JP3309215B2 - Endoscope for endotracheal tube intubation - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to the case of inserting an endotracheal tube into a patient who has suffered from dyspnea due to an injury or sudden onset of an accident or disaster and has to urgently need to secure an airway. In order to facilitate the insertion of the endotracheal tube into the trachea, it relates to an endotracheal tube intubation endoscope which can be inserted while optically observing the inside of a body cavity,
More specifically, the present invention relates to a bending structure of an endoscope for endotracheal tube intubation.

[0002]

2. Description of the Related Art Conventionally, as a method for intubating an endotracheal tube safely, reliably, and quickly, an endoscope having a bending function at an insertion portion is inserted into the interior of the endotracheal tube to directly view the larynx. A method of confirming and guiding the patient and inserting the endotracheal tube into the trachea using the endoscope as a guide has been performed.

[0003] However, in the insertion operation of this method,
There are various problems. One of the problems is that when the endoscope is bent, the length of the insertion portion changes. In this method, it is general that the tip of the endoscope is slightly retracted from the tip of the endotracheal tube, attached, and inserted into a human body. This is often because the patient's larynx is bleeding due to injuries, etc., and in such cases, if the endoscope is inserted and inserted so that the end of the endoscope comes out from the end of the endotracheal tube, This is because a certain objective lens becomes dirty with blood and cannot be seen. However, if you retract too much,
At this time, the inner wall of the endotracheal tube becomes visible in the visual field, and the visual field is narrowed, so that the lumen cannot be observed widely, and it becomes difficult to search for the target site. Therefore, upon insertion, the endoscope is set and inserted in a place where the end of the endotracheal tube is retracted from the end of the endotracheal tube and the inner wall of the endotracheal tube is not visible in the field of view.

[0004] In an endoscope used for intubating an endotracheal tube as in the present case, since the endotracheal tube is strong, a considerable force is required to bend it, so that the endoscope is more durably and strongly bent. Such a structure is taken.
That is, an insertion portion is formed by connecting a resin tube to the distal end portion of the endoscope, and a wire is displaced in a radial direction with respect to the insertion direction central axis of the distal end portion of the endoscope or the distal end side of the resin tube. And a structure in which the wire is pulled to bend, or a resin tube is connected to the end portion of the endoscope, and a bending restoration portion made of a coil spring or the like is attached to the tip side of the resin tube. Similar to the structure, a wire is connected to the distal end of the endoscope, the resin tube, or the distal end of the bending restoration portion, and the wire is bent by pulling the wire so that the bending restoration is improved. .

[0005] However, in such a structure, the wire is directly or indirectly fixed to the endoscope distal end, so that not only the wire pulling force but also the endoscope distal end is bent. It also acts as a pulling force, so that the insertion part is compressed, and consequently the insertion part is meandered or shrunk, thus causing the above-mentioned problem that the length of the insertion part changes.

In such a case, the distal end of the endoscope is further retracted into the endotracheal tube, and the inner wall of the endotracheal tube becomes visible in the field of view of the endoscope. Will be hard to find. Therefore, the operator must adjust the amount of the endoscope pushed into the endotracheal tube so that the inner wall of the endotracheal tube is not visible in the visual field.
In addition, if the amount of curvature is reduced while searching for the target site even after readjustment, the endoscope will now extend and the endoscope end will protrude from the endotracheal tube. Then, blood or the like may adhere to the distal end objective lens and become invisible. Then you have to pull it out, wipe the tip and put it back in. Performing such operations in an emergency is extremely troublesome.

Another problem is that the insertion portion of the endoscope is twisted and bent when the endoscope is bent. The endotracheal tube is bent to facilitate insertion into the trachea. If the endoscope is not bent in the same direction as its bending habit, the endotracheal tube will be inserted with the endoscope as a guide, so when the endotracheal tube is pushed in, it will be pushed in an unexpected direction This can lead to poor tracheal entry.
Therefore, the endoscope is inserted into the endotracheal tube and used in accordance with the bending direction of the endotracheal tube and the bending direction of the endoscope. Not necessarily. This is due to the fact that the attachment of the wire is slightly biased or that the resin tube itself, which is the exterior of the insertion portion, has a habit of twisting. The elastic member such as a resin tube or a coil spring used has a circular cross section, does not act to control torsion, and can be bent in any direction.

[0008]

DISCLOSURE OF THE INVENTION The present invention has been made to solve the above-mentioned problems, and the position of the distal end of the endoscope does not shrink due to compression even when the endoscope is bent. Accordingly, it is an object of the present invention to provide an endoscope for endotracheal tube intubation in which the position of the distal end portion of the endoscope does not change, and a stable visual field can be secured.

It is still another object of the present invention to provide an endoscope for intubating an endotracheal tube which can bend in a fixed direction stably and can guide the endotracheal tube well.

[0010]

The endoscope for endotracheal tube intubation of the present invention is characterized in that it has at least an image transmission fiber bundle and an illumination light transmission fiber bundle inside, and has a distal end and a proximal end. An elongated insertion portion having a portion, a hand operation portion connected to a base end portion of the insertion portion, a bending operation mechanism provided in the hand operation portion, and a portion extending from the inside of the insertion portion to the bending operation mechanism. A bending element that bends the insertion portion provided, one end of the bending element forms a free end inside the insertion portion, and the other end corresponds to a base end portion or the hand operation portion of the insertion portion. A long end elastic body serving as a fixed end, and a push / pull element having one end connected to the vicinity of the free end of the elastic body and the other end connected to the bending operation mechanism. Further, the elastic body is a thin plate.
Further, the push-pull element is a thin plate.

In the endoscope of the present invention, a bending element for bending the insertion portion provided from the inside of the insertion portion to the bending operation mechanism has one end forming a free end inside the insertion portion, and the other end forming the insertion portion. A long elastic body that forms a fixed end to the base end or the hand operation unit, and one end is connected near the free end of the elastic body,
The other end is composed of a push / pull element connected to the bending operation mechanism, so that even if the push / pull element is pulled and bent, the compressive force due to the pulling force of the push / pull cable is applied to the endoscope end and the insertion section. Since the endoscope insertion portion does not work, the length of the endoscope insertion portion does not shrink, and thus the end of the endoscope mounted in the endotracheal tube does not fluctuate when the endoscope is bent. Therefore, once the endoscope is mounted at an appropriate position in the endotracheal tube, a stable visual field free of blood adherence and not obstructed by the inner wall of the endotracheal tube can be obtained at any time.

Further, since the elastic body of the bending element is made of a thin plate, the flat plate bends in the thickness direction but hardly bends in the width direction even if the insertion portion of the endoscope is twisted when the bending is applied. The bending direction acts as a drag for twisting, and the stable bending direction is maintained. Further, since the push / pull element of the bending element is made of a thin plate, the resistance to twisting becomes stronger, and a more stable bending direction can be maintained.

[0013]

An embodiment of the present invention will be described below with reference to the drawings. FIG. 1 is an overall configuration diagram of an embodiment of the present invention. The endoscope of the present invention is an endotracheal tube 2.
The insertion section 1 is inserted into the inner space of the insertion section 1 and a hand operation section 2 connected to the base end of the insertion section 1 and arranged outside the endotracheal tube 20.

The detailed structure will be described based on the cross-sectional view of the insertion portion of the endoscope shown in FIG. 2 and the cross-sectional view of the hand operation unit shown in FIG. The insertion portion 1 has an elongated shape, and has a tip portion 3 at the tip, and an objective lens 4 at the end face of the tip portion 3.
The distal end of the image transmission fiber 5 is optically connected to the optical fiber, and is guided to the hand operation unit 2 through the inner space of the insertion unit 1. The other end of the image transmission fiber 5 is optically connected to an eyepiece 6 provided in the hand operation unit 2. Around one end of the objective lens 4, one end or a plurality of illumination light transmission fibers 7 are open at the end, and the other end is optically connected to a light source unit 8 provided in the hand operation unit 2. Are linked. A space between the distal end 3 and the proximal end of the insertion section 1 is covered with a resin tube 9.

Further, a thin plate-like elastic body 10 made of a metal having elasticity such as stainless steel is provided in the insertion portion 1.
And a bending element 12 made of a thin plate-like push-pull member 11 made of a metal having elasticity such as stainless steel as a push-pull element for bending the same. The distal end of the elastic body 10 extends to the vicinity of the distal end 3 of the insertion section 1, and the proximal end thereof is fixed to the proximal end of the insertion section 1.
The push / pull member 11 has a distal end connected to the distal end of the elastic body 10 and a proximal end provided with the bending operation mechanism 1 provided in the hand operation unit 2.
3 is connected. Then, the elastic body 10, the push-pull member 1
The connected distal end portion 1 is not fixed to the distal end portion 3 of the insertion section 1 nor to the resin tube 9 and has a free end.

The base end of the elastic body 10 may be fixed to the hand operation unit 2 instead of the base end of the insertion section 1. Further, the push-pull member 11 may be a linear member such as a wire instead of a thin plate member. Further, the elastic body 10 and the push-pull member 11 may be made of resin or the like instead of metal.

The connecting portion of the push / pull member 11 to the bending operation mechanism 13 has a terminal 14 fixed to the terminal of the push / pull member 11, and when the terminal 14 grips the lever 15 of the bending operation mechanism 13 with the lever 15. The terminal 14 is engaged so as to be pulled toward the eyepiece. And, by this operation, the push-pull member 11
Is pulled to the eyepiece side, and the tip of the push-pull member 11 is
The elastic body 10 is bent by this force,
The bending of the elastic body 10 causes the insertion portion 1 to be bent and bend. In addition, the base ends of the elastic body 10 and the push-pull member 11 are both covered with a reinforcing pipe 16 made of metal, and a curved portion is formed when the reinforcing pipe 16 is removed.

The proximal end of the illumination light transmitting fiber 7 is bundled and optically connected to a light source 17 provided in the hand operation unit 2. Power is supplied to the light source 17 via a cable by a power supply unit 18 also provided in the hand operation unit 2.

An endotracheal tube connecting portion 19 is provided near the connecting portion between the insertion portion 1 and the operation portion 2 at hand. The endotracheal tube connection portion 19 can be advanced and retracted in the insertion direction and can be fixed at an arbitrary position, and the position of the distal end of the endotracheal tube 20 to be used is adjusted according to the position of the distal end portion 3 of the endoscope. I can do it.

In the endoscope thus constructed, first, the endoscope is inserted into the inner space of the endotracheal tube 20 by matching the direction of the bending tendency of the endotracheal tube 20 with the direction of the bending of the endoscope. The part 1 is inserted, and the endotracheal tube 20 is connected to the endotracheal tube connection part 19.

The position of the distal end portion 3 of the endoscope slightly withdrawn from the distal end of the endotracheal tube 20, specifically, within a range where the inner wall of the endotracheal tube 20 does not enter the visual field of the endoscope. The position of the endotracheal tube 20 is fixed by adjusting the set position of the endotracheal tube connection portion 19 so that the endotracheal tube 20 comes to a position slightly retracted from the tip of the tube.

Thereafter, the endotracheal tube 20 is inserted into the human body from the mouth, and the endotracheal tube 20 is advanced or retracted while looking into the eyepiece 6 of the endoscope, or the lever 15 of the bending operation mechanism 13 is gripped to bend. When the larynx is visible by pushing or loosening it, push the endotracheal tube 20 toward it when the larynx is visible, and insert the endotracheal tube 20 into the trachea until it does not fall out easily. Only the endoscope is removed except for the endoscope 20, and after that, an air supply device is connected to the endotracheal tube 20 to supply oxygen to the lungs and ensure respiration of the patient.

The bending of the endoscope at this time is performed as follows. When the lever 15 of the bending operation mechanism 13 is gripped, the lever 15
Pulls the terminal 14 engaged therewith in the eyepiece direction. Since the terminal 14 is fixed to the end of the push / pull member 11, the terminal 14 is pulled to
1 is pulled toward the eyepiece. The distal end of the push / pull member 11 is connected to the distal end of the elastic body 10, and the proximal end side of the elastic body 10 is fixed to the proximal end of the insertion section 1 and does not move.
When the push / pull member 11 is pulled, the elastic body 10 is bent. Since the elastic body 10 inside is bent, the insertion portion 1 including the elastic body 10 is forcibly bent, that is, bent. At this time, the distal ends of the elastic body 10 and the push / pull member 11 are free ends that are not fixed to the distal end portion 3 of the insertion section 1 nor to the resin tube 9 forming the exterior of the insertion section 1. The pulling force of the member 11 is not applied to the distal end portion 3 or the resin tube 9 at all, that is, the distal end portion 3 is not subjected to a force for compressing the distal end portion 3 in the eyepiece direction, that is, the insertion axis direction. The elastic body 10 and the push / pull member 11 are forced to be curved. The insertion portion 1 is bent without being shrunk by the force by which the push-pull member 11 is pulled.

In the curved state, since the bending element 12 is made of the thin plate-like elastic body 10, it bends in the thickness direction but hardly in the width direction. When a force is applied to the tip, it bends stably in the thickness direction. This also acts as a drag when the insertion section is about to be twisted, and the insertion section 1 is stably curved in a certain direction. Further, when the push-pull member 11 is formed in a thin plate shape, this effect is further increased.

[0025]

As described in detail above, in the endoscope for endotracheal tube intubation of the present invention, the bending element for bending the insertion portion is fixed at the distal end thereof to the distal end of the endoscope insertion portion. The end of the insertion part is not attached to the endoscope because the force that pulls the bending element does not act as a force to compress the tip of the insertion part when bending, because it is provided as a free end without being attached The distal end of the endoscope will not be retracted into the endotracheal tube. Therefore, the problem that the endoscope retracts when the curve is applied and the inner wall of the endotracheal tube becomes visible in the field of view and narrows the field of view, making it difficult to search for the target site in the body cavity can be solved.

Further, since the elastic body of the bending element is made of a thin plate, it can be bent in a fixed direction stably, and the bending tendency of the endotracheal tube differs from the bending direction, so that the endotracheal tube can be inserted in the target direction well. The problem of being unable to do so can be solved.

Further, the elastic body 10 of the bending element and the push / pull member 1
By using a thin plate for both of them, the bending direction can be further stabilized.

[Brief description of the drawings]

FIG. 1 is an overall configuration diagram of an embodiment of the present invention.

FIG. 2 is a cross-sectional view of an insertion portion according to the embodiment of the present invention.

FIG. 3 is a sectional view of a hand operation unit according to the embodiment of the present invention.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Insertion part 2 Hand operation part 3 Tip part of insertion part 9 Resin tube 10 Elastic body 11 Push-pull member 12 Bending element 13 Bending operation mechanism 14 Terminal 15 Lever 19 Endotracheal tube connection part 20 Endotracheal tube

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

Claims (3)

(57) [Claims] 1. An elongated insertion portion having at least an image transmission fiber bundle and an illumination light transmission fiber bundle therein and having a distal end portion and a proximal end portion, and connected to a proximal end portion of the insertion portion. A bending operation mechanism provided in the hand operation unit; a bending element configured to bend the insertion portion provided from the inside of the insertion portion to the bending operation mechanism; A long elastic body having one end forming a free end near the distal end in the insertion portion and the other end forming a fixed end to the base end portion or the hand operation portion of the insertion portion; An endoscope for endotracheal tube intubation, comprising: a push / pull element connected near a free end and the other end connected to the bending operation mechanism. 2. The endoscope for endotracheal tube intubation according to claim 1, wherein the elastic body is made of a thin plate. 3. The endoscope for endotracheal tube intubation according to claim 1, wherein the push / pull element is made of a thin plate.