JP2017169994A - Endoscope distal end position specification system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To further easily specify a position of an endoscope distal end in a body, from the outside of the body.SOLUTION: A first coil 20 is provided at a distal end of an insertion part 16 of an electronic scope body 13. A signal processor 22 calculates a three-dimensional position of the first coil 20 and a three-dimensional position of a second coil 21 that is operable with it held in hand, by using a magnetic field generated by a magnetic field generator 23 including a third coil. A calculated physical relationship of the first coil 20 and the second coil 21 is configured into a three-dimensional graphic, and a monitor 24 displays it as the three-dimensional image from a prescribed point of view.SELECTED DRAWING: Figure 1

Description

  The present invention relates to an alignment apparatus using an endoscope apparatus for the upper digestive tract.

  For patients who have difficulty ingesting food, drink, medicine, etc., form artificial fistulas in the stomach from the outside of the abdomen, attach a catheter to the formed fistula, and directly feed foods, drinks, and drugs through the catheter Percutaneous endoscopic gastrostomy (PEG) is known which makes it possible to insert into the urine. In the construction of a gastrostoma, the position of gastrostoma formation is confirmed with an endoscope inserted into the stomach, and strong light is irradiated from the tip of the endoscope toward the gastrostoma formation position. A gastrostoma formation position from the outside is specified from the position, and a fistula is formed at the same position. In addition, in an apparatus that inserts an endoscope into a body cavity through a hole in a patient's body, and operates the endoscope and treatment tool using a manipulator, the manipulator controls the endoscope and treatment tool. Therefore, a method for teaching the position of the insertion hole opened in the body to the apparatus is known (Patent Document 1).

Japanese Patent Laid-Open No. 08-215205

  An object of the present invention is to more easily identify the position of the endoscope tip from the outside of the body.

  An endoscope distal end position specifying system according to the present invention includes a first coil disposed at the distal end of an endoscope insertion portion, a second coil that can be hand-held, and a third coil, and includes a first coil and a second coil. And a positional relationship display unit for displaying the positional relationship.

  The position detecting means detects three-dimensional position information of the first and second coils. The positional relationship display means displays, for example, the three-dimensional positional relationship between the first and second coils.

  An endoscope apparatus according to the present invention is characterized in that the endoscope tip position specifying system described above is mounted.

  According to the present invention, the position of the endoscope tip in the body can be identified from outside the body more easily.

It is a block diagram which shows the structure of the endoscope front-end | tip position specific system which is one Embodiment of this invention. It is a schematic diagram which shows the usage method of the endoscope front-end | tip position identification system of this embodiment. It is a figure which shows an example of the display of the monitor screen at the time of operation of FIG. It is a schematic diagram of a stomach and an abdominal wall which shows the state after percutaneous endoscopic gastrostomy (PEG).

  Hereinafter, embodiments of the present invention will be described with reference to the drawings. FIG. 1 is a block diagram showing a configuration of an endoscope tip position specifying system according to an embodiment of the present invention.

  The endoscope tip position specifying system 10 according to this embodiment includes an electronic endoscope apparatus 11 and a three-dimensional position measuring apparatus 12 connected to the electronic endoscope apparatus 11. The electronic endoscope device 11 is an upper digestive organ endoscope, an electronic scope main body 13, a processor device 14 that processes an image signal from the electronic scope main body 13, and a monitor that displays an image processed by the processor device 14. Device 15. Note that the processor device 14 of the present embodiment includes a light source (not shown) used for illumination for endoscopic observation.

  The electronic scope body 13 includes an insertion portion 16 to be inserted into the body, an operation portion 17 to which the proximal end side of the insertion portion 16 is connected, and the operation portion 17 to the processor device 14 electrically and optically via a universal cord. The connector part 18 connected with is provided. The insertion portion 16 is made of a flexible tube, and an image sensor 19 is disposed at the tip thereof. Light from the light source of the processor device 14 is transmitted from the distal end of the insertion portion 16 through a light guide (not shown), and is irradiated as illumination light. An image photographed by the image sensor 19 is subjected to predetermined signal processing by the processor device 14 and then output to the monitor device 15 to be displayed as an endoscopic image.

  Further, a bending portion that can be bent by operating an operation lever or an operation knob (not shown) provided in the operation portion 17 is provided in the vicinity of the distal end portion of the insertion portion 16 over a predetermined length. The practitioner can operate the operation unit 17 and the operation lever while observing the endoscopic image of the monitor device 15 to place the distal end of the insertion unit 16 at various positions in the stomach and direct it in various directions.

  The three-dimensional position measuring device 12 of the present embodiment is a magnetic field type position measuring device, and a first part of the three-dimensional position measuring device 12 is formed at the distal end of the insertion portion 16 (segment ahead of the bending portion). A coil 20 is arranged. In addition to the first coil 20 provided at the distal end of the insertion portion 16, the three-dimensional position measuring device 12 is disposed outside the patient's body and is operated by a practitioner by hand. A signal processing unit 22 that receives signals from the coils 20 and 21, and a magnetic field generator (external) that is connected to the signal processing unit 22 and generates a magnetic field by a third coil (not shown) based on a control signal from the device. Device) 23 and a monitor 24 that graphically displays the three-dimensional positions of the first and second coils 20 and 21.

  The first and second coils 20 and 21 are, for example, wound around an iron core, and the three-dimensional positions of the first and second coils 20 and 21 are the magnetic field generated by the magnetic field generator 23. The signal processing unit 22 calculates the distortion and the signals of the first and second coils 20 and 21 disposed in the same magnetic field. The signal processing unit 22 generates a three-dimensional image viewed from a predetermined viewpoint based on the calculation result, and outputs the three-dimensional image to the monitor 24. The signal from the first coil 20 is sent to the signal processing unit 22 through a signal line that is detachably connected to a relay circuit 25 provided in the connector unit 18, for example. It is detachably connected directly to the signal processing unit 22 via.

  FIG. 2 is a schematic diagram illustrating a method of using the endoscope tip position specifying system 10 according to the present embodiment. FIG. 2 shows a state in which the insertion portion 16 of the electronic scope main body 13 is inserted into the stomach G, and the operator operates the operation portion 17 to place the distal end of the insertion portion 16 close to the fistula formation position. It is. In this state, the practitioner picks the second coil 21 and moves it along the abdominal wall W of the patient, and while looking at the monitor 24, the position of the second coil 21 is provided at the distal end of the insertion portion 16. Approach 20 At this time, the patient and the magnetic field generator 23 are arranged so that the first and second coils 20 and 21 are located in the magnetic field generated by the magnetic field generator 23 during the treatment.

  FIG. 3 shows an example of a graphic image displayed on the screen S of the monitor 24 when the operation of FIG. 2 is performed. In FIG. 3, the mark 20 </ b> P indicates the position of the first coil 20, and the mark 21 </ b> P indicates the position of the second coil 21. The state of FIG. 3A shows a state in which the position of the second coil 21 outside the body (mark 21P) is still far from the position of the first coil 20 inside the body (mark 20P). The practitioner moves the second coil 21 while observing the screen S to bring the mark 21P closer to the mark 20P. In FIG. 3A, the second coil 21 (mark 21P) is moved in the direction of arrow A along the abdominal wall W.

  FIG. 3B shows a state where the second coil 21 is moved and the position of the mark 21P is closest to the mark 20P. In this vicinity, the practitioner moves the second coil 21 back and forth and right and left along the abdominal wall W, and if the position of the mark 21P does not approach the mark 20P any more, the same position on the abdominal wall W becomes a position for opening a fistula. When the position is specified, the practitioner punctures the stomach G from the same position as shown in FIG. 4, attaches the catheter C, and constructs a artificial gastrostomy in the patient's stomach G.

  As described above, according to the present embodiment, the positional relationship between the distal end position of the endoscope (first coil) and the hand-held second coil of the practitioner applied to the abdominal wall can be recognized visually and easily. The position of the mirror tip can be easily identified from outside the body.

  In the present embodiment, an electronic endoscope has been described as an example, but the present invention can also be applied to an endoscope using an image guide fiber or the like. In the present embodiment, the first coil is arranged at the distal end of the insertion portion of the electronic scope (the distal side of the bending portion). For example, the first coil is provided at the distal end of the probe-like instrument, and the instrument is inserted from the forceps opening to the insertion portion. It is good also as a structure attached to. In this case, the first coil provided in the insertion unit is directly connected to the signal processing unit without going through the connector unit, and the endoscope tip position specifying system can be configured independently of the endoscope. Note that one of the first coil and the second coil, or both the first coil and the second coil may be connected to the signal processing unit by wireless communication. In the present embodiment, a magnetic field is generated by the third coil of the external device disposed outside the patient's body, and the same magnetic field is detected by the first coil disposed in the patient's body and the second coil operated by hand. However, it is good also as a structure which generates a magnetic field with a 1st, 2nd coil, and detects a magnetic field with a 3rd coil.

  In the present embodiment, the three-dimensional position measuring device is used. However, the present invention only needs to be able to specify the relative positional relationship between the first and second coils. Therefore, it is sufficient that the relative positional relationship between the first and second coils can be shown without displaying the positions of the first and second coils three-dimensionally. For example, the position of the second coil around the first coil. The structure which shows the information corresponding to the top view which shows these, or both distance may be sufficient. Further, in the present embodiment, the first coil is disposed only at the distal end of the insertion portion. However, a configuration may be adopted in which a plurality of first coils are disposed along the longitudinal direction of the insertion portion and the shape of the insertion portion can be grasped.

DESCRIPTION OF SYMBOLS 10 Endoscope position specification system 11 Electronic endoscope apparatus 12 Three-dimensional position measurement apparatus 13 Electronic scope main body 16 Insertion part 19 Imaging element 20 1st coil 21 2nd coil 22 Signal processing part 23 Magnetic field generator (external device)
24 Monitor

Claims (5)

A first coil disposed at the distal end of the endoscope insertion portion;
A second coil capable of hand-held operation;
A position detecting means comprising a third coil, and detecting a positional relationship between the first coil and the second coil;
An endoscope tip position specifying system comprising: a positional relationship display means for displaying the positional relationship.   The endoscope tip position specifying system according to claim 1, wherein the position detecting unit detects three-dimensional position information of the first and second coils.   The endoscope tip position specifying system according to any one of claims 1 to 2, wherein the positional relationship display means displays a three-dimensional positional relationship between the first and second coils.   The endoscope tip position specifying system according to any one of claims 1 to 3, wherein the first coil is provided at a tip of a probe-like instrument that can be attached to the endoscope insertion portion.   An endoscope apparatus on which the endoscope tip position specifying system according to any one of claims 1 to 4 is mounted.

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