JP3273676B2 - Double curved endoscope - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an improvement of a two-stage bending endoscope having two bending portions provided at an insertion portion.

[0002]

2. Description of the Related Art In recent years, by inserting an elongated insertion portion into a body cavity, it is possible to observe an organ in the body cavity, and if necessary,
2. Description of the Related Art Medical endoscopes capable of performing various treatments using a treatment tool inserted into a treatment tool channel are widely used.

[0003] Boilers, gas turbine engines,
2. Description of the Related Art Industrial endoscopes are widely used for observing and inspecting internal scratches and corrosion of pipes of chemical plants and the bodies of automobile engines and the like.

[0004] For example, when observing the large intestine, the large intestine is complicatedly bent, and it is not easy to insert with a normal endoscope having one curved portion, and it takes time to reach a target site. Was.

[0005] In order to improve the insertion performance, a two-stage bending endoscope having a two-stage bending portion has been proposed. An example of the endoscope is disclosed in Japanese Patent Publication No. 49-28388. The endoscope shown here has twice as many wires as the number of operation wires required for the bending operation as compared with an endoscope having a single-step bending portion.

[0006]

The insertion portion of the endoscope includes:
In addition to the operation wires, a channel for inserting forceps, an image guide fiber for observation, a light guide fiber for illumination, and a channel for air / water supply are incorporated. Since the thicker any of the internal organs can achieve a higher effect for each purpose, the internal organs are mounted without gaps in the insertion portion. Therefore, in order to insert an increase in the number of operation wires required to increase the bending portion from one stage to two stages in such an insertion portion, the outer diameter of the insertion portion must be increased, or other internal components must be provided. Had to be thinner. This increases the pain given to the patient when inserting the endoscope, or leads to a decrease in the intrinsic function of the endoscope.

[0007] The present invention has been made in view of the above circumstances, and even if the endoscope has two bending portions, the number of operation wires for performing the bending operation is increased by increasing the number of operation wires outside the endoscope insertion portion. It is an object of the present invention to provide a two-stage curved endoscope that does not affect the diameter or function.

[0008]

SUMMARY OF THE INVENTION According to the present invention, there is provided a method of inserting a subject into a subject.
Connected to the distal end side of the endoscope insertion portion
A first bending portion that bends under traction, and the second bay;
Connected to the distal end side of the curved portion, different from the first traction force
A second bending portion that bends by receiving a predetermined second traction force;
A tubular for transmitting the first traction to the first bend;
The first traction force transmitting means and the second bending portion
A first traction force transmitting hand having a tubular shape for transmitting a second traction force;
A second tractive force transmitting means inserted into the step;
A first traction device for applying the first traction force to the traction force transmission means;
The second traction force transmitting means and the second traction force transmitting means;
Second traction force applying means for applying the traction force of
It is characterized by that.

[0009]

In the structure of the present invention, the front curved portion of the two curved portions bends in a desired direction by the pulling / relaxing of the traction member, while the rear curved portion is pulled / pulled by the tubular member.
It bends in the desired direction due to relaxation. Since the traction member is inserted through the inside of the tubular member, it is not necessary to arrange the traction member in parallel to bend the two curved portions, so that the outer diameter of the endoscope insertion portion can be increased. Also, by forcibly reducing the diameter, the function that the endoscope should originally have is not reduced.

[0010]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS An embodiment of the present invention will be described below with reference to the drawings. 1 to 7 relate to a first embodiment of the present invention. FIG. 1 is a longitudinal sectional view of a two-stage curved endoscope, and FIG.
-A line, BB line, CC line sectional view, Fig. 3 is an arrangement configuration diagram of a wire, a tube, and a coil tube, Fig. 4 is a comparative explanatory diagram of a conventional example and this embodiment, and Fig. 5 is a two-stage diagram. FIG. 6 is an explanatory view of the use of a curved endoscope, FIG. 6 is an overall configuration diagram of an endoscope system, and FIG. 7 is an external view of a two-stage endoscope.

An endoscope system 1 shown in FIG. 6 has a two-stage curved endoscope 2 having two curved portions, a TV camera head 3 connected to an eyepiece of the endoscope, and an endoscope. A light source device 4 for supplying illumination light to the mirror 2, a motor control unit (hereinafter referred to as MCU) 5 for controlling the bending operation,
A camera control unit (hereinafter, referred to as CCU) 6 for performing signal processing on signals captured by the endoscope 2;
And a monitor 7 for displaying a video signal output from the CU 6 on a screen.

The endoscope 2 includes an elongated insertion portion 8, a large-diameter operation portion 8 connected to the rear end of the insertion portion 8, and an eyepiece portion connected to the rear end of the operation portion 9. 10, a light guide cable 11 and an MCU extending from the side of the operation unit 9.
Cable 12. The light guide cable 11 is connected to the light source device 4, and the MCU cable 12 is connected to the MCU 5.

A camera cord 13 extending from the rear of the TV camera head 3 is connected to the CCU 6.

The insertion portion 8 has a bendable first end.
And a second bendable portion 16 that can bend to the rear side adjacent to the first bendable portion 15 is provided. Further, a flexible flexible portion 17 is provided behind the second curved portion 16. The first and second bending portions 15 and 16 are respectively operated by operating joystick switches (hereinafter referred to as joysticks) 18 and 19 provided for the operation portion 8 for bending operation.
It can be bent to the left and right.

An objective lens (not shown) is provided at the tip of the insertion section 2, and behind the lens, an objective lens is provided from the insertion section 8 to the operation section 9 and the eyepiece section 10 as shown in FIG.
The incident end of the image guide fiber 20 shown in FIG. An eyepiece (not shown) of the eyepiece 10 is arranged at the emission end of the image guide fiber 20 so that it can be observed with the naked eye. Around the objective lens, the tip of a light guide fiber 21 shown in FIG. 1B is arranged in a ring shape. The light guide fiber 21 is guided through the insertion section 8, the operation section 9, and the light guide cable 11, and is connected to the light source device 4.

FIGS. 1A and 1B show the first bending portion 15.
FIG. 5 is a cross-sectional view illustrating a configuration of a second bending portion 16 and a bending operation mechanism that bends them.

The operation unit 9 is provided with four motors 22. Of the four motors, motor 22a,
Reference numeral 22b denotes a pinion gear 2 via reduction gears 23 and 23, respectively.
4, 24, respectively. One pinion gear 24
Has two racks 26, 26 supported by two bearings 25, 25, respectively, so as to slide in parallel with each other. The other pinion gear 24 is configured similarly to the racks 26 and 26 as described above. When the one pinion gear 24 rotates, the two racks 26 forming a pair slide in parallel (in the axial direction of the insertion portion) and in a direction opposite to the rotation. On the motor 22b side, two racks 26 are similarly driven relative to the other pinion gear 24.

The motor 2 of the four motors 22
2c and 22d are connected to pulleys 27 and 23 via reduction gears 23 and 23, respectively.
27 respectively. Wires 28, 28 as traction members are wound around the pulleys 27, 27, and are disposed in a folded state. The wires 28, 28 pass through the through holes penetrating in the longitudinal direction of the two racks 26, 26, pass through the center of a tube 29 as four tubular members whose ends are fixed to the four racks 26, Further, it passes through the flexible portion 17 and the second bending portion 16 and is inserted into the first bending portion 15. The first bending portion 15 has a plurality of bending pieces 30 as a bending structure that is rotatably combined with two degrees of freedom inside.
Both ends of 8, 28 are fixed. This wire 28,
28 is pulled and relaxed, a plurality of bending pieces 30
Rotates.

The four tubes 29, the ends of which are fixed to the racks 26, 26, pass through the centers of the four coil tubes 31 whose ends are fixed to the operating part 9, and pass through the flexible part 17, the fourth part. The second bending portion 16 is inserted. The second bending portion 16 has a plurality of bending pieces 32 rotatably combined therein with two degrees of freedom, and the ends of the four tubes 29 are fixed to the foremost pieces 32a. I have. By pulling and loosening the four tubes 29, a plurality of bending pieces 32 rotate.

The plurality of bending pieces 30 disposed on the first bending section 15 and the plurality of bending pieces 32 disposed on the second bending section 16 are covered with a skin rubber 33.

Both ends of the wires 28, 28 are fixed to a bending piece 30a at the foremost side of the first bending portion 15, as shown in FIG. Have been. In the sectional view 2 (a), (c),
(C) corresponds to the motor 22c, and (d),
(D) indicates that it corresponds to the motor 22d. That is, when the motor 22c rotates, the first bending portion 15 bends around the (d)-(d) axis, while when the motor 22d rotates, the (c)-(c)
Bend around the axis.

The ends of the four tubes 29 are
As shown in FIG. 2B, which is a cross section taken along the line BB in FIG. 1, the second bending portion 16 is fixed to a bending piece 32a located on the most distal end side. (A) of the tube 29 shown in FIG.
(A), (b) and (b) are motors 22a and 22b, respectively.
3 shows the correspondence between the tube and the tube 29. That is, when the motor 22a rotates, the second bending portion 16
(B) While bending around the (b) axis, the motor 22b rotates to perform bending around the (a)-(a) axis.

On the other hand, the four coil tubes 31
As shown in FIG. 2C, which is a cross-section taken along the line CC in FIG. 1, the curved frame fixing portion 34 located at the hand of the second curved portion 16.
It is fixed to.

FIG. 3 shows the structure and arrangement of the wire 28, the tube 29, and the coil tube 31. As the wire 28, a single wire of an ultrafine particle steel wire, which is a high-tensile wire, is used, so that it is possible to cope with a high tensile strength and a small diameter. The tube 29 is made of stainless steel such as SUS304 or Ti (titanium) -Ni
By using a superelastic alloy made of (nickel), it becomes possible to cope with breakage or breakage of the tube 29 itself due to bending of the insertion portion 8 or the second bending portion 16 due to bending.
The coil tube 31 is formed by winding a single wire of SUS316 in a tight coil shape.

FIG. 4 is a cross-sectional view for comparison between the conventional example and this embodiment. FIG. 1A shows a twisting wire 35 for bending operation of a bending portion and a coil tube 36 which have been conventionally used in an endoscope. FIG. 4B shows a wire 28, a tube 29, and a coil tube 31 used in the present embodiment, and a difference in cross-sectional configuration among them will be described below.

It is experimentally required that the wire 28 of the present embodiment can be reduced in diameter by 40% under the same strength condition by using a high-strength single wire wire as compared with the conventional stranded wire 35. I have. It is generally confirmed that the tube 29 made of a stainless alloy has a permissible maximum strain of 2%, and the tube 29 made of a superelastic metal has a permissible maximum strain of 5% or more.

Even if the inside diameter of the coil tube 31 is formed to the same inside diameter as that of the conventional example, and the inside of the coil tube 31 is replaced by the conventional stranded wire 35 with the tube 29 and the wire 28 of the present embodiment, the mechanical strength of the coil tube 31 is reduced. It is understood in the following description that no deterioration is observed.

The outer diameter of the stranded wire 35 is φ0.62 mm.
On the other hand, in the case of the hypertonic single wire 28, the diameter can be reduced by 40%. When the clearance between the tube 29 and the wire 28 is 0.03, the outer diameter D and the inner diameter d of the tube 29 are φ0.62 mm and φ2, respectively.
0.43 mm. SUS3 which is the material of tube 29
04 is generally 220 kg / mm or more, so the tensile strength Ft of the tube 29 is

(Equation 1) That is, Ft is 35 kg or more.

On the other hand, since the tensile strength of the stranded wire 35 having a diameter of φ0.62 mm is 35 kg, it can be seen that it is almost the same.

When the minimum bending radius R of the stainless steel tube is calculated on condition that the allowable maximum strain is 2%,

(Equation 2) Becomes If you need a smaller bend radius,
A superelastic metal tube 29 is used.

Assuming that the maximum allowable strain of the superelastic metal is 5%, the minimum bending radius R is

(Equation 3) Thus, bending can be performed with a sufficiently small bending radius.

As described above, instead of the conventional stranded wire 35 in the coil tube having the same inner diameter and outer diameter, the wire 28 is used.
It can be understood that a total of two tubes 29 can be passed through.

As shown in the external view of the double curved endoscope 2 in FIG.
9 are provided. The joystick 18 has two degrees of operation indicated by arrows a and b in the figure, and the operation in the direction of the degree of freedom corresponds to the operation in the rotation direction of the motors 22a and 22b. . The joystick 19 also has two degrees of operation indicated by arrows c and d in the figure, and the operation in the direction of the degrees of freedom corresponds to the operation in the rotation direction of the motors 22c and 22d. It has become.

The joysticks 18 and 19 are MCU5.
MCU5 is a joystick 1
The corresponding motors of the four motors 22 are driven in accordance with the operation directions and operation amounts of 8, 19.

Therefore, for example, when the lever of the joystick 18 is tilted to the a (+) side, the motor 22 corresponding to this is tilted.
a rotates in the forward direction by an amount corresponding to the angle at which the lever is tilted, and as a result, the first bending portion 15 is bent in the corresponding direction. When the lever of the joystick 18 is tilted to the a (-) side, the first bending portion 15 bends in the opposite direction. Others are the same.

According to the two-stage curved endoscope of the present embodiment, the first
Since the wire 28 for performing the bending operation of the second bending portion 16 is inserted through the tube 29 for performing the bending operation of the second bending portion 16, the wire for performing the bending operation is parallel even if it has two bending portions. In this case, the outer diameter of the endoscope insertion portion can be made smaller than that of the endoscope insertion portion, and a decrease in function due to forcibly reducing the diameter does not occur.

Further, since the wire 28 for bending the first bending portion 15 is inserted through the tube 29, it is possible to prevent the wire 28 from being strayed or entangled in the insertion portion 8. Further, in the present embodiment, since the tube 29 is inserted through the coil tube 31, it is possible to prevent the tube 29 from interfering with other internal organs and adversely affecting each other.

In this embodiment, in the bending operation mechanism,
Since the wire 28 is inserted into the through hole in the rack 26, the pinion 24 and the pulley 2
7 can be arranged in series in the axial direction. If the above configuration is not adopted, the pinion 24 and the pulley 27 must be arranged in parallel in the axial direction, and a complicated mechanism is required to realize the bending operation in this state. On the other hand, in the present embodiment, the configuration of the bending operation mechanism can be simplified, and unnecessary increase in the diameter of the operation unit can be prevented.

In the case where an integrally molded multi-lumen tube having a plurality of conduits provided in parallel is used as the configuration of the endoscope insertion portion, the wire 28 inserted through the tube 29 may be arranged in the conduit. In particular, the coil tube 31 need not be provided.

FIG. 5 shows an example of inserting the double curved endoscope 2 of the present embodiment into the large intestine 41. By bending the two curved portions 15 and 16 in desired directions along the lumen of the large intestine 41, the insertion operation can be facilitated even in the complicated intestine 41 having such a complicated shape.

8 and 9 relate to a second embodiment of the present invention. FIG. 8 is an external view of a two-stage bending endoscope, and FIG. 9 is a longitudinal sectional view of the two-stage bending endoscope.

The endoscope 42 shown in FIG. 8 is provided with angle knobs 43 and 44 on the operation section 9. Whereas the endoscope 2 of the first embodiment performs the bending operation by electric power, the bending operation is manually performed in the second embodiment. For this reason, this endoscope system has a configuration in which the MCU 5 and the code 12 of the first embodiment are omitted. In addition, the same configurations and operations as those of the first embodiment are denoted by the same reference numerals, and description thereof is omitted.

The angle knobs 43 and 44 of the operation unit 9
As shown in FIG. 9A, each of the operation knobs 43
a, 43b and operation knobs 44c, 44d.

The operation knob 43a is connected to the pinion 24 via a hollow shaft 45, while the operation knob 43b is connected to the shaft 4 passing through the center of the hollow shaft 45.
6 to the pinion 24. The operation knob 44c is connected to the pulley 27 via the hollow shaft 47.
The operation knob 44d is connected to the pulley 27 via a shaft 48 passing through the center of the hollow shaft 47. The configurations of the wire 28, the tube 29, and the coil tube 31 are the same as those of the first embodiment, and thus the description will be omitted.

The other constructions and functions and effects are the same as those of the first embodiment, and the description is omitted.

The endoscope 42 has a channel (not shown) opened at the tip of the insertion section 8 inserted therethrough, and an insertion port 46 for this channel is provided at an end of the operation section 9. The following treatment tools are inserted into this channel in addition to biopsy forceps and the like.

Hereinafter, the treatment tool will be described with reference to FIGS. 10 and 11.

FIG. 10 is a configuration diagram showing the configuration of the treatment tool for an endoscope, and FIG. 11 is an explanatory diagram showing the operation and use state of the treatment tool.

The treatment tool 51 shown in FIG. 11B has an insertion portion 49 and an operation portion 50 connected to the insertion portion 49.
And a tip grip 61 that protrudes and retracts at the tip of the insertion portion 49.

The insertion portion 49 has a flexible distal sheath 52, a proximal sheath 53 disposed on the operation portion 50 side, and a coupling for coupling the proximal sheath 53 and the distal sheath 52. A sheath tube 54 and a sheath tube 55 covering the distal sheath 52, the proximal sheath 53, and the connecting sheath 54.
And

The sheaths 52, 5 in the insertion section 8
Reference numeral 3 denotes a pipe made of a close-wound coil, and a distal end sheath 5
2a is fixed by an adhesive or the like. The outer skin tube 55 further covers the outer peripheral portion of the distal end cover 52a attached to the distal end of the distal end sheath 52 at the distal end side, and extends about 1 mm from the distal end of the distal end cover 52a.

An operation wire 56 is inserted into the proximal sheath 53, and a distal sheath 52 is inserted into the distal sheath 52.
Two elastic gripping members 57 as a treatment section attached to the distal end of the operation wire 56 are inserted. The proximal end of the elastic gripping member 57 and the distal end of the operation wire 56 are connected by a relay member 58.

The two elastic gripping members 57 are formed of an elastic linear material, and one ends of the two elastic gripping members 57 are bundled and brazed by a relay member 58 and connected to the distal end of the operation wire 56.

As shown in FIG. 11B, the operation section 50 includes an operation section main body 59, a slider member 60 slidably attached to the operation section main body 59, and an operation section main body 5.
9 and a ring 59a for inserting a thumb provided at the base end. An end portion of the operation wire 56 is fixed to the slider member 60, and a connector 62 is provided on a side portion. By pushing and pulling the ring 59a, the slider member 60 advances and retreats and the wire 56
Alternatively, the elastic holding member 57 also slides back and forth. The connector 62 is electrically connected to the operation wire 56.

The thickness of the distal sheath 52 is formed to be thinner than the thickness of the proximal sheath 53, thereby increasing the flexibility of the distal sheath 52 and increasing the thickness of the proximal sheath 53. Is set low so that the force on the hand side can be transmitted to the tip side well.

Further, a rotation guide groove 58a is formed spirally on the outer periphery of the relay member 58, and a projecting portion 54a which engages with the groove 58a is provided on the connecting member 54. The wire 56 is pulled or loosened by the ring 59a.
In addition, the elastic gripping member 57 moves forward and backward and rotates by the engagement.

By pushing and pulling the operation wire 56, the distal grip 61 formed by the distal portion of the elastic gripping member 57 can be protruded and retracted from the distal cover 52a.

At each end of the elastic gripping member 57, a claw portion 57a bent inward is provided. The claw portion 57a of the elastic holding member 57 is elastically spread by its own elastic restoring force. That is, as shown in FIG. 11A, the distal end portion of the elastic gripping member 57 retracted and accommodated in the distal end sheath 52 is moved by the operation of the operation wire 56 to the distal end cover 52a.
When it is protruded from the front end, as shown in FIG.

As described above, the treatment tool 51 for an endoscope is similar to that shown in FIG.
As shown in FIG. 1 (b), the tissue is introduced into the body cavity through the treatment tool insertion channel of the endoscope 42, so that a tissue or the like in a living body can be grasped and cut off.

When operating the endoscope treatment tool 51 having the above-described configuration, first, the insertion portion 8 of the endoscope 42 is inserted into a body cavity, and then the endoscope 42 is inserted as shown in FIG. The distal end portion of the endoscope treatment tool 51 is led out from the distal end portion of the endoscope 42 through the treatment instrument insertion channel to introduce it into the body cavity. At the time of introduction into the body cavity, the slider member 60 is pulled to pull the operation wire 56 toward the hand, and FIG.
As shown in (1), the distal end grip 61 is guided into the distal end cover 52a and the distal end side sheath 52 in advance. At this time, the portion 57a provided at the distal end of each elastic gripping member 57 is accommodated inside the outer periphery of the distal end cover 52a and the distal end sheath 52.

Next, the endoscope 42 is operated under the endoscope observation by the eyepiece 10 to collect the distal end grip 61 of the treatment tool 51 for the endoscope introduced into the body cavity. Close to the cell tissue etc. Thereafter, by moving the slider member 60 forward, the operation wire 56 responsive to the movement of the slider member 60 is pushed forward to cause each elastic gripping member 57 to protrude from the distal end cover 52a, and as shown in FIG. The tip grip 61 is expanded. Then, the expanded tip grip 61 is guided to the tissue to be collected, and the collected tissue is taken into the tip grip 61. In this operation, the distal end grasping portion 61 is closed by pulling the operation wire 56 toward the hand side, and the tissue inside the distal end grasping portion 61 is securely grasped. At this time, the tissue is cut off by the high-frequency current flowing through the connector 62, and the distal end gripping part 61 slides backward while rotating while maintaining the state of holding the tissue, and collects the tissue.

Since the treatment tool 51 rotates with the distal end grasping portion 61 grasping the tissue, the grasping portion comes into close contact with the tissue, and when resection is performed, a high-frequency current is used together and the rotating portion is pulled toward the hand side while rotating. A large force is applied and the tissue can be easily excised.

For example, when a large polyp is to be excised, it can be easily excised from the near side, and there is no need to apply a snare wire to the polyp as in the prior art.

[0064]

As described above, according to the two-stage bending endoscope of the present invention, the traction member for performing the bending operation on the front bending structure is provided within the tubular member for performing the bending operation on the rear bending structure. , The outer diameter of the endoscope insertion portion can be formed smaller than that in which the traction member for performing the bending operation is arranged in parallel even if it has two bending portions, and the original function of the endoscope This has the effect of not causing a decrease.

[Brief description of the drawings]

FIGS. 1 to 7 relate to a first embodiment, and FIG. 1 is a longitudinal sectional view of a two-stage curved endoscope.

FIG. 2 is a sectional view taken along lines AA, BB, and CC of FIG. 1;

FIG. 3 is an arrangement configuration diagram of a wire, a tube, and a coil tube.

FIG. 4 is a comparative explanatory diagram of a conventional example and this embodiment.

FIG. 5 is a diagram illustrating the use of a two-stage curved endoscope.

FIG. 6 is an overall configuration diagram of an endoscope system.

FIG. 7 is an external view of a two-stage endoscope.

8 and 9 relate to a second embodiment, and FIG. 8 is an external view of a two-stage curved endoscope.

FIG. 9 is a longitudinal sectional view of a two-stage curved endoscope.

FIG. 10 is a cross-sectional view showing a configuration of the treatment tool.

FIG. 11 is an explanatory view showing an operation and a use mode of the treatment tool.

[Explanation of symbols]

 2 ... two-stage bending endoscope 8 ... insertion part 15 ... first bending part 16 ... second bending part 28 ... wire 29 ... tube 31 ... coil tube 22a, 22b, 22c, 22d ... motor 24 ... pinion 26 ... rack

──────────────────────────────────────────────────続 き Continued on the front page (58) Field surveyed (Int.Cl. ⁷ , DB name) A61B 1/00-1/32 G02B 23/24

Claims (1)

(57) [Claims] 1. A distal end of an endoscope insertion portion to be inserted into a subject
Side which is connected to the first side and bends under a predetermined first traction force.
A first bending portion connected to a distal end side of the second bending portion and the first traction portion;
A second bend under a predetermined second traction force different from the force
And a tubular portion for transmitting the first traction force to the first curved portion.
Transmitting the second traction force to the first bending force transmitting means and the second bending portion;
Second traction inserted into the tubular first traction transmission means
Force transmitting means for applying the first traction force to the first traction force transmitting means.
Applying the second traction force to the first traction force applying means and the second traction force transmission means.
Two-stage bending endoscope characterized by comprising a second traction force application means, the that.