JP3859491B2 - Endoscope sheath - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to an endoscope sheath that is adsorbed and fixed to a tissue in a body cavity with the endoscope attached.
[0002]
[Prior art]
2. Description of the Related Art Conventionally, as a medical technique using an endoscope, a detachable tip hood is attached to the tip of an endoscope like an endoscope tip hood device described in Japanese Patent Application Laid-Open No. 11-4799. In some cases, suction was applied to the tissue to adsorb the tissue for treatment.
[0003]
In addition, as a medical technique using an endoscope, there is also a catheter-type fiberscope described in Japanese Utility Model Laid-Open No. 63-180006 in which a balloon is provided at an insertion portion of the endoscope to fix the endoscope. there were. Alternatively, it is generally known that such a balloon can be used to create a treatment cavity.
[0004]
[Problems to be solved by the invention]
In the endoscope front hood device described in Japanese Patent Application Laid-Open No. 11-4799, blood is collected by suction pressure when suction is applied to the front end hood when used for hemostasis. Moreover, although the tip hood and suction improve the sniping ability to the target tissue, since the endoscope itself is not fixed, skill is required to capture the target tissue. In the method of fixing an endoscope with a balloon or the like like the catheter-type fiberscope described in Japanese Utility Model Publication No. 63-180006, for example, when used in the ventricle, brain damage must be prevented, Adjustment when the balloon was fixed by applying pressure was difficult. Similarly, when creating a cavity in the brain for treatment with a balloon, it was difficult to adjust the pressure in order to prevent damage to the brain.
[0005]
The present invention has been made in view of the above circumstances, improves the operability by fixing the endoscope, creates a cavity necessary for the treatment, and at the same time improves the sniperability by tissue adsorption, An object of the present invention is to provide an endoscope sheath that can prevent an increase in bleeding due to tissue damage or adsorption during the fixation of the endoscope or the creation of the cavity.
[0006]
[Means for Solving the Problems]
In order to achieve the object, an endoscope sheath according to claim 1 is provided on a tube body into which an endoscope can be inserted into a tube and an outer surface of the tube body, and by excluding tissue in the body cavity. A first fixing means that can be fixed and open or can be adjusted in any desired strength; a double substantially cylindrical tip hood provided at the tip of the tube body; It is characterized by comprising: a conduit that circulates between the outer mantle and the inner mantle; and second fixing means that is provided on the distal end side of the tube body and that can be attached to and detached from the endoscope.
[0007]
In the endoscope sheath according to claim 1, the first fixing means excludes the tissue in the body cavity, so that the endoscope can be fixed and the operability can be improved, and a cavity necessary for the treatment can be created. Furthermore, by adsorbing the tissue between the mantle and the inner mantle of the tip hood, the sniping property is improved, and at the same time, the endoscope is fixed and the tissue is damaged during the creation of the cavity and the bleeding is increased due to the adsorption. Can be prevented.
[0008]
DETAILED DESCRIPTION OF THE INVENTION
Hereinafter, embodiments of the present invention will be described with reference to the drawings.
(Embodiment)
1 to 4 relate to an embodiment of the present invention, FIG. 1 is a perspective view of an endoscope to which an endoscope sheath is attached, FIG. 2 is a sectional view of the endoscope sheath, and FIG. 3 is an endoscope. FIG. 5 is a perspective view showing a controller for operating a mirror sheath, and FIG. 4 is a block diagram showing an internal configuration of the controller.
[0009]
(Constitution)
In FIG. 1, an insertion portion of an endoscope 1 is covered with an endoscope sheath 2.
The endoscope sheath 2 is formed with a tube body 20 into which the endoscope 1 can be inserted into a tube as a basic structure. A distal end hood 4 having a shape that is transparent to the balloon 3 and does not obstruct the field of view of the endoscope is provided on the distal end side of the tube body 20 of the endoscope sheath 2.
[0010]
The balloon 3 is provided on the outer surface on the distal end side of the tube body 20 and is fixed by excluding the tissue in the body cavity. The first fixing means can arbitrarily select fixing and opening or can adjust the fixing strength. It has become.
[0011]
On the proximal end side of the endoscope sheath 2, a suction tube 5 and a suction connector 6 connected to a suction conduit from a distal hood 4 described later are provided.
[0012]
Further, an air supply tube 9 and an air supply connector 10 for inflating the balloon 3 are provided on the proximal end side of the endoscope sheath 2.
[0013]
Next, the structure of the endoscope sheath 2 will be described with reference to FIG.
In FIG. 2, a distal end hood 4 is provided at the distal end of the endoscope sheath 2. The tip hood 4 is formed in a double substantially cylindrical shape by an outer cannula 12 and an inner cannula 13. A suction port 8 is formed between the outer cannula 12 and the inner cannula 13. The suction port 8 is a suction conduit that circulates between the outer sleeve 12 and the inner sleeve 13. The suction port 8 communicates with the suction tube 5 and the suction connector 6 so that the tissue can be sucked by a suction means described later.
[0014]
On the other hand, a tip mounting portion 7 is formed at the root of the tip hood 4. The tip mounting portion 7 is fixed to the endoscope 1. In this embodiment, the endoscope 1 and the tip mounting portion 7 have a snap fit due to unevenness. However, the form is not particularly limited as long as it can be fixed and detachable. With such a structure, the distal end mounting portion 7 is provided on the distal end side of the tube body 20 and serves as a second fixing means that can be attached to and detached from the endoscope 1.
[0015]
A balloon 3 is provided on the proximal side of the tip hood 4. The balloon 3, the air supply tube 9, and the air supply connector 10 communicate with each other, and the balloon 3 can be inflated by an air supply means described later.
[0016]
A proximal end attachment portion 11 for fixing to the endoscope 1 is formed on the proximal end side of the tube body 20 of the endoscope sheath 2, and like the distal end attachment portion 7, the proximal end attachment portion 11 is fixed to the endoscope 1. Fix and remove.
[0017]
Next, a controller 21 for operating the endoscope sheath 2 will be described with reference to FIG.
The controller 21 accommodates various times and pumps to be described later in a box-shaped housing.
[0018]
The front plate of the housing of the controller 21 is provided with an air supply time setting panel 27 and an air supply pressure setting panel 28 for inflating the balloon 3, and set values are displayed respectively. . Further, an air supply time warning light 29 and an air supply pressure warning light 30 are provided on the front plate of the housing of the controller 21. The air supply time warning light and the air supply pressure warning light 30 are turned on when the set air supply time and pressure are exceeded, and a warning sound is emitted. It is like that. For example, if the endoscope 1 is a ventricular scope, it is contraindicated to press the same place for a long time and apply strong pressure because the brain is very delicate. This is because it is necessary to give a warning to the user when the set time and pressure are exceeded. Further, an air supply port 31 through which air is sent out is provided on the front plate of the housing of the controller 21, and the air supply connector 10 shown in FIG. 1 can be connected to the air supply port 31. ing.
[0019]
Similarly, a suction time setting panel 32, a suction pressure setting panel 33, a suction time warning lamp 34, and a suction pressure warning lamp 35 are provided on the front plate of the housing of the controller 21. The suction time setting panel 32 and the suction pressure setting panel 33 are for setting the suction time and the suction pressure for sucking the tissue from the tip hood 4 shown in FIG. The suction time warning lamp 34 and the suction pressure warning lamp 35 are turned on when a set suction time and pressure are exceeded, respectively, and a warning sound is emitted. Further, a suction port 36 for performing suction is provided on the front plate of the housing of the controller 21, and the suction connector 6 shown in FIG. 1 can be connected to the suction port 36.
[0020]
In addition, a foot switch 22 for operation is connected to the controller 21 via a cable 37.
[0021]
The foot switch 22 includes a suction pedal 23 for performing a suction operation, a suction release pedal 24 for releasing suction, an air supply pedal 25 for performing air supply operation, and an air supply release pedal for releasing air supply 26 is provided.
[0022]
Next, the internal configuration of the controller 21 will be described with reference to FIG.
The air supply means 40 for inflating the balloon 3 includes an air supply time setting panel 27, an air supply pressure setting panel 28, an air supply time warning light 29, an air supply pressure warning light 30, and an air supply port 31. The air supply controller 41, the air supply pump 42, the air supply pressure sensor 43, and the air supply release valve 44 are configured.
[0023]
An air supply time setting panel 27 and an air supply pressure setting panel 28 are connected to the air supply controller 41. The air supply time setting panel 27 and the air supply pressure setting panel 28 input the air supply time and pressure to the air supply controller 41 and display them. The air supply controller 41 drives the air supply pump 42 based on the input information to supply air. The air supply from the air supply pump 42 is sent out to the air supply port 31 via the air supply pressure sensor 43 and the air supply release valve 44.
[0024]
During the air supply, the air supply pressure sensor 43 measures the pressure of the air supply from the air supply pump 42 and sends the information to the air supply controller 41. The air supply controller 41 determines information from the air supply pressure sensor 43 and the elapsed time, turns on the air supply time warning lamp 29 and the air supply pressure warning lamp 30 as necessary, and sounds a warning sound. In addition, the air supply controller 41 can release the air supply by operating the air supply release valve 44 by operating the foot switch 22. Then, the air supplied from the air supply port 31 is sent to the balloon 3 via the air supply connector 10 of FIG.
[0025]
The suction circuit 50 for sucking the tissue includes a suction time setting panel 32, a suction pressure setting panel 33, a suction time warning lamp 34, a suction pressure warning lamp 35, a suction port 36, a suction controller 51, a suction The pump 52, the suction pressure sensor 53, and the suction release valve 54 are comprised.
[0026]
A suction time setting panel 32 and a suction pressure setting panel 33 are connected to the suction controller 51. The suction time setting panel 32 and the suction pressure setting panel 33 input the suction time and pressure to the suction controller 51 for display. The suction controller 51 drives the suction pump 52 based on the input information to perform suction. The suction force by the suction pump 52 is transmitted to the suction port 36 via the suction pressure sensor 53 and the suction release valve 54.
[0027]
At the time of suction, the suction pressure sensor 53 measures the suction pressure by the suction pump 52 and sends the information to the suction controller 51. The suction controller 51 determines this information and the elapsed time, turns on the suction time warning lamp 34 and the suction pressure warning lamp 35 as necessary, and sounds a warning sound. Further, the suction controller 51 can operate the suction release valve 54 by operating the foot switch 22 to release the suction. In such a state, suction is performed from the suction port 36 via the suction tube 5 and the suction connector 6 from the suction port 8 of the tip hood 4.
[0028]
(Function)
FIG. 5 is a flowchart showing the operation when the balloon 3 is inflated.
[0029]
In FIG. 5, when the balloon 3 is inflated, the user first operates the air supply time setting panel 27 and the air supply pressure setting panel 28 of the controller 21 to set the air supply pressure and time in step S1. Next, in step S2, the air supply pedal 25 of the foot switch 22 is depressed. Thereby, the controller 21 supplies air to the balloon 3 from the air supply port 31 via the air supply connector 10, and inflates the balloon 3 to a prescribed pressure as shown in step S3.
[0030]
Thereafter, in step S4, when there is an abnormal pressure increase, the controller 21 turns on the air supply pressure warning lamp 30 and sounds a warning sound in step S5. Here, in step S6, when the user steps on the air supply release pedal 26 of the foot switch 22, the controller 21 reduces the air supply pressure to a normal value or less in step S7. Here, when the pressure is increased again in step S8, the process returns to step S2 and the user steps on the air supply pedal 25 of the foot switch 22. If there is no problem with the pressure in step S8, the controller 21 compares the specified time with the elapsed time in step S9. If the specified time is exceeded, the air supply time warning lamp 29 is turned on in step S10. Sound a warning sound. Here, in step S11, when the user steps on the air supply release pedal 26 of the foot switch 22, the controller 21 sets the air supply pressure to zero and ends the use in step S12. Of course, when the use is terminated before the specified time is reached, the processes in steps S11 and S12 are similarly performed, and the pressure is set to zero and the process is terminated.
[0031]
In step S4, if there is no abnormal pressure increase, the controller 21 proceeds to the determination in step S9.
[0032]
FIG. 6 is a flowchart showing the operation when tissue is adsorbed.
In FIG. 6, when the tissue is adsorbed, the user first sets the suction pressure and time by operating the suction time setting panel 32 and the suction pressure setting panel 33 of the controller 21 in step S21. In step S22, by stepping on the suction pedal 23 of the foot switch 22, in step S23, the controller 21 performs suction and sucks the tissue from the suction hole 8 of the tip hood 4 with a specified pressure. Adsorb tissue.
[0033]
Thereafter, in step S24, if there is an abnormal pressure increase, the controller 21 turns on the suction pressure warning lamp 35 and sounds a warning sound in step S25. Here, when the user steps on the suction release pedal 24 of the foot switch 22 in step S26, the controller 21 reduces the suction pressure to a normal value or less in step S27. Here, when the pressure is increased again in step S28, the process returns to step S22, and the user steps on the suction pedal 23 of the foot switch 22. If there is no problem in the pressure in step S28, the controller 21 compares the specified time with the elapsed time in step S29. If the specified time is exceeded, the suction time warning lamp 34 is turned on in step S30 to alert Make a sound. Here, in step S31, when the user steps on the suction release pedal 24 of the foot switch 22, in step S32, the controller 21 sets the suction pressure to zero and ends use. Of course, when the use is terminated before the specified time is reached, the processes of steps S31 and S32 are similarly performed, and the pressure is set to zero and the process is terminated.
[0034]
In step S24, if there is no abnormal pressure increase, the controller 21 proceeds to the determination in step S29.
[0035]
FIGS. 7 and 8 are explanatory views for explaining the suction operation of the tip hood 4 according to the present embodiment in comparison with the prior art. FIG. 7 shows the operation of the conventional tip hood, and FIG. The operation in the case of a hood is shown.
[0036]
As shown in FIG. 7, in the case of an endoscope 91 or a sheath provided with a conventional tip hood 94, when the tissue 61 is adsorbed to stop the bleeding point 62 of the tissue 61 and hemostasis is performed by the hemostatic means 92, Since the tissue 61 is adsorbed through suction from the suction hole of the endoscope 91, there is a problem that bleeding from the bleeding point 62 is further caused by the negative pressure due to suction at the time of suction. Positioning is surely ensured by suction. Despite the advantage of being able to do so, he was not well suited for hemostasis.
[0037]
On the other hand, in the distal end hood 4 of the endoscope sheath 2 of the present embodiment, as shown in FIG. 8, suction is applied from the suction hole 8 of the distal end hood 4 and the outer sheath 12 and inner sheath 13 of the distal end hood 4. Since the tissue 61 is adsorbed during this time, the bleeding point 62 inside the inner cannula 13 does not become negative pressure and does not promote bleeding. In this state, the bleeding point 62 can be reliably stopped by the hemostatic means 14 of the endoscope 1.
[0038]
9 to 11 are explanatory views showing a use state when the balloon 3 of the present embodiment is inflated.
[0039]
First, as shown in FIG. 9, for example, an endoscope 1 fitted with the sheath 2 is approached through a cavity 73 to a lesion or a bleeding point 72 in a deep part of the brain 71 or the like. In such a case, a cavity having a size required for the treatment is often not secured. Therefore, it is necessary to create a cavity having a required size.
[0040]
Following the state of FIG. 9, the endoscope 1 is inserted up to the vicinity of the bleeding point 72. Thereafter, the controller 21 is operated to set the air supply pressure and time, and the air supply pedal 25 of the foot switch 22 is stepped on to inflate the balloon 3 as shown in FIG. And a cavity 74 necessary for the treatment is created by the expansion action of the balloon 3.
[0041]
The endoscope 1 is operated following the state of FIG. 10, the tip of the endoscope 1 is directed to the bleeding point 72, the tip hood 4 is applied to the tissue, and the controller 21 is operated to set the suction pressure and time. 11, the suction pedal 23 of the foot switch 22 is operated to adsorb the tissue on the wall surface of the cavity 74 of the brain 71, and the bleeding point 72 is stopped by the hemostatic means 14 in the same manner as shown in FIG. 8. .
[0042]
During the series of operations, the controller 21 warns as described above when the tissue 61 is excessively compressed due to an increase in the pressure of the balloon 3 or when the pressureable time is exceeded. By stepping on the air release pedal 26 of the foot switch 22, the balloon 3 can be decompressed.
[0043]
Similarly, if the suction is excessively negative or if the suctionable time is exceeded, the controller 21 warns as described above. Therefore, if necessary, depress the suction release pedal 24 of the foot switch 22. Accordingly, the adsorption of the tissue 61 can be weakened or released.
[0044]
(effect)
As described above, according to the present embodiment, the balloon 3 excludes the tissue in the body cavity, thereby improving the operability by fixing the endoscope 1 and creating a cavity necessary for the treatment. In addition, the tissue is adsorbed between the outer cannula 12 and the inner cannula 13 of the tip hood 4 to improve the sniping ability, and at the same time, the endoscope 1 is fixed and the tissue is damaged during the creation of the cavity or bleeding due to the adsorption. Since the increase can be prevented, workability is greatly improved.
[0045]
[Appendix]
According to the embodiment of the present invention described in detail above, the following configuration can be obtained.
[0046]
(Additional Item 1) A tube body in which an endoscope can be inserted into a tube,
A first fixing means which is provided on the outer surface of the tube body and fixes the tissue in the body cavity by squeezing out, and can be arbitrarily selected between fixing and opening or the fixing strength can be adjusted;
A double substantially cylindrical tip hood provided at the tip of the tube body;
A conduit that circulates between the mantle and the mantle of the tip hood;
A second fixing means provided on the distal end side of the tube body and attachable to and detachable from the endoscope;
An endoscope sheath characterized by comprising:
[0047]
(Additional Item 2) The endoscope sheath according to Additional Item 1, further comprising means for monitoring a fixing pressure and a fixing time of the first fixing means.
[0048]
(Additional Item 3) The endoscope sheath according to Additional Item 1 or 2, further comprising means for applying suction to the pipe line of the tip hood.
[0049]
(Additional Item 4) The sheath for an endoscope according to Additional Item 3, wherein the suction pressure of the conduit is arbitrarily variable.
[0050]
(Additional Item 5) The sheath for an endoscope according to Additional Item 4, which has means for monitoring the suction pressure of the conduit and the time during which suction is applied.
[0051]
(Additional Item 6) A tip hood provided at the tip of the endoscope or detachably attached,
A tip hood, which is formed of a double structure including an outer mantle and an inner mantle, and a pipe line which is open at a substantially distal end of the tip hood is formed between the outer mantle and the inner mantle.
[0052]
(Additional Item 7) The tip hood according to Additional Item 6, wherein the pipe line can be connected to a suction means separately prepared.
[0053]
(Additional Item 8) The distal end hood according to Additional Item 7, wherein suction or tissue adsorption can be performed from substantially the distal end of the distal end hood.
[0054]
【The invention's effect】
As described above, according to the endoscope sheath of the present invention, it is possible to improve operability by fixing the endoscope, create a cavity necessary for the treatment, and improve sniperability by tissue adsorption. At the same time, it is possible to prevent an increase in bleeding due to tissue damage or adsorption at the time of fixing the endoscope or creating the cavity, so that workability is greatly improved.
[Brief description of the drawings]
FIG. 1 is a perspective view of an endoscope to which an endoscope sheath according to an embodiment of the present invention is attached.
FIG. 2 is a cross-sectional view of an endoscope sheath according to an embodiment of the present invention.
3 is a perspective view showing a controller for operating the endoscope sheath of FIG. 1. FIG.
4 is a block diagram showing an internal configuration of the controller in FIG. 3;
FIG. 5 is a flowchart showing an operation when the balloon of the embodiment of FIG. 1 is inflated;
6 is a flowchart showing an operation when adsorbing the tissue according to the embodiment of FIG. 1;
FIG. 7 is a first explanatory diagram illustrating comparison between the suction operation of the tip hood of the embodiment of FIG.
FIG. 8 is a second explanatory diagram illustrating the suction operation of the tip hood according to the embodiment of FIG. 1 in comparison with the prior art.
FIG. 9 is a first explanatory diagram showing a use state when the balloon of the present embodiment of FIG. 1 is inflated;
10 is a second explanatory diagram showing a use state when the balloon of the present embodiment of FIG. 1 is inflated. FIG.
11 is a third explanatory view showing a use state when the balloon of the present embodiment of FIG. 1 is inflated. FIG.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 1 ... Endoscope 2 ... Endoscope sheath 3 ... Balloon 4 ... Tip hood 5 ... Suction tube 6 ... Suction connector 7 ... Tip attachment part 8 ... Suction hole 9 ... Insufflation tube 10 ... Insufflation connector 12 ... Outer sheath 13 ... inner sleeve 20 ... tube body

Claims (1)

A tube body into which an endoscope can be inserted into the tube;
A first fixing means which is provided on the outer surface of the tube body and fixes the tissue in the body cavity by squeezing out, and can be arbitrarily selected between fixing and opening or the fixing strength can be adjusted;
A double substantially cylindrical tip hood provided at the tip of the tube body;
A conduit that circulates between the mantle and the mantle of the tip hood;
A second fixing means provided on the distal end side of the tube body and attachable to and detachable from the endoscope;
An endoscope sheath characterized by comprising:

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