JP2615301B2 - Electronic laparoscope - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an electronic laparoscope which is inserted into an abdominal cavity to take an image of the abdominal cavity.

[0002]

2. Description of the Related Art In the medical field, surgery for performing treatment while observing an endoscope image of an endoscope has been conventionally performed.
As such surgery, for example, there is a cholecystectomy operation performed under laparoscopic surgery. The gall bladder is removed while the operator recognizes the internal state.

Conventionally, a rigid one having a relay lens system is usually used as the laparoscope. A TV camera is attached to an eyepiece on the hand side, and an image of the abdominal cavity is taken and displayed on a monitor. It is supposed to. In order to observe the inside of the abdominal cavity with such a laparoscope, a hole is made in the abdominal wall of the patient with the inner needle of the trocar using a trocar, the inner needle is removed, and the optical tube of the laparoscope is inserted into the abdominal cavity. I have.

In the case of laparoscopic surgery,
In addition to the perforation for puncturing for observation as described above, at least one
A perforation for a treatment tool is required, and various treatments are performed by inserting a treatment tool such as forceps through the perforation for the treatment tool.

[0005]

However, the conventional laparoscope requires a single perforation for observation, so that many perforations must be made in the abdominal wall of the patient. For this reason, there is a problem that the patient suffers a great deal of pain when making a puncture in the abdominal wall with the inner needle of the trocar, and it takes a long time to recover even after the operation, and many scars remain.

[0006] Further, there is a small-diameter laparoscope in which a channel for a treatment tool is additionally provided. In such a laparoscope,
The obtained image in the abdominal cavity was dark and unclear, and the condition in the abdominal cavity could not be observed well.

[0007] The present invention has been made in view of these circumstances, and it is possible to perform good observation and treatment of a surgical site with one perforation, and to reduce the number of perforations when performing a procedure. It is intended to provide a laparoscope.

[0008]

An electronic laparoscope according to the present invention is provided with a tubular main body having an inner cavity through which a treatment tool can be inserted from the hand side, and is connected to the distal end side of the main body so as to be displaceable, and is used for imaging. A distal end component having a small diameter toward the distal end so that it can be inserted into the abdominal cavity by piercing and having a means, and a displacing means for displacing the distal end component and opening the lumen at the distal end side. It is provided.

[0009]

The tip component is inserted into the abdominal cavity by piercing from the tip component, and the tip component is displaced by the displacement means to open the lumen of the main body on the tip side. Then, an image of the abdominal cavity is taken by the imaging means, and the treatment instrument can be inserted into the cavity from the hand side.

[0010]

Embodiments of the present invention will be described below with reference to the drawings. FIGS. 1 to 3 relate to a first embodiment of the present invention. FIG. 1 is a perspective view showing a configuration of an electronic laparoscope, FIG. 2 is an explanatory view showing a state in which a tip component is inverted, and FIG. FIG. 3 is a configuration explanatory view showing the configuration of the means.

As shown in FIG. 1, an electronic laparoscope 1 has a distal end portion 2 having a small diameter toward the distal end so that it can be punctured and inserted into the abdominal cavity. And a tubular main body 3 connected to the main body. The main body 3 is provided with a lumen 4 so that a treatment tool can be inserted from the near side. Also, the grip of the main body 3 includes:
A universal cord 5 is extended from the side, a light source device for generating illumination light for irradiating the abdominal cavity through the universal cord 5, and a camera control unit (CCU) for controlling an imaging unit and processing an image signal. And are connected. Further, the main body 3 is provided with a tip displacement operation knob 6 for reversing the tip component 2, and by operating the tip displacement operation knob 6, the tip component 2 is inverted.

FIG. 2 shows a state in which the distal end portion 2 is inverted. The distal end component 2 is provided as an imaging unit,
Objective optical system 7 for forming a subject image, and objective optical system 7
Is provided with a solid-state imaging device (not shown),
An image of the inside of the abdominal cavity is taken in the inverted state. An illumination light emission window 8 for emitting illumination light is provided on the distal end side of the main body 3, and an end of a light guide (not shown) is provided inside the illumination light emission window 8. The light guide is inserted into the main body 3 and the universal cord 5 and connected to the light source device, and transmits the illumination light to the illumination light exit window 8. When the distal end component 2 is inverted, the distal end side of the lumen 4 provided in the main body 3 is opened. Although not shown, a signal line from the solid-state imaging device in the distal end component 2 is inserted through the main body 3 and the universal cord 5 and connected to the CCU.

The distal end portion 2 is inverted by distal end inverting means as displacement means as shown in FIG. The distal end component 2 is fixed to the main body 3 so as to be rotatable about a rotation shaft 9. A pulley 10 is connected to a shaft of a tip displacement operation knob 6 provided on the main body 3, and a transmission wire 12 for transmitting a driving force between the pulley 10 and a pulley 11 connected to the rotary shaft 9 is provided. Have been. By rotating the tip displacement operation knob 6, the driving force is transmitted, the pulley 11 is rotated, and the tip component 2 is reversed in the direction of the arrow.

Next, the operation of this embodiment will be described.
The electronic laparoscope 1 is inserted into the abdominal cavity of the patient from the distal end component 2. At this time, since the distal end component 2 has the same shape as the inner needle of the trocar, the perforation is pierced into the abdominal wall and inserted into the abdominal cavity. When the distal end component 2 is inserted into the abdominal cavity, the distal end displacing operation knob 6 is rotated to invert the distal end component 2. As a result, the objective optical system 7 faces the operation site in the abdominal cavity, the illumination light is emitted from the illumination light exit window 8, and an image of the abdominal cavity is taken. In addition, since the lumen 4 opens at the distal end, various treatments are performed by inserting a treatment tool into the abdominal cavity from the near side of the lumen 4.

As described above, the imaging means is provided at the distal end portion for inserting a hole into the abdominal cavity by piercing a hole in the abdominal wall, so that a single hole can be used to observe a surgical site using the imager and to perform various treatments using the treatment tool. And can do both. In addition, since images are taken in the abdominal cavity by the electronic imaging means having the solid-state imaging device, a clear in-abdominal cavity observation image can be obtained. As a result, various treatments can be performed with a small number of perforations, so that the patient's pain can be alleviated and post-operative recovery can be accelerated.

FIGS. 4 and 5 relate to a second embodiment of the present invention. FIG. 4 is an explanatory view showing the configuration of the distal end side of the electronic laparoscope, and FIG. 5 is a configuration explanatory view showing the configuration of the distal end rotating means. is there.

As shown in FIGS. 4A and 4B, the second
In the embodiment, the distal end component 21 rotates around a rotation axis provided in the main body 3 so that the distal end side of the lumen 4 and the illumination light emission window 8 are exposed. The objective optical system 7 is provided on the distal end side of the distal end component 21.

The tip rotating means as the displacement means of the tip constituting portion 21 is configured as shown in FIG. A rotating shaft 22 extends from the rear end of the tip component 21, and the rotating shaft 22 is inserted into a rotation bearing hole 23 provided in the main body 3, so that the tip component 21 can be rotated by the main body 3. Fixed. A bevel gear 2 is provided at the end of the rotating shaft 22.
The bevel gear 24 is meshed with a bevel gear 25 connected to the tip displacement operation knob 6.

When the distal end component 21 is inserted into the abdominal cavity in the same manner as in the first embodiment, and the distal end displacing operation knob 6 is rotated in this state, the rotating shaft 22 is rotated by the bevel gears 24 and 25.
Rotate, the distal end component 21 rotates about the rotation shaft 22, and as shown in FIG. 4B, the illumination light emission window 8 is exposed, and the imaging means performs imaging in the abdominal cavity. ,
The distal end side of the lumen 4 of the main body 3 is open. Then, various treatments are performed by inserting a treatment tool into the abdominal cavity from the proximal side of the lumen 4.

Other configurations, operations and effects are the same as those of the first embodiment.

FIG. 6 is an explanatory view showing the configuration on the distal end side of an electronic laparoscope according to a third embodiment of the present invention.

As shown in FIGS. 6A and 6B, the third
In the embodiment, the tip component 31 is provided with the parallel support members 32 and 3.
3 to the main body 3. Both ends of the parallel support members 32 and 33 are fixed to be rotatable about a rotation axis. Note that the parallel support members 32 and 33 are the same as those in FIG.
Are rotated by pulleys, transmission wires and the like (not shown) similar to the tip reversing means shown in FIG. Also,
The objective optical system 7 is provided on the distal end side of the distal end component 31 as in the second embodiment.

As in the first embodiment, when the distal end operation knob 6 is rotated while the distal end component 31 is inserted into the abdominal cavity, the parallel support members 32 and 33 are rotated, and FIG.
As shown in (b), the distal end component 31 is displaced upward, so that the distal end side of the lumen 4 and the illumination light emission window 8 are exposed. Then, while imaging the abdominal cavity by the imaging means,
Various treatments are performed by inserting a treatment tool into the abdominal cavity from the proximal side of the lumen 4.

Other configurations, operations and effects are the same as those of the first embodiment.

FIGS. 7 to 10 relate to a fourth embodiment of the present invention. FIG. 7 is an explanatory view showing an insertion state of an electronic laparoscope into a body cavity, and FIG. 8 shows a configuration of a gripping device in a distal end portion. FIG. 9 is an explanatory diagram showing a state in which the gripping device is gripping the abdominal wall, and FIG. 10 is an explanatory diagram showing a state of treatment in the abdominal cavity using an electronic laparoscope.

As shown in FIG. 7A, the electronic laparoscope 1
Has a distal end portion 41 having a small diameter toward the distal end so as to be inserted into the abdominal cavity by puncturing, and a tubular main body 3 connected to the distal end portion 41. Have been. An objective optical system 7 is provided on a side portion of the distal end component 41, and constitutes a side-view type imaging unit. An operation knob 42 for performing a separating operation of the distal end component 41 is provided on the grip portion of the main body 3. A universal cord 5 extends from the side of the grip of the main body 3, and a camera control unit (CCU) is connected via the universal cord 5. The electronic laparoscope 1 is inserted into the abdominal cavity by piercing the abdominal wall 43 by the distal end component 41.

As shown in FIG. 8, the distal end component 41 is provided with a gripping device 44 for gripping the abdominal wall in the abdominal cavity. The gripping device 44 includes two claws 4 for gripping the abdominal wall.
5 and 46, and the base ends of the claws 45 and 46 are rotatably fixed by fixed shafts 47 and 48, respectively. The claws 45 and 46 are each provided with a rod-shaped transmission member 49.
a, 49b, and is connected to a rotating member 51 fixed to be rotatable about a rotating shaft 50. The rotating member 51 is provided with an elastic member (not shown) having an elastic force to rotate counterclockwise. Further, a rod-shaped support member 52 is connected to the claw 46, and the rear end side of the support member 52 is inserted to the main body 3. The main body 3 is provided with a holder 53 for pulling and holding the rear end of the support member 52, and the holder 53 is connected to the operation knob 42. By holding, the distal end component 41 is supported in a state of being connected to the main body 3. When the operation knob 42 is operated and the holder 53 releases the support member 52, the distal end component 41 is separated from the main body 3 and the inner cavity 4
Is open at the tip side. Further, the distal end portion 41 is provided with an objective optical system 7 for forming an image of a subject and an imaging device 54 configured with a solid-state image sensor for capturing the image of the subject. A signal line (not shown) is connected to the image pickup device 54, and the signal line is inserted through the main body 3 and the universal cord 5 and connected to the camera control unit. The illuminating means is configured by providing an irradiation window for irradiating the illumination light transmitted by the light guide on the distal end surface of the main body 3, or by providing a lamp or the like on the distal end component 41.

Next, the operation of the present embodiment will be described.
As shown in FIG. 7A, the abdominal wall 4 is
3 and the tip component 41 of the electronic laparoscope 1 and the main body 3
Insert the distal end into the abdominal cavity. Then, as shown in FIG. 7B, the operation knob 42 is operated in a state where the side portion of the distal end component 41 is pressed against the abdominal wall 43, thereby fixing the distal end component 41 to the abdominal wall 43, and at the same time, Is separated from the main body 3 to open the distal end side of the lumen 4.

The gripping device 44 provided in the distal end portion 41 grips the abdominal wall 43 as shown in FIG. When the operating knob 42 is operated to open the holding portion at the tip of the holder 53 and the support member 52 is released, the rotating member 51 rotates counterclockwise by elastic force, and the claws 45 and 46 rise. The abdominal wall 43 is gripped by the claws 45 and 46 to fix the distal end component 41, and is separated from the main body 3 so that the distal end side of the lumen 4 is opened. At this time, FIG.
As shown in FIG. 0, the distal end component 41 is fixed in the abdominal cavity,
The image in the abdominal cavity is captured by the imaging device 54. A signal line 55 for transmitting an image signal connected to the imaging device 54 is connected to the main body 3, and the image signal is transmitted to the camera control unit via the main body 3 and the universal cord 5, and the abdominal cavity is transmitted to a monitor or the like. The image inside is displayed.
In addition, a treatment tool 56 such as a biopsy forceps is inserted into the lumen 4 from the near side, and a treatment in the abdominal cavity is performed by the distal treatment section 56a.

As described above, it is possible to perform both the observation of the operation site by the imaging means and various treatments by the treatment tool by one perforation, and it is possible to perform various treatments with a small number of perforations. Further, since the imaging means and the perforation of the treatment tool are separated, treatment can be performed without affecting the observation image.

Other configurations, operations and effects are the same as those of the first embodiment.

FIGS. 11 and 12 relate to a fifth embodiment of the present invention. FIG. 11 is an explanatory view showing the configuration of a gripping device in the distal end portion, and FIG. 12 shows a state in which the gripping device grips the abdominal wall. FIG.

The fifth embodiment is a modification of the fourth embodiment, and is an example in which the configuration of a gripping device provided at a distal end portion having the same shape as a trocar head is changed. The configuration of parts other than the gripping device is the same as in the fourth embodiment, and a description thereof will be omitted.

As shown in FIG. 11, the distal end component 71 of the electronic endoscope according to the fifth embodiment includes two claws 7 for gripping the abdominal wall.
A gripping device 72 having 3,74 is provided. The pawls 73 and 74 of the gripping device 72 are rotatably fixed at their center portions by fixed shafts 75 and 76, and have their base end portions pivoted through shafts 78a and 77b via rod-shaped transmission members 77a and 77b. And is connected to a rotating member 79 that is rotatably fixed.
The rotating member 79 is provided with an elastic member (not shown) having an elastic force for urging in the clockwise direction. Further, a rod-shaped support member 80 is connected to the base end of the claw 74, and a click 80 a is provided at an intermediate portion of the support member 80, and the rear end is inserted through the main body 3.
The main body 3 is provided with a holder 53 for holding the rear end of the support member 80 as in the fourth embodiment.
Reference numeral 3 is inserted through the insertion hole 81 of the main body 3 and the rear end is connected to the operation knob 42 of the grip portion. By holding the rear end of the support member 80 by the holder 53, the front end component 71 is supported in a state of being connected to the main body 3.

Then, as shown in FIG.
2 is operated to retract the holder 53, tow the support member 80, hook the click 80a on the rear end of the distal end component 71, and fix the claw 73, 74. At this time, when the holder 53 releases the support member 80, the distal end component 71 is separated from the main body 3, and the distal end of the lumen 4 is opened.
Here, when the rear end of the support member 80 is released from the state in which the support member 80 is held by the holder 53, the holding portion of the holder 53 is opened in the insertion hole 81 of the main body 3. It has a diameter that can keep the state sufficiently.

The support member 8 provided in the distal end portion 71
In the state where the rear end portion of the abdominal wall 0 is held by the holder 53, the abdominal wall 43 is gripped by the gripping device 72 as shown in FIG. Is fixed. Here, when the operating knob 42 is operated from the state of FIG. 11 to pull the holder 53 toward the user, the supporting member 80 is also pulled, and the click 80 a provided on the supporting member 80 is moved to the rear end of the distal end component 71. Caught on At this time, the pawl 74 rotates counterclockwise about the fixed shaft 76, and the rotating member 7
9 also rotates counterclockwise by one transmission member 77b, and rotates the claw 73 clockwise by the other transmission member 77a, so that the claw 3 and the claw 4 bite into the abdominal wall 43, and the distal end component 71 Is fixed. Then, the holder 53
By opening the gripper and releasing the support member 80,
The distal end component 71 is separated from the main body 3 and the distal end of the lumen 4 is opened.

As described above, similarly to the fourth embodiment, it is possible to insert the imaging means and the perforation of the treatment instrument in a separated state in the abdominal cavity, and perform the treatment without affecting the observation image. Can be.

By the way, when performing an operation under a laparoscope, in order to insert an optical sight tube or a treatment tool into the abdominal cavity,
In general, a trocar that pierces the abdominal wall and inserts a guide tube or a pneumoperitoneal needle into the abdominal cavity is used, but such a trocar determines whether or not it has penetrated the abdominal wall by the sense of the operator's hand. As a result, it was not possible to reliably detect whether or not the car passed through the abdominal wall. For this reason, there is a possibility that internal organs may be damaged in some cases, and use of the trocar requires skill. Therefore, it is conceivable to provide means for detecting whether or not the tip of the trocar has reliably penetrated the abdominal wall so that the trocar can be safely inserted into the abdominal cavity.

FIG. 13 shows a first example in which means for detecting whether or not the above-described tip has reliably penetrated the abdominal wall is provided. As shown in FIG. 13, an ultrasonic probe 62 is provided at the tip of an outer tube 61 of the trocar. A notifying device 63 made up of an LED or the like for notifying the operator that the tip has penetrated the abdominal wall is provided at the grip portion of the outer tube 61. In addition, a power supply (not shown), an ultrasonic wave transmitting / receiving circuit, and the like are provided inside the outer tube 61.

When the trocar is inserted into the abdominal cavity, the ultrasonic probe 62 transmits and receives ultrasonic waves to detect whether or not the trocar is in contact with the abdominal wall. In this case, the notification device 63 is turned on to notify the operator that the patient is in the abdominal cavity. Thereby, the surgeon can surely recognize whether the tip of the trocar has penetrated the abdominal wall, and can safely pierce the abdominal cavity. In addition, as the notification device, not only a device that emits light but also a device that emits a buzzer or the like may be used.

As a second example in which means for detecting whether or not the trocar has penetrated the abdominal wall is provided, as shown in FIG. 14, an example in which an ultrasonic probe is provided on the outer periphery of the tip of the inner needle of the trocar. . The inner needle 64 of the trocar is provided with an ultrasonic probe 65 on the outer periphery of the tip and a notification device 66 on the hand. As in the first example, the ultrasonic probe 65 detects whether or not the abdominal wall is in contact with the abdominal wall. It is possible to reliably recognize whether the abdominal wall has been penetrated or not, and it is possible to safely pierce the abdominal cavity.

[0042]

As described above, according to the present invention, 1
With one perforation, good observation and treatment of the surgical site can be performed, and there is an effect that it is possible to reduce perforations when performing a procedure.

[Brief description of the drawings]

1 to 3 relate to a first embodiment of the present invention,
FIG. 1 is a perspective view showing the configuration of an electronic laparoscope.

FIG. 2 is an explanatory view showing a state in which a tip component is inverted.

FIG. 3 is a structural explanatory view showing the structure of a tip reversing means.

FIGS. 4 and 5 relate to a second embodiment of the present invention, and FIG. 4 is an explanatory view showing a configuration of the distal end side of an electronic laparoscope.

FIG. 5 is a configuration explanatory view showing a configuration of a tip rotating means.

FIG. 6 is an explanatory diagram showing a configuration of a distal end side of an electronic laparoscope according to a third embodiment of the present invention.

7 to 10 relate to a fourth embodiment of the present invention, and FIG. 7 is an explanatory view showing an insertion state of an electronic laparoscope into a body cavity.

FIG. 8 is an explanatory view showing the configuration of a gripping device in the distal end component.

FIG. 9 is an explanatory diagram showing a state in which the gripping device is gripping the abdominal wall.

FIG. 10 is an explanatory diagram showing a state of a treatment in an abdominal cavity using an electronic laparoscope.

FIG. 11 and FIG. 12 relate to a fifth embodiment of the present invention, and FIG. 11 is an explanatory view showing a configuration of a gripping device in a distal end component.

FIG. 12 is an explanatory diagram showing a state in which the gripping device is gripping the abdominal wall.

FIG. 13 is an explanatory view showing an example in which an ultrasonic probe is provided at the tip of a trocar outer cylinder.

FIG. 14 is an explanatory view showing an example in which an ultrasonic probe is provided on the outer periphery of the tip of the inner needle of the trocar.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... Electronic laparoscope 2 ... Tip constituent part 3 ... Main body 4 ... Internal cavity 6 ... Tip displacement control knob 7 ... Objective optical system 8 ... Illumination light emission window 10, 11 ... Pulley 12 ... Transmission wire

 ──────────────────────────────────────────────────続 き Continuing on the front page (72) Inventor Shinkichi Tanizawa 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside O-Limpus Optical Co., Ltd. (72) Inventor Shiro Bito 2-43-2 Hatagaya, Shibuya-ku, Tokyo No. Within Olympus Optical Co., Ltd. (72) Inventor Tsuyoshi Tsukagoshi 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Co., Ltd. (72) Hiroaki Kagawa 2-43-2, Hatagaya, Shibuya-ku, Tokyo No. O-Limpus Optical Industry Co., Ltd. (72) Inventor Yoshinao Daiaki 2-43-2 Hatagaya, Shibuya-ku, Tokyo In-Olympus Optical Industry Corporation (72) Inventor Tadao Hagino 2-43-2, Hatagaya, Shibuya-ku, Tokyo No. Olympus Optical Industry Co., Ltd. (56) References: Japanese Utility Model Application No. Sho 57-90112 (JP, U) JP 7-63477 (JP, B) 2)

Claims (1)

(57) [Claims] 1. A tubular main body having a lumen through which a treatment tool can be inserted from the proximal side, and a displaceably connected to the distal end side of the main body, having an imaging means and piercing and inserted into the abdominal cavity. An electronic laparoscope, comprising: a distal end component, which has a smaller diameter as far as possible in the distal direction; and a displacement means for displacing the distal end component, and opening the lumen at the distal end.