 26, that is, a treatment instrument insertion port 36 is also provided in the operation section 22.

  The connection cable 23 connected to the operation unit 22 is connected to a camera control unit 41 having an image processing unit for processing an image obtained by the endoscope 11. The camera control unit 41 includes a central processing unit (CPU) and a memory, and outputs a video signal for displaying an endoscopic image on the monitor 42. The surgeon can observe the inside of the body cavity while looking at the endoscopic image output to the monitor.

  As will be described later, the main unit 12 has a liquid delivery function. The configuration of the main unit 12 will be described later. The endoscope 11 and the main body apparatus 12 can be connected by a connection tube 51 for sending the liquid from the main body apparatus 12 to the endoscope 11. The connection tube 51 has one connector portion 51 a fixedly or detachably connected to the water supply connector portion 12 a (FIG. 4) of the main body device 12, and the other connector portion 51 b connected to the water supply port 35 of the endoscope 11. It is designed to be detachably connected to.

  A foot switch 13 is connected to the main unit 12. As will be described later, the foot switch 13 has a pedal 13a. The pedal 13a is a switch that the operator presses with a foot when instructing a forward water supply operation. The pedal 13a constitutes an operation unit that can be operated by the operator. The foot switch 13 constitutes an operation unit that can be operated by an operator, and liquid is simultaneously emitted from the two openings 30 based on the operation of the foot switch 13 as will be described later.

The main unit 12 is connected to a monitor 52 for displaying information related to forward water supply.
As will be described later, the user can perform endoscopic observation and measurement or confirmation of the size of an object while operating the endoscope 11 and the foot switch 13.
In this embodiment, an example in which water is used as the liquid used for forward water supply will be described. However, as the liquid, physiological saline, acetic acid, or the like may be used. In particular, acetic acid has the effect of making it easier to see the state of the mucosal surface.
(Configuration of the tip of the insertion part)
Next, the structure of the front-end | tip part of the insertion part 21 is demonstrated. FIG. 2 is a cross-sectional view illustrating a configuration example of the distal end portion of the insertion portion 21. FIG. 3 is a front view of the distal end portion of the insertion portion 21. A tip cover 24 a is provided at the tip of the tip hard portion 24. The tip cover 24 a is fixed to the main body 24 b of the tip rigid portion 24. The distal end hard portion 24 has a structure to which various members such as an objective optical system, a pipe, and an LED can be attached, but the configuration thereof is omitted in FIG.

  As shown in FIG. 3, the observation window 31 is disposed substantially at the center of the tip cover 24a when viewed from a direction orthogonal to the tip surface 21a. The observation window 31, the objective optical system 44 including a lens, and the imaging element 45 are disposed and fixed at predetermined positions in a metal pipe 43. The objective optical system 44 is provided at the distal end portion of the endoscope insertion portion 21 and is an objective optical system for observing the observation site. The pipe 43 is fixed to the distal end hard portion 24 so as to fit into the opening of the distal end cover 24a. A signal line 46 of the image sensor 45 such as a CCD passes through the insertion portion 21 and is electrically connected to the camera control unit 41.

  The two openings 30 for forward water supply communicate with the forward water supply channel 27. The forward water supply channel 27 is configured by a pipe portion 27 a in the insertion portion 21. The tube portion 27a is, for example, a resin or rubber tube. The two openings 30 are formed by ends of metal pipes 30a and 30b, respectively. Each of the two pipes 30a and 30b has an inner diameter of 1 mm, for example. The two pipes 30 a and 30 b are disposed in parallel in the distal end hard portion 24 along the axial direction of the distal end hard portion 24. The reason why the two pipes 30a and 30b are arranged in parallel in the distal end hard portion 24 is to allow the water flow WJ (FIG. 7) from the two openings 30 to be emitted in parallel as will be described later. It is.

  The distal end portion of the pipe portion 27a forming the forward water supply channel 27 is branched into two pipe portions. The tube portion 27a is formed with a tube portion 27b branched from a part thereof. The ends of the two pipe portions 27a and 27b are connected to the base ends of the two pipes 30a and 30b, respectively. The liquid passing through the pipe portion 27 a is here discharged from the two openings 30 through the pipe portions 27 a and 27 b.

  That is, the pipe line including the front water supply channel 27 is a pipe 30 a serving as a first pipe line part communicating with one of the two openings 30 and a second pipe line part communicating with the other of the two openings 30. It has a pipe 30b, and the two pipes 30a and 30b are provided in parallel at the tip.

As shown in FIG. 3, the observation window 31 is arranged so that the center is located at the center of the line segment connecting the centers of the two openings 30. Therefore, the distances L1 and L2 from the centers of the two openings 30 to the center of the observation window 31 are equal. In other words, the distance between one of the two openings 30 and the objective optical system 44 and the distance between the other of the two openings 30 and the objective optical system 44 when viewed from a direction orthogonal to the distal end surface 21a of the distal end portion are: equal.
Here, the two openings 30 are provided at positions where the distances L1 and L2 from the respective centers to the center of the observation window 31 are equal, but the two openings 30 are positions where the distances L1 and L2 are not equal. May be provided.

As described above, the two openings 30 are connected to the other end of the conduit including the forward water supply channel 27, and are formed at the distal end portion of the insertion portion 21 based on a predetermined treatment reference value related to an observation site to be described later. An opening composed of one or more openings is formed.
As will be described later, the distance between the two openings is the same as a predetermined treatment reference value.
(Configuration of main unit)
FIG. 4 is a configuration diagram of the main body device 12. As shown in FIG. 4, the foot switch 13 is connected to the main body device 12 and includes a control unit 61 and a pump 62. An operation instruction signal from the foot switch 13 connected to the main unit 12 is supplied to a control unit 61 including a CPU and a memory. A liquid tank 63 is connected to the pump 62. The pump 62 and the liquid tank 63 constitute a liquid supply source that supplies the liquid.

  The discharge end of the pump 62 is connected to the water supply connector 12a via a pipe or a tube. When the pump 62 is driven, water output from the pump 62 is output from the water supply connector 12 a of the main body device 12 and supplied to the front water supply channel 27 of the endoscope 1 through the connection tube 51. Here, the forward water supply channel 27 constitutes a pipe line having one end connected to the liquid supply source.

When receiving the operation instruction signal from the foot switch 13, the control unit 61 outputs an activation signal to the pump 62 to activate the pump 62. When activated, the pump 62 draws water from the liquid tank 63 and discharges it from the discharge end. When the operation instruction signal is not received, the control unit 61 stops the pump 62 and stops discharging water.
(Operation)
5 and 6 are flowcharts for explaining the operation of the endoscope apparatus 1.
When the surgeon observes the inside of the body cavity of the subject using the endoscope apparatus 1, the size of the lesioned part found in the endoscopic image displayed on the monitor 42 is a predetermined value or more. There is a case where it is desired to measure or confirm whether or not there is. Here, a case will be described where a polyp of a tumor is found in the colon examination, and the surgeon confirms whether the diameter of the polyp is equal to or greater than a predetermined value.
In the present embodiment and other embodiments or modifications described later, the object whose size is measured or confirmed may be an ulcer other than a colon polyp, esophageal varices, or the like. The treatment reference value is predetermined according to each object.

  A colorectal polyp may be removed by surgery when its size is greater than or equal to a predetermined value. That is, if a colon polyp is found, it is not immediately removed, but a treatment standard value for whether or not to remove the colon polyp is determined in advance in a guideline such as a hospital, and the size of the tumor colon polyp is predetermined. If the treatment standard value is less than the treatment reference value, the treatment may not be performed and the examination may be performed again after a predetermined period of time, and the colorectal polyp may be excised after reaching a predetermined treatment reference value or more.

  When examining the colon polyp, the surgeon connects the endoscope 11 and the main body device 12 with the connection tube 51 and performs an examination using the endoscope. FIG. 5 is a flowchart for explaining operations of the camera control unit 41 and the endoscope 11.

The surgeon operates or operates various operation buttons of the operation unit 22 of the endoscope 11 to perform an examination or treatment while viewing an endoscopic image in the large intestine. Therefore, the endoscope 11 and the camera control unit 41 execute an examination or treatment operation (step (hereinafter abbreviated as S) 1).
The surgeon can record an endoscopic image during examination or treatment. The surgeon operates a predetermined operation button, such as a freeze button, of the operation unit 22 of the endoscope 11 to view an endoscopic image (still image or moving image) while viewing the endoscopic image in the large intestine. Recording can be performed. Therefore, the endoscope 11 and the camera control unit 41 execute an endoscope image recording operation (S2).
FIG. 6 is a flowchart for explaining the operation of the control unit 61 of the main device 12. The surgeon may want to check the size of the colon polyp during the examination.
In that case, the surgeon presses the pedal 13a of the foot switch 13 with his / her foot. The controller 61 determines whether or not the pedal 13a is turned on by detecting an operation instruction signal from the pedal 13a (S11). If the pedal 13a is not on, the process is terminated without doing anything (S11, NO).

  If the control part 61 determines with the pedal 13a having been turned on (S11, YES), it will start the pump 62 (S12). When activated, the pump 62 draws water from the liquid tank 63 and outputs the water to the connection tube 51. The output water passes through the pipe part 27 a and the pipe part 27 b of the front water supply channel 27 of the endoscope 11 and exits from the two openings 30.

  FIG. 7 is a view for explaining the state of the water flow emitted from the distal end portion of the endoscope 11. Two water flows WJ from the two openings 30 formed at the distal end portion of the insertion portion 21 are emitted in parallel to each other. That is, the distance D1 between the two water flows WJ immediately after exiting from the two openings 30 and the distance D2 between the two water flows WJ immediately before hitting the polyp 71 of the intestinal wall 72 are substantially equal. The distances D1 and D2 are 5 mm, which is the treatment reference value TH for colorectal polyps.

  FIG. 8 is a diagram showing an endoscopic image displayed on the monitor 42. As shown in FIG. 8, an endoscopic image 81 displayed on the monitor 42 is an image generated by being picked up by the image pickup element 45 arranged on the proximal end side of the observation window 31 at the distal end. While viewing the endoscopic image 81, the surgeon adjusts the position of the distal end portion of the insertion portion 21 or adjusts the bending angle of the bending portion 25 so that the polyp 71 which is a lesioned portion is located at the center of the screen. To do. When the surgeon steps on the pedal 13a when the polyp 71 is positioned at substantially the center of the endoscopic image 81, the processing in FIG. 6 is executed. As a result, the endoscopic image is the image shown in FIG. As shown in FIG. 8, the two water flows WJ appear to go from the left and right sides to the center of the screen. The water flow WJ that hits the intestinal wall of the large intestine flows around on the surface of the intestinal wall 72. While viewing the endoscopic image, the operator adjusts the position of the insertion portion 21 of the endoscope 11 so that the polyp 17 is positioned between the two water flows WJ.

  Here, the distance between the two water columns hit by the two water flows WJ is always 5 mm (treatment reference value TH) regardless of the distance between the distal end portion of the insertion portion 21 and the polyp 71. In FIG. 8, the distance between the two water streams WJ is not the distance between the centers of the two water streams WJ, but the shortest distance between the two water streams WJ. In other words, the distance between the two water columns is equal to the shortest distance between the two openings 30 in the distal end surface of the insertion portion 21.

Therefore, the surgeon looks at whether or not the size of the polyp 71 in the endoscopic image 81 is equal to or larger than the distance between the two water flows WJ (that is, the treatment reference value). Whether or not this is the case can be determined. FIG. 8 shows a case where the polyp 71 is less than the treatment reference value TH. In FIG. 8, if the polyp 71 has a size as indicated by a dotted line, the surgeon knows that the polyp 71 is equal to or greater than the treatment reference value TH.
At this time, the surgeon can also record the endoscope image of FIG. 8 as a still image by operating the operation unit 22 and performing the imaging process S2.

  Returning to FIG. 6, when the pump 62 is activated, it is determined whether or not the pedal 13a is turned off, that is, whether or not the pedal 13a is not pressed (S13). As long as the pedal 13a is not turned off, the pump 62 operates. When the pedal 13a is turned off (S13, YES), the controller 61 stops the pump 62 (S14).

  When the pump 62 is turned on, the two water flows WJ from the two openings 30 operate so as to push out water with such a pressure that the water flows WJ in parallel as shown in FIG. The two water streams WJ need only have such a momentum that the two water streams WJ can maintain a constant distance from each other even if they do not radiate vigorously.

  As described above, according to the present embodiment, the surgeon looks at the two water flows WJ emitted from the distal end of the insertion portion 21 and determines the size of the lesioned portion based on the distance between the two water flows WJ. It is possible to determine whether or not the treatment reference value is greater than or equal to. And the front end side of the channel 27 for the forward water supply provided in the insertion part 21 of the endoscope 11 is made into two pipe parts, and two openings corresponding to the two pipe parts are made in the front end part of the endoscope 11. Since it is only necessary to provide it, the configuration of the distal end portion of the endoscope 11 is relatively simple.

  Further, since the water flow WJ described above can be used for cleaning the conventional observation site, the surgeon turns on the foot switch 13 to emit two water flows WJ even when cleaning is necessary. The observation site can be cleaned. In addition, since two water streams WJ are generated, the cleaning range becomes wider than in the case of cleaning with a single conventional water stream.

In the example described above, the front side of the forward water supply channel 27 is branched into two, but two forward water supply channels corresponding to the two openings may be provided individually.
Furthermore, the shape of each of the two openings 30 may be an ellipse instead of a circle.
(Second Embodiment)
The endoscope apparatus according to the first embodiment is configured to emit two water streams from two openings using the front water supply channel, but the endoscope apparatus according to the present embodiment is It is comprised so that two water flow may be radiate | emitted from two openings using a treatment tool penetration channel.

FIG. 9 is a configuration diagram of the endoscope apparatus according to the present embodiment.
In the present embodiment, the same components as those in the first embodiment are denoted by the same reference numerals, and description thereof is omitted. As shown in FIG. 9, in the endoscope 11A, the treatment instrument insertion channel 26 branches at the distal end portion of the insertion portion 21, and the branched tube portion 26a is connected to the opening 30 at the distal end portion.

  FIG. 10 is a front view of the distal end portion of the insertion portion 21 according to the present embodiment. FIG. 11 is a diagram for explaining a state of water emitted from the distal end portion of the endoscope 11A. Two water flows WJ from the opening 30 formed at the distal end portion of the insertion portion 21 and the opening 34 of the treatment instrument insertion channel 26 are emitted in parallel to each other. The two openings 30 and 34 are connected to the other end of the duct including the treatment instrument insertion channel 26, and are formed of one or more openings formed at the distal end portion of the insertion portion 21 based on a predetermined treatment reference value. Parts.

  The opening 30 has an inner diameter of 1 mm, for example. The opening 34 has an inner diameter of 2.8 mm, for example. That is, the distance D3 between the two water flows WJ emitted from the opening 30 and the opening 34 is 5 mm, which is the treatment reference value TH. 10 and 11, the distance between the two water streams WJ is not the distance between the centers of the two water streams WJ, but the shortest distance between the two water streams WJ. In other words, the distance between the two water columns is equal to the shortest distance between the two openings 30 and 34 in the distal end surface of the insertion portion 21.

  The operation of the pump 62 is the same as that of the first embodiment, and the endoscope image 81 displayed on the monitor 42 is different only in that one of the two water flows WJ is thicker than the other. This is the same as the first embodiment.

According to the present embodiment, in addition to the same effects as those of the first embodiment, one of the two water flows is output from the opening 34 of the treatment instrument insertion channel 26 and the other is branched from the treatment instrument insertion channel 26. Since the output is made from the opening 30 connected to the tube part 26a, the configuration of the insertion part of the endoscope 11A becomes easier than the endoscope 11 of the first embodiment. is there.
Also in the present embodiment, the shape of each of the two openings 30 may be an ellipse instead of a circle.
(Third embodiment)
The endoscope according to the first and second embodiments described above is configured to emit two water streams from the distal end portion of the insertion portion 21, but the endoscope according to the present embodiment is inserted. Only one water flow is emitted from the tip of the portion 21.

FIG. 12 is a configuration diagram of the endoscope apparatus according to the present embodiment. FIG. 13 is a front view of the distal end portion of the insertion portion 21.
In the present embodiment, the same components as those in the first embodiment are denoted by the same reference numerals, and description thereof is omitted. As shown in FIG. 12, an arcuate opening 30A is formed at the distal end surface of the insertion portion 21 of the endoscope 11B. A forward water supply channel 27 </ b> A is provided in the insertion portion 21. The forward water supply channel 27A is connected to the opening 30A. A distance L3 between both ends of the arc-shaped opening 30A is a treatment reference value TH, for example, 5 mm. The distance L3 between both ends of the opening 30A is the diameter or width of the opening 30A.

  FIG. 14 is a diagram for explaining a state of water emitted from the distal end portion of the endoscope 11B. The water flow WJ from the opening 30A formed at the distal end of the insertion part 21 hits the intestinal wall 72 while maintaining the shape of the opening 30A. Therefore, the distance between both ends of the water flow WJ immediately after exiting from the opening 30A is equal to the distance between both ends of the water flow WJ immediately before hitting the polyp 71 of the intestinal wall 72.

  FIG. 15 is a diagram showing an endoscopic image displayed on the monitor 42. When the surgeon steps on the pedal 13a when the polyp 71 is positioned substantially at the center of the endoscopic image 81, the endoscopic image becomes the image shown in FIG. As shown in FIG. 15, the water flow WJ appears to go from the left side to the center of the screen. The water flow WJ that hits the intestinal wall of the large intestine flows around on the surface of the intestinal wall 72.

However, the width D4 of the water flow WJ is 5 mm, which is the treatment reference value TH. Therefore, the surgeon views the endoscopic image 81 and compares the width D4 of the water flow WJ with the size of the polyp 71 to determine whether the size of the polyp 71 is equal to or greater than the treatment reference value TH. Can do. FIG. 15 shows a case where the polyp 71 is less than the treatment reference value TH. In FIG. 15, if the polyp 71 has a size as indicated by a dotted line, the surgeon can know that the polyp 71 is equal to or greater than the treatment reference TH.
As described above, according to the endoscope apparatus of the present embodiment, the water from the forward water supply channel 27A is emitted from the single opening 30A, and the size of the lesioned part is determined from the width of the water flow WJ. It is also possible to check whether it is equal to or higher than TH and take a record. And since the opening formed in circular arc shape only needs to be provided in the front-end | tip part of the insertion part 21 of the endoscope 11B, the structure of the endoscope 11B is simple.
Also in the present embodiment, the shape of each of the two openings 30 may be an ellipse instead of a circle.
(Modification)
Next, an endoscope apparatus according to a modification of each embodiment described above will be described. In the following modifications, the same components as those in the above-described embodiments are denoted by the same reference numerals and description thereof is omitted.
(Modification 1)
In each embodiment described above, the liquid emitted from the distal end portion of the insertion portion is water, but physiological saline may be used instead of water.
Furthermore, you may color the liquid radiate | emitted from the front-end | tip part of an insertion part. For example, water or physiological saline is colored using blue indigo carmine or the like. Since the colored water or physiological saline is conspicuous with respect to the background intestinal wall on the endoscopic image, the operator can easily confirm or measure the size of the lesion.
(Modification 2)
In Modification 1 described above, the liquid emitted from the distal end portion of the insertion portion is colored, but instead, visible light may be introduced into the liquid so that the water flow shines on the endoscopic image. .
FIG. 16 is a diagram for describing a configuration example of a main body device 12A having a configuration for introducing visible light into the water flow according to the present modification. The main body device 12A includes a tank 161, a pump 162 connected to a liquid tank or the like to draw water into the tank 161, a control unit 163 including a CPU and a memory, and a light source 164.

  The control unit 163 is connected to the foot switch 13, receives an on / off signal from the foot switch 13, and controls the pump 162, the light source 164, and the like as will be described later. The pump 162 and the tank 161 constitute a liquid supply source for sending water into the front water supply channel or the treatment instrument insertion channel constituting the pipe portion.

The light source 164 is a visible light source that emits visible light in a predetermined wavelength range. Here, the light source 164 emits white light having a wavelength of 400 nm to 800 nm.
The light source 164 and the tank 161 are arranged so that the light emitted from the light source 164 travels toward the entrance window 161a provided in the tank 161 through the optical system 172 such as the shutter 171 and the lens.
The shape of the tank 161 may be a box shape or a cylindrical shape.
The incident window 161a and the discharge port 161b are arranged so that light that has entered the tank 161 from the incident window 161a hits the water discharge port 161b. The optical system 172, the incident window 161a, and the discharge port 161b constitute a visible light introducing unit that introduces visible light into the water supplied in the front water supply channel or the treatment instrument insertion channel.

  Incidentally, the size of the incident window 161a is set so that a sufficient amount of light is collected at the outlet 161b, that is, more light that has passed through the optical system 172 is collected. If the incident window 161a is made of, for example, a circular glass member, the diameter is preferably set to a size that allows more light to enter. For example, the size of the opening diameter D10 of the incident window 161a of the tank 161 is a size corresponding to the diameter of the condensed light beam emitted from the optical system 172.

  The control unit 163 is connected to the foot switch 13, the pump 162, the light source 164, the shutter driving unit 171 a that drives the shutter 171, and the monitor 52.

  When the instruction signal from the foot switch 13 is input, the control unit 163 drives the pump 162 and also drives the shutter driving unit 171 a that drives the shutter 171 to output visible light from the light source 164 into the tank 161. To do.

  Visible light is guided from one end of the tank 161 into the water flow WJ emitted from the distal end portion of the insertion portion 21 through the connection tube 51, the forward water supply channel in the endoscope, or the treatment instrument insertion channel.

  The inner surfaces of the connecting tube, the front water supply channel, and the treatment instrument insertion channel are provided with a mirror-finished metal coating or a reflective material such as magnesium oxide so as to reflect light.

  Therefore, when the pump 162 is driven, water passes from the pump 161 through the connection tube 51 and further through the front water supply channel or treatment instrument insertion channel of the insertion portion 21 of the endoscope, and opens at the distal end portion of the endoscope. The light emitted from the water and emitted into the water is reflected inside the connection tube 51, the treatment instrument insertion channel, etc., to which the above-described metal coating is applied, and also inside the water flow WJ sent from the opening. Reflected.

  The inner wall of the connection tube 51 and the treatment instrument insertion channel and the water have different refractive indexes, and light is reflected by the inner wall and travels. Moreover, since the periphery of the water flow WJ emitted from the opening is air and has a refractive index different from that of water, the light travels while being totally reflected inside the sent water flow WJ.

Since the surrounding water stream WJ is air, and the refractive index of air is smaller than that of water, the light in the water stream WJ is totally reflected at the boundary between water and air, like an optical fiber. Reach the target site. The water flow WJ appears to shine in the endoscopic image to the operator.
Therefore, according to this modified example, the water flow WJ has an effect of being easily seen by the operator.
(Modification 3)
In the endoscope apparatus according to each of the above-described embodiments and modifications, the water flow WJ hits the peripheral part of the lesioned part or the lesioned part when checking the size of the lesioned part. The lesion is not always in a state suitable for observation, and blood, dirt, etc. may be attached to the surface of the lesion, so the water flow WJ for confirming the size of the lesion is the lesion The surface can be used for cleaning the surface of a part or the like.

  In this case, the water flow WJ is continuously emitted by driving the pump 62. However, since the lesioned part may easily bleed, the pump 62 is pulsed in order to reduce the water pressure of the water flow WJ hitting the lesioned part. It may be driven to reduce the water pressure of the water flow WJ.

  In that case, as shown in FIGS. 7, 11 and 15, the pulse of the pump 62 is emitted so that water is emitted at such a pressure that the water flow WJ is emitted in such a shape that the treatment reference value can be seen. The drive is controlled.

As described above, the endoscope apparatus according to this modification reduces the pressure of the water flow WJ by driving the pump 62 in a pulsed manner, and the surgeon confirms whether the size of the lesioned part is equal to or larger than the treatment reference value. In addition, the surface of the lesioned part can be cleaned with a low-pressure water flow WJ with a reduced probability of bleeding or the like in the lesioned part.
(Modification 4)
In each of the above-described embodiments and Modifications 1 to 3, it has been described that the water flow can be used for cleaning. However, the endoscope apparatus according to this modification has two cleaning modes by devising the configuration of the distal end portion. Is configured to have
In this modification, the air / water discharge direction of the air / water nozzle 33 for the observation window 31 is directed to the direction in which one opening from which the water flow WJ exits exists.

  FIG. 17 is a front view of the distal end portion of the insertion portion 21 according to this modification. The discharge direction A of the water supply / air supply of the air supply / water supply nozzle 33 for the observation window 31 is directed substantially to the center of the observation window 31. One of the two openings 30 is located. That is, one of the two openings 30 is arranged in the direction of air supply or water supply of the air / water supply nozzle 33.

  In each of the above-described embodiments and Modifications 1 to 3, the liquid that has passed through the front water supply channel or the treatment instrument insertion channel exits from the openings 30, 30a, and 34, and looks at the water flow WJ to determine the size of the lesion. In addition to being able to confirm, the water flow WJ can be used as it is as a cleaning water flow for a lesion or the like. That is, the surgeon turns on the foot switch 13 to enter the first washing mode, and two water streams are emitted as shown in FIGS. 7, 11, and 14 to wash the lesioned part and the like. can do.

  In the present modification, for example, when a water flow WJ is emitted using a predetermined switch of the operation unit 22, an operation is performed so as to supply water or supply air also from the air / water supply nozzle 33. For example, when the pedal 13a of the foot switch 13 is pressed while a predetermined switch of the operation unit 22 is pressed, the second cleaning mode is set and the lesioned part or the like can be cleaned.

FIG. 18 is a diagram for explaining a state of two water flows when water is also supplied from the air / water supply nozzle 33 when two water flows WJ are emitted from the two openings 30.
The water WJN emitted from the air / water supply nozzle 33 collides with one of the two water flows WJ, and the emission direction of one of the water flows is not as straight as the other water flow, but is disturbed. Since the water flow WJa having a disordered emission direction has a lower pressure when it hits the lesioned part than the pressure when the other water flow WJ having a straight emission direction hits, the lesioned part is gently washed. The cleaning with the water flow WJa whose emission direction is disturbed is effective cleaning particularly in a cancerous part that is likely to bleed.

FIGS. 17 and 18 are diagrams illustrating a case where gentle cleaning is performed by changing one of the water flows WJ exiting from the two openings 30 in the first embodiment to a water stream WJa in which the exit direction is disturbed. One of the two water streams that exit from the openings 30 and 34 according to the second embodiment may be a water stream with a disturbed exit direction.
Furthermore, you may make it make the one water flow radiate | emitted from the opening 30A of 3rd Embodiment into the water flow from which the radiation | emission direction was disturbed.

  Therefore, in the endoscope apparatus of this modification, the liquid that has passed through the forward water supply channel or the treatment instrument insertion channel is emitted from the openings 30, 30a, and 34, and the size of the lesioned part is confirmed by looking at the water flow WJ. In addition, the first cleaning mode in which the water flow WJ can be used as it is as a cleaning water flow for the lesioned part, and the second cleaning mode in which the lesioned part or the like can be gently cleaned by the water stream disturbed in the emission direction. And have.

As described above, according to the endoscope devices according to the above-described embodiments and modifications, the operator can measure or confirm the size of the target with a simple configuration without requiring a complicated operation. Can do.
The present invention is not limited to the above-described embodiments, and various changes and modifications can be made without departing from the scope of the present invention.

1, 1A, 1B Endoscope, 11, 11A, 11B Endoscope, 12, 12A Main unit, 12a Water supply connector part, 13 Foot switch, 13a Pedal, 21 Insertion part, 22 Operation part, 23 Connection cable, 24 distal end rigid portion, 25 curved portion, 26 treatment instrument insertion channel, 26a, 27a, 27b pipe, 27, 27A forward water supply channel, 30, 30A, 34 opening, 30a, 30b, 43 pipe, 31 observation window, 32 illumination Window, 33 Air supply / water supply nozzle, 35 Water supply port, 36 Treatment instrument insertion port, 41 Camera control unit, 42, 52 Monitor, 44 Objective optical system, 45 Image sensor, 46 Signal line, 51 Connection tube, 51a, 51b Connector part , 61, 163 Controller, 62, 162 Pump, 63 Liquid tank, 71 Polyp, 7 2 intestinal wall, 81 endoscopic image, 161 tank, 161a entrance window, 161b outlet, 171 shutter, 171a shutter drive unit, 172 optical system

Claims (11)

A liquid supply source for supplying the liquid;
A conduit having one end connected to the liquid source;
An objective optical system for observing the observation site, provided at the distal end of the endoscope insertion portion;
The other end of the conduit is connected, and an opening formed of one or more openings formed in the distal end portion based on a predetermined treatment reference value related to the observation site;
An endoscope apparatus characterized by comprising: The opening comprises first and second openings,
The endoscope apparatus according to claim 1, wherein a distance between the first opening and the second opening at the distal end is the same as the predetermined treatment reference value. The pipeline has a first pipeline portion communicating with the first opening, and a second pipeline portion communicating with the second opening,
The endoscope apparatus according to claim 2, wherein the first pipe section and the second pipe section are provided in parallel at the distal end portion.   The distance between the first aperture and the objective optical system and the distance between the second aperture and the objective optical system are equal when viewed from a direction orthogonal to the tip surface of the tip portion. The endoscope apparatus according to claim 2 or 3. It has an operation part that can be operated by the surgeon,
The endoscope apparatus according to any one of claims 2 to 4, wherein the liquid is simultaneously emitted from the first opening and the second opening based on an operation of the operation unit. Provided at the distal end of the insertion portion, and has a nozzle for supplying air or water toward an observation window corresponding to the objective optical system,
The endoscope apparatus according to any one of claims 2 to 5, wherein the first opening is arranged in the direction of air supply or water supply of the nozzle.   The endoscope apparatus according to claim 1, wherein the opening is one opening having a diameter or a width of the predetermined treatment reference value.   The endoscope apparatus according to claim 1, wherein the predetermined treatment reference value is a treatment reference value for a colorectal polyp.   The endoscope apparatus according to claim 8, wherein the predetermined treatment reference value is 5 mm.   The endoscope apparatus according to any one of claims 1 to 9, wherein the liquid is water, physiological saline, acetic acid, colored water, or colored physiological saline. A visible light source that emits visible light;
The endoscope apparatus according to claim 1, further comprising a visible light introducing unit that introduces the visible light into the liquid supplied from the liquid supply source to the pipe.

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