JP2014094273A - Endoscope hood, endoscope, pressure sensor for endoscope and tissue size measurement method - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an endoscope hood capable of directly measuring pressure in a lumen of the gastrointestinal tract and the abdominal cavity, a pressure sensor for endoscopes suited for measuring the pressure in the lumen of the gastrointestinal tract and the abdominal cavity, and an endoscope including the pressure sensor for endoscopes.SOLUTION: An endoscope hood 1 to be mounted on a distal end of a shaft S of an endoscope comprises: a cylindrical body part 2, axial both end of which are opened; and a pressure sensor mounted on the body part 2. When the body part 2 is mounted on the distal end of the shaft S, the body part 2, along with the shaft S, can be inserted into the lumen of the gastrointestinal tract or the like such that the pressure sensor 5 can be disposed in the lumen of the gastrointestinal tract or the like. Thereby, the pressure in the lumen of the gastrointestinal tract or the like can be directly measured by the pressure sensor. Consequently, on the basis of the pressure in the lumen of the gastrointestinal tract or the like measured by the pressure sensor 5, an amount of carbon dioxide gas to be supplied inside the lumen of the gastrointestinal tract or the like is adjusted so as to prevent an excessive air supply state.

Description

  The present invention relates to an endoscope hood, an endoscope, an endoscope pressure sensor, and a tissue size measuring method.

  In recent years, many examinations and treatments using an oral endoscope (so-called stomach or colon camera, hereinafter referred to as a flexible endoscope) have been performed. In such examination / treatment, a flexible endoscope is inserted into the stomach or large intestine from the mouth or the like, and the inner surface of the stomach or large intestine is confirmed by a camera provided at the distal end of the flexible endoscope.

  However, since the stomach and large intestine are usually in a state where the inner walls overlap each other, if the flexible endoscope is covered by this inner wall, the field of view of the flexible endoscope and the surgical field for performing the procedure disappear, and the stomach It is difficult to observe the inside of the large intestine and to treat it. For this reason, during examination and treatment with a flexible endoscope, carbon dioxide gas is supplied from the suction / air supply port provided in the flexible endoscope, and is expanded into the stomach or large intestine, so that the flexible endoscope Securing the field of view and surgical field of the mirror is being carried out. Specifically, the endoscopist performing the examination and treatment presses the suction / air supply button on the left hand operation part of the flexible endoscope (stomach camera), so that the carbon dioxide gas supplied to the stomach and large intestine The amount of insufflation and the amount of gas sucked from the stomach and large intestine are adjusted. The stomach and large intestine are inflated and contracted so that they are in a state suitable for examination and treatment.

  The endoscopist adjusts the amount of air supply and suction while observing the state of the stomach and large intestine, but by concentrating on the examination and treatment, he pushes the air supply button too much and enters the patient's stomach. May cause over-feeding. When such over-feeding occurs, an abnormal increase in pressure in the stomach or large intestine occurs, which may cause excessive abdominal bloating or abdominal pain, placing a burden on the patient.

  In particular, endoscopic treatment / surgery using an electric knife such as NOTES (transluminal endoscopic surgery) and ESD (endoscopic submucosal dissection) is a long-term treatment / surgery that takes several hours. In addition, since the endoscopist concentrates on excision of the lesion, excessive air feeding into the stomach is likely to occur. In some cases, mucosal hemorrhage or gastric cardia (entrance) rupture due to over-feeding may occur.

  On the other hand, in surgery using a laparoscope (rigid endoscope), carbon dioxide gas is supplied into the abdominal cavity in order to secure a visual field and a surgical field. In such laparoscopic surgery, apart from instruments such as laparoscopes for confirming the surgical field and forceps for excision, etc., dedicated to supplying carbon dioxide gas into the abdominal cavity and sucking gas from the abdominal cavity Has a pneumoperitoneal needle.

  The pneumoperitoneum is connected to the pneumoperitoneum, and maintains the pressure in the abdominal cavity at a constant pressure by supplying air from the pneumoperitoneum or sucking intraperitoneal gas by the pneumoperitoneum. Specifically, a sensor for measuring the pressure of carbon dioxide gas supplied to the pneumoperitoneum is provided in the pneumoperitoneum, and the pressure in the abdominal cavity is adjusted based on the signal of this sensor. Therefore (see Patent Document 1), the problem of over-feeding is unlikely to occur in laparoscopic surgery.

  Therefore, it can be considered that there is a possibility that the problem of excessive air supply may be prevented if the insufflation apparatus is used for control of air supply and suction in the flexible endoscope.

JP-A-7-327920

  However, the pneumoperitoneum as described above is a technique for determining the pressure in the abdominal cavity from the pressure in the flow path by providing a sensor in the flow path for supplying carbon dioxide gas to the pneumoperitoneum needle. Since this insufflation apparatus measures the pressure including the pressure loss of the flow path, the measured pressure does not necessarily match the pressure in the abdominal cavity. For example, when the pressure is determined without considering the pressure loss, the pressure in the abdominal cavity may be estimated higher than the actual pressure. On the other hand, when the pressure is determined in consideration of the pressure loss, if the pressure loss becomes larger than the assumed value, a situation occurs in which the pressure in the abdominal cavity is estimated lower than the actual pressure. And in the latter case, it becomes a cause which produces over-feeding.

  For laparoscopic surgery, use a pneumoperitoneum provided separately from the laparoscope. For this reason, the size of the insufflation needle, that is, the cross-sectional area of the flow path and the length of the flow path can be freely adjusted to some extent. In other words, the cross-sectional area of the flow path can be increased or the flow path can be shortened to some extent. If the cross-sectional area of the flow path is increased or the flow path is shortened, the pressure loss of the flow path can be reduced. If the pressure loss of the flow path is reduced, the difference between the estimated pressure and the actual intra-abdominal pressure can be reduced even if the pressure in the flow path of the pneumoperitoneum is measured to estimate the pressure in the abdominal cavity. Therefore, in the case of surgery using a laparoscope, the pressure in the abdominal cavity can be accurately grasped to some extent by using an insufflation apparatus.

  On the other hand, in the case of a flexible endoscope, a flow path for supplying and sucking air is provided in the endoscope itself, so it is substantially impossible to adjust the cross-sectional area and the flow path length of the flow path. Is possible. That is, since it is practically impossible to reduce the pressure loss by adjusting the cross-sectional area of the flow channel or the flow channel length, it is very difficult to accurately estimate the pressure loss of the flow channel. Therefore, it is difficult to grasp the internal pressure of the stomach, etc., even if the pneumothorax device used for laparoscopes is used for air supply and inspiration of flexible endoscopes, preventing problems such as overfeeding It ’s difficult. In reality, the effect of pressure loss in the flow path provided in the flexible endoscope is too great, and it is difficult to estimate the pressure in the digestive tract and the abdominal cavity with the pneumo-abdominal device used in the laparoscope, An insufflation device used for a laparoscope cannot be used for insufflation and intake of a flexible endoscope.

In view of the above circumstances, the present invention provides an endoscope hood that can directly measure the pressure in the digestive tract cavity and the abdominal cavity, an endoscope, an endoscope that can perform pressure measurement even when attached to an endoscope hood, and an endoscope. An object is to provide a pressure sensor for a mirror.
It is another object of the present invention to provide a tissue size measuring method for accurately measuring the size of a tissue using the endoscope hood or endoscope.

(Endoscopic hood)
An endoscope hood of the first invention is an endoscope hood attached to the distal end of an endoscope, and has a cylindrical main body having both ends opened in the axial direction, and a pressure sensor attached to the main body. It is characterized by comprising.
The endoscope hood of the second invention is characterized in that, in the first invention, the pressure sensor is configured such that a sensor part for detecting pressure is formed by a MEMS sensor.
An endoscope hood of a third invention is characterized in that, in the first or second invention, the pressure sensor includes a light reflecting layer that reflects light on a surface thereof.
An endoscope hood according to a fourth invention is characterized in that, in the first, second or third invention, the main body part is provided with a signal transmission part for wirelessly transmitting a signal of the pressure sensor to the outside.
An endoscope hood according to a fifth aspect of the present invention is the first, second, third, or fourth aspect, wherein the main body portion is provided with a housing recess that is recessed from the inner surface and that accommodates the pressure sensor. The accommodation recess has a depth equal to or greater than the thickness of the pressure sensor.
(Pressure sensor for endoscope)
An endoscope pressure sensor according to a sixth aspect of the invention is a sensor for detecting an atmospheric pressure attached to an endoscope and / or an endoscope hood, and the pressure detection unit in the sensor is a MEMS sensor. .
The endoscope pressure sensor according to a seventh aspect is characterized in that, in the sixth aspect, the surface of the pressure detection portion of the sensor includes a light reflection layer.
The endoscope hood of the eighth invention is characterized in that, in the sixth or seventh invention, the main body part is provided with a signal transmission part for wirelessly transmitting the signal of the pressure sensor to the outside.
(Endoscope)
The endoscope of the ninth invention is characterized in that a pressure sensor for detecting an atmospheric pressure in a digestive tract cavity or the like is provided on a distal end surface and / or a side surface of a shaft.
An endoscope pressure sensor according to a tenth aspect of the present invention is the endoscope pressure sensor according to the sixth, seventh or eighth aspect, according to the ninth aspect.
(Tissue size measurement method)
The tissue size measuring method of the eleventh aspect of the invention is a method for measuring the size of the tissue existing on the inner surface of the pre-gastrointestinal lumen, etc., and supplying gas into the gastrointestinal lumen etc. while measuring the pressure in the gastrointestinal lumen etc. Then, the gastrointestinal tract is inflated, and the size of the tissue is measured in a state where the inside of the gastrointestinal tract cavity or the like is at a predetermined pressure or higher.
The tissue size measurement method of the twelfth invention is the same as that of the eleventh invention, in which the gastrointestinal tract is inflated by supplying gas from the endoscope into the digestive tract cavity and the like through the forceps port of the endoscope. The size of the tissue is measured by a measuring instrument inserted into the.
The tissue size measuring method of the thirteenth invention is characterized in that, in the eleventh or twelfth invention, marking is performed at a plurality of locations on a tissue in a digestive tract cavity or the like.
The tissue size measuring method of the fourteenth invention is the endoscope hood according to any one of the eleventh to fifth inventions and / or the endoscope of the ninth or tenth invention according to the eleventh, twelfth or thirteenth invention. The pressure in the digestive tract cavity or the like is measured by a pressure sensor provided in the device.
The tissue size measurement method of the fifteenth aspect of the invention is characterized in that, in the eleventh, twelfth, thirteenth or fourteenth aspect of the invention, the predetermined pressure is a pressure which becomes an inflection point of an extension curve of a digestive tract cavity or the like. To do.

According to the first invention, when the main body is attached to the distal end of the endoscope shaft, the main body is mounted together with the endoscope shaft in the digestive tract cavity or the abdominal cavity (hereinafter referred to as the digestive tract cavity or the like). Since it can be inserted, the pressure sensor can be arranged in the digestive tract cavity or the like. Then, the pressure in the digestive tract cavity or the like can be directly measured by the pressure sensor. Therefore, based on the pressure in the digestive tract cavity etc. measured by the pressure sensor, the amount of carbon dioxide gas supplied into the digestive tract cavity etc. and the amount of gas sucked from inside the digestive tract cavity etc. are adjusted automatically or manually. If it does, it can prevent becoming the state of over-feeding.
According to the second invention, since the sensor portion of the pressure sensor is formed by the MEMS sensor, the pressure sensor can be reduced in size and thickness. Then, even if the pressure sensor is provided on the inner surface of the main body, it is possible to prevent the field of view of the endoscope from being narrowed by the pressure sensor. In addition, even if a force that bends or presses against the inner surface of the digestive tract cavity is applied to the main body, the effect on the pressure measurement of the sensor can be reduced, so the pressure in the digestive tract cavity can be measured more accurately. can do.
According to the third aspect of the invention, the light radiated from the light source of the endoscope can be reflected by the light reflecting layer, so that the temperature of the pressure sensor rises due to the light or an error current is generated due to the photoelectric effect of the semiconductor. Can be prevented. Therefore, measurement errors caused by light emitted from the light source of the endoscope can be suppressed.
According to the fourth invention, since the signal of the pressure sensor is wirelessly transmitted to the outside from the signal transmission unit, the main body unit can be attached to the endoscope only by performing the same operation as in the case of using a conventionally used hood. It can be attached to and detached from the shaft. In addition, since there is no need to arrange a conducting wire or the like on the side surface of the shaft of the endoscope, the same operability as when a conventional hood is attached can be maintained.
According to the fifth invention, if the pressure sensor is arranged in the housing recess, the amount of the pressure sensor protruding from the inner surface of the main body can be reduced, so that the field of view of the endoscope can be kept wide even if the pressure sensor is provided, Interference between the forceps and the pressure sensor can be prevented. Moreover, since the sensor portion is provided on the inner surface of the main body, it is possible to prevent erroneous detection of pressure even if the pressure sensor contacts the inner surface of the digestive tract cavity or the like. In addition, it is possible to prevent the pressure sensor from becoming an obstacle when the endoscope shaft with the main body portion is inserted into a digestive tract cavity or the like.
(Pressure sensor for endoscope)
According to the sixth aspect, since the pressure detection unit is formed by the MEMS sensor, the pressure sensor can be very miniaturized. Then, even if the pressure sensor is attached to the endoscope hood, it does not disturb the observation and treatment by the endoscope. The endoscope shaft has a forceps port, a camera, a light source, etc. disposed in a narrow area on the distal end surface, and the extra space is small, but the pressure sensor is very small, so the distal end surface of the endoscope shaft Also, it becomes possible to attach a pressure sensor. In addition, the endoscope shaft can be bent, but the pressure sensor is very small, so even if the pressure sensor is attached to the side of the endoscope shaft, Does not become the resistance.
According to the seventh aspect, since the light emitted from the light source of the endoscope is reflected by the light reflecting layer, even if the pressure sensor is provided at the position where the light source of the endoscope hits, the light is emitted from the light source of the endoscope. Therefore, it is possible to prevent the temperature of the pressure sensor from rising due to the light that is generated and the generation of an error current due to the photoelectric effect of the semiconductor. Therefore, even if it is attached to a hood or the like, it is possible to suppress occurrence of measurement errors due to light emitted from the light source of the endoscope.
According to the eighth invention, since the signal of the pressure sensor is wirelessly transmitted to the outside from the signal transmission unit, it is not necessary to arrange a conducting wire or the like on the side surface of the shaft of the endoscope. Therefore, the operability of the endoscope can be maintained even if the pressure sensor is attached to the hood or the shaft of the endoscope.
(Endoscope)
According to the ninth aspect, since the pressure sensor is provided on the front end surface and / or the side surface of the shaft, the pressure sensor is disposed in the digestive tract cavity or the like when the shaft is inserted into the digestive tract cavity or the like. Can do. Then, the pressure in the digestive tract cavity or the like can be directly measured by the pressure sensor. Therefore, if the amount of carbon dioxide gas supplied into the digestive tract cavity or the like or the amount of gas sucked from the digestive tract cavity or the like is adjusted based on the pressure in the digestive tract cavity or the like measured by the pressure sensor, It is possible to prevent a state of over-feeding.
According to the tenth aspect of the invention, since the pressure detection unit is formed by the MEMS sensor, it does not obstruct observation and treatment by the endoscope, and the operability of the shaft does not deteriorate. Further, if a light reflecting layer is provided on the surface of the pressure sensor, measurement errors due to light emitted from the light source of the endoscope can be suppressed. Furthermore, if a signal transmission part is provided, the signal of the pressure sensor is wirelessly transmitted to the outside, so that there is no need to arrange a conducting wire or the like on the side surface of the shaft, so that the operability of the endoscope can be maintained.
(Tissue size measurement method)
According to the eleventh invention, the size of the tissue is measured in a state where the digestive tract is inflated and the inside of the digestive tract cavity or the like is at a predetermined pressure or higher. Then, since the pressure can be measured in a state where the digestive tract is extended, the size of the tissue can be accurately measured. Moreover, since the gas is supplied into the digestive tract cavity or the like while measuring the pressure in the digestive tract cavity or the like, the amount of gas supply can be accurately adjusted. Accordingly, it is possible to prevent a problem caused by over-feeding air from occurring while the digestive tract is inflated and the size of the tissue is measured.
According to the twelfth aspect, since the size of the tissue can be measured while observing the tissue with an endoscope, the size of the tissue can be accurately measured. In addition, gas can be supplied into the digestive tract cavity or the like by the endoscope, and the measurement instrument can be inserted into the digestive tract cavity or the like through the forceps opening of the endoscope, so that measurement can be performed with minimal invasiveness.
According to the thirteenth invention, if the distance between the markings is measured in a state where the inside of the digestive tract cavity is equal to or higher than a predetermined pressure, the excised tissue is removed from the digestive tract cavity and the like even after the tissue is excised. Can be reproduced in the state of measuring the size.
According to the fourteenth aspect, since the pressure in the digestive tract cavity or the like can be directly measured by the pressure sensor, the reproducibility of the measurement can be improved.
According to the fifteenth aspect, the tissue size can be measured with the inner surface of the gastrointestinal tract extending, so that the measurement accuracy and reproducibility of the measurement can be improved.

It is a schematic explanatory drawing of the state which attached endoscope hood 1 of a 1st embodiment to the tip of shaft S, (A) is a perspective view and (B) is a side view. BRIEF DESCRIPTION OF THE DRAWINGS It is a schematic explanatory drawing of the state which attached the endoscope hood 1 of 1st Embodiment to the front-end | tip of the shaft S, (A) is a top view, (B) is a front view, (C) is ( It is CC sectional view taken on the line of B). It is the figure which showed an example of the sensor part 20 of the pressure sensor 5. FIG. It is a schematic explanatory drawing of the state which attached the endoscope hood 1 of 2nd Embodiment to the front-end | tip of the shaft S, (A) is a perspective view, (B) is a side view. It is a schematic explanatory drawing of the state which attached the endoscope hood 1 of 2nd Embodiment to the front-end | tip of the shaft S, (A) is a top view, (B) is a front view, (C) is ( It is CC sectional view taken on the line of B). It is a schematic explanatory drawing of the state which attached the endoscope hood 1 of 3rd Embodiment to the front-end | tip of the shaft S, (A) is a perspective view, (B) is a side view. It is a schematic explanatory drawing of the state which attached the endoscope hood 1 of 4th Embodiment to the front-end | tip of the shaft S, (A) is a perspective view, (B) is a side view. (A) is a photograph of the experimental status of the example, and (B) is the experimental result of the example.

Next, an embodiment of the present invention will be described with reference to the drawings.
The endoscope hood of the present invention is an instrument used in an operation using a flexible endoscope (for example, transluminal endoscopic surgery (hereinafter referred to as NOTES)) or an inspection using a flexible endoscope. It is characterized in that the pressure in the space where the distal end of the flexible endoscope is arranged can be measured.

  The space in which the distal end of the flexible endoscope is arranged is, for example, a space in the digestive tract cavity such as the stomach or the large intestine or in the abdominal cavity. Hereinafter, the space in the digestive tract cavity and the space in the abdominal cavity are collectively referred to as a space in the digestive tract cavity or the like.

  The endoscope hood of the present invention is mainly used by being attached to a flexible endoscope, but can also be used by being attached to the tip of a rigid endoscope (laparoscope).

(Flexible endoscope)
First, before describing the endoscope hood of the present invention, the shape of the flexible endoscope to which the endoscope hood of the present invention is attached will be briefly described.
The flexible endoscope includes a shaft S that is inserted into a digestive tract of a living body, an operation unit (not shown) that operates the shaft S, a portion that is connected to a light source body that supplies light to the tip of the shaft S, and the like. . The diameter of the shaft S of this flexible endoscope is about 5 to 15 mm, and about 10 mm for a general flexible endoscope.

The flexible endoscope shaft S (hereinafter simply referred to as the shaft S) is supplied with carbon dioxide gas into the forceps port, which is a through-hole penetrating in the axial direction, or inside the digestive tract cavity or the like. A suction / air supply port for exhausting gas from the space and a camera for photographing the front end of the shaft S are provided.
The suction / air supply port communicates with the air supply / discharge device at the proximal end of the shaft S. The exhaust / exhaust device switches the suction / air supply port between the air supply mechanism that supplies carbon dioxide gas and the exhaust mechanism that is equipped with a device such as a vacuum pump via a switching valve. , A device that can communicate with either one.
When the endoscopist operates the suction / air supply button of the operation unit of the flexible endoscope, the air supply mechanism and the exhaust mechanism can be switched and connected to the suction / air supply port.

For this reason, if the endoscopist operates the suction / air supply button on the operation part of the left hand of the flexible endoscope to adjust the air supply / suction, the gastrointestinal tract cavity such as the stomach and the large intestine is appropriately inflated or contracted. You can make it. Then, if the gastrointestinal tract cavity or the like is appropriately inflated, the inner surface of the gastrointestinal tract cavity or the like is extended to some extent, so that the inner surface of the gastrointestinal tract cavity or the like can be easily observed. In addition, a space in which the shaft S can be moved or an instrument such as forceps disposed in the digestive tract cavity or the like can be operated through the forceps opening can be formed in the digestive tract cavity. It becomes easier to perform surgery.
Conversely, if the gastrointestinal tract cavity is appropriately contracted, the distance between the flexible endoscope and the inner surface of the gastrointestinal tract cavity can be adjusted, and the digestive tract cavity etc. can be easily excised with a knife or the like. You can also.

(About endoscope hood 1)
As shown in FIG. 1, an endoscope hood 1 according to this embodiment is used by being attached to the tip of a shaft S, and includes a main body 2, a pressure sensor 5, and the pressure sensor 5 and an external measuring device. And a conductive wire 10 that electrically connects the two.

First, the main body 2 is a member whose basic structure is substantially equivalent to a commercially available endoscope hood.
Specifically, as shown in FIGS. 1 and 2, the main body 2 is a substantially cylindrical member that is hollow and open at both ends. The main body 2 has a structure that can be fixed to the distal end of the shaft S by inserting the distal end of the shaft S from one end thereof (the right end in FIGS. 1 and 2, hereinafter referred to as a base end). The main body 2 is formed so that the outside can be photographed from the front end opening of the main body 2 by the camera at the front end of the shaft S in a state where the base end of the main body 2 is fixed to the front end of the shaft S. Yes.
In addition, the raw material equivalent to the commercially available food | hood for endoscopes can also be used for the raw material of the main-body part 2. FIG. For example, a rubber material such as polyvinyl chloride or silicone rubber can be used as the material of the main body 2.

  As shown in FIG. 2, a pressure sensor 5 is attached to the inner surface of the main body 2. The pressure sensor 5 is disposed at a position that does not interfere with the shaft S when the main body portion 2 is attached to the distal end of the shaft S, and is located inward from the distal end of the endoscope to some extent (FIG. 2 ( C)). For example, specifically, it is attached so that it may be about 1-2 mm from the front-end | tip surface of the shaft S in the state which attached 1-2 mm from the front-end | tip of the main-body part 2, and the main-body part 2 was attached to the front-end | tip of the shaft S.

  In addition, a housing recess 2s that is recessed from the inner surface is formed on the inner surface of the main body portion 2, and the pressure sensor 5 is housed in the housing recess 2s.

  Further, one end of a conducting wire 10 is connected to the pressure sensor 5. This conducting wire 10 is for electrically connecting the pressure sensor 5 to an external control device or the like. The external control device to which the conducting wire 10 is connected receives, for example, a power supply function for supplying power to the pressure sensor 5 and an electric signal transmitted from the pressure sensor 5 and calculates a pressure based on the electric signal. A device having a pressure detection function.

The conducting wire 10 is not particularly limited as long as the pressure sensor 5 can be electrically connected to an external control device. However, the conducting wire 10 is attached along the shaft S and connected to the control device. Since the shaft S bends its main body and adjusts the position of the tip, the conducting wire 10 needs to have a degree of flexibility that does not interfere with the movement of the shaft S such as bending.
Moreover, when the conducting wire 10 is thick, the outer diameter of the shaft S with the conducting wire 10 attached becomes thick and the handling property deteriorates, such as being difficult to insert into the digestive tract cavity or the like. Therefore, the outer diameter of the conducting wire 10 is preferably about 0.02 to 0.2 mm, and more preferably 0.02 to 0.05 mm.

  As the conducting wire 10 having such an outer diameter and flexibility, for example, an enameled wire can be adopted. If it is an enameled wire, the outer diameter can be set to about 0.02 to 0.2 mm, and it is flexible enough to follow the bending of the shaft S. That is, if an enameled wire is used as the conducting wire 10, the wire diameter of the conducting wire 10 can be made very thin, and the operability of the shaft S can be prevented from being lowered due to the presence of the conducting wire 10.

  As described above, if the endoscope hood 1 of the present embodiment is used, the main body 2 is attached together with the shaft S by attaching the main body 2 to the tip of the shaft S and inserting the shaft S into the digestive tract cavity or the like. Can be inserted. Then, since the pressure sensor 5 provided on the inner surface of the main body 2 can also be arranged inside the digestive tract cavity or the like, the pressure sensor 5 can directly measure the pressure in the digestive tract cavity or the like. .

  Therefore, if the amount of carbon dioxide gas supplied into the gastrointestinal tract cavity or the like is adjusted based on the pressure in the gastrointestinal tract cavity or the like measured by the pressure sensor 5, a state of over-feeding air is brought about. Can be prevented.

  For example, an indicator for displaying the pressure in the digestive tract cavity or the like measured by the pressure sensor 5 is provided in the control device electrically connected to the pressure sensor 5 described above. Then, by confirming the indicator, the endoscopist can grasp the internal pressure of the digestive tract cavity and the like, and can appropriately adjust the internal pressure of the digestive tract cavity.

  In addition, if the control device emits a warning sound such as a buzzer when a predetermined pressure is detected, even if the endoscopist forgets to concentrate on the examination or surgery and check the indicator, it will You can notice that.

  Furthermore, if the sending / exhausting device automatically supplies and exhausts air based on the pressure signal from the control device, the pressure in the digestive tract cavity and the like can be maintained within a certain range, resulting in an over-feeding state. Can be prevented. Then, the endoscopist does not have to worry about being in an over-delivery state, and can concentrate on the examination and the surgery.

  Moreover, since the pressure sensor 5 is provided in the inner surface of the main-body part 2 as mentioned above, it can prevent that the pressure sensor 5 contacts the inner surfaces, such as a digestive tract cavity. Then, it is possible to prevent erroneous detection of pressure due to contact with the digestive tract cavity or the like.

  In addition, when the shaft S with the endoscope hood 1 of the present embodiment is inserted into the digestive tract cavity or the like, the surface of the main body 2 can be in the same state as a normal hood. Providing the sensor 5 can also prevent problems such as the difficulty of performing operations such as inserting the shaft S.

  Here, a problem is how to handle the lead wire 10 that connects the pressure sensor 5 and an external control device. However, a method of wiring the lead wire 10 at the boundary between the main body 2 and the outer surface of the shaft S is as follows. There is no particular limitation.

  However, if the shaft 10 is arranged so that the axial direction of the conducting wire 10 is substantially parallel to the axial direction of the distal end of the shaft S at the base end of the main body 2, the force applied to the conducting wire 10 even if the shaft S is moved or bent. Can be made as small as possible. Then, when operating the shaft S, the possibility that the conducting wire 10 is disconnected can be reduced.

  Moreover, although the conducting wire 10 needs to be wired over the outer surface of the shaft S, since the pressure sensor 5 is provided on the inner surface of the main body 2, the conducting wire 10 comes out from the inner surface of the main body 2. It must later be placed on the outer surface of the shaft S. That is, in order for the conducting wire 10 to run over the outer surface of the shaft S, the conducting wire 10 must be taken out from the inner surface of the main body 2, but the method is not particularly limited.

  For example, as shown in FIGS. 4 to 6, a through hole 2 t that communicates with the outer surface is formed, inserted through the through hole 2 t, and taken out of the main body portion 2, and then along the outer surface of the main body portion 2. Then, it may be arranged so as to run over the outer surface of the shaft S.

  As shown in FIG. 2, a conductor housing groove 2 g that continues from the housing recess 2 s to the base end of the body 2 may be formed on the inner surface of the body 2. In this case, if the conducting wire 10 is accommodated in the conducting wire accommodation groove 2 g, the conducting wire 10 is not exposed to the space in the main body 2 or the surface of the main body 2. Then, it can prevent that the conducting wire 10 contacts with inner surfaces, such as a digestive tract cavity, and forceps, and becomes obstructive for treatment.

  In particular, as shown in FIG. 2, it is preferable to provide the conductor housing groove 2g so that the axial direction of the main body 2 is parallel to the axial direction of the conductor housing groove 2g. Then, if the conducting wire 10 is accommodated in the conducting wire accommodation groove 2g, the axial direction of the conducting wire 10 is set to the distal end of the shaft S at the proximal end of the body portion 2 only by attaching the proximal end of the body portion 2 to the distal end of the shaft S. It can be made substantially parallel to the axial direction.

(Signal transmitter 6)
In the above example, the case where the signal of the pressure sensor 2 is transmitted to the outside by the conducting wire has been described. However, the signal transmitter 6 may be provided so that the signal of the pressure sensor 2 can be transmitted wirelessly. In this case, since it is not necessary to wire a conductor on the side surface of the shaft S, the endoscope hood 1 of this embodiment is attached to and detached from the tip of the shaft S in the same operation as the case of using a commonly used hood. can do. That is, the attaching / detaching operation of the endoscope hood 1 of the present embodiment can be performed quickly and easily. And since there is no conducting wire in the side surface of the shaft S, even if the endoscope hood 1 of this embodiment is attached, the operability equivalent to the case where the conventional hood is attached can be maintained.

  For example, as shown in FIG. 7, a signal transmitter 6 connected to the pressure sensor 5 attached to the main body 2 by wiring or the like is provided in the main body 2. That is, like the pressure sensor 5, the signal transmission unit 6 is provided in the main body 2 by being embedded in the inner surface of the main body 2 or in the main body 2. The control device is provided with a reception function for receiving a signal from the signal transmission unit 6. Then, based on the signal transmitted from the signal transmission unit 6 (that is, the measurement result of the pressure sensor 5), the control device operates an indicator that constantly displays the pressure in the digestive tract cavity or the like, It is also possible to automatically supply and discharge air to and from the exhaust device so that the inside of the inside is at a predetermined pressure.

  Of course, the signal transmission unit 6 may be provided on the same substrate as the pressure sensor 5, and in this case, the apparatus including the pressure sensor 5 and the signal transmission unit 6 can be further downsized.

  Moreover, the structure of the signal transmission part 6 and the method of signal transmission are not specifically limited. For example, a known ultra-small wireless module, a wireless device employed in a capsule endoscope, or the like can be used as the signal transmission unit 6.

(About the pressure sensor 5)
In the pressure sensor 5, the structure and mechanism of the sensor unit 20 that detects pressure is not particularly limited, but the sensor unit 20 is preferably formed of a MEMS sensor.

MEMS is an abbreviation for Micro Electro Mechanical Systems, and is a microelectromechanical element having a micron-level structure in which mechanical parts and electronic circuits are integrated, and its creation technology.
A MEMS sensor is a sensor formed by this MEMS technology (a technology for creating a microelectromechanical element). However, as long as an equivalent size and necessary pressure sensitivity are realized, its manufacturing method and The material is not limited to existing technology.
In this specification, “the sensor part of the pressure sensor 5 is formed of a MEMS sensor” means that the sensor part 20 of the pressure sensor 5 is formed in a structure capable of measuring pressure by MEMS technology. doing.

  Various structures can be adopted as the structure of the sensor unit 20, that is, the structure formed by the MEMS technology so that the pressure can be measured. For example, the following structure can be adopted.

  As shown in FIG. 3, the sensor unit 20 of the pressure sensor 5 includes a measuring unit 21 having a cylindrical hole 21h. In the hole 21h of the measurement part 21, a film-like part 22 that divides the hole 21h is provided. That is, the hole 21 h of the measurement part 21 is divided by the film-like part 22 into a measurement hole 21 a that is recessed from the front side of the measurement part 21 and a reference hole 21 b that is recessed from the back side of the measurement part 21.

As shown in FIG. 3, the opening on the surface side of the measurement unit 21 is open, and the measurement hole 21a communicates with the outside (in FIG. 3, the internal space of the main body 2).
On the other hand, a base plate 23 which is, for example, a glass plate is provided on the back surface of the measurement unit 21, and the opening on the back surface side of the measurement unit 21 is closed by the base plate 23. In other words, the reference hole 21b is a hermetically sealed space by the base plate 23. There is no particular limitation on the pressure inside the reference hole 21b in the state of being sealed by the base plate 23, but it is normally at atmospheric pressure.

  The film-like portion 22 has such a strength (thickness) as to be deformed and distorted when a pressure difference (hereinafter simply referred to as a pressure difference) occurs between the pressure in the measurement hole 21a and the pressure in the reference hole 21b. Is formed. That is, the film-like part 22 is formed so as to function as a diaphragm.

For example, when the film-shaped part 22 is formed of silicon, the film-shaped part 22 has a thickness of about several μm to several tens of μm and an area of about 0.785 mm ² (that is, the inner diameter of the hole 21h is about 0.5 mm). To do. In this case, if the pressure difference is about 13 Pa (about 0.1 mmHg) or more, the film-like portion 22 can be bent, and a pressure difference of about 13 to 13 kPa (100 mmHg) can be measured.

  In addition, the film-like portion 22 is provided with a strain detection element. This strain detection element is an element formed of a semiconductor material such as a piezoresistive element, and can detect the bending of the film-like portion 22. For example, since the electric resistance of the piezoresistive element changes due to the bending of the film-like portion 22, if the change in the electric resistance is detected as a voltage change, the bending of the film-like portion 22 is calculated based on this voltage change. can do.

  This strain detection element is connected to the conducting wire 10 of the endoscope hood 1 of the present embodiment. And it connects with the apparatus (measuring instrument mentioned above) which detects the change of the electrical resistance of a strain detection element through the conducting wire 10.

  Since the pressure sensor 5 is configured as described above, the pressure in the stomach can be measured by the sensor unit 20 when the endoscope hood 1 of the present embodiment including the pressure sensor 5 is placed in the stomach. That is, if the pressure in the stomach deviates from the atmospheric pressure, the membranous portion 22 is bent due to the atmospheric pressure difference. Then, since the electrical resistance of the strain detection element changes in accordance with the amount of deflection of the membranous portion 22, the measuring instrument can calculate the pressure in the stomach based on the change in electrical resistance.

(Manufacturing method of the sensor part 20)
When the sensor unit 20 of the pressure sensor 5 is manufactured by the MEMS technology, various methods can be adopted. For example, the sensor unit 20 can be manufactured as follows.

First, an impurity that becomes a strain gauge is diffused in semiconductor silicon, and a pattern such as a metal thin film that becomes a wiring is formed to form a strain gauge circuit that becomes a sensor circuit.
Next, a part of the semiconductor silicon is selectively thinned in order to form a portion that becomes a diaphragm that responds to pressure.
After that, if an airtight chamber for setting a reference pressure is provided and sealed with a reference pressure (for example, atmospheric pressure), the sensor unit 20 of the pressure sensor 5 can be formed.

  In the above example, the case where the reference hole 21b is sealed by the base plate 23 has been described. However, if the inside of the reference hole 21b can be hermetically sealed from the outside, the base plate 23 is not necessarily provided. Good. For example, the reference hole 21 b may be hermetically sealed by bringing the opening on the back surface side of the measurement unit 21 into close contact with the inner surface of the main body 2.

  Further, the thickness and area of the film-like portion 22 are not limited to the above-described thickness and area. What is necessary is just to set suitably according to the range which measures the pressure with the raw material of the film-shaped part 22, or the pressure sensor 5. FIG. Of course, the material of the film-like portion 22 is not limited to silicon, and various materials can be adopted.

  As described above, the strain detection element for detecting the deflection of the film-like portion 22 is formed on the surface of the film-like portion 22, but the method for forming such a strain detection element is not particularly limited. If a known fine processing technique is used, a strain detecting element can be formed on the surface of the film-like portion 22.

  As described above, when the endoscope hood 1 of the present embodiment has the conducting wire 10, the strain detection element is connected to the conducting wire 10, but the endoscope hood 1 of the present embodiment provides the signal transmission unit 6. If so, it is connected to a circuit or the like provided with the signal transmission unit 6. Specifically, the strain detection element is connected to a circuit or the like having a power supply and a control unit, and the circuit detects the change in resistance of the strain detection element as a voltage change. In the case of such a configuration, information (measurement information) on the detected voltage change is transmitted to the outside by the signal transmission unit 6, but detection of voltage change, formation of measurement information, and measurement to the outside by the signal transmission unit 6 Transmission of information is controlled by a control unit of the circuit.

  Needless to say, the structure of the sensor unit 20 is not limited to the above structure, and any structure can be adopted as long as the pressure of the gas can be measured. In the above-described example, the cylindrical hole 21h has the measurement hole 21a. However, the cylindrical hole 21h in the sensor unit 20 of the membrane pressure sensor 5 may have a shape that does not have the measurement hole 21a. That is, the surface of the film-like portion 22 may be exposed. However, if the structure having the measurement hole 21a is used, the wall surface forming the measurement hole 21a functions as a member that protects the membranous portion 22, so that the membranous portion 22 can be damaged by contact with tissue in the stomach. Can be lowered.

  In the above-described example, the case where the strain gauge circuit is used as the pressure detection method using the sensor is described. However, the pressure detection method using the sensor is not limited to the method using the strain gauge circuit. For example, it is possible to adopt a capacitance type pressure sensor system in which a fixed electrode having a minute gap is formed facing the diaphragm and a change in capacitance between the movable electrode formed on the diaphragm is read.

(Light reflecting layer)
By the way, the endoscope is provided with a light that irradiates light from the light source on the end surface of the shaft S in order to ensure brightness for imaging the stomach. When the light from this light is applied to the pressure sensor 5, the temperature of each part of the pressure sensor 5 (especially, the film-like part 22 of the sensor part 20 and its surrounding fixed part) may rise due to the energy of the light. There is sex. When the temperature of each part of the pressure sensor 5 rises, the signal transmitted even with the same differential pressure difference may change, resulting in a measurement error.

  In order to prevent the occurrence of measurement errors due to the light from the light, it is preferable to form a light reflection layer 25 on the surface of the pressure sensor 5 (see FIG. 3). If such a light reflecting layer 25 is provided, light from the light is reflected by the light reflecting layer 25, and the sensor unit 20 of the pressure sensor 5 does not absorb light energy. Then, since the temperature rise of each part of the pressure sensor 5 can be prevented, it is possible to suppress the occurrence of a measurement error due to the temperature rise or the occurrence of an error current due to the semiconductor photoelectric effect.

  Although the material which forms this light reflection layer 25 is not specifically limited, For example, chromium etc. can be used. Further, the method for forming the light reflecting layer 25 is not particularly limited. For example, the light reflection layer 25 may be formed when the sensor unit 20 of the pressure sensor 5 is manufactured using the MEMS technology, or the manufactured pressure sensor 5 is later formed by a method such as metal deposition. The light reflecting layer 25 may also be formed by coating chromium or the like.

(Size of sensor unit 20)
When the sensor unit 20 is formed by a MEMS sensor, the entire size of the pressure sensor 5 can be formed to be about 0.5 to 1.5 mm in length and about 0.8 to 2.0 mm in width. With such a size, the pressure sensor 5 is sufficiently smaller than the diameter of the main body 2 and the length of the main body 2 in the axial direction. Then, when the outer surface or the like of the main body 2 is brought into contact with the inner surface of the digestive tract cavity or the like, it can be deformed with the same degree of flexibility as a commercially available hood.

  In the case where the sensor unit 20 is a pressure sensor 5 formed of a MEMS sensor, the total thickness including the substrate is about 0.2 to 1.0 mm, preferably about 0.2 to 0.5 mm. It can be. Then, even when the pressure sensor 5 is directly attached to the inner surface of the main body 2 without providing the housing recess 2s as described above on the inner surface of the main body 2, the amount of protrusion from the inner surface of the main body 2 is at most 0.5 mm. It is suppressed to the extent. Then, even if the pressure sensor 5 is provided, it is possible to prevent the field of view of the endoscope from being narrowed.

  On the other hand, in the case of the pressure sensor 5 having a thickness of about 0.2 to 0.5 mm, if the depth of the housing recess 2 s is the same as the thickness of the pressure sensor 5, the amount of protrusion from the inner surface of the main body 2 is almost the same. There can be no state. For example, even if the thickness of the main body 2 is about 0.5 to 1.5 mm, it is possible to obtain a state in which there is almost no protrusion from the inner surface of the main body 2.

(Mounting position of pressure sensor 5)
Furthermore, in the case of a MEMS sensor, pressure is not detected unless a force is directly applied to the pressure detection portion. For example, the pressure sensor 5 is arranged so that the part for detecting the pressure of the MEMS sensor faces the hollow space 2 h side of the main body 2. In this case, even if the outer surface or the like of the main body 2 comes into contact with the inner surface of the digestive tract cavity or the like and a bending or pressing force is applied to the main body 2, the bending or pressing force hardly affects the detected pressure. The endoscope hood is usually moved along the inner surface of the digestive tract cavity or the like, or is pressed against the inner surface of the digestive tract cavity or the like. When the pressure sensor 5 adopting the pressure sensor 5 is used and the pressure sensor 5 is attached to the inner surface of the main body 2, the pressure of the space in the main body 2, that is, the internal pressure of the digestive tract cavity or the like should be measured accurately. Can do.

  Further, when the pressure sensor 5 is attached to the inner surface of the main body 2, there are advantages as described above, but the pressure sensor 5 may be attached to the outer surface of the main body 2. In this case, the pressure sensor 5 may come into contact with the inner surface of the digestive tract cavity or the like, and there is a possibility that the pressure cannot be measured in that state, but the light of the light does not directly hit the sensor unit 20 of the pressure sensor 5. Measurement errors due to light energy are less likely to occur. Of course, the pressure sensor 5 may be provided on both the inner surface and the outer surface of the main body 2, or the pressure sensor 5 may be provided on the tip of the main body 2.

  Further, the number of pressure sensors 5 attached to the main body 2 is not particularly limited. For example, a plurality of pressure sensors 5 may be provided side by side along the circumferential direction of the outer surface or inner surface of the main body 2. In this case, even if some of the pressure sensors 5 come into contact with the inner surface or tissue such as in the digestive tract cavity or the like, or blood or gastric juice enters the hole 21h and cannot measure the pressure, the other pressure sensors 5 Pressure measurement can be continued.

  When a plurality of pressure sensors 5 are provided, the difference in sensitivity between the pressure sensors 5 can be adjusted using the measurement value of each pressure sensor 5, so that the pressure in the digestive tract cavity or the like can be adjusted. The accuracy of the measured values can be increased. Further, when one pressure sensor 5 is completely covered with mucus or a foreign substance and the sensor sensitivity is lowered, it is possible to detect an abnormality in the sensor operation. For this reason, more reliable pressure measurement can be implemented by constantly comparing the sensor outputs.

(Material of pressure sensor 5)
Since gastric acid and the like exist in the digestive tract cavity and the like, the pressure sensor 5 needs to be formed so as not to be damaged by the gastric acid and the like. For example, the entire pressure sensor 5 is formed of a material having acid resistance. Then, even if stomach acid or the like comes into contact with the pressure sensor 5, damage to the pressure sensor 5 can be prevented, so that it is possible to prevent problems such as a decrease in pressure measurement accuracy and inability to measure.

  For example, in the case of the sensor unit 20 in the pressure sensor 5 described above, if the material is silicon, silicon oxide, acid-resistant glass or the like, and the light reflection layer 25 is also formed of a material having acid resistance, gastric acid or the like can be obtained. Even if it contacts, it can prevent that the sensor part 20 is damaged. For example, if the sensor unit 20 is formed using an SOI (Silicon On Insulator) substrate and a chromium layer having acid resistance is formed on the surface of the sensor unit 20 to form the light reflecting layer 25, the entire pressure sensor 5 is formed. Can have acid resistance.

  Further, when a part or the whole of the pressure sensor 5 is made of a material damaged by stomach acid or the like, the part formed by the material damaged by stomach acid or the like or the whole of the pressure sensor 5 has acid resistance. The material may be coated or coated. For example, the entire pressure sensor 5 may be subjected to a treatment such as using a structure that protects parts other than the diaphragm portion from gastric acid using silicone that is not harmful to the human body. In addition, hydrochloric acid, the main component of stomach acid, does not dissolve semiconductor silicon or chromium in a short time, so if the diaphragm is formed of semiconductor silicon and coated with chromium, the movable diaphragm portion is exposed. Can protect the diaphragm from gastric acid damage without problems

(Cover 2c)
Further, if the pressure sensor 5 is protected from stomach acid or the like, a cover 2c may be provided.
For example, as shown in FIG. 2, a cover 2c made of a flexible resin or the like is provided on the inner surface of the main body 2 so as to cover the pressure sensor 5 housed in the housing recess 2s. In this case, since the pressure sensor 5 can be prevented from coming into contact with stomach acid or the like by the cover 2c, damage to the pressure sensor 5 due to stomach acid or the like can be prevented.

  When the cover 2c is provided, the distance from the surface of the cover 2c to the inner surface of the main body 2, that is, the amount of protrusion from the inner surface of the main body 2 is about 0 to 0.2 mm. Is desirable. With this amount of protrusion, even when the main body 2 is attached to the tip of the shaft S, the field of view can be maintained wide, and the cover 2c can be prevented from interfering with forceps.

  Of course, even when the pressure sensor 5 is provided on the outer surface of the main body 2, the cover 2 c may be provided so as to cover the pressure sensor 5. Also in this case, damage to the pressure sensor 5 due to stomach acid or the like can be prevented.

  In the case of providing the cover 2c, it is necessary to use a material having flexibility that does not hinder the application of pressure to the pressure sensor 5 in addition to acid resistance and the like as the material of the cover 2c. That is, the pressure applied to the pressure sensor 5 without the cover 2c needs to be flexible enough to be applied to the pressure sensor 5 in a situation where there is little decrease due to the cover 2c.

(Endoscope)
As described above, the pressure sensor 5 may be attached to the endoscope hood 1 of the present embodiment, but may be directly attached to the shaft S of the endoscope. In this case, if the pressure sensor 5 is connected to a lead wire or the like wired in the shaft S of the endoscope, power is supplied to the pressure sensor 5 or a signal detected by the pressure sensor 5 is transmitted to the outside through this lead wire. can do. And it becomes unnecessary to provide the conducting wire 10 in the pressure sensor 5, and it becomes unnecessary to arrange | position a conducting wire etc. on the surface of the shaft S of an endoscope. Then, even if the pressure sensor 5 is provided on the shaft S, the same operability as when the pressure sensor 5 is not provided can be maintained. And if the pressure sensor 5 provided with the signal transmission part 6 mentioned above is used, even if the pressure sensor 5 is attached to the shaft S of the existing endoscope later, the conducting wire 10 etc. do not need to be attached to the shaft S. Therefore, it is preferable. Of course, the pressure sensor 5 having the conductive wire 10 may be used as a pressure sensor to be attached to the shaft S of an existing endoscope later. Even in this case, if the flexible thin conducting wire 10 as described above is used and the conducting wire 10 is arranged along the shaft S, the same operability as when the pressure sensor 5 is not provided can be maintained. it can.

  Further, the position and number of the pressure sensor 5 attached to the endoscope shaft S are not particularly limited. For example, you may provide the pressure sensor 5 in the end surface and side surface of the shaft S of an endoscope.

  When the pressure sensor 5 is provided on the side surface of the shaft S of the endoscope, the pressure sensor 5 may be provided side by side along the axial direction or the circumferential direction of the shaft S. If the pressure sensor 5 is provided along the axial direction of the shaft S, a difference in pressure depending on the position in the digestive tract cavity or the like can be confirmed. Further, if the pressure sensors 5 are provided along the circumferential direction of the shaft S, even if some of the pressure sensors 5 cannot contact the inner surface of the digestive tract cavity or the like to measure the pressure, the other pressure sensors 5 Pressure measurement can be continued.

  When a plurality of pressure sensors 5 are provided, the sensitivity difference of each pressure sensor 5 can be adjusted using the measurement value of each pressure sensor 5, so that the accuracy of the measured pressure value can be increased. Can be increased. Further, when one pressure sensor 5 is completely covered with mucus or a foreign substance and the sensor sensitivity is lowered, it is possible to detect an abnormality in the sensor operation. For this reason, more reliable pressure measurement can be implemented by constantly comparing the sensor outputs.

(Tissue size measurement method)
As described above, when the endoscope hood 1 or the endoscope according to the present embodiment including the pressure sensor 5 is used, the size of the tissue (for example, a tumor) on the inner surface such as the digestive tract cavity as described below is reduced. It becomes possible to measure accurately.

  In the diagnosis of the tissue on the inner surface such as in the digestive tract cavity, the size (width, length, etc.) of the tissue is an important element for diagnosing the state of the tissue in addition to the appearance of the tissue.

  Currently, the size of the tissue on the inner surface of the digestive tract cavity or the like is measured using a forceps or a paper measure. The measure forceps are stamped or printed with marks indicating scales of various dimensions such as a ruler at the tip. For this reason, the size of the tissue can be measured through the camera of the endoscope if the distal end portion of the measure forceps is applied to the tissue or placed near the tissue. The paper measure has scales of various dimensions printed on its surface. If it is attached in the vicinity of the tissue, the size of the tissue can be measured through the endoscope camera.

  However, the inside of the digestive tract cavity and the like can be expanded and contracted and may have a large number of pleats. Then, even if the size of the tissue is measured with a measure forceps or the like, the size of the tissue changes depending on the extension state in the digestive tract cavity or the like and the state of the inner folds in the digestive tract cavity or the like. For example, it is natural that the size of the tissue to be measured changes depending on whether or not tension is applied to the inside of the digestive tract cavity or the like. Even if the tension applied to the lumen or the like differs, the size of the tissue to be measured changes. This means that the tissue size may change with each measurement.

  If tension is applied so that the inside of the digestive tract cavity and the like is extended and the tension is made the same, the size of the tissue can be measured almost every time under the same conditions. If only tension is applied so that the inside of the digestive tract cavity and the like extends, this can be realized by supplying carbon dioxide gas from the endoscope or the like to the inside of the digestive tract cavity or the like. The tension applied to the inside of the digestive tract cavity and the like is related to the atmospheric pressure inside the digestive tract cavity, etc. If the internal pressure inside the digestive tract cavity etc. can be measured, It is considered that the size of the tissue can be measured under the same conditions of tension applied to the etc. In other words, if the pressure inside the digestive tract cavity or the like can be measured, the size of the tissue can be measured under the same conditions almost every time.

  However, until now, it was not possible to directly measure the pressure inside the gastrointestinal tract cavity, etc., so the inside of the gastrointestinal tract cavity etc. when the carbon dioxide gas was supplied to inflate the gastrointestinal tract cavity etc. It was never assumed that the measurement conditions were the same based on the internal atmospheric pressure. On the contrary, we are not even aware that the measurement conditions change due to the atmospheric pressure inside the digestive tract cavity, etc., and of course, the size of the tissue to be measured changes due to this change in the measurement conditions. It was not considered at all.

  The inventors of the present invention have first conceived that the size of a tissue to be measured changes due to a change in measurement conditions caused by an internal air pressure such as in the digestive tract cavity. Since the internal pressure of the gastrointestinal tract and the like can be measured by the endoscope hood 1 and endoscope of the present embodiment, the tissue size measuring method of the present invention has been completed. is there.

Hereinafter, the tissue size measuring method of the present invention will be described.
In addition, below, the case where the endoscope hood 1 of this embodiment is attached to the tip of the shaft S and the size of the tissue on the stomach inner surface is measured will be described as a representative.

  First, an extension status checker such as a paper measure is attached to the inner surface of the stomach wall so that the extension status of the stomach wall can be checked. Next, the endoscope shaft S to which the endoscope hood 1 of the present embodiment is attached is inserted into the stomach.

  And if the front-end | tip of the shaft S is arrange | positioned in a stomach, a carbon dioxide gas will be supplied in a stomach from an air supply port. Then, the atrophied stomach swells, and the gastric pressure value (hereinafter referred to as the gastric pressure measurement value) measured by the pressure sensor 5 of the endoscope hood 1 also increases.

  If the supply of carbon dioxide gas is continued even after the stomach swells, the pressure applied to the stomach increases, and tension is applied to the stomach to stretch the stomach wall. And tension | tensile_strength increases so that a stomach wall may be extended, and a gastric pressure measurement value also increases. At this time, the extension state of the stomach wall is simultaneously recorded based on the extension state confirmation tool. Specifically, measure the linear distance of a predetermined position (for example, between edges if a paper measure) of the extension status confirmation tool with a measure forceps, and use this measurement value (distance measurement value) as a gastric pressure measurement value. Record with.

  Furthermore, if the supply of carbon dioxide gas is continued, the stomach wall can no longer extend. When the situation in which the stomach wall can no longer be extended is confirmed by the extension status confirmation tool, the gastric pressure measurement value at that time is recorded as the limit pressure value together with the distance measurement value. Then, when the limit pressure value is recorded, the gas is once sucked from the stomach to atrophied the stomach.

  And the fluctuation graph which shows the relationship between the gastric pressure measurement value and distance measurement value after arrange | positioning the front-end | tip of the shaft S in the stomach and starting air supply to a limit pressure value is created. For example, a fluctuation graph (elongation curve) is created with the horizontal axis representing the pressure measurement value and the vertical axis representing the distance measurement value. Then, the pressure at the inflection point of the extension curve (inflection point pressure) is obtained, and a pressure slightly higher than the obtained inflection point pressure is set as the measurement reference pressure.

  The measurement reference pressure only needs to be higher than the inflection point pressure. However, in the extension curve, the pressure at which the extension curve is almost flat (that is, the stomach wall does not progress even if the pressure is increased) is the measurement reference pressure. It is preferable that This is because in such a state, it is considered that the stomach wall is stretched in a state where it does not stretch, and it is considered that no error in size measurement occurs.

  When the measurement reference pressure is determined, carbon dioxide gas is supplied again into the stomach, and when the gastric pressure measurement value reaches the measurement reference pressure, the supply of carbon dioxide gas is stopped.

In this state, by inserting a measuring forceps from the forceps opening of the endoscope, it is possible to measure a tissue (that is, a stomach wall) in a fully extended state (a state without sagging or wrinkles).
If the measured gastric pressure becomes the measurement reference pressure, the state of the stomach wall becomes almost the same every time, so that the tissue can be measured almost the same every time. That is, the reproducibility of tissue measurement can be increased. Then, when observing a time-series change in the size of the tissue, it is possible to appropriately grasp the change in the size of the tissue, and the diagnosis of the tissue can be performed accurately.

(marking)
Here, when measuring the tissue size of the stomach inner surface, it is desirable to mark a plurality of locations on the stomach inner surface and measure the distance between the marked locations. If such marking is performed, when the tissue is excised and removed from the stomach wall, the same state as the state in which the size in the stomach is measured can be reproduced outside the body. In other words, in the excised tissue, if the distance between the marked locations is matched with the distance between the marked locations measured in the stomach, the same tension is applied to the tissue as the tissue size is measured in the stomach. Can be added. Then, even the excised tissue (in other words, outside the body) can be reproduced in the same state as that in the stomach when the size of the tissue is measured.

  For example, the universal and objective tumor diameter in the stomach (that is, the tumor diameter when the stomach wall is extended) is measured, and the photograph is directly pasted on the pathological specimen. Then, relying on the marked part and pasting the excised specimen as shown in the picture, the same state as in the stomach can be reproduced. If the same state as that in the stomach can be reproduced, pathological evaluation can be performed in the same state as the tumor diameter and tumor form in the living body. Such pathological results are very important in order to influence a patient's treatment policy and life prognosis.

  Note that the marking on the tissue or the like may be performed in a state where the stomach wall or the like is extended, or may be performed in a state where the stomach wall or the like is atrophied.

(Method other than endoscope)
The tissue size measuring method of the present invention should be adopted if the gastrointestinal tract can be inflated by supplying gas into the gastrointestinal tract while measuring the pressure in the gastrointestinal tract. Can do.

  For example, after providing a dedicated port for supplying gas to the inside of the digestive tract cavity or the like, or providing a dedicated port for measuring the internal pressure of the digestive tract cavity or the like, the tissue size measuring method of the present invention Tissue size may be measured by That is, tissue size measurement can be performed by the tissue size measurement method of the present invention without using the endoscope hood 1 or the endoscope of the present embodiment.

  However, if the tissue size measuring method of the present invention is performed using the endoscope hood 1 or the endoscope of the present embodiment, gas can be supplied into the digestive tract cavity or the like by the endoscope, and the endoscope Measuring forceps can be inserted into the digestive tract cavity or the like through the forceps port. That is, since the surface of the living body is not damaged, measurement can be performed with minimal invasiveness.

  It was confirmed that pressure measurement in the stomach can be performed by the endoscope hood of the present invention.

  In the experiment, an endoscope hood with a pressure sensor attached was attached to the tip of the endoscope shaft, and the tip of the endoscope shaft was inserted into the stomach of a beagle dog. And the pressure fluctuation in the stomach was measured with the pressure sensor in the state which supplied and sucked air with the endoscope.

  In order to compare with the measured value of the endoscope hood, the pressure in the stomach of the beagle dog was simultaneously measured using a pressure gauge (Testo 505-P1). Pressure measurement in the stomach of a beagle dog with a pressure gauge was performed through a gastrostomy formed in the beagle dog (see FIG. 8A).

  The pressure sensor provided in the endoscope hood has a shape shown in FIG. A piezoresistive element was provided on the surface of the diaphragm of the pressure sensor, and this piezoresistive element was connected to a voltmeter via an enameled wire, and the change in electrical resistance of the piezoresistive element was taken out as a voltage change.

The specifications of the pressure sensor provided in the endoscope hood are as follows.
Material: Semiconductor silicon
Size: width 2mm, length 1.3mm, thickness about 1mm
Hole diameter: 0.7mm diameter
Diaphragm: Silicon (thickness 5μm)
Light reflecting layer: Chrome plating (thickness 0.1 μm)

The results are shown in FIG.
As shown in FIG. 8 (B), it was confirmed that the measured value by the pressure sensor fluctuated by performing the air supply and suction. Moreover, it was confirmed that the measured value was consistent with the pressure gauge.
Moreover, when the pressure gauge 0 value (atmospheric pressure) and the pressure sensor output value 0 mV (no differential pressure difference) are combined, the pressure gauge measurement value and the pressure sensor measurement value are almost the same. .

  From the above results, it was confirmed that the pressure in the stomach can be directly measured by the endoscope hood of the present invention, and the pressure can be accurately measured following the pressure fluctuation.

The endoscope hood and endoscope of the present invention are suitable for a hood and an endoscope that are used for surgery using a flexible endoscope such as NOTES or an examination using a flexible endoscope.
The tissue size measuring method of the present invention is suitable for a method for measuring the size of the tissue on the inner surface of the digestive tract such as the stomach.

DESCRIPTION OF SYMBOLS 1 Endoscope hood 2 Main-body part 2s accommodation recess 2g Conductor accommodation groove 5 Pressure sensor 6 Signal transmission part 6
DESCRIPTION OF SYMBOLS 10 Conductor 20 Sensor part 21 Measuring part 22 Film-like part 23 Base plate S Shaft

Claims (15)

An endoscope hood attached to an endoscope,
A cylindrical main body with both axial ends open;
An endoscope hood comprising: a pressure sensor attached to the main body. The pressure sensor is
The endoscope hood according to claim 1, wherein the sensor portion for detecting pressure is formed by a MEMS sensor. The pressure sensor is
The endoscope hood according to claim 1 or 2, further comprising a light reflecting layer for reflecting light on a surface thereof. In the main body,
4. The endoscope hood according to claim 1, further comprising a signal transmission unit that wirelessly transmits a signal of the pressure sensor to the outside. On the inner surface of the main body,
An accommodation recess for receiving the pressure sensor, which is recessed from the inner surface, is provided,
The housing recess is
5. The endoscope hood according to claim 1, wherein the depth is equal to or greater than the thickness of the pressure sensor. A sensor for detecting atmospheric pressure attached to an endoscope and / or an endoscope hood,
A pressure sensor for an endoscope, wherein a pressure detection unit in the sensor is formed by a MEMS sensor. The pressure sensor for an endoscope according to claim 6, wherein a surface of the pressure detection unit in the sensor includes a light reflection layer. In the main body,
The endoscope pressure sensor according to claim 6 or 7, further comprising a signal transmitter that wirelessly transmits a signal of the pressure sensor to the outside. An endoscope, wherein a pressure sensor for detecting an atmospheric pressure in a digestive tract cavity or the like is provided on a distal end surface and / or a side surface of a shaft. The pressure sensor is
The endoscope pressure sensor according to claim 9, wherein the endoscope pressure sensor is an endoscope pressure sensor according to claim 6. A method for measuring the size of tissue existing on the inner surface of a digestive tract cavity,
While measuring the pressure in the digestive tract cavity etc., supply gas into the digestive tract cavity etc. to inflate the digestive tract and measure the size of the tissue in the state where the inside of the digestive tract cavity etc. exceeds the predetermined pressure. A method for measuring tissue size. In a state where the gastrointestinal tract is inflated by supplying gas from the endoscope into the digestive tract cavity, the size of the tissue is measured by a measuring instrument inserted into the digestive tract cavity or the like through the forceps port of the endoscope. 12. The tissue size measuring method according to claim 11, wherein the tissue size is measured. The tissue size measuring method according to claim 11 or 12, wherein marking is performed at a plurality of locations on a tissue in a digestive tract cavity or the like. A pressure in a digestive tract cavity or the like is measured by a pressure sensor provided in the endoscope hood according to any one of claims 1 to 5 and / or the endoscope according to claim 9 or 10. The tissue size measuring method according to claim 11, 12 or 13. The predetermined pressure is
The tissue size measuring method according to claim 11, 12, 13, or 14, wherein the pressure is an inflection point of an extension curve of a digestive tract cavity or the like.