JP2013183933A - Device for securing visual field of intracoelomic observation - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a device for securing the visual field of intracoelomic observation, which enlarges the diameter of a protrusion-direction tip in the outer peripheral direction of an endoscope.SOLUTION: A device 70 for securing the visual field of intracoelomic observation is attached in the state of protruding at a tip of an endoscope 100 inserted into a cylindrical cover tube 101, and extended in the outer peripheral direction of the endoscope 100 to secure the visual field of observation from the endoscope 100 in the state of expanding it. The device includes: an cylindrical attachment part 73 which is fitted to one end on the outer periphery of the endoscope 100; an annular ring-shaped member 71 which has one end attached to the side of the other end of the cylindrical attachment part 73; and a plurality of loop springs 72 which are erected in such a manner that an elastic restoring force directed in the outer peripheral direction of the endoscope 100 from the other edge of the ring-shaped member 71 is urged. The diameters of the plurality of loop springs 72 are reduced and enlarged by movement relative to the cover tube 101.

Description

  The present invention relates to a body cavity observation visual field securing device that can be attached to a distal end of an endoscope or the like to expand a treatment position inside a body cavity and secure an observation visual field of the endoscope, in particular, an endoscope diameter. The present invention relates to an intra-body-cavity observation visual field securing device that can secure a wider observation visual field stably and secure an observation visual field even when mucous membranes or the like are attached.

  In general, an endoscope has an illumination light, a CCD camera lens, an air / water supply nozzle, a plurality of channels for penetrating treatment tools such as forceps and an incision tool toward the distal end, and is inserted into a body cavity. In this state, the image of the part in the body cavity illuminated by the illumination light is observed with the CCD camera lens, and the treatment with the treatment tool is performed.

  For example, in the case of an operation for incising around the affected part of the gastric mucosal layer and excising the fibrous muscle located in the lower layer of the mucosal layer, the endoscope is provided with a mucosal layer and a muscle layer following the incision of the mucosal layer. The incision tool is inserted into the fibrous muscle between the two, and the incision tool is operated while confirming the image of the affected area with the CCD camera lens. Since the visual field is narrow, it is common to use an intra-body-cavity observation visual field securing device that expands between the mucosal layer and the fibrous muscle to secure or expand the visual field of the affected area image.

  The following patent documents can be cited as documents describing the apparatus for securing an observation visual field in the body cavity according to this conventional technique. Patent Document 1 describes a technique in which a pair of retractor members that are curved in the outer circumferential direction of the endoscope are provided at the distal end of the endoscope, and the retractor member lifts the mucosal layer. Patent Document 2 describes the technique at the distal end of the endoscope. A technique for securing an endoscope visual field by providing a permeable hood extending in the distal direction is described, and Patent Document 3 provides a grasping forceps at the distal end of the endoscope, and pulls up the mucous membrane layer by the grasping forceps. Describes a technique for ensuring a visual field between a mucosal membrane and a fibrous muscle.

JP 2009-219743 A JP 2003-204919 A JP 2008-194302 A

  Although the techniques described in Patent Documents 1 and 3 described above can lift the mucosal layer with a pair of retractor members or gripping forceps, a driving force for driving the retractor members or gripping forceps is supplied from the operation unit. However, the retractor member and the grasping forceps may obstruct the observation visual field, and the technique described in Patent Document 2 is such that mucus adheres to the transparent hood and the observation visual field. There is a problem that a good field of view can be obtained only in the opening range of the hood.

  In view of such problems, the present invention is intended to solve the above-described problems caused by the prior art, and it is not necessary to obstruct the observation field of view of an elongated medical instrument such as an endoscope. It is an object of the present invention to provide an intra-body-cavity observation visual field securing device that can expand a treatment section and secure an observation visual field.

  In order to achieve the above-mentioned object, the present invention is attached to a distal end of a long medical instrument inserted into a cylindrical cover tube, and expands toward the outer peripheral direction of the medical instrument. An intra-body-cavity observation visual field securing device capable of expanding and securing an observation visual field from an instrument, wherein a cylindrical mounting part having one end fitted to the outer periphery of the distal end of the medical instrument, and one end at the other end of the cylindrical mounting part And a plurality of spring members biased with elastic restoring force from the other end of the ring-shaped member toward the outer peripheral direction of the medical device. To do.

  In addition, the present invention is attached to the distal end of a long medical instrument inserted into a cylindrical cover tube, and expands toward the outer peripheral direction of the medical instrument to observe the field of view from the medical instrument. A device for securing an observation visual field in a body cavity that can be expanded and secured, and a cylindrical mounting portion having one end fitted to the outer periphery of the distal end of the medical instrument, and an annular shape having one end attached to the other end of the cylindrical mounting portion A second ring-shaped member, and a plurality of loop springs erected while being bent by an elastic restoring force from the other end of the ring-shaped member toward the outer peripheral direction of the medical device. Features.

  The third feature of the present invention is that, in the body cavity observation visual field securing device of the second feature, the plurality of loop springs are erected on the ring-shaped member so as to intersect in the radial direction, In the body cavity observation visual field securing device of the second or third feature, a fourth feature is that the plurality of loop springs are erected on the ring-shaped member so that laterally curved portions of adjacent loops overlap. In the body cavity observation visual field securing device according to any one of the second to fourth features, the plurality of loop springs are arranged such that a left lateral curved portion of an arbitrary loop spring is an inner peripheral side of a right lateral curved portion of a left loop spring, A fifth feature is that the right lateral curved portion of the arbitrary loop spring is erected on the ring-shaped member such that the right lateral curved portion of the right loop spring is located on the outer peripheral side of the left lateral curved portion. In the body cavity observation visual field securing device of the features of It said plurality of loop springs, one of the adjacent loop inner circumferential side, the other loop and the sixth aspect of the erected to the ring-shaped member so that the outer peripheral side.

  In the in-body-cavity observation visual field securing device according to any one of the fourth to sixth aspects, the present invention provides an interval between the standing positions of adjacent loop springs so that the loop overlap amount is reduced. In the body cavity observation visual field securing device having any one of the fourth to sixth characteristics, the plurality of loop springs are adjacent to each other so that the amount of overlap of the loops is large. The eighth feature is that the interval between the standing positions of the loop springs is maximally erected.

  The intra-body-cavity observation visual field securing device according to the present invention includes a plurality of spring members biased by an elastic restoring force from the other end edge of the ring-shaped member toward the outer peripheral direction of the medical device, or the spring member is a ring. Observation from a medical instrument such as an endoscope by being constituted by a plurality of loop springs that are erected while being bent by being elastically restored from the other end edge of the shaped member toward the outer periphery of the medical instrument An observation field of view can be secured by expanding the target region without obstructing the field of view.

The figure which shows the endoscope equipped with the in-body-cavity observation visual field ensuring apparatus by 1st Embodiment of this invention. The figure for demonstrating the operation method of the observation visual field securing apparatus in a body cavity by 1st Embodiment. The figure for demonstrating the endoscope operation which mounted | wore the body cavity observation visual field ensuring apparatus by 1st Embodiment. The figure for demonstrating the observation visual field securing apparatus in a body cavity by this 1st Embodiment. The figure for demonstrating the observation view ensuring apparatus in a body cavity by 2nd Embodiment of this invention. The figure for demonstrating the observation view ensuring apparatus in a body cavity by 3rd Embodiment of this invention.

DESCRIPTION OF EMBODIMENTS Hereinafter, an embodiment of a body cavity observation visual field securing device according to the present invention will be described in detail with reference to the drawings.
[Assumptions]
First, a usage pattern of the endoscope 100 equipped with the intra-body-cavity observation visual field securing device 70 according to the present invention will be described with reference to FIGS. 1 to 3.
As shown in FIG. 1, the intra-body-cavity observation visual field securing device 70 according to the present invention is inserted into a cylindrical cover tube 101 with a reduced diameter, and is operated to bend or the like by the operation unit 110. The endoscope 100 is attached to the distal end of the endoscope 100, inserted into the body cavity of the human body in a state of being housed in the cover tube 101 shown in FIG. 2A, and at the position where the distal end of the cover tube 101 reaches the affected part. The cover tube 101 is exposed from the cover tube 101 by moving the cover tube 101 toward the operation unit 110 (in the direction of arrow A) while maintaining the insertion position in the body cavity, and the elastic restoring force of a plurality of linear loop springs 72 to be described later The diameter of the distal end side is expanded to expand an arbitrary part in the body cavity, so that the image by the CCD camera lens of the endoscope 100 bent by the bending portion 109 is obtained. It is possible to ensure the field of view. This intra-body-cavity observation visual field securing device 70 can reduce and increase the diameter of the plurality of loop springs 72 by relative movement with the cover tube 101.

  Specifically, for example, when the affected part 8 generated in the stomach wall or the like is excised, the intra-body-cavity observation visual field securing device 70 according to the present invention is housed inside the distal end of the cover tube 101 as shown in FIG. In this state, it is inserted into the stomach together with the endoscope 100, and the incision tool 9 is protruded from the endoscope 100 so that the mucosa layer 2 below the affected part 8 and the fibrous muscle between the mucosa layer 2 and the muscle layer 3 are inserted. When incising 4, a plurality of loop springs 72 push and expand between the mucosa layer 2 and the muscle layer 3, thereby ensuring an observation field.

[First Embodiment]
The body cavity observation visual field securing device 70 according to the first embodiment of the present invention has an outer periphery of the distal end of the endoscope 100 as shown in FIG. 4A viewed from the distal end side and FIG. A cylindrical mounting portion 73 made of plastic or the like having an elastic force to be fitted to the portion, an annular ring member 71 made of metal or the like attached to the distal end side of the cylindrical mounting portion 73, and a metal wire are wound. A plurality of loop springs 72 each having an elastic restoring force, which is provided in a hole opened at the front-end-side annular edge of the ring-shaped member 71, and the plurality of loop springs 72. The cylindrical cover tube 101 (see FIGS. 1 to 3) that is housed inside the cylinder in a closed state, and in a free state that is not inserted into the cover tube 101, a plurality of loop springs 72 have elastic restoring force. As shown in FIG. The plurality of loop springs 72 are configured so as to bend toward the outer peripheral direction of the endoscope 100, and as shown in FIG. The left lateral curved portion of the spring (for example, the center upper loop spring) is the inner peripheral side of the right lateral curved portion of the left loop spring, and the right lateral curved portion of the arbitrary loop spring is the left lateral curved portion of the right loop spring. The ring-shaped member 71 is erected so that the interval between the standing positions is minimized by brazing or welding so as to be on the outer circumferential side of the ring member 71 (that is, so that the laterally curved portions of the loop springs are alternately overlapped).

  As shown in FIG. 4C, the loop spring 72 is brazed or welded at a position indicated by a symbol Z by inserting a loop end portion into a hole opened at the front-end-side annular edge of the ring-shaped member 71. An elastic wire made of a single wire or a stranded wire is formed in a loop shape. For example, when the outer diameter of an endoscope is 9 to 12 mm, the diameter is 0.5 mm to 0.8 mm with seven stranded wires. The amount is preferably about 10 mm to 30 mm.

  The cover tube 101 is made of a flexible material that is not flexible when the endoscope is inserted or is hard and does not place a burden on the patient when inserted into the body. For example, the cover tube 101 is thin-walled silicon or elastic. A urethane tube and a Teflon (registered trademark) tube are preferable, and the loop spring 72 of the intra-body-cavity observation visual field securing device 70 according to the present embodiment may be narrowed. The number of the loop springs 72 according to the present embodiment is eight as shown in FIG. 4A, but in FIG. 4B, in order to prevent the loop springs viewed from the side from becoming complicated. The three loop springs on the side are not shown, and the same applies to other embodiments described later.

  The intra-body-cavity observation visual field securing device 70 configured as described above is inserted into the stomach together with the endoscope 100 while being housed inside the distal end of the cover tube 101 as described above, and the mucosa layer and the muscular layer below the affected area. When the incision tool is used to incise the fibrous streaks in the CCD camera lens while using the incision tool, the plurality of loop springs 72 are moved outward in the outer peripheral direction by elastic restoring force. The diameter can be expanded to expand between the mucosa layer and the muscle layer. Particularly in the present embodiment, the adjacent loops interfere with each other by arranging a plurality of elastic loop springs 72 welded so that the left and right loops are alternately overlapped with the ring edge of the ring-shaped member 71. Thus, the elastic restoring force of the loop can be applied to the adjacent loop to increase the elastic restoring force, and the space between the mucous membrane layer and the muscle layer can be pushed and expanded with a strong force to secure the visual field.

  That is, the body cavity observation visual field securing device 70 according to the present embodiment includes a plurality of loop springs 72 erected adjacent to the front-end-side annular edge of the ring-shaped member 71 so that the vicinity of the roots of the adjacent loops intersects each other. Arranged so that part of the loop bending part overlaps in order, adjacent loops interfere with each other, giving the elastic restoring force of the loop to the adjacent loop, pushing out the fibrous streaks etc. with a strong force, securing a field of view can do.

[Second Embodiment]
The intra-body-cavity observation visual field securing device 70 according to the second embodiment of the present invention includes an outer peripheral portion of the endoscope 100 as shown in FIG. 5A viewed from the distal end side and FIG. A cylindrical attachment portion 73 made of plastic or the like having an elastic force to be fitted into the ring, an annular ring member 71 made of metal or the like attached to the distal end side of the attachment portion 73, and a metal wire A plurality of loop springs 72a and 72b having elastic restoring force, which are formed in a loop shape of a stranded wire and are erected in a hole opened at a ring edge of the ring-shaped member 71, and the plurality of loop springs 72a And 72b in a closed state, and a cylindrical cover tube 101 (see FIGS. 1 to 3) that is housed inside the cylinder, and in a free state that is not inserted into the cover tube 101, a plurality of loop springs 72a and 72b However, FIG. As shown in FIG. 5, the plurality of loop springs 72a and 72b are configured to bend in the radial direction as shown in FIG. 5A. In addition, the interval between the standing positions is minimized by brazing or welding so that one loop spring 72a adjacent to the circumferential direction of the ring-shaped member 71 is on the inner peripheral side and the other loop spring 72b is on the outer peripheral side. It is erected to become.

  As shown in FIG. 5C, the loop springs 72a and 72b are brazed at a position indicated by a symbol Z by inserting a loop end portion into a hole opened at the front-end-side annular edge of the ring-shaped member 71. Or it is welded. The characteristics such as the material and shape are the same as those in the first embodiment, and the material and shape of the cover tube 101 are also the same.

  In the intra-body-cavity observation visual field securing device 70 configured as described above, when the incision tool is used for incision while confirming the affected part image as described above, the plurality of loop springs 72a and 72b are moved in the outer circumferential direction by elastic restoring force. It can spread and push the fibrous streaks. In particular, in this embodiment, by using a plurality of elastic loop springs 72a and 72b which are loop-shaped and welded so that the loops are alternately overlapped with the tip-side annular edge of the ring-shaped member 71, Adjacent loops interfere with each other to give the elastic restoring force of the loops to the adjacent loops, so that the elastic restoring force can be strengthened and the above-mentioned mucosa layer and muscle layer can be pushed and expanded with a strong force.

  That is, the intra-body-cavity observation visual field securing device 70 according to the present embodiment intersects a plurality of loop springs 72a and 72b erected adjacent to the front-end-side annular edge of the ring-shaped member 71 at the vicinity of the roots of the adjacent loops. By arranging the loops so as to alternately overlap in the radial direction, the loop spring 72a on the inner circumference side of the endoscope interferes so as to expand and spread the outer loop spring 72b, and a strong force is applied between the mucosa layer and the muscle layer. You can widen and secure a field of view.

[Third Embodiment]
In the above-described embodiment, the example in which the adjacent loop spring bending portions of the intra-body-cavity observation visual field securing device 70 overlap has been described, but the intra-body-cavity observation visual field securing device 70 according to the present embodiment overlaps the loop bending portions. For example, as shown in FIG. 6, the intra-body-cavity observation visual field securing device 70 according to the third embodiment of the present invention is viewed from FIG. As shown in FIG. 6 (b), a plastic cylindrical attachment portion 73 made of plastic or the like having an elastic force to be fitted to the outer peripheral portion of the endoscope 100, and a metal attached to the distal end side of the cylindrical attachment portion 73. An annular ring-shaped member 71 made of a metal, etc., and a plurality of elastic restoring forces standing in a hole opened in the front-end-side annular edge of the ring-shaped member 71 in a loop shape wound with a metal wire Loop springs 72a and 72b and the plurality of loop springs It consists of a cylindrical cover tube 101 (see FIGS. 1 to 3) that houses the springs 72a and 72b in a closed state. In a free state where the springs 72a and 72b are not inserted into the cover tube 101, a plurality of loop springs 72a and 72b are As shown in FIG. 6 (b), the plurality of loop springs 72a and 72b are configured to bend toward the outer periphery of the endoscope 100 by an elastic restoring force, as shown in FIG. 6 (a). One loop spring 72a that intersects in the radial direction and is adjacent to the circumferential direction of the ring-shaped member 71 is on the inner peripheral side, and the other loop spring 72b is on the outer peripheral side, so that the amount of overlap of the loops increases. Is installed by brazing or welding with a maximum interval between adjacent loop springs. The material and shape of the loop springs 72a and 72b and the cover tube 101 are the same as in the above embodiment.

  In the intra-body-cavity observation visual field securing device 70 configured as described above, when the incision tool is used for incision while confirming the affected part image, the plurality of loop springs 72a and 72b are expanded in the outer circumferential direction by elastic restoring force, and the mucosal layer And can spread between the muscle layers. In particular, in the present embodiment, the interval between adjacent loop springs is maximized, and the overlap amount of the plurality of loop springs 72a and 72b overlapping each other is increased compared to the other embodiments, so that the loop on the inner peripheral side is increased. The pushing and expanding force that the spring 72a gives to the loop spring 72b on the outer peripheral side can be increased, the elastic restoring force of the relatively short loop spring can be increased, and the space between the mucosa layer and the muscle layer can be pushed and expanded with a strong force. .

In each of the above-described embodiments, an example in which the shape of all the loop springs in each embodiment is the same has been described. However, the present invention is not limited to this, for example, a relatively small loop spring and a relatively small loop spring. The large-sized loop springs may be arranged so as to alternately overlap, and the small-sized loop spring may be configured to support the elastic restoring force of the large-sized loop spring. Although the example of the body cavity observation visual field securing device that pushes and expands the distal end side of the endoscope using the elastic restoring force of the loop spring has been described, the member for performing the above-mentioned expansion according to the present invention is not limited to the loop spring, For example, it may be a spring member having other shapes such as a plurality of tongue plates. In this case, the spring member expands from the root side toward the tip side, so that a visual field can be secured. Furthermore, in the above-described embodiment, the example in which the cylindrical mounting portion of the in-vivo observation visual field securing device is attached mainly to the distal end portion of the endoscope has been described. The present invention is not limited to an endoscope, and can be used for a long medical instrument that needs to secure a visual field on the distal end side.
Further, the cylindrical mounting portion 73 and the ring-shaped member 71 in the above-described embodiment are made of hard engineering plastic such as nylon having elastic restoring force or PEEK (Polyether ether ketone) (strength less than 500 kgf / cm ² , flexural modulus 24000 kg). / Plastic group of less than / cm ² ).

2 Mucosal layer 3 Muscle layer 4 Fibrous muscle 8 Affected part 9 Incision tool 70 Intracorporeal observation visual field securing device 71 Ring-shaped members 72, 72a, 72b Loop spring 73 Cylindrical attachment part 100 Endoscope 101 Cover tube 110 Operation part

Claims (8)

Projecting and attaching to the tip of a long medical instrument inserted into a cylindrical cover tube, and expanding toward the outer peripheral direction of the medical instrument to expand and secure an observation field of view from the medical instrument A body cavity observation visual field securing device capable of
A cylindrical attachment part having one end fitted to the outer periphery of the distal end of the medical instrument, an annular ring-shaped member having one end attached to the other end of the cylindrical attachment part, and the medical use from the other end edge of the ring-shaped member An intra-body-cavity observation visual field securing device comprising a plurality of spring members biased by an elastic restoring force toward the outer peripheral direction of the instrument. Projecting and attaching to the tip of a long medical instrument inserted into a cylindrical cover tube, and expanding toward the outer peripheral direction of the medical instrument to expand and secure an observation field of view from the medical instrument A body cavity observation visual field securing device capable of
A cylindrical attachment part having one end fitted to the outer periphery of the distal end of the medical instrument, an annular ring-shaped member having one end attached to the other end of the cylindrical attachment part, and the medical use from the other end edge of the ring-shaped member An intra-body-cavity observation visual field securing device comprising: a plurality of loop springs that are erected while being bent by being elastically restored by an elastic restoring force toward the outer peripheral direction of the instrument.   The in-vivo observation visual field securing device according to claim 2, wherein the plurality of loop springs are erected on the ring-shaped member so as to intersect in the radial direction.   4. The intra-body-cavity observation visual field securing device according to claim 2, wherein the plurality of loop springs are erected on the ring-shaped member so that laterally curved portions of adjacent loops overlap.   In the plurality of loop springs, a left lateral curved portion of an arbitrary loop spring is an inner peripheral side of a right lateral curved portion of a left loop spring, and a right lateral curved portion of the arbitrary loop spring is a left lateral curved portion of a right loop spring. The in-vivo observation visual field securing device according to any one of claims 2 to 4, wherein the ring-shaped member is erected so as to be on the outer peripheral side.   5. The plurality of loop springs are erected on the ring-shaped member so that one adjacent loop is on the inner peripheral side and the other loop is on the outer peripheral side. 6. Intra-body cavity observation visual field securing device.   The in-vivo observation field according to any one of claims 4 to 6, wherein the plurality of loop springs are erected at a minimum interval between adjacent positions of the loop springs so that the overlapping amount of the loops is small. Securing device. The in-vivo observation field according to any one of claims 4 to 6, wherein the plurality of loop springs are set up at a maximum interval between adjacent positions of the loop springs so that the overlapping amount of the loops is increased. Securing device.

Images