JP3704103B2 - Endoscope guide tube - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to an endoscope guide tube, and more particularly, to an improvement of an endoscope guide tube capable of directly observing tissue existing under the skin such as muscles, tendons, and nerves with an endoscope.
[0002]
[Prior art]
In general, endoscopes are used as tools for observing lumens by expanding the space between joints, abdominal cavity, urinary bladder, gastrointestinal tract and other cavities in the living body using gas or liquid as a medium. Widely used in urology and urology.
[0003]
FIG. 13 shows a state in which the endoscope 51 is used. In FIG. 13, an intercavity 53 is formed between a pair of opposing bones 52, 52, and the endoscope 51 is placed in the intercavity 53. It is inserted and the inside of the joint A is observed. The endoscope 51 is formed in an elongated cylindrical shape and is inserted into a metal guide tube 54. An optical system is incorporated in the endoscope 51, and light is emitted forward from the distal end portion thereof, and the interior space 53 of the joint A is observed through a transparent lens provided at the distal end portion. Yes.
[0004]
However, in the endoscope 51 as described above, the observable place is limited to a place where there is a space in the living body, and in particular, a subcutaneous tissue such as a muscle, a tendon, or a nerve is directly observed. I could not.
[0005]
Therefore, for example, as shown in Japanese Patent Publication No. 4-10328 (Japanese Patent Laid-Open No. 63-49125) proposed by the applicant of the present application, in FIG. 14, one end is closed and the endoscope 51 can be inserted inside. And a guide tube 54 for an endoscope in which a part or all of the tube body 55 is made transparent. That is, by using a so-called perspective mirror in which the distal end portion 56 of the endoscope 51 is inclined by configuring the tube body 55 with a transparent glass or plastic material such as Pyrex, the guide tube 54 is formed in an angle range of 360 degrees. The touching subcutaneous tissue is observed.
[0006]
Then, as shown in FIG. 15, the guide tube 54 is provided with at least one slit or slot-like opening 57 through which a surgical instrument 58 such as a scalpel is projected to the outside. Yes. As a result, the surgical instrument 58 such as a scalpel protruding from the opening 57 is appropriately operated with the operation rod 59 while observing the state of the subcutaneous tissue by the optical system incorporated at the distal end of the endoscope 51, thereby subcutaneously. Tissue surgery is being performed.
[0007]
[Problems to be solved by the invention]
However, the guide tube 54 is in an open state in which the inside of the guide tube 54 communicates with the subcutaneous tissue or the like through a slit or slot-like opening 57, and body fluid or the like enters the inside. As a result, there has been a problem that body fluid or the like comes into contact with the lens of the endoscope, and thus the ability to mirror is lowered, so that the original surgical purpose cannot be achieved.
[0008]
Therefore, means for covering the opening 57 and its periphery with a plastic film has been taken. In this case, if a knife such as a scalpel is used as a surgical instrument, the knife breaks part of the plastic film and protrudes from the opening 57. As a result, the body fluid or the like entered the guide tube 54 due to damage of the plastic film, which was not an essential solution.
[0009]
Therefore, an object of the present invention is to form a tubular member capable of closing one end and inserting an endoscope inside, and providing a guide member for guiding a surgical instrument such as a blade outside the guide tube. An object of the present invention is to provide an endoscope guide tube that prevents intrusion of body fluids or the like into a guide tube and can safely perform surgery on subcutaneous tissues such as muscles and tendons.
[0010]
[Means for Solving the Problems]
An object of the present invention is to provide a guide tube for an endoscope which is configured by a tubular member which is closed at one end and into which an endoscope can be inserted, and in which a part or all of the tubular member is transparent. A guide member for guiding a surgical instrument such as a blade is provided on the outer side, and the guide member forms a bulge extending from the proximal side to the distal side along the axial direction on the outer side of the guide tube. The bulge is used to guide a surgical instrument such as a scalpel in a state where an edge protrudes outside the guide tube, so that bodily fluids or the like in the living body do not enter the guide tube. This is achieved by enabling safe operation.
[0011]
Further, the above object of the present invention is to guide a surgical instrument such as a scalpel movably by the guide member and to freely move and rotate the axial direction of the endoscope inserted into the guide tube and the axis. This is achieved by performing the operation safely and accurately while observing the tissue in the living body through the transparent part formed in the guide tube.
[0012]
In addition, the object of the present invention is to form a groove in the shape of an L-shaped section or an inverted L-shaped section together with the guide tube as the guide member, and guide a surgical instrument such as a scalpel along the groove. This is achieved by doing so.
[0013]
That is, the above-described object of the present invention is achieved by forming a bulge extending from the proximal end side toward the distal end side along the axial direction on the outside of the guide tube as a guide member. It is only necessary to guide along the protrusion as a guide member, and anyone can perform an operation easily and accurately.
[0014]
DETAILED DESCRIPTION OF THE INVENTION
Embodiments of an endoscope guide tube according to the present invention will be described below with reference to the drawings.
[0015]
FIG. 1 shows a use state of an endoscope 2 in a joint 1. The endoscope 2 is used in a space 4 formed between a pair of opposing bones 3, 3, and subcutaneous tissues such as muscles and tendons. Is supposed to be inserted into The figure shows a state where the endoscope 2 is inserted into the guide tube 5 and the subcutaneous tissue in the joint 1 is directly observed. That is, the endoscope 2 has an optical system incorporated therein so that light is emitted forward from the distal end portion and the subcutaneous tissue around the joint 1 is observed through an objective lens provided at the distal end portion. It has become.
[0016]
An electronic endoscope may be used as the endoscope. In this case, as shown in FIG. 2, the endoscope 2 emits light forward from the distal end portion, and the transparent lens 6 provided at the distal end portion. The image data in the intercavity 4 is taken in via the image, and the image is displayed on the monitor 10 from the CCD lens 7 via the signal cable 8 and the signal processing means 9, and the state in the intercavity 4 is observed. ing.
[0017]
As a feature of the present invention, FIG. 3 shows a state in which the endoscope 2 is inserted into the guide tube 5, and FIG. 4 is a view of the guide tube 12 viewed from the side. In these drawings, on the outside of the main body 11 of the guide tube 5, a single recess 12 is formed along the axial direction. As shown in FIG. 5, a surgical instrument 13 such as a thin scalpel is fitted in the recess 12 so as to be movable along the axial direction, and the surgical instrument 13 such as a scalpel is guided along the recess 12. It is supposed to be. On the open end side of the guide tube 5, a handle portion 14 extending outward in the radial direction is integrally formed. The main body 11 is preferably formed integrally from transparent glass or plastic. The main body 11 has a substantially cylindrical shape, and the inner diameter of the hollow portion is set slightly larger than that of the endoscope. Thereby, after setting the guide tube 5 to a predetermined position, the endoscope 2 is inserted, and the subcutaneous tissue in the living body is observed through the guide tube 5. Furthermore, the endoscope 2 is movable in the axial direction in the guide tube 5 and can be rotated 360 degrees around the axis, and a part or all of the main body 11 is formed to be transparent. Can be observed inside.
[0018]
As a result, when there is an abnormal portion inside the living body, the size, the distance from the incision point, and the like can be immediately determined. When the surgical instrument 13 such as a scalpel is attached to the recess 12 of the guide tube 5, the edge 13a protrudes to the outside of the guide tube 5, and the operator grasps the operating rod 14a and While observing the inside, the surgical instrument 13 can be slid along the recess 12 for surgery. The recess 12 may be formed over a part or the entire length of the guide tube 5.
[0019]
6 and 7 show a second embodiment of the endoscope guide tube according to the present invention. In these drawings, the same members as those in the first embodiment are denoted by the same reference numerals, and the description thereof is omitted.
[0020]
A protrusion 15 is formed on the outside of the guide tube 5 along the axial direction, and a surgical instrument 13 such as a scalpel is mounted on the protrusion 15 so as to be movable in the axial direction, thereby guiding the surgical instrument 13. Yes. In this case, as shown in FIG. 8, the surgical instrument 13 such as a scalpel is mounted at a right angle or an arbitrary angle with respect to the ledge 15 and is movable in the axial direction.
[0021]
Therefore, also in the second embodiment, the surgical instrument 13 such as a scalpel is mounted on the outside of the guide tube 5, so that bodily fluids and the like in the living body do not enter the inside of the guide tube 5. As a result, the endoscope 2 is inserted into the guide tube 5, and the surgeon can perform an operation on the abnormal portion with the surgical instrument 13 while observing the state in the living body. Therefore, the same operation and effect as the first embodiment can be obtained.
[0022]
9 and 10 show a third embodiment of the endoscope guide tube according to the present invention. In these drawings, the same members as those in the first and second embodiments are denoted by the same reference numerals, and the description thereof is omitted.
[0023]
As shown in FIG. 11, a protrusion 16 having an inverted L-shaped cross section is formed along the axial direction on the outside of the guide tube 5, and the protrusion 16 and the guide tube 5 are formed as shown in FIG. A surgical instrument 13 such as a scalpel is movably attached to the groove 17 along the groove 17. Therefore, since the surgical instrument 13 such as a scalpel is attached to the outside of the guide tube 5, bodily fluids and the like in the living body do not enter the inside of the guide tube 5. As a result, the abnormal part can be operated with the surgical instrument 13 while the endoscope 2 is inserted into the guide tube 5 and the state in the living body is observed. Therefore, the same operation and effect as the first and second embodiments can be obtained.
[0024]
Accordingly, in each of the above embodiments, a guide member for guiding the surgical instrument 13 such as a scalpel is provided outside the guide tube 5. That is, the recess 12 is formed outside the guide tube 5 in the first embodiment, the protrusion 15 is formed outside the guide tube 5 in the second embodiment, and the cross section is formed outside the guide tube 5 in the third embodiment. An inverted L-shaped protrusion 16 was formed. The surgical instrument 13 can be mounted on the outside of the guide tube 5 and moved along the groove 17 formed by the recess 12, the ledge 15 and the ledge 16. As a result, an opening leading to the outside is not formed in the guide tube 5, and body fluid or the like in the living body does not enter the guide tube 5. Therefore, even when an operation is performed using the endoscope 2, there is no problem that the bodily fluid or the like comes into contact with the objective lens or the CCD lens in the endoscope and the mirror ability is deteriorated. Therefore, a surgical instrument such as a scalpel can be operated while viewing a clear image near the predicate on a monitor or the like, and a surgical operation on a subcutaneous tissue such as a muscle or a tendon can be performed safely.
[0025]
【The invention's effect】
As described above, according to the endoscope guide tube of the present invention, one end is closed and the tubular member into which the endoscope can be inserted is formed, and a guide member, that is, a recess is formed outside the guide tube. Or a bulge or the like is formed, and a surgical instrument such as a scalpel is attached to the depression or bulge. Therefore, the guide tube has no opening communicating with the inside of the living body, so that bodily fluids or the like in the living body do not enter the inside of the guide tube and come into contact with lenses such as an endoscope objective lens or a CCD lens. , Mirror vision does not deteriorate. As a result, on the monitor, etc., the situation around the surgical site is always displayed with clear images, and even doctors who are not familiar with surgery can operate safely and accurately by guiding surgical instruments such as scalpels with guide members. The risk of damaging surrounding tissues such as nerves, blood vessels, and tendons can be avoided.
[Brief description of the drawings]
FIG. 1 is a diagram showing a use state of an endoscope guide tube according to the present invention.
FIG. 2 is an explanatory diagram showing a schematic configuration of an electronic endoscope.
FIG. 3 is a perspective view showing an appearance of an endoscope guide tube equipped with a surgical instrument.
4 is a side view of the endoscope guide tube shown in FIG. 3. FIG.
5 is a cross-sectional view taken along line AA in FIG.
FIG. 6 is a perspective view showing an appearance of an endoscope guide tube according to a second embodiment of the present invention.
7 is a side view of the endoscope guide tube shown in FIG. 6. FIG.
8 is a cross-sectional view taken along line BB in FIG.
FIG. 9 is a perspective view showing an appearance of an endoscope guide tube according to a third embodiment of the present invention.
10 is a side view of the endoscope guide tube shown in FIG. 9; FIG.
11 is a cross-sectional view taken along the line CC of FIG.
FIG. 12 is a view showing a state in which a surgical instrument such as a scalpel is inserted into a groove formed by projecting out of the endoscope guide tube.
FIG. 13 is a diagram showing a use state of a conventional endoscope guide tube between living body lumens.
FIG. 14 is an explanatory view showing a state where an endoscope is inserted into a conventional endoscope guide tube.
FIG. 15 is a perspective view showing a state in which an endoscope and a surgical instrument are mounted on a conventional endoscope guide tube.
[Explanation of symbols]
2 Endoscope 4 Space 5 Guide tube 7 CCD lens 11 Main body 12 Recess 13 Surgical instrument 15 Protrusion 16 Protrusion 17 Groove

Claims (3)

An endoscope guide tube that is configured with a tubular member in which one end is closed and an endoscope can be inserted therein, and a part or all of the tubular member is transparent. A guide member for guiding the instrument is provided, and the guide member forms a bulge extending from the proximal end side toward the distal end side along the axial direction on the outside of the guide tube, and uses the bulge. Thus, a surgical instrument such as a scalpel can be guided movably with the edge protruding outside the guide tube, so that body fluids and the like in the living body cannot enter the guide tube and can be operated safely. An endoscope guide tube characterized in that it is configured as described above.   The guide member is formed in the guide tube by guiding a surgical instrument such as a scalpel so as to be movable and allowing the endoscope inserted into the guide tube to move and rotate in the axial direction and around the axis. The endoscope guide tube according to claim 1, wherein the operation can be performed safely and accurately while observing the tissue in the living body through the transparent portion. 2. The guide member according to claim 1, wherein the guide member forms a groove with an L-shaped cross section or an inverted L-shaped cross section together with the guide tube, and guides a surgical instrument such as a scalpel along the groove. Endoscope guide tube.

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