JP2013192775A - Forceps, diagnosis assisting system and endoscope system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide forceps, a diagnosis assisting system and an endoscope system capable of reducing time and labor of work and improving work efficiency when continuously performing the work of excising a lesion or the like while specifying the range of the lesion at a plurality of parts.SOLUTION: Forceps include a pair of claw parts 50 and 51 formed in a scissor shape to be opened and closed so as to hold the living tissue of a lesion, and an acquisition part provided on the inner side part of the claw part 50, for acquiring the biological information of the living tissue held by the claw parts 50 and 51. At the inner side part of the claw parts 50 and 51, cautery teeth 52a and 52b for cauterizing the living tissue are formed. The cautery teeth 52a and 52b are formed in a sawtooth shape, and conductive members 53a and 53b capable of energizing a high frequency current are provided on the tips of the teeth. The acquisition part includes a lens 57 for emitting inspection light toward the living tissue and making reflected light reflected at the living tissue be incident, and acquires incident reflected light as the biological information.

Description

  The present invention relates to a forceps, a diagnostic assistance system, and an endoscope system.

  Endoscopic Mucosal Resection (EMR) is a method of treating early cancer using an endoscope, where a metal ring called snare is hooked on the affected area (affected area), and a high-frequency current is applied to cut it off. Has been done. Also, recently, endoscopic submucosal dissection (ESD), which uses an ablation forceps such as an IT knife to incise the mucosa around the lesion and then removes the submucosa and removes the lesion. ) Is also done.

  When performing this ESD, a two-stage operation is performed in which the range of the lesion is accurately specified and then the specified lesion is excised. That is, first, an endoscope is introduced into a body cavity, and optical forceps are inserted into a forceps channel of the endoscope to perform an optical examination of a living tissue. When the optical examination is completed, the optical forceps are removed, the cautery forceps are inserted into the forceps channel, and a high frequency current is supplied to the cautery forceps to excise the lesion. Therefore, when there are a plurality of lesions, the optical forceps and the cautery forceps are replaced each time.

  As described above, in ESD, when the operation of excision of a lesioned part is continuously performed while specifying the range of the lesioned part at a plurality of locations, the number of times the optical forceps and the cautery forceps are alternately replaced increases. There was a problem that it took time. In addition, since the operation of specifying the lesion area using optical forceps and the operation of excising the lesion area using cautery forceps are completely separate operations, the lesion area and cauterization identified by optical inspection are not included. There has been a problem that a positional deviation occurs between the lesion area to be excised by the forceps.

  Patent Document 1 discloses a system in which an optical terminal (optical fiber) and a biopsy forceps are integrated. According to the technique described in Patent Document 1, the tissue of the biopsy specimen collection region close to the end of the biopsy forceps can be confirmed by the optical terminal inserted into the biopsy forceps.

Special Table 2002-505904

  As shown in FIG. 11, the technique described in the above-mentioned Patent Document 1 specifies a site for biopsy sampling by exciting a tissue in the body with an optical terminal (optical fiber) for optical coherence tomography. It is described that a biopsy specimen is collected in the cup 126 portion. However, once the biopsy specimen is taken, it is necessary to pull out the biopsy forceps so that the biopsy specimen in the cup 126 does not fall into the body outside the body cavity. I can't confirm. Therefore, it is not possible to continuously perform the operation of collecting the biopsy sample while confirming the tissue of the biopsy sample collection region at a plurality of locations. That is, the technique described in Patent Document 1 is originally intended to collect a biopsy specimen at an accurate position confirmed using an optical terminal, and specifies a range of a lesioned part at a plurality of locations. However, it does not have a configuration for solving the above problem in the case of continuously performing the operation of excising the lesion.

  The present invention can reduce work effort and time and improve work efficiency in the case where work such as excision of the affected part is performed continuously while specifying the affected part range at a plurality of locations. An object of the present invention is to provide forceps, a diagnostic assistance system, and an endoscope system.

The forceps according to the present invention are:
A pair of nail parts formed in a stagnation shape that opens and closes the living tissue of the lesioned part,
An acquisition unit that is provided in an inner part of the pair of nail portions and acquires biological information of the living tissue in a state of being gripped by the nail portions;
Is provided.

In addition, a diagnostic assistance system according to the present invention includes:
A pair of nail parts formed in a stagnation shape that opens and closes the living tissue of the lesioned part,
An acquisition unit that is provided in an inner part of the pair of nail portions and acquires biological information of the living tissue in a state of being gripped by the nail portions;
With
A cautery tooth for cauterizing the living tissue is formed on the inner part of the pair of claws,
The cautery tooth is formed in a sawtooth shape, and a forceps provided with a conductive member capable of passing a high-frequency current at the tooth tip;
An energization control unit that controls energization of a high-frequency current supplied to the conductive member;
A diagnostic unit for diagnosing the biological information acquired by the acquisition unit;
An output unit for outputting a diagnosis result by the diagnosis unit;
Is provided.

In addition, an endoscope system according to the present invention includes:
A pair of nail parts formed in a stagnation shape that opens and closes the living tissue of the lesioned part,
An endoscope in which a forceps and an image sensor are attached to a distal end portion, provided at inner portions of the pair of claws, and an acquisition unit that acquires biological information of the living tissue while being gripped by the nails The body,
An endoscope apparatus for processing a video signal of the living tissue imaged by the imaging element;
Is provided.

  According to the present invention, when work such as excision of a lesioned part is continuously performed while specifying the range of the lesioned part at a plurality of locations, work effort and time can be reduced and work efficiency can be improved. Possible forceps, diagnostic aid systems and endoscope systems can be provided.

It is a figure showing composition of an endoscope system showing a 1st embodiment concerning the present invention. It is a perspective view of the front-end | tip part of the endoscope main body which shows 1st Embodiment based on this invention. It is a figure which shows the structure of the forceps front-end | tip part which shows 1st Embodiment based on this invention. It is a figure which shows the acquisition operation | movement of the biometric information by the forceps front-end | tip part which shows 1st Embodiment based on this invention. It is a figure which shows the usage method of the forceps front-end | tip part which shows 1st Embodiment based on this invention. It is a flowchart which shows the operation example of the diagnostic / control apparatus which shows 1st Embodiment based on this invention. It is a figure which shows the structure of the forceps front-end | tip part which shows 2nd Embodiment based on this invention. It is a figure which shows the structure of the forceps front-end | tip part which shows 2nd Embodiment based on this invention. It is a figure which shows the opening / closing mechanism of the forceps front-end | tip part which shows 2nd Embodiment based on this invention. It is a figure which shows the acquisition operation | movement of the biometric information by the forceps front-end | tip part which shows 2nd Embodiment based on this invention. It is a figure explaining a prior art.

(First embodiment)
Hereinafter, a first embodiment of the present invention will be described in detail with reference to the drawings. An endoscope system 1 shown in FIG. 1 includes an endoscope body 2, an endoscope apparatus 3, and a diagnosis / control apparatus 4.

  The endoscope main body 2 includes a flexible long introduction portion 21 formed so as to be capable of being introduced into a body cavity, an operation portion 22 provided at a proximal end portion 21a of the introduction portion 21, and an operation portion 22. And a cable 23 that connects the introduction unit 21 and the endoscope device 3 so as to communicate with each other.

  The introduction portion 21 has flexibility over substantially the entire length so that it can be easily bent following the curvature of the body cavity when entering the inside of the body cavity. In addition, the introduction part 21 has a mechanism (not shown) that can bend a certain range (operable part 21c) on the tip part 21b side at an arbitrary angle in accordance with the operation of the knob 22a of the operation part 22.

  As shown in FIG. 2, which is a perspective view of the distal end portion 21b, the introduction portion 21 includes a camera CA, a light guide LG, and a forceps channel CH.

  The light guide LG guides the illumination light (visible light) emitted from the illumination light source 31 of the endoscope apparatus 3 to the distal end portion 21b, and emits the illumination light from the distal end portion 21b.

  The camera CA is an electronic camera provided with a solid-state imaging device, images an area illuminated with illumination light emitted from the light guide LG, and transmits the imaging signal to the endoscope apparatus 3.

  The forceps channel CH is a lumen having a diameter of, for example, 2.6 mm formed in the introduction portion 21 so as to communicate with the introduction port 22 b formed in the operation portion 22. Various devices for observing the lesion, diagnosing the lesion, performing surgery on the lesion, and the like can be inserted into the forceps channel CH. In the present embodiment, as shown in FIG. 1, it is possible to insert a forceps 11 that can specify the range of a lesioned part in a body cavity and excise the specified lesioned part.

  As shown in FIG. 1, the forceps 11 is a long flexible linear member extending from the forceps base end portion 11 a to the forceps tip end portion 11 b. The forceps 11 is connected to the diagnosis / control device 4 via a connector provided at the forceps base end portion 11a.

  Next, the configuration of the diagnosis / control apparatus 4 will be described. The diagnosis / control device 4 includes a laser 41 as a diagnostic light source, a spectroscope 42, a CPU (Central Processing Unit) 43 functioning as a diagnosis unit, an energization control unit 44, and a storage device 45. An input device 5 and a monitor 7 functioning as an output unit are connected to the diagnosis / control device 4.

  The input device 5 inputs a user instruction to the diagnosis / control device 4. In the present embodiment, the input device 5 is configured by, for example, a keyboard, a mouse, a switch, or the like. The monitor 7 inputs and displays the image data output from the diagnosis / control device 4.

  The laser 41 emits a laser beam when an instruction to execute a process for inspecting a living tissue of an examination target site (for example, a lesion) in a body cavity is input to the input device 5. When the forceps 11 are introduced into the body cavity by being inserted into the forceps channel CH, the forceps 11 guides the laser light emitted from the laser 41 and emits it as inspection light to the inspection target site. The forceps 11 receives reflected light from the examination target part as biological information of the examination target part and guides it to the spectroscope 42 of the diagnosis / control device 4. As a method for receiving the reflected light from the site to be inspected, known techniques such as fluorescence spectroscopy, OCT (Optical Coherence Tomography), and a confocal microscope can be applied.

  The spectroscope 42 performs spectrum analysis on the reflected light guided by the forceps 11. The CPU 43 diagnoses the presence / absence and type of a lesion in the examination target site in the body cavity based on the spectrum analysis result by the spectroscope 42. Then, the CPU 43 displays a diagnosis result on the monitor 7 by outputting a diagnosis result image indicating the diagnosis result to the monitor 7. The user can evaluate the extent of the lesion and the degree of illness by looking at the diagnosis result displayed on the monitor 7.

  The energization control unit 44 is electrically connected to a high frequency power source (not shown). The energization control unit 44 starts the supply of the high-frequency current to the forceps 11 when an instruction to execute the high-frequency current output process is input to the input device 5. The energization control unit 44 ends the supply of the high-frequency current to the forceps 11 when an instruction to stop the output process of the high-frequency current is input to the input device 5. Further, the energization control unit 44 changes the magnitude of the high-frequency current, the output frequency, and the like in accordance with the user instruction input to the input device 5 while supplying the high-frequency current to the forceps 11.

  The storage device 45 is an HDD (Hard Disk Drive) or the like built in the diagnosis / control device 4. The storage device 45 stores a diagnosis result by the CPU 43 and the like. The storage device 45 does not have to be built in the diagnosis / control device 4, for example, may be external to the diagnosis / control device 4, or exists on a communication network. It may be.

  Next, the configuration of the endoscope apparatus 3 will be described. The endoscope apparatus 3 includes an illumination light source 31, a video processing unit 32, and a CPU 33. An input device 6 and a monitor 8 are connected to the endoscope device 3.

  The input device 6 inputs a user instruction to the endoscope device 3. In the present embodiment, the endoscope apparatus 3 is configured by, for example, a keyboard, a mouse, a switch, or the like. The monitor 8 inputs and displays the image data output from the endoscope apparatus 3.

  The illumination light source 31 supplies the illumination light to the light guide LG by emitting illumination light in order to illuminate the region to be examined in the body cavity.

  The video processing unit 32 receives an imaging signal from the endoscope body 2, performs predetermined signal processing on the imaging signal, and outputs the processed signal to the monitor 8 as an endoscope video signal. Thereby, an endoscopic video based on the endoscopic video signal is displayed on the screen of the monitor 8. That is, when an examination site in the body cavity is imaged, the image is displayed on the monitor 8. The CPU 33 controls the operation of the illumination light source 31 and the video processing unit 32.

  Next, the configuration of the distal end portion of the forceps 11 will be described with reference to FIG. 3A is an enlarged view of the forceps tip 11b, and shows a state in which the movable claw 51 is opened about 30 ° with respect to the fixed claw 50. FIG. The fixed claw part 50 and the movable claw part 51 are a pair of claw parts formed in a stagnation shape that opens and closes a living tissue of a lesioned part so as to be gripped.

  A movable claw portion 51 is rotatably connected to a central axis provided at a position retracted from the distal end of the fixed claw portion 50 toward the proximal end side. Specifically, the movable claw portion 51 is connected to the fixed claw portion 50 by a stopper 54 that penetrates the fixed claw portion 50 in the lateral direction. A wire 55 is connected to the proximal end portion of the fixed claw portion 50 and the proximal end portion of the movable claw portion 51. When the user moves the wire 55 in the X direction via a handle-side operation mechanism (not shown) having the forceps 11, the movable claw portion 51 rotates in the closing direction with respect to the fixed claw portion 50. . On the other hand, the movable claw portion 51 is rotated in the opening direction with respect to the fixed claw portion 50 by moving the wire 55 in the direction opposite to the X direction.

  A plurality of cautery teeth 52a for cauterizing the living tissue are formed on the inner portion of the fixed claw portion 50. Of the surface of the fixed claw portion 50, the surface other than the surface of the cautery tooth 52a is insulated. In the present embodiment, the cautery tooth 52a is formed in a sawtooth shape, and a conductive member 53a capable of supplying a high-frequency current is provided on the tooth tip.

  Similar to the fixed claw portion 50, a plurality of cautery teeth 52b for cauterizing the living tissue are formed on the inner portion of the movable claw portion 51. Of the surface of the movable claw portion 51, the surface other than the surface of the cautery tooth 52b is insulated. In the present embodiment, the cautery tooth 52b is formed in a sawtooth shape, and a conductive member 53b capable of supplying a high-frequency current is provided on the tooth tip.

  As shown in FIG. 3 (b), inside the fixed claw portion 50, there are a conducting wire (plus side) 56a and a conducting wire for supplying a high-frequency current from the energization control unit 44 of the diagnosis / control device 4 to the conductive member 53a. A (minus side) 56b is formed. Although not shown in the inside of the movable claw portion 51, there are a lead wire (plus side) and a lead wire (minus side) for supplying a high frequency current from the energization control portion 44 of the diagnosis / control device 4 to the conductive member 53b. Is formed.

  The energization control unit 44 of the diagnosis / control device 4 starts supplying high-frequency current to the conductive members 53 a and 53 b when an instruction to execute high-frequency current output processing is input to the input device 5. On the other hand, the energization control unit 44 ends the supply of the high-frequency current to the conductive members 53a and 53b when an instruction to stop the output process of the high-frequency current is input to the input device 5.

  At a position (tip portion) at a sufficient creepage distance from the cautery tooth 52a in the inner portion of the fixed claw portion 50, an emission portion that emits laser light toward the living tissue, and a laser emitted from the emission portion A lens 57 is provided that functions as an incident portion for receiving the reflected light reflected by the living tissue among the light.

  As shown in FIG. 3B, a light guide member 60 and a mirror 61 are provided inside the fixed claw portion 50. In the present embodiment, the light guide member 60 is an optical fiber that guides the laser light 62 emitted by the laser 41 of the diagnosis / control apparatus 4 to the mirror 61.

  The mirror 61 reflects the laser light 62 guided from the light guide member 60 to the lens 57 side. The lens 57 emits the laser light 62 reflected by the mirror 61 toward a living tissue (not shown). And the lens 57 injects the reflected light 63 reflected by the biological tissue.

  The mirror 61 reflects the reflected light 63 incident on the lens 57 to the light guide member 60 side. The reflected light 63 is guided to the spectroscope 42 of the diagnosis / control apparatus 4 through the light guide member 60. The lens 57, the light guide member 60, and the mirror 61 function as an acquisition unit of the present invention.

  Next, an operation for acquiring reflected light as biological information by the forceps tip 11b will be described. FIG. 4A shows a state in which the movable claw portion 51 is open with respect to the fixed claw portion 50, that is, a state before the lesioned portion 64 in the body cavity is gripped by the movable claw portion 51 and the fixed claw portion 50. . 4B and 4C show a state where the movable claw portion 51 is closed with respect to the fixed claw portion 50, that is, a state where the lesioned portion 64 in the body cavity is gripped by the movable claw portion 51 and the fixed claw portion 50. ing.

  As shown in FIG. 4C, when the execution instruction for the process of inspecting the inspection target region 65 is input to the input device 5 while the lesioned part 64 is held, the laser 41 emits the laser light 62. The laser light 62 is guided to the mirror 61 by the light guide member 60. The laser beam 62 guided to the mirror 61 is reflected to the lens 57 side and is emitted from the lens 57 to the examination target portion 65. Next, the reflected light 63 reflected by the inspection target portion 65 enters the lens 57 and is reflected by the mirror 61 to the light guide member 60 side. Then, the reflected light 63 is guided to the spectroscope 42 of the diagnosis / control apparatus 4 through the light guide member 60.

  Next, a general method of using the forceps tip 11b when performing endoscopic submucosal dissection (ESD) will be described with reference to FIG. For example, as shown in FIG. 5A, the lesioned part 66 can be twisted in the direction of the arrow while holding the lesioned part 66 with the forceps tip part 11b. Further, as shown in FIG. 5 (b), a high frequency current is supplied to the conductive members 53 a and 53 b of the movable claw portion 51 and the fixed claw portion 50 while holding the lesioned portion 66 with the distal end portion of the forceps 11. Thus, the living tissue of the lesioned part 66 can be excised. This excision is performed, for example, when the lesioned part 66 is considerably large and is divided into a plurality and recovered outside the body cavity.

  Further, as shown in FIG. 5 (c), while holding the lesioned part 66 in a state where the cautery teeth 52a and 52b of the movable claw part 51 and the fixed claw part 50 are stood up, By supplying a high frequency current to the conductive members 53a and 53b, the lesioned part 66 can be peeled from the mucous membrane 67 in the body cavity. Further, as shown in FIG. 5D, a high-frequency current is applied to the conductive members 53a and 53b of the movable claw portion 51 and the fixed claw portion 50 while pinching the marking portion around the lesioned portion 66 at the distal end portion of the forceps 11. By supplying, a plurality of marks 68 indicating the range to be excised can be provided.

  As described above in detail, in the first embodiment, the forceps 11 has a pair of claw parts (movable claw part 51 and fixed claw part) that are formed in a squeeze shape that opens and closes the living tissue of the lesioned part 64 so as to be graspable. 50) and an acquisition unit (lens 57, light guide member 60, and mirror 61) that is provided in an inner portion of the pair of claws and obtains biological information of the biological tissue grasped by the claws. Cauterized teeth 52a and 52b for cauterizing the living tissue of the lesioned part 64 are formed on the inner portions of the pair of claws. The cautery teeth 52a and 52b are formed in a sawtooth shape, and conductive members 53a and 53b capable of supplying a high-frequency current are provided on the tooth tips. Further, the acquisition unit includes a lens 57 that emits the inspection light toward the living tissue of the lesioned part 64 and that reflects the reflected light reflected by the living tissue out of the emitted inspection light. Obtained as biometric information.

  According to the first embodiment configured as described above, the operation of excising the lesioned part 64 can be continuously performed with only one forceps 11 while specifying the range of the lesioned part 64 at a plurality of locations. . That is, since the living tissue is inspected after grasping the lesioned part 64, if it can be determined that it is not necessary to excise the grasped living tissue, it is appropriate to grasp and examine another living tissue. Since the lesioned part can be excised, it is not necessary to bother to replace the forceps 11 and labor and time can be reduced. Furthermore, while grasping the lesioned part 64 with the distal end of the forceps 11, an operation for specifying the range of the lesioned part 64 and an operation for excising the lesioned part 64 can be performed simultaneously. Therefore, no positional deviation occurs between the range of the lesioned part 64 specified by the optical inspection and the range of the lesioned part 64 to be excised, and the lesioned part 64 can be excised at the correct position.

  In the first embodiment, the example in which the lens 57 is provided at the tip of the inner portion of the fixed claw 50 has been described, but the present invention is not limited to this. For example, the lens 57 may be provided at the center portion or the hand portion (near the connection portion with the movable claw portion 51) of the inner portion of the fixed claw portion 50.

  In the first embodiment, the example in which the lens 57, the light guide member 60, and the mirror 61 are provided in the fixed claw portion 50 has been described. However, the present invention is not limited to this. For example, the lens 57, the light guide member 60, and the mirror 61 may be provided on the movable claw portion 51. Further, the lens 57, the light guide member 60, and the mirror 61 may be provided on both the fixed claw portion 50 and the movable claw portion 51. In this case, in the state where the lesioned part 64 is grasped by the distal end part of the forceps 11, it is possible to diagnose the presence / absence and type of the lesion on the rear surface as well as the front surface of the site to be examined of the lesioned part 64.

  Moreover, although the said 1st Embodiment demonstrated the example in which the lens 57 was provided in the inner site | part of the fixed nail | claw part 50, this invention is not limited to this. For example, two or more lenses 57 may be provided on the inner portion of the fixed claw portion 50. In this case, the presence / absence and type of a lesion can be diagnosed simultaneously for a plurality of examination target portions of the lesion 64 while the lesion 64 is gripped by the distal end portion of the forceps 11.

  In the first embodiment, the example in which the lens 57 functions as the emitting portion and the incident portion of the present invention has been described. However, the present invention is not limited to this. For example, two lenses may be provided so that each lens functions as an emission part and an incident part.

  In the first embodiment, energization of the high-frequency current to the conductive members 53a and 53b of the forceps 11 may be controlled according to the diagnosis result by the CPU 43. In this case, the diagnosis / control apparatus 4 performs energization control of the high-frequency current according to the flowchart shown in FIG. In the energization control process shown in FIG. 6, an instruction to execute the process for inspecting the examination target region 65 is given to the input device 5 in a state where the lesion part 64 in the body cavity is gripped by the movable claw part 51 and the fixed claw part 50 of the forceps 11. Start by being entered.

  First, the laser 41 of the diagnosis / control apparatus 4 emits laser light 62 (step S100). Laser light 62 emitted from the laser 41 is emitted from the lens 57 of the fixed nail 50 to the examination target region 65 of the lesion 64. The reflected light 63 reflected by the examination target portion 65 is guided to the spectroscope 42 of the diagnosis / control device 4.

  Next, the spectroscope 42 performs spectrum analysis on the reflected light 63 (step S120). Next, the CPU 43 diagnoses the presence or absence of a lesion in the examination target region 65 based on the spectrum analysis result by the spectroscope 42 (step S140).

  If the examination target region 65 has a lesion (that is, positive) and is diagnosed by the CPU 43 (YES in step S160), the diagnosis / control device 4 ends the energization control process in FIG.

  On the other hand, when the CPU 43 diagnoses that there is no lesion (that is, negative) in the examination target region 65 (NO in step S160), there is no uncut portion of the lesion 64 even if the examination target site 65 is excised. In order to estimate, the energization control part 44 starts supply of the high frequency current with respect to the forceps 11 (step S180). Thereafter, the diagnosis / control apparatus 4 ends the energization control process in FIG.

  In the case where the range of the lesioned part 64 is specified and the lesioned part 64 is excised by the energization control process shown in FIG. 6, after the user inputs an instruction to execute the process for inspecting the examination target region 65, It is possible to reduce the trouble of inputting an execution instruction for output processing.

  As described above, in the first embodiment, the description has been given of obtaining the reflected light 63 reflected by the examination target portion 65 out of the laser light 62 emitted from the lens 57 as the biological information of the lesioned part 64.

(Second Embodiment)
In the second embodiment, a description will be given of acquiring transmitted light that has passed through a region to be inspected, as laser information emitted from a lens, as biological information of a lesion. Since the configuration other than the tip of the forceps 11 is the same as that of the first embodiment, the description thereof is omitted.

  The configuration of the forceps tip portion 11b in the second embodiment will be described with reference to FIGS. FIG. 7 is an enlarged view of the forceps tip portion 11b, and shows a state where the movable claw portion 70 and the movable claw portion 71 are opened by approximately 90 °. The movable claw part 70 and the movable claw part 71 are a pair of claw parts formed in a stagnation shape that opens and closes a living tissue of a lesioned part so as to be graspable.

  A wire 72 is connected to the proximal end portion of the movable claw portion 70 and the proximal end portion of the movable claw portion 71. When the user moves the wire 72 in the X direction via a handle-side operation mechanism (not shown) having the forceps 11, the movable claw portion 70 and the movable claw portion 71 are rotated in the closing direction. On the other hand, when the wire 72 is moved in the direction opposite to the X direction, the movable claw portion 70 and the movable claw portion 71 are rotated in the opening direction. More detailed opening / closing mechanisms of the movable claw portion 70 and the movable claw portion 71 will be described later.

  A plurality of cautery teeth 73a for cauterizing the living tissue are formed on the inner portion of the movable claw portion 70. Of the surface of the movable claw portion 70, the surfaces other than the surface of the cautery tooth 73a are covered with insulation. In the present embodiment, the cautery tooth 73a is formed in a sawtooth shape, and a conductive member 74a capable of supplying a high-frequency current is provided at the tooth tip.

  Similar to the movable claw portion 70, a plurality of cautery teeth 73 b for cauterizing the living tissue are formed on the inner portion of the movable claw portion 71. Of the surface of the movable claw portion 71, the surfaces other than the surface of the cautery teeth 73b are covered with insulation. In the present embodiment, the cautery tooth 73b is formed in a sawtooth shape, and a conductive member 74b capable of passing a high-frequency current is provided at the tooth tip.

  As shown in FIG. 8, inside the movable claw portion 70, a lead wire (plus side) 80a for supplying a high frequency current from the energization control portion 44 of the diagnosis / control apparatus 4 shown in FIG. 1 to the conductive member 74a. And the conducting wire (minus side) 80b is formed. Further, inside the movable claw portion 71, a conducting wire (plus side) 80c and a conducting wire (minus side) 80d for supplying a high frequency current from the energization control unit 44 to the conductive member 74b are formed.

  The energization control unit 44 of the diagnosis / control device 4 starts supplying high-frequency current to the conductive members 74 a and 74 b when an instruction to execute high-frequency current output processing is input to the input device 5. On the other hand, the energization control unit 44 ends the supply of the high-frequency current to the conductive members 74 a and 74 b when the instruction to stop the output process of the high-frequency current is input to the input device 5.

  A lens 75a that functions as an emitting part that emits laser light toward a living tissue is provided at a position (tip part) at a sufficient creepage distance from the cautery tooth 73a in the inner portion of the movable claw part 70. . In addition, in the inner portion of the movable claw portion 71, the transmitted light that has passed through the living tissue out of the laser light emitted from the lens 75a is incident on a position (tip portion) that has a sufficient creepage distance from the cautery tooth 73b. A lens 75b that functions as an incident portion is provided.

  As shown in FIG. 8, a light guide member 76 a and a mirror 77 a are provided inside the movable claw portion 70. In the present embodiment, the light guide member 76a is an optical fiber that guides the laser beam 78 emitted by the laser 41 of the diagnosis / control apparatus 4 to the mirror 77a. The mirror 77a reflects the laser beam 78 guided from the light guide member 76a toward the lens 75a. The lens 75a emits the laser beam 78 reflected by the mirror 77a toward a living tissue (not shown).

  Inside the movable claw portion 71, a light guide member 76b and a mirror 77b are provided. The mirror 77b reflects the transmitted light 79 transmitted through the living tissue and incident on the lens 75b toward the light guide member 76b. In the present embodiment, the light guide member 76 b is an optical fiber that guides the transmitted light 79 reflected by the mirror 77 b to the spectroscope 42 of the diagnosis / control apparatus 4. The lenses 75a and 75b, the light guide members 76a and 76b, and the mirrors 77a and 77b function as an acquisition unit of the present invention.

  Next, the opening / closing mechanism of the distal end portion of the forceps 11 will be described with reference to FIG. As shown in FIG. 9A, the movable claw portion 70 and the movable claw portion 71 are centered on a central axis provided at a position retracted from the distal end of the movable claw portion 70 and the movable claw portion 71 to the proximal end side. It is pivotally connected. Specifically, the movable claw portion 70 and the movable claw portion 71 are connected by a stopper 82 that penetrates both in the lateral direction.

  FIG. 9B is a front sectional view of the movable claw portion 70 and the movable claw portion 71. FIG. 9C is a front sectional view of the movable claw portion 71. FIG. 9D is a front sectional view of the movable claw portion 70. As shown in FIGS. 9B and 9C, the movable claw portion 70 and the movable claw portion 71 are formed with stopper holes 83a and 83b for inserting the stopper 82, respectively. Then, as shown in FIG. 9B, after combining the movable claw portion 70 and the movable claw portion 71, the movable claw portion 70 and the movable claw are inserted by inserting the stopper 82 into the stopper holes 83a and 83b. The parts 71 can be connected.

  Next, an operation of acquiring transmitted light as biological information by the distal end portion of the forceps 11 will be described. FIG. 10A shows a state in which the movable claw portion 70 and the movable claw portion 71 are open to each other, that is, a state before the lesioned portion 85 in the body cavity is gripped by the movable claw portion 70 and the movable claw portion 71. FIGS. 10B and 10C show a state where the movable claw portion 70 and the movable claw portion 71 are closed with each other, that is, a state where the lesioned portion 85 in the body cavity is gripped by the movable claw portion 70 and the movable claw portion 71. Yes.

  As shown in FIG. 10 (c), in the state where the lesioned part 85 in the body cavity is grasped, when the execution instruction for the process of inspecting the inspection target region 86 is input to the input device 5, the laser 41 emits the laser beam 78. Emits light. The laser beam 78 is guided to the mirror 77a by the light guide member 76a. The laser beam 78 guided to the mirror 77a is reflected to the lens 75a side and is emitted from the lens 75a to the inspection target portion 86. Next, the transmitted light 79 that has passed through the inspection target part 86 enters the lens 75b and is reflected by the mirror 77b toward the light guide member 76b. Then, the transmitted light 79 is guided to the spectroscope 42 of the diagnosis / control apparatus 4 through the light guide member 76b.

  The spectroscope 42 performs spectrum analysis on the transmitted light 79 guided by the forceps 11. The CPU 43 diagnoses not only the presence / absence and type of lesions on the front and back surfaces of the examination target part 86 in the body cavity, but also the tomographic structure of the examination target part 86 based on the spectrum analysis result by the spectroscope 42.

  As described above in detail, in the second embodiment, the forceps 11 is a pair of claw portions (movable claw portion 70 and movable claw portion) that are formed in a squeeze shape that opens and closes the living tissue of the lesioned portion 85 so as to be graspable. 71) and an acquisition unit (lens 75a, 75b, light guide members 76a, 76b, and mirrors 77a, 77b) that is provided in an inner part of the pair of nail parts and acquires biological information of a living tissue grasped by the nail parts. With. Ablation teeth 73a and 73b for cauterizing the living tissue of the lesioned part 85 are formed on the inner portions of the pair of claws. The cautery teeth 73a and 73b are formed in a sawtooth shape, and conductive members 74a and 74b capable of passing a high-frequency current are provided at the tooth tips.

  According to the second embodiment configured as described above, it is possible to continuously perform the operation of excising the lesioned portion 85 with only one forceps 11 while specifying the range of the lesioned portion 85 at a plurality of locations. . Therefore, it is not necessary to bother to replace the forceps 11, and labor and time can be reduced. Furthermore, while gripping the lesioned part 85 with the distal end portion of the forceps 11, an operation of specifying the range of the lesioned part 85 and an operation of excising the lesioned part 85 can be performed simultaneously. Therefore, no positional deviation occurs between the range of the lesioned part 85 specified by the optical inspection and the range of the lesioned part 85 to be excised, and the lesioned part 85 can be excised at the correct position.

  In the second embodiment, a lens 75a that emits laser light 78 as inspection light toward the living tissue, and transmitted light 79 that has passed through the living tissue out of the laser light 78 emitted from the lens 75a is incident. And the transmitted light 79 is acquired as biological information. According to this, by performing spectrum analysis on the transmitted light 79, not only the presence / absence and type of lesions on the front and back surfaces of the inspection target part 86 in the body cavity, but also the tomographic structure of the inspection target part 86 is diagnosed. be able to. The depth of the lesion can be determined by diagnosing the tomographic structure.

  In the second embodiment, the example in which the lens 75a is provided at the tip of the inner portion of the movable claw 70 has been described, but the present invention is not limited to this. For example, the lens 75a may be provided at the central portion or the hand portion (near the connecting portion with the movable claw portion 71) of the inner portion of the movable claw portion 70. Moreover, although the example in which the lens 75b is provided at the tip of the inner portion of the movable claw 71 has been described, the present invention is not limited to this. For example, the lens 75b may be provided at the central portion or the hand portion (near the connecting portion with the movable claw portion 70) of the inner portion of the movable claw portion 71. In short, in a state where the movable claw portion 70 and the movable claw portion 71 are closed, the lens 75a and the lens 75b do not necessarily have to be provided at positions facing each other, and the lesioned portion 85 of the laser light 78 emitted from the lens 75a is removed. It is only necessary that the transmitted transmitted light 79 can be incident on the lens 75b.

  In the second embodiment, the example in which one lens 75a as the emitting portion is provided in the inner portion of the movable claw portion 70 has been described. However, the present invention is not limited to this. For example, two or more lenses may be provided on the inner portion of the movable claw portion 70. In addition, although an example in which one lens 75b as an incident portion is provided in the inner portion of the movable claw portion 71, the present invention is not limited to this. For example, two or more lenses may be provided on the inner portion of the movable claw portion 71. In this case, the presence / absence or type of a lesion and the tomographic structure can be diagnosed simultaneously for a plurality of examination target parts of the lesioned part 85 in a state where the lesioned part 85 is grasped by the distal end portion of the forceps 11.

  In the second embodiment, as described in the first embodiment, the energization of the high-frequency current to the conductive members 74a and 74b of the forceps 11 is controlled according to the diagnosis result by the CPU 43. Anyway.

  In the first and second embodiments, a laser is used as the diagnostic light source. However, various light sources such as LEDs, xenon, and halogens may be used.

  Moreover, although the said 1st and 2nd embodiment demonstrated the example in which the cautery teeth 52a, 52b, 73a, 73b were formed in sawtooth shape, this invention is not limited to this. In short, any shape can be used as long as it can grasp the living tissue of the lesion.

  In the first and second embodiments, an example in which conductive members 53a, 53b, 74a, and 74b capable of supplying a high-frequency current are provided on the tooth tips of the cautery teeth 52a, 52b, 73a, and 73b will be described. However, the present invention is not limited to this. In short, it is only necessary that the tooth tips of the cautery teeth 52a, 52b, 73a, 73b be provided with means for cauterizing the living tissue.

  In the first and second embodiments, the example in which the biological information of the lesions 64 and 85 is optically described has been described. However, the present invention is not limited to this. For example, the biological information of the lesioned part 64 may be electrically acquired by generating ultrasound in the lesioned parts 64 and 85, receiving the reflected ultrasound and processing it as image data. By detecting the electrical resistance (bioimpedance) of the lesioned parts 64 and 85, the biological information of the lesioned parts 64 and 85 may be acquired electrically. Moreover, you may acquire the hardness or temperature of the lesioned parts 64 and 85 as biometric information using a pressure sensor or a temperature sensor.

  Moreover, although the said 1st and 2nd embodiment demonstrated the example which uses the forceps 11 in order to excise the lesion part specified by specifying the range of a lesion part, this invention is not limited to this. For example, the forceps 11 is not limited to the medical field, and may be used for other purposes such as finding a victim during a disaster.

  In addition, each of the first and second embodiments described above is merely an example of a specific example for carrying out the present invention, and the technical scope of the present invention is interpreted in a limited manner. It must not be. That is, the present invention can be implemented in various forms without departing from the gist or the main features thereof.

DESCRIPTION OF SYMBOLS 1 Endoscope system 2 Endoscope main body 3 Endoscope apparatus 4 Diagnosis / control apparatus 5, 6 Input device 7, 8 Monitor 11 Forceps 11a Forceps base end part 11b Forceps tip part 21 Introduction part 21a Base end part 21b Tip part 21c Operation possible part 22 Operation part 22a Knob 23 Cable 31 Illumination light source 32 Image processing part 33, 43 CPU
41 laser 42 spectroscope 44 energization control unit 45 storage device 50 fixed claw unit 51, 70, 71 movable claw unit 52a, 52b, 73a, 73b cauterized tooth 53a, 53b, 74a, 74b conductive member 54, 82 stopper 55, 72 wires 56a, 80a, 80c Conductor (positive side)
56b, 80b, 80d Conductor (minus side)
57, 75a, 75b Lens 60, 76a, 76b Light guide member 61, 77a, 77b Mirror 62, 78 Laser light 63 Reflected light 64, 66, 85 Lesions 65, 86 Examination site 67 Mucosa 68 Mark 79 Transmitted light 83a, 83b Stopper hole CA Camera LG Light guide CH Forceps channel

Claims (8)

A pair of nail parts formed in a stagnation shape that opens and closes the living tissue of the lesioned part,
An acquisition unit that is provided in an inner part of the pair of nail portions and acquires biological information of the living tissue in a state of being gripped by the nail portions;
With forceps.   The forceps according to claim 1, wherein a cautery tooth for cauterizing the living tissue is formed in an inner portion of the pair of claws.   The forceps according to claim 2, wherein the cautery tooth is formed in a sawtooth shape, and a conductive member capable of passing a high-frequency current is provided on the tooth tip. The acquisition unit
An emission part that is provided at one inner part of the nail part and emits inspection light toward the living tissue;
Provided on one inner portion of the nail part, and includes an incident part for incident reflected light reflected by the living tissue out of the inspection light emitted from the emitting part,
The forceps according to any one of claims 1 to 3, wherein the reflected light incident on the incident portion is acquired as the biological information. The acquisition unit
An emission part that is provided at one inner part of the nail part and emits inspection light toward the living tissue;
An incident portion that is provided in the other inner portion of the nail portion, and that enters the transmitted light that has passed through the living tissue out of the inspection light emitted from the emission portion;
The forceps according to any one of claims 1 to 3, wherein the transmitted light incident on the incident portion is acquired as the biological information. A forceps according to claim 3;
An energization control unit that controls energization of a high-frequency current supplied to the conductive member;
A diagnostic unit for diagnosing the biological information acquired by the acquisition unit;
An output unit for outputting a diagnosis result by the diagnosis unit;
Diagnostic assistance system with   The diagnosis assisting system according to claim 6, wherein the energization control unit controls energization of a high-frequency current to the conductive member according to a diagnosis result by the diagnosis unit. An endoscope body in which the forceps and the imaging device according to any one of claims 1 to 5 are attached to a distal end portion;
An endoscope apparatus for processing a video signal of the living tissue imaged by the imaging element;
Endoscope system equipped with.

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