JP3542549B2 - Anal Diagnosis / Treatment Instruments - Google Patents

Description

[0001]
TECHNICAL FIELD OF THE INVENTION
The present invention relates to an anoscope, and in particular to a device used for the diagnosis and / or treatment of an anus.
[0002]
[Prior art]
Conventional anoscopes usually have a front end and a rear end that are open, and a rear end has a flared outer cylinder that widens, and a mandrel member (core) attached to the outer cylinder. The mandrel member enables easy and smooth insertion into the patient's anus. In use, first, the mandrel member is inserted into the outer cylinder through the opening at the rear end, and a part of the shell-shaped head at the tip of the mandrel member is projected forward from the front end opening of the outer cylinder to remove the mandrel. The distal end portion of the tube is smoothly inserted into the patient's anus, and the mandrel member is pressed and fixed. The prepared anoscope is inserted into the anus, the mandrel member is released from the fixed state in the inserted state, and the mandrel member is pulled out. Thereafter, visual observation of mucous membranes and tissues in the anus is performed with the outer tube inserted or with the outer tube pulled out. In addition, a camera is mounted on the rear peripheral portion of the outer cylinder in an inserted state, and an image of the inner wall of the anus is observed on a monitor connected to the camera. Furthermore, the inner wall of the anus is observed while rotating and pulling out the outer cylinder in the inserted state.
[0003]
[Problems to be solved by the invention]
However, the conventional anoscope may not always be inserted smoothly into the patient's anus, and when the inserted anoscope is rotated or pulled out while rotating, the mucous membrane in the anus may be removed. And the tissue is damaged, causing pain for the patient.
[0004]
The present invention has been made in view of the above-mentioned problems of the related art, and without using a mandrel member, can be smoothly inserted into the anus. Another object of the present invention is to provide an anal diagnosis / treatment device that does not damage the inner wall of the anus.
[0005]
[Means for Solving the Problems]
The present inventor has been diligently developed in order to solve the problems of the conventional anoscope, but can be easily inserted without using a mandrel member at the time of insertion into the anus. The present inventors have succeeded in developing an anoscope that can perform even one separate use of an anoscope for inspection / diagnosis and a treatment / operation, and completed the present invention.
[0006]
The anal diagnostic / therapeutic instrument of the present invention has a cylindrical insertion portion consisting of a distal end portion and a main body portion, and the distal end portion is tapered toward the distal end and has a shape with the tip being rounded. In the peripheral surface of the insertion portion, an opening is formed at a predetermined opening angle (α) from the front end to the rear end on the opposite side in the longitudinal direction, The formula: AB / AC = 1/1 so that the position (C) of the end of the opening at the tip is located above the position (B) of the center axis of the insertion portion and at a position short of the front end. .1 to 1.8 (where the line segment AB represents the vertical distance from the position (A) on the outer peripheral surface of the insertion portion to the position (B) of the central axis, and the line segment AC represents the insertion portion. The vertical distance from the position (A) on the outer peripheral surface to the position (C) of the end of the opening at the front end is represented.) Have been.
[0007]
An opening is provided at a predetermined position at a predetermined opening angle (center angle) α, and the end of the opening at the front end is configured to be at the position (C) as described above. Since the opening in is not inclined straight to reach the end of the opening when viewed from the side, it is configured so that the inclination angle is arbitrarily changed in the middle and reaches the end of the opening in two stages of inclination. In addition, the device can be smoothly inserted into the anus, and even if the device is rotated, pulled out, or removed while rotating, the device may damage the mucous membrane, tissue, etc. of the inner wall of the anus. And does not hurt the patient being diagnosed / treated. If the position of the distal end of the opening deviates from AB / AC = 1 / 1.1 to 1.8 in the above range, the insertion of the device cannot be performed smoothly, and the inner wall of the anus is damaged, so that the patient may be damaged. It will be painful.
[0008]
The edge of the opening in the tapered tip portion, when viewed from the side, is inclined in two steps at an arbitrary angle such that the inner wall of the anus is caught in the opening and is not taken in, so that the opening is at the distal end. Preferably, it is formed to reach the position (C). As anus inner wall is not caught in the opening, viewed from the side surface of the edge portion, the radius of curvature R: comprising a second inclined surface having a -10～10Mm: first inclined surface and a curvature having a 20~180mm radius R The rounded surface is preferably inclined in two stages at a predetermined inclination angle to reach the position (C) at the end of the opening. Furthermore, it is preferable that the entire edge of the opening is rounded in the thickness direction so that the inner wall of the anus is caught during operation of the device and is not caught. Thereby, the achievement of the above advantages becomes more remarkable.
[0009]
BEST MODE FOR CARRYING OUT THE INVENTION
Hereinafter, embodiments of the present invention will be described with reference to the drawings.
[0010]
FIG. 1 is a plan view showing an example of an embodiment of an anal diagnosis / treatment device of the present invention, FIG. 2 is an enlarged view of a cross section taken along line AA in FIG. 1, and FIG. FIG. 4 is a sectional view showing another embodiment of the device of the present invention, FIG. 4 is a side view of the device shown in FIG. 1, and FIG. 5 is another embodiment of the present invention shown in FIG. It is a side view which shows the state which attached the camera to the apparatus shown. 1 to 5, the same components are denoted by the same reference numerals.
[0011]
The ammunition-like anal diagnostic / therapeutic instrument 1 of the present invention has a cylindrical insertion portion made of a metal such as brass material, and this insertion portion includes a distal end portion 2 and a main body portion 3. The rear end of the portion facilitates operations such as insertion, withdrawal, and rotation of the device 1 and a grip portion (handle portion) having an arbitrary shape so that the device can be fixed and gripped during treatment. ) 4 is provided. The tip 2 has a shape that tapers gradually toward the tip so that the device can be smoothly and easily inserted into the anus without pain, and the tip is rounded. Is running. In addition, the main body 3 has a cylindrical shape, but has a taper so as to become thinner toward the distal end along the longitudinal direction so that the main body 3 can be inserted smoothly into the anus without pain. It may be an attached cylinder. It is preferable that the grip portion 4 is integrated with the insertion portion from the viewpoint of the operation and strength of the device.
[0012]
An opening 5 is provided in an insertion portion of the anal diagnosis / treatment instrument 1 of the present invention. The opening is formed on the peripheral surface of the insertion portion from the distal end 6 of the distal end portion 2 to the rear end of the opposite main body portion 3 in the longitudinal direction thereof. Used to As shown by the opening angle (center) α in FIG. 2, the opening 5 is formed such that the thick portion of the appliance 1 is formed in an arc with a predetermined opening angle α (in FIG. 2, approximately 100 °) in the longitudinal direction. It is provided so that it may open over. Is usually about 60 to 180 °, preferably 80 to 150 °. If it is opened with a large width such as more than 180 °, the inner wall of the anus becomes entangled in the device 1 through the opening 5 during rotation, and is easily damaged, and has a small width such as less than 60 °. When the mouth is opened, there is a problem that it becomes difficult to inspect, diagnose, treat, and operate the condition of the inner wall of the anus. In addition, when the upper limit of the opening angle is set to 150 ° or less, the entanglement of the inner wall of the anus is further reduced, and when the lower limit is set to 80 ° or more, observation and treatment with the naked eye become easier.
[0013]
The edges and 8 of the opening 5 are rounded in the thickness direction, and are preferably, for example, R (radius of curvature) : 0.05 mm or more. This is in order not to damage the inner wall of the anus. Further, as shown in FIG. 3, a projection 9 having an arbitrary shape integrated with the edge protrudes along the longitudinal direction toward the inside of the insertion portion. You may. The projection is provided to further prevent the inner wall of the anus from being caught, and the shape is not particularly limited.

[0014]
Also, as shown in FIGS. 2 to 4, the end of the opening 5 in the distal end portion 2 is located at a position (C) in front of the distal end of the distal end portion 2 and is located at the center axis (horizontal axis) of the insertion portion. It is located above the position (B). That is, the opening 5 in the distal end portion 2 has a side surface shape of the edge 8 inclined along the tapered shape of the distal end portion, but does not open to the center of the distal end of the distal end portion. It is configured to end at a position above the position (B). This point will be described with reference to FIG. 2. The opening 5 in the distal end portion 2 has a formula: AB / AC = 1 / 1.1 to 1.8, preferably 1.1 to 1.5 (however, , The line segment AB represents the vertical distance from the position (A) on the outer peripheral surface of the insertion portion to the position (B) of the central axis, that is, the outer radius of the insertion portion, and the line segment AC represents the outer radius of the insertion portion. It represents the vertical distance from the position (A) on the surface to the position (C) of the end of the opening at the tip.) The tip 6 of the tip 2 of the device 1 is rounded. The roundness is not particularly limited as long as it can be smoothly inserted when the instrument 1 is inserted into the anus, but it is preferable that the inner wall has an R of 4 mm and the outer wall has an R of 5 mm.
[0015]
The edge 8 of the opening 5 at the tip 2 is inclined so as to reach a straight line near the tip 6 which is rounded along the tapered shape of the tip (that is, the end of the opening) when viewed from the side. Instead, it is formed so as to be inclined in two steps to reach the end of the opening, that is, the vicinity of the rounded tip 6. When viewed from the side, R is a two-step inclined surface at a predetermined angle on a rounded surface composed of a first inclined surface having 20 to 180 mm and a second inclined surface having R: -10 to 10 mm. It is configured to reach the terminal position (C). If it is not a slope having a roundness in such a range, after inserting the device, if the device is rotated or pulled out while rotating, the anal inner wall will be caught in the opening in the device, and the inner wall will be The patient may be injured or damaged.
[0016]
The grip portion 4 provided on the device 1 of the present invention may be any shape as long as it facilitates handling of the device, and its shape is not particularly limited.
[0017]
The instrument for anal diagnosis / treatment 1 of the present invention as described above is preferably applied to the entire instrument with lubricating oil or an anesthetic and inserted into the patient's anus, and the symptoms of the inner wall appearing through the opening are visually observed. While observing, the instrument is rotated and inserted / removed to diagnose and treat the anal inner wall. Although the mandrel member is not used at the time of insertion, it can be smoothly inserted into the affected part without difficulty. Since the mandrel member is not used, the time for insertion and extraction is shortened, and the labor for the operation can be saved. In addition, since the specific structure as described above is employed, the inner wall of the anus is not damaged during diagnosis and treatment, and the patient is not distressed. Furthermore, there is an advantage that diagnosis and treatment can be performed with a single instrument.
[0018]
In the device of the present invention, the entire length of the insertion section is usually about 30 to 200 mm, and the diameter of the insertion section is usually about 5 to 40 mm. The insertion portion is processed so that the surface thereof is smooth, and the material is not particularly limited. However, in the present invention, since the area of the opening is large, a predetermined thickness (for example, 2 mm) is made of bronze or the like. (Preferably the degree). By doing so, the opening of the device is not deformed, and a hemostatic effect at the time of treatment can be obtained by the weight of the device itself. In any case, the surface of the device of the present invention can be appropriately selected in terms of smooth surface finish, shape, size, length, and the like so as to be easily inserted from the anus.
[0019]
In the above-described embodiment of the present invention, the anal diagnostic / therapeutic instrument for performing diagnosis and treatment while visually observing the state of the anal inner wall that appears in the opening of the instrument has been described. However, in addition, as shown in FIG. 5, a camera mounting member 12 is installed on the peripheral edge portion 11 at the rear end of the instrument, and a CCD camera 13 and the like are mounted on the member 12 and are led out from the camera 13 in this state. Diagnosis and treatment can be performed while looking at the image of the affected part on the monitor connected to the cable.
[0020]
【The invention's effect】
According to the anal diagnostic / treatment device of the present invention, an opening is provided at a predetermined position, and the edge of the opening at the distal end is inclined along the tapered shape of the distal end when viewed from the side, and is inclined halfway. Since the angle is changed so as to be a two-step inclination, the inclined surface is rounded when viewed from the side, and the edge is configured to be rounded in the thickness direction, The device can be smoothly inserted into the anus without using a mandrel member. In addition, rotating or pulling out the device during or after insertion does not damage the inner wall of the anus, and does not hurt the patient during diagnosis / treatment. Further, by using the anal diagnosis / treatment device of the present invention, examination / diagnosis and treatment / operation can be performed in one.
[Brief description of the drawings]
FIG. 1 is a plan view of a configuration example of an instrument for anal diagnosis / treatment according to the present invention.
FIG. 2 is an enlarged sectional view of the device shown in FIG. 1 taken along line AA.
FIG. 3 is a cross-sectional view of another configuration example of the anal diagnosis / treatment device of the present invention.
FIG. 4 is a side view of the device shown in FIG. 1;
FIG. 5 is a side view of a configuration example when a camera is mounted on the device shown in FIG. 1;
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 1 Anal diagnostic / therapeutic instrument 2 Tip part of insertion part 3 Body part of insertion part 4 Grip part 5 Opening part 6 Tip part of tip part 7 Edge part of opening part 8 Edge part of opening part 9 Protrusion part 11 Rear end of device Peripheral part 12 Camera mounting member 13 Camera

Claims (4)

It has a cylindrical insertion portion consisting of a distal end portion and a main body portion, and is configured such that the distal end portion is tapered toward the distal end and the distal end is rounded, and a peripheral surface of the insertion portion is provided. Has an opening formed at a predetermined opening angle (α) from the front end to the rear end on the opposite side in the longitudinal direction, and the position of the end of the opening at the front end (C ) Is located above the central axis position (B) of the insertion portion and before the front end, so that the equation: AB / AC = 1 / 1.1 to 1.8 (where the line segment AB represents a vertical distance from a position (A) on the outer peripheral surface of the insertion portion to a position (B) of the central axis, and a line segment AC represents a distance from the position (A) on the outer peripheral surface of the insertion portion to the tip. The vertical distance to the position (C) of the end of the opening in the part.) Therapeutic instruments. 2. The anus according to claim 1, wherein the edge of the opening at the tapered tip is formed so as to be inclined in two steps to reach the end (C) of the opening when viewed from the side. Diagnostic / treatment equipment. Edge of the opening in the tapered tip, as viewed from its side, the curvature radius R: first incline plane has an 20~180mm curvature radius R: rounded comprising a second inclined surface having a -10~10mm The anal diagnostic / therapeutic instrument according to claim 1, wherein the instrument is formed so as to be inclined in two steps on the contacted surface to reach the position (C) of the end of the opening. The anal diagnosis / treatment device according to any one of claims 1 to 3, wherein the entire edge of the opening is rounded in a thickness direction thereof.

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